Tag Archives: value-based care

Is a provider-led health plan a good fit? Evaluate 6 areas to find out

To drive down costs and improve care through value-based models, one must have a deep understanding of the population they serve. Health care providers have this knowledge. Their familiarity with the demographics, economics and general needs of their communities means some are well-positioned to launch their own provider-sponsored health plans (PSHP) and have a sense […]
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Care transitions can feel like changing the tires while driving

While providers may now see population health programs as key to value-based care success, many are struggling with implementing change in a way that affects outcomes. “It’s like the proverbial changing of the tires while driving down the road at 90 mph,” says Steve Griffiths, senior vice president of Health Care Analytics Consulting at Optum. […]
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MACRA is big for doctors. What about hospitals?

With the Medicare Access and CHIP Reauthorization Act replacing the sustainable growth rate, changes are coming for physicians. But will MACRA impact facility providers? Consultants at Optum say yes. Specifically they say hospitals and health systems should prepare for changes to referral patterns and readmission rates. Jay Hazelrigs, vice president and lead actuary at Optum, […]
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Confirm patients’ medical memories to develop complete health histories

Can you remember what you wore to work last Thursday? How about what you had for lunch yesterday? We humans aren’t particularly great at recalling details. Study after study shows it. Colonoscopy patients don’t remember details of their procedures when more than a year has passed, according to a report in Healio. How about hip […]
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Who should make up the team that directs your move to accountable care?

As the U.S. health care system moves away from reimbursement models that reward volume and toward those that reward care coordination – traditional industry roles are blurring. • New #5in5 video: Fee for value requires revised relationships As this integration accelerates, organizations must build new governance structures that can provide strategic direction and accountability. That […]
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Identify the linchpin to cultural change

There are hurdles that make implementing an analytics platform a unique challenge. But at its core the job is really one of change management. The linchpin to any cultural change is clinical and administrative leadership. Dr. Lewis Sandy, senior vice president of clinical advancement for UnitedHealth Group, says leadership is probably the most difficult requirement […]
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ACOs and the future of health care

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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Not perfect, but practice makes progress for ACOs

Recently released results of the Medicare Shared Savings Program (MSSP) highlight the fact that Accountable Care Organizations need to be in it for the long haul. In August, the Centers for Medicare & Medicaid Services issued an update announcing that participating ACOs continue to show improvements in their ability to contain costs. Three hundred and […]
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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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Understanding a new, mandatory payment model

As the health care industry moves toward population health management, providers and payers are working to determine which value-based reimbursement models show the most promise. The Centers for Medicare and Medicaid Services gave the bundled payments a boost this year by making the model mandatory for a number of hospitals — first for hip and […]
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