Accountable Care

November 19, 2014 | Anthony Brino

A new payer-led patient information exchange in California is getting ready to hit the ground running.

November 4, 2014 | Ashley Rekem

In the quest for population health, lifestyle interventions for diabetes may pose the biggest rewards and most vexing challenges. Some are making progress, however.

October 27, 2014 | Madelyn Kearns

Facing the fact that just 5 percent of the patient population was responsible for nearly half of its spending, one health organization has tried some fairly radical changes.

October 20, 2014 | Anthony Brino

Trying to wean themselves off fee-for-service reimbursement, some health systems may be taking a non-committal strategy, dipping their toes in the water before deciding if they want to learn to swim. Insurers should be looking for more than that, if they can offer the right expertise.

October 16, 2014 | Anthony Brino

Insurers are trying to use a new model to improve treatment in costly, difficult chronic diseases like Crohn's, and rationalize reimbursement.

October 16, 2014 | Anthony Brino

How did one large employer keep its healthcare costs flat for six years? A wide-ranging wellness program, provider bidding and "enlightened consumerism."

October 7, 2014 | Anthony Brino

After years of research, design, pilot programs and technology investment, the movement for quality improvement and pay-for-performance is facing skepticism from outside and within.

September 30, 2014 | Anthony Brino

Health insurers are betting on value-based payments, broadly defined, but providers still seem skittish.

September 25, 2014 | Anthony Brino

In bundled payments, where once there was so much promise, there is now conflicting evidence.

September 24, 2014 | Anthony Brino

The stakes for improvement and innovation are high in American cancer care, and insurers are trying to wield some of their influence to get a return on investment for their members and their budgets.

September 19, 2014 | Anthony Brino

With uncertainty in Medicare's accountable care program, some hospital systems are scrambling for long-term options and may give insurers a run for their money.

September 15, 2014 | Anthony Brino

Ahead of a corporate branding change and a new open enrollment period, WellPoint is charging ahead with accountable care and population health strategies.

June 2, 2014 | White Papers
Today, value-based payments reward successful health outcomes, increased quality of care, and higher patient satisfaction. For health plans, this shift presents dramatic challenges. For many, technology will be the key enabler of these new payment models.

April 2, 2014 | White Papers
A new paradigm for population health management

April 2, 2014 | White Papers
Better outcomes and new revenue streams mean hospital CFOs are increasingly excited about the opportunities presented by telehealth.

February 19, 2014 |
There is little doubt mobile technologies are poised to make significant contributions to improve the care of patients and to help payers significantly decrease the costs of treating chronic conditions. For this reason, adoption of mHealth technologies is accelerating at a rapid clip. With lower prices of mobile technologies comes increased deployment and in the process lower reimbursements. And while it is clear that people are engaged with their mobile devices, the trick under new care and reimbursement models is to find ways to leverage the various mHealth technologies to also get members actively engaged in their own healthcare. This white paper will explore those various technologies, including remote patient monitoring, the new era of home care and the old standby: texting.

November 20, 2013 | White Papers
Whether they realize it or not, most healthcare payers are losing millions of dollars each year across activities such as COB, subrogation, eligibility, MSP validation, and more. Fortunately, a new generation of "intelligent" cost containment solutions helps cut the losses and achieve significantly improved recoveries, cost avoidance, and increased revenue - all of which support health reform priorities such as medical loss ratio and waste and abuse efforts. This white paper details real-world examples of "intelligent" cost containment success, best practices for improvement, and more.

May 1, 2013 | White Papers
This white paper includes five strategic imperatives for providers facing dramatic transformations in the US health care system – and why analytics is the key to executing them. Read about how to: simplify data integration across the extended enterprise; manage the financial risks and incentives of emerging reimbursement models; proactively improve care quality and outcomes; drive greater efficiency of care delivery; and engage patients as unique individuals.

April 4, 2013 | White Papers
Accountable care offers the nation’s ailing health care system new hope — but it isn’t a new idea. For the past decade, health systems, payers, and providers across the country have been practicing accountable care principles through initiatives such as the Collaborative Payer™ Model, a care delivery innovation jointly developed by a payer and provider that approximates an accountable care organization.

April 4, 2013 | White Papers
This case study profiles a struggling Medicare Advantage business responsible for 11,600 lives in the southeastern United States. Lumeris recommended that the client implement the Collaborative Payer™ Model, an approach to improving clinical and cost outcomes via a strong payer-provider relationship. The company guided the client through a three-phase approach to develop this model, achieving outcomes including: earning appropriate revenue, reducing unnecessary utilization, improving quality metrics, and improving cost outcomes.

October 20, 2012 | White Papers
Recent claims data analysis, gathered for a 12-month period ending 3Q of 2011, found that 17% of all medical expenses were related to orthopedic services, and 80% of spine care costs associated with non-surgical services. This paper examines how the current health care delivery system can affect the quality of care and demonstrates how a conservative approach is a priority to more effectively manage expenditures and enhance outcomes related to evidenced-based, orthopedic treatment of musculoskeletal issues.

Advertisement. Closing in 15 seconds.