Tag Archives: provider network

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 […]
Read More »

Timing a transition to value-based care

Once providers decide they will transition to value-based care, the next question is when should they make their move. Providers can do more than pick an arbitrary date. There are tools to help organizations make informed decisions on transition timing. Providers can conduct a financial impact assessment. Doing so allows groups to model several factors […]
Read More »

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 […]
Read More »

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 […]
Read More »

The journey to value: Taking the first value-based steps with population health management-Part 1

In our previous Journey to Value post, we suggested four elements that organizations should consider as they as they determine their roadmap for value-based care. With a roadmap that accounts for market needs, financial impacts, provider network strategies and aligned incentives, organizations are ready to program the milestones around which they will convert to value-based […]
Read More »

The journey to value: Handling risk means understanding your patient population

In our last Journey to Value post, we discussed how having all key players in alignment allows a provider organization to better manage risk. There’s one element still to consider: the patient. To get a true handle on risk, health care providers must first understand the needs of the populations they’re serving. Here are four […]
Read More »

Aligning network adequacy to meet greater expectations

With the passing of the Affordable Care Act (ACA) and the advent of the health insurance marketplace, network adequacy has come under greater scrutiny. Increased emphasis getting the right providers to consumers is leading health plans away from expansive networks to a narrow, more efficient network design that better serves member needs. Not lost in […]
Read More »