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Possible Future of U.S. Healthcare
Possible Future of U.S. Healthcare What is the difference between a Single-Payer and Universal Health ... Health Care System, and how could the U.S. implement a system that would reduce the growth of medical costs ...- Authors: Roy Goldman
- Date: Nov 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Our Value-Based Cup Runneth Over
Honestly, we’re not sure. (We just looked it up. It’s 37.) To make things more complicated, each contract ... of inconsistency across value-based contracts, let’s dive into one important piece of these arrangements: ...- Authors: Daniel Reck (Dan), Lisa Swan, Sam Johnmeyer
- Date: Aug 2022
- Competency: Communication; External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Enterprise Risk Management>Risk appetite; Enterprise Risk Management>Risk measurement - ERM; Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Health & Disability>Provider risk
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Better Care Through Understanding the Customer Not Just the Patient
types of data exist outside a health plan or provider’s walls that would enable us to develop a more holistic ... data sources that can help inform us of a member’s needs and wants. The first two are publicly available ...- Authors: James Dolstad, Craig Cartossa, Justin Hartmann
- Date: Dec 2021
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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Provider Risk-Sharing and Random Noise
paid to the provider. Table 1 breaks this down for dif- ferent size groups. Table 1 Sample Random Variation ... HMOs. Managed Care, Dec. 1, 2000. https://www .managedcaremag.com/archives/2000/12/downstream-without-paddle ...- Authors: Thomas Messer
- Date: Jul 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Payment models; Health & Disability>Provider networks; Health & Disability>Provider risk
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Session 023: A Common Vision of Value-Based Care: Case studies of Payer-Provider Collaboration
Presentation Disclaimer 2019 Health Meeting DAVID S HANEKOM, MD, FACP, CMPE MAUREEN TRESNAK, FSA, MAAA ... follow federal law. The Sherman Act, is the primary U.S. antitrust law pertaining to association activities ...- Authors: David Hanekom, Maureen B Tresnak , Fan Zhang
- Date: May 2019
- Competency: Strategic Insight and Integration
- Topics: Health & Disability>Health care quality; Health & Disability>Payment models
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Session 044: Transitioning a Health System from Separate Physician and Hospital Reimbursement to Global Payment
follow federal law. The Sherman Act, is the primary U.S. antitrust law pertaining to association activities ... global risk as an integrated network using System 3’s LKK license © 2019 Axene Health Partners, LLC 16 ...- Authors: David Axene, Elaine Corrough, Stephanie Dawn Entzminger
- Date: May 2019
- Competency: Strategic Insight and Integration
- Topics: Health & Disability>Payment models; Predictive Analytics
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Is Your Integrated Delivery System Throwing Away Free Money?
bid characteristics and plan financials shown in Table 1. We have highlighted the key numbers in dark ... increase by $26.25 PMPM (highlighted in yellow in Table 2). Since CMS funds these claims, the increased ...- Authors: Karan Rustagi
- Date: Feb 2018
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional development; Health & Disability>Payment models; Social Insurance>Medicare
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Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans?
Business Group on Health (NBGH), 11 percent of large U.S. employers have adopted direct-to-employer arrangements ... possibility for meaningful transformation within the U.S. health care system to a value-based approach. For ...- Authors: Andrew James Timcheck, Cory Gusland, Michael Gaal
- Date: Dec 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Payment models