MACRA's Strategic Implications: What Providers and Health Plans Need to KnowMACRA's Strategic Implications: What Providers and Health Plans Need to Know MACRA not only impact providers, ... Value-based insurance design, Health care payment reforms, Managed care 7/3/2019 12:00:00 AM ...
Description: MACRA not only impact providers, it will impact the entire healthcare market. MACRA published studies and commentary to date have primarily focused on providers, with the majority of the information addressing the impacts to clinicians. However, our investigation indicates MACRA has far reaching impacts to payers as well as providers. MACRA is impacting each geographic market and line of business in a unique way, and health payers will have multiple strategic decisions to consider given the changing market dynamics.Hide
- Authors: Julie Witt, James Dolstad
- Date: Jul 2019
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Economics; Economics>Health economics; Health & Disability
ACO Shared Savings – Can today’s friction turn into collaborationyears now in an attempt to reduce the total cost of care. Often neither party has a complete view of the ... that work better for both parties. Accountable Care Organization = ACO Risk Adjustment Value Based Insurance ...
Description: ACOs and payers have been engaged in shared savings agreements for several years now in an attempt to reduce the total cost of care. Often neither party has a complete view of the data with providers missing pharmacy data, and payers are often missing historic data on a provider group’s members when they were previously covered by other payers. Inconsistent data and black box predictive models have created friction that has become amplified given the continual increase in ACO membership and the dollars at stake. Learn how payers and providers are working through these challenges to find solutions that work better for both parties.Hide
- Authors: Jeremiah Reuter, , James Dolstad
- Date: Sep 2019
- Competency: Results-Oriented Solutions; Strategic Insight and Integration
- Topics: Experience Studies & Data; Financial Reporting & Accounting; Health & Disability