How to achieve best-in-class capability for value-based risk contracting
Health systems embarking on value-based contracting should give attention to three areas: understanding market profit pools, acknowledging inherent challenges in the health plan market, and developing the key elements that are essential for success.
Health plan-owned PCP clinics steer members to lower-cost sites-of-service
Hospitals and health systems need to be able to deliver high-quality outcomes in a cost-efficient manner to ensure they are not implicitly tiered out of a health plan's network.
Optum360 helps providers and payers work together to resolve revenue cycle problems
Optum360 illustrates how it is driving change across healthcare by empowering and engaging staff to be creative in solving payer and provider challenges and viewing the revenue cycle more holistically.
When movement isn’t movement: A wake-up call for healthcare finance professionals I HFMA
The results of healthcare finance executives' efforts to drive change will be of little value if they don't also help improve quality, patient experience or cost of care.
How pharmacists can play a role in curtailing the rising cost of drug therapy
Evidence shows improved collaboration between clinical pharmacists and prescribing physicians can help mitigate problems with selection, adherence and overutilization of pharmaceuticals, which cost the nation hundreds of billions of dollars each year.
Key takeaways from North Carolina’s move to value-based healthcare
Keith Moore, CEO of McManis Consulting, shares his perspectives on North Carolina’s move to value-based payment and what it means for hospitals and health systems nationwide.
With millions of physician referrals up for grabs, partnerships with consumer-centric sites of service matter
HFMA’s Chad Mulvany says in today’s competitive environment where traditional referral patterns are at risk of being upended, it’s crucial for health systems to partner with disruptors like CVS to capture these downstream opportunities.
Feb. 2-7: Senate hearing on private provider care for veterans is among upcoming healthcare finance events
A complete listing of healthcare finance-related hearings, conferences, webinars, public forums and deadlines for the week of Feb. 2.
MedPAC backs Medicare changes to increase hospital pay in 2021 by up to 3.3%
For 2021, MedPAC has recommended that hospitals’ Medicare rates increase 2%, plus a potential 0.8% quality bonus and elimination of a 0.5% quality cut.
How using artificial intelligence enabled Flagler Hospital to reduce clinical variation
Flagler Hospital used an artificial intelligence application to support physician-led efforts to develop and adopt care pathways aimed at improving care quality and outcomes while reducing cost.