Reimbursement
New compliance measures and shifts in information technology stalled payer performance improvement in 2011 according to the seventh annual PayerView rankings released today by health IT company athenahealth.
Payer performance improvement remained flat in 2011, according to the seventh annual PayerView rankings released today by health IT company athenahealth.
In central Pennsylvania, Capital BlueCross and PinnacleHealth recently announced an accountable care arrangement (ACA), that officials with both organizations say is similar in design to the Medicare-based accountable care organizations (ACOs) being promoted by the Centers for Medicare & Medicaid Services (CMS).
In its June 2012 report to Congress, the Medicare Payment Advisory Commission (MedPAC) focused on three areas: Medicare benefit design, care coordination for fee-for-service (FFS) Medicare and care coordination for those dually-eligible for Medicare and Medicaid.
Do you know what you do best? Traditionally, that's a question many healthcare providers may not ever have bothered to ask themselves. That's because under the fee-for-service model which has shaped healthcare in this country for years, providers really haven't needed to know which parts of their practices were the most efficient or resulted in the highest health outcomes. Just so long as they were compensated for the services they provided.
Healthcare providers are being told they need to change the way they deliver their services, and payers are being told they need to change the way they reimburse providers. One way to help bridge the divide is for payers to develop effective strategies and programs to deliver value-based reimbursement programs.
Payers who want to affect the change needed to revamp the healthcare delivery system will need to forge closer relationships with providers, be engaged more with members to help them manage their health, and create better alignment with the government said three health plan executives Thursday at AHIP Institute 2012 in Salt Lake City.
To observers and stakeholders alike, "innovation" may be the watchword that best sums up the mindset across much of the healthcare sector these days. One place where that innovation is beginning to take place is in the new partnerships being formed between providers and payers..
As more individuals, as opposed to group employers who might bring with them hundreds of employees, enter the insurance market in search of individual policies, health plans are going to have to figure out how to sell to them.
On Wednesday, at the AHIP Institute 2012 in Salt Lake City, Rick Solano, president and CEO of Mirixa, moderated a workshop entitled "Medication Therapy Management: The Next Phase in Managing Chronic Disease." The session delved into many aspects of MTM and Solano recently took a few moments to discuss MTM and its role in improving the care of people with chronic illness.