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Our Value-Based Cup Runneth Over
Our Value-Based Cup Runneth Over Discussion of how to mature value-based contracts between health insurers and provider organizations to improve population health and financial sustainability.- 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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Give Me Some Credibility: Addressing the Challenge of Volatility in Value-Based Contracts—Part 2
Give Me Some Credibility: Addressing the Challenge of Volatility in Value-Based Contracts—Part 2 Discover the key components of value-based care (VBC) contracts and their impact on provider ...- Authors: Maria Knox, James Pisko, Keith Passwater
- Date: May 2023
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; 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; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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MACRA/QPP Provider Revenue Model
MACRA/QPP Provider Revenue Model The MACRA/QPP Provider Revenue Model is designed to provide an estimate of the revenue impact of the QPP (MIPS, AAPM) on a provider group or ACO, based on the ...- Authors: Julie Witt
- Date: Sep 2019
- Competency: External Forces & Industry Knowledge
- Topics: Health & Disability>Health care quality; Health & Disability>Affordable Care Act (ACA); Health & Disability>Provider risk
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Provider Risk-Sharing and Random Noise
Provider Risk-Sharing and Random Noise Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements 7/3/2019 12:00:00 AM ...- 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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Understanding the Medical Stop-Loss Market
Understanding the Medical Stop-Loss Market This article details the medical stop-loss coverages purchased by HMOs, small insurers and providers taking delegated financial risk in payor ...- Authors: Keith Passwater, Peter Robinson, David Nelson
- Date: Jun 2022
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Reinsurance; Health & Disability>Provider risk
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AI and EMRs: Pioneering the New Frontier in Healthcare Actuarial Practice
AI and EMRs: Pioneering the New Frontier in Healthcare Actuarial Practice In the evolving realm of healthcare actuarial practice, value-based contracts are reshaping the landscape. This article ...- Authors: Netanel Lederer
- Date: May 2024
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Innovators & Entrepreneurs
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health information technology; Health & Disability>Provider risk; Health & Disability>Electronic medical record
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Money Matters: Making Medicaid Payment More Effective Through Population-Based Payment
Money Matters: Making Medicaid Payment More Effective Through Population-Based Payment State Medicaid agencies have been implementing value-based payment (VBP) models for the last decade and are ...- Authors: Anne Smithey, Kelsey Brykman
- Date: May 2023
- Competency: External Forces & Industry Knowledge
- Publication Name: In The Public Interest
- Topics: Health & Disability; Health & Disability>Health care quality; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Social Insurance; Social Insurance>Medicaid; Health & Disability>Provider risk