Health plans: Consider new metrics for assessing organ transplant programs

Organ transplants save lives, and the number of transplants is rising. That’s why it’s important for health plans to reassess the metrics they use to measure the value of organ transplant programs. Our white paper,“Reassessing how payers determine the value of organ transplant programs,” explores the Transplant Value Initiative. This Optum initiative looks at how […]
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A way to save real dollars on each business transaction

As providers work to meet the demands of value-based care and population health management, they are discovering the importance of data and the ability to share that data. Often the focus is on the shareability of clinical data. But data sharing can also provide opportunities for efficiencies and cost savings in claims submissions and patient payments — […]
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New rules govern how health care providers partner with payers

Since the Patient Protection and Affordable Care Act was signed in 2010 there has continued to be some uncertainty about how healthcare reform will evolve. However, most  large health care organizations agree that value-based care is here to stay. They invested in robust technologies and began implementing population health management strategies. The market’s smaller players […]
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Blinkers on: It’s time to move into the value-based care fast lane

Providers and payers are converging and seeing new opportunities to collaborate to improve care quality and control costs under new value-based care models.  Increasingly, providers are evolving to take more accountability for cost of care and patient outcomes—issues historically laid at payers’ feet. However, providers must continue to operate in a fee-for-service environment while transitioning […]
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The missing ingredient for population health management success

Medicare Accountable Care Organizations (ACOs), the Bundled Payments for Care Improvement program, and value-based contracting in general have driven the health care industry to invest in population health management (PHM) applications and services. But it turns out that it takes more to succeed in value-based care than purchasing technology or engaging in a short-term consulting […]
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Payers, avoid value leakage. Opt for the right comprehensive sourcing model

Part 2 of a 2-part series Payers leave a lot of value on the table when they manage IT, process, and medical costs separately. Our research shows that payers can achieve breakthrough cost savings improvements if they manage medical and operational costs together. This blog series offers a plan that enables payers to convert their […]
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Three steps: Get ready for risk-based, fee-for-value health care

Ready or not, here it comes — risk-based, fee-for-value health care is here or coming to a market near you! Health care providers are no longer asking whether they should get ready. They are asking: How fast should we make the transition? They know it may not be pretty. “Organizations need to set a goal […]
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Better outcomes and reduced costs for our frailest populations

Patients living in skilled nursing facilities (SNFs) are a small subset of Medicare beneficiaries. But these clinically complex individuals generate nearly two times the average medical expense for all Medicare members, according to The Henry J. Kaiser Family Foundation. By promoting more intense attention to this institutional population, health plans can drive better care and […]
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Population health management is more than analytics

How do you define population health management (PHM)? If you’re like most health care leaders, you believe that PHM is the practice of improving health outcomes of a large population of patients and identifying groups that are most at risk and need additional care by applying clinical analytics. That’s correct, but execution against this is […]
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Improving health care outcomes through patient engagement

“Anytime you have a patient that’s more engaged and involved in their care, your outcomes are better.” That’s a quote from Judy Herrington, who has 30 years’ experience in the health care field and serves as the vice president of nursing, medicine services at Parkland Hospital in Texas. Her front-line observation echoes the results of […]
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