Tag Archives: accountable care organizations

Accelerating the progression toward an integrated clinical model

As we sit post-ACA, it has become apparent that we have entered one of the most dynamic times in all of health care. Risk for all stakeholders has been on an accelerated course since 2010, but managing risk looks different depending where you are in the health care space. Providers — whether hospitals or physician […]
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After promising results, Medicare will likely continue expanding risk-based contracting efforts

In our last blog post, we shared a few reasons why risk-based contracting in health care is here to stay. In this post, we’ll share some data points that point to current and future impacts on the industry, and a few suggestions to help you jump on the value-based train. The value-based train has left […]
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Health plans expanding risk-based contracting efforts

Are risk-based contracting arrangements between health insurers and providers here to stay? The answer can be summed up in three words: “Follow the money.” Health plans are investing in and paying for an increasing amount of care covered by risk-based contracts. And these contracts aren’t just with the obvious accountable care organizations (ACO) and patient-centered […]
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Five common areas where provider-based risk can falter

There is no single path to success for provider organizations who want to learn how to take on patient risk. Hospital/physician gainsharing, patient-centered medical homes, bundled payments, shared savings models and global payments all vary in the level of risk managed by the provider, as well as in their ability to bend the cost curve. […]
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After coding, highest-risk patients improve the most

Humedica’s analysis of a data set representing more than 4 million patients revealed that patients without a coded diagnosis are relatively high risk—and use less ambulatory care than coded patients. But what happens after they are coded?

Use population health management to get patients to care about their care

People want to be healthy, but healthcare options can be confusing, and without a strong relationship with their physicians and other providers, patients may ignore their problems instead of face the difficult path toward treatment and recovery.

Information transparency is vital to population health management, yet difficult to achieve

You’d think providing up-to-date, relevant information to physicians in your accountable care organization (ACO) would be easy. Share files, email data, and voila! Transparency! But it’s not that simple. Data transparency is critical for population health management (PHM) success; without it, physicians won’t trust data that shows sub-optimal care patterns or outlier behavior. Transparency requires […]
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Engagement: The top fundamental to successful population health management

Accountable Care Organizations (ACOs) are in a unique position to engage patients faster and closer to the point of care than traditional models. This is true because of its reliance on population health management (PHM). Over the next few posts, we’ll discuss the five fundamental principles that drive PHM.

Risky business for providers: Planning for financial realities and capacity downturns

Ultimately, the financial side and the clinical side of the ACO equation need to be in balance. Adjusting to the financial realities of value-based contracting is essential. Therefore, our fourth risk-bearing action for provider organizations is financial and capacity planning.

Risky business for providers: Population-based planning in provider risk-bearing arrangements

Provider organizations that want to bear patient risk need to be informed by their local markets and the attending health care concerns that come with that market. That’s why our third action that leads to bearing risk is population-based planning.