Tag: Value Based Care

What’s driving the transition to value-based care?

What’s driving the transition to value-based care?

The COVID-19 pandemic has taught us it’s possible for the health care system to transform care delivery—and quickly. We saw vaccines come to market in record time, heightened cross-industry collaboration to track vaccine statuses, and virtual care use surge. Similarly, the pandemic demonstrated that value-based care delivery models, where payment is based on outcomes versus […]
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AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

AMA: Prior Authorization Creates Physician Burden, Patient Care Delays

Although health plans aim to promote value-based care with prior authorization requirements, providers and patients may experience negative repercussions from the process. Prior authorization negatively impacted patients and providers alike by leading to care delays for patients and creating administrative burden for physicians, according to a survey from the American Medical Association (AMA). Health plans […]
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Survey finds just 14% of hospitals are compliant with price transparency

Survey finds just 14% of hospitals are compliant with price transparency

The biggest noncompliance was non-posting or incomplete posting of all of the negotiated prices for each item and service. In a federal price transparency rule that took effect January 1, 2021, hospitals were tasked with posting all of their prices online in clear, easily accessible formats. But a new survey from patientrightsadvocate.org has found that, […]
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Health Equity and SDOH: A Payer Perspective / Update

Health Equity and SDOH: A Payer Perspective / Update

As part of its ongoing mission to improve the health of America, the Blue Cross Blue Shield Association (BCBSA) announced its National Health Equity Strategy in April 2021 to confront the nation’s crisis in racial health disparities. This strategy is intended to change the trajectory of health disparities and reimagine a more equitable health care […]
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How Population Health, Risk Stratification Support Value-Based Care

How Population Health, Risk Stratification Support Value-Based Care

To excel in value-based care, providers must lean on strategies for managing population health and skillful risk stratification. Amid the COVID-19 pandemic, organizations observed the ramifications of fee-for-service, leading to communication and revenue challenges for both providers and patients. While value-based care is not a novel idea, the pandemic greatly accelerated the adoption of this […]
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6 BEST REIMBURSEMENT STORIES OF 2021

6 BEST REIMBURSEMENT STORIES OF 2021

  Here are the six best reimbursement stories from 2021 HealthLeaders’ coverage and beyond. COVID-19 continued to impact healthcare reimbursement as the pandemic entered its second year. Yet, what’s different is that longer-term strategies and new business opportunities are emerging beyond crisis response. The Centers for Medicare & Medicaid Services (CMS) aided these plans by […]
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The Role of Provider-Sponsored Health Plans in Value-Based Care

The Role of Provider-Sponsored Health Plans in Value-Based Care

Provider-sponsored health plans can be naturally aligned with value-based care goals while also being attuned to providers’ needs. Providence Health Assurance’s Medicare Advantage provider-sponsored health plan received a five-star rating through the CMS Medicare Advantage Star Ratings system for the 2022 Medicare open enrollment season. The health plan, which serves Oregon and Washington State, is […]
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Preparing Providers For Value-Based Care

Preparing Providers For Value-Based Care, Consumerism In Healthcare

Technology can transform data into actionable insights for providers needing to meet the demands of value-based care and consumerism in healthcare. Transforming raw data into actionable information is crucial to the financial future of provider organizations, especially as pressure builds on providers to align their care delivery approach with value-based care and consumerism in healthcare. […]
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