Description: Essay where payers desiring to optimize health gains per dollar spent should avoid “across the board” cost sharing, and instead implement a “value based” design that removes barriers/provides incentives to encourage desired behaviors for patients and providers.

Description: Many top-performing businesses aren’t just risk aware, but rather risk intelligent. Such a posture helps prepare companies for a major event and can demonstrate to a regulator or auditor that an appropriately strong control framework is in place. Better still, companies gain real strategic value from a “risk adjusted” understanding not only of their threats and vulnerabilities, but also the upside opportunities associated with various risks. It starts with having both qualitative and quantitative information to identify, assess and manage risks. Strategic risk management, at its core, is about creating value by increasing transparency and accountability, and quality of information. More than a mere compliance exercise, effective risk management enables more informed strategic decision making, increased accountability and transparency, a greater likelihood of organizational success, and – ultimately – competitive advantage, as borne out by many studies that correlate risk management and financial results.

Description: Disease management DM is increasingly encountered in health plans and employer groups as a health care intervention targeted to individuals with chronic diseases chronics. The untested assumption is that without DM, the chronic and non-chronic trends are identical. From Financing Chronic Care Monograph, M-HB05-1.