Friday, November 22, 2019
After the enactment of the Affordable Care Act, insurers had to cut down on the ‘cherry-picking’ of members and not provide insurance to just low-risk individuals. To some extent, the scope for earning high-profit margins had decreased for health insurance companies. This rule created an imperative for them to look for ways to curb expenses
[ Read More ]The provider community strives day and night to improve patient outcomes and contribute to the dream of value-based healthcare. However, the complexity of chronic diseases renders strategies ineffective and prevents them from reducing available utilization. In the US, chronic diseases account for 75 percent of all healthcare spending, to the tune of $3.5 trillion. In
[ Read More ]One of the many aspects that insurers focus on to create more value through their health plans is to improve communication with the members. In the era of growing digitization, most payers have started to offer online services. However, many beneficiaries still use traditional channels to interact with insurers. Does it imply that members are
[ Read More ]Digital transformation in healthcare is tricky. It’s a $3 trillion space, after all! For all the ways digitization has transformed the way people shop, travel, and handle their finances, it has yet to make a major impact on how they deliver and receive healthcare. Digital transformation in healthcare has taken on an image that is
[ Read More ]Transitioning and succeeding in value-based care (VBC) is increasingly becoming the focus of many providers. Despite initial reservations, many providers are becoming ardent supporters of VBC payment models and are often the catalysts for change in their organizations. Traditionally, most providers were compensated under fee-for-service (FFS) arrangements (i.e., they were paid for services rendered, not
[ Read More ]“Pop health is still a pretty manual process. Having a dedicated solution, let alone a dedicated analytics platform, to address pop health is not as widespread as one might think.” –Brendan FitzGerald, Research Director at HIMSS Analytics When I first heard this line, a number of thoughts came rushing into my mind around the different
[ Read More ]Imagine your favorite football team is in a real neck-to-neck with another team, and the game could tip in anyone’s favor. It is the last minute, and in an insane turn of events, the quarterback throws the ball in the air, hoping the player in the end zone could make a touchdown. Instead, the reckless
[ Read More ]What is that one factor that separates one patient from another? Can one identify why two patients with the same illness but from different regions respond differently to a particular treatment? Do we need to cater to the needs of patients even after they leave the clinic? These questions have always intrigued not only the
[ Read More ]The healthcare circles in the United States are reeled up by debates around the need for price transparency. The federal agencies are coming up with regulations. Healthcare associations are weighing in their concerns. Physicians, patients, and economists – everyone is articulating the pros and cons in a rather plausible manner. Wait. What has triggered this
[ Read More ]One of the greatest challenges in healthcare is keeping up with the changing landscape. Considering only since the beginning of 2019, the Centers for Medicare and Medicaid Services (CMS) and other federal agencies, such as the Office of National Coordinator of Health IT (ONC) and the Department of Health and Human Services (HHS), have introduced
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