Offering blended options, individual risk pools, and net neutral capitation payments providers can embark on their journey toward value-based care at a pace aligned with their tolerance and readiness.
Success requires both novel VBC models as well as moving care beyond the clinic walls to meet patients where they are.
At the Payer Insights sessions on Day 1 of ViVE 2024, a panel on prior authorization offered compelling insights from speakers who shared the positive developments in this area after years of mounting frustration. Speakers also shared challenges as they work with providers to figure out how policy developments and technology will work in practice.
Physicians often diagnose patients with chronic kidney disease (CKD) too late in the process, when dialysis is the only option left. This isn’t negligence on the part of physicians — it’s simply a consequence of a fee-for-service (FFS) healthcare model that works against patients’ financial well-being and deemphasizes preventative care.
Vera, a value-based primary care provider, will buy all the outstanding shares of Castlight, in a move that will merge the two companies.
Under the terms of the deal, select Humana Medicare Advantage HMO plan and dual-eligible members in Southern and Central California will have in-network access to Heritage Provider Network's facilities and physician practices.
The system connects payer networks to providers and payment systems, breaking down data silos and helping to streamline authorization, claims submission and payments.
This eBook, in collaboration with Care Logistics, details how hospitals and health systems can facilitate more effective decision-making by operationalizing elevated awareness.
After five years of slow growth, health costs are expected to rise as much as 6.8 percent next year. This forecast is sure to energize Washington lawmakers who have long sought to slash health spending, particularly within Medicare. Efforts to cut Medicare have typically focused on the quantity and cost of treatment, with little regard […]
by Jay J. Cohen, MD, Senior Vice President, Optum and Glenn D. Steele, Jr. MD, President and CEO Geisinger Health System Lost in much of the debate over the federal health care law are the surprising powers that reside in states to reduce health care costs and improve quality. With 46 state legislatures set to […]