Tag Archives: fee-for-value reimbursement

Trust: The secret sauce for the next generation of health care

Survival in today’s value-based health care industry takes trust — in people, technologies and business processes. Trust is the “secret sauce” that brings everything together, said health care futurist Joe Flower in the Spring/Summer edition of Optum RISKMATTERS. Volume to value, the shift from doing fee-for-service medicine to taking a financial risk in one way […]
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Relationships the secret to value-based health care success

Lehigh Valley Health Network (LVHN) executives believe no doctor, hospital or insurance company can stand alone and succeed in value-based care. That’s why the Pennsylvania-based system’s leadership emphasizes building relationships with internal staff and external partners — each of whom influences how the others perform. In the Spring/Summer edition of Optum RISKMATTERS, LVHN CEO Brian […]
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Eliminate silos, strengthen teamwork for better patient care

More than 40 years ago, the Institute of Medicine released its Educating for the Health Team report that advocated cross-functional provider teamwork over siloed service areas. But fee-for-service payment models kept such forward thinking from taking hold. Under value-based reimbursement, which incentivizes providers to take on risk, inter-professional collaboration is now the rule rather than […]
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Match provider networks with value-based care models, payer contracts

High-performing provider networks aren’t built on luck. They take careful strategy and an accurate vision of how an organization will best perform under value-based reimbursement models. Providers chosen for a network will vary in performance and quality. Organizations should build networks with current contracts in mind, with long-term vision of its position on the risk […]
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The risks and rewards of value-based contracting

In the new Optum white paper, “The speed of transformation: Preparing for the payment models of tomorrow,” we discuss the drivers that are pushing the move to value-based reimbursement. One area that will see some of the greatest — and fastest — changes is contracting with payers. Moving to fee-for-value creates significant financial risk for […]
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Coding can have a profound impact on quality of care

Coding and reimbursement have become almost synonymous in the health care industry. Diagnostic Related Groups (DRGs) have been the standard for inpatient reimbursement for more than 30 years, with the Inpatient Classification of Diseases (ICD) a global system used for public health and policy purposes. In the new era of pay-for-value, however, the type of […]
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