Tag Archives: payer

A whole-person view reveals individual needs

For many people, the health care system is disjointed and confusing. It’s easy to get overwhelmed and frustrated, which leads to disengagement. This is literally bad for one’s health. To make matters even worse for consumers, they are assuming more of the financial risk than ever before to manage their health. This comes also at […]
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Interaction analytics: Harnessing the power of conversation to improve the consumer experience

Companies like Amazon, Zappos and Netflix continue to raise the bar. Consumer expectations related to service and tailored experiences have risen accordingly. Retail may have set the stage for these new norms, but consumers are increasingly expecting higher levels of service when interacting with all types of organizations — including health plans. To meet these […]
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What health care execs can learn from Billy Beane

“We are in the midst of a generational business model transformation. It takes a strong man or woman to stand up in front of an organization and say we are going in a different direction.” Health care consultant Ted Schwab, formerly of Oliver Wyman, is quoted in the Optum eBook Moneyball, emphasizing the importance of […]
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5 -priorities for groups pursuing a risk-based strategy

When you’re used to being paid based on a tally of procedures, it can be daunting to consider taking on the financial responsibility for outcomes. Where do you start? Or if you are already bearing some risk, how do you prepare to accept more? Organizations pursuing a risk-based strategy need to address five key areas […]
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Rethinking department cooperation to build IT, HIE systems

To really manage clinical and financial risks, healthcare providers may need to do more with their data. To enable that goal, they may need to rethink how tasks are divided between departments. Health Data Management reported on an issue paper from the Workgroup for Electronic Data Interchange. WEDI found a strong health IT infrastructure and […]
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Identify six focus areas to manage business model changes

Providers can better manage enterprise-wide care transitions by addressing six key focus areas. As provider organizations map their strategy for transitioning into a value-based care organization, they may find they need to redefine their whole business model. It’s a big undertaking. Providers can make it more manageable by breaking the work into six categories. Physician […]
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In provider networks bigger not necessarily better … or worse

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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