Are accountable care organizations (ACOs) the future of health care? In Washington, DC and throughout the country, a lot of people are betting that they are. Designed to improve the coordination and quality of care and lower costs for Medicare patients, ACOs are considered an important step in the effort to move Medicare – and […]
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In the era of health care reform, the mandate for providers is clear: Keep patients healthy and out of the hospital, improve patient satisfaction and reduce costs. Across the country, health care systems are grappling with how to achieve these goals. Even for the very best, this isn’t an easy task. One of the organizations […]
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Access to good, quality data is one of the most pressing challenges related to the use of analytics in health care. If you input incomplete or “dirty” data, outputs won’t be reliable. Even the best algorithms in the world won’t work when applied to a distorted source. To ensure you are crunching numbers in a […]
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As the health care industry adapts to the Affordable Care Act and value-based care, provider networks and their size are making news. Insurers are ditching large preferred provider organizations in favor of narrower networks. The appeal is easy to see. In a Huffington Post blog, President and CEO of the New York State Health Foundation James […]
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There is a link between the transition to value-based care and an increased interest in analytics-based models that can successfully predict patient outcomes. As providers move to payment models that reward results over total number of procedures performed, they are accepting more financial liability. To meet that responsibility, providers must understand more about how their […]
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Even the most practiced at population health management may struggle with one factor deemed by many to be crucial for success as an accountable care organization or ACO. The challenge? Implementing a health IT infrastructure and data analytics strategy. Health IT Analytics lists analytics as a defining capability of successful ACOs. It reports that a robust […]
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An effective analytics strategy can help provider organizations control costs and identify risks and opportunities – key techniques to succeeding in a world of payments based on outcomes rather than volume. Any effective analytical strategy needs three elements. 1. Highly accurate data Analytics tools that provide the most usable insights generally draw data from a […]
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Health care providers across the country are looking at ways they can increase their clinical and financial risk exposure under value-based contracts. But if they’re not experienced with risk, they may enter into contracts that put them in difficult situations. The consequences of bad risk contracts could include poor cash flows, non-competitive rates resulting in […]
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How can you adapt to population health? If you’re a health care provider, such a question can’t be answered in a sentence or a paragraph—or even an entire article. But providers who are undergoing a fee-for-service to fee-for-value transformation have offered some insight into how and why they’re evolving to become excellent at managing the […]
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By: The Optum Risk & Quality Solutions Team Health care is awash in data, so one might think that providers and payers would be on the forefront of the big data movement. While it’s true that claims data has been used for various purposes, including epidemiological research and predictive modeling, it doesn’t have the richness […]
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