Tag Archives: payer contracts

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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Linking quality data to risk-based contracting success

What you don’t know might hurt you. That seems to be the fear plaguing health care executives eyeing a transition to contracts that put providers on the hook for financial risk. Healthcare Informatics (HCI) reported on a survey from trade association American Medical Group Association (AMGA). It asked health care executives about the biggest barriers […]
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Learn about business pros who can make risk less risky

When the Centers for Medicare and Medicaid Services (CMS) called on health plans to apply for a value-based insurance test project, it stipulated that interested organizations must include financial projections and that those projections must be “actuarially certified.” While that term wouldn’t stump health plans and traditional payers – for whom the use of actuaries […]
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