Category: Thought Leadership

By Thomas A Malone, MD, Vice President, Health Plan Accounts Health systems have a variety of strategies at their disposal for improving population health management, and self-funded employer health plans are an option that many health systems are exploring. A key advantage associated with self-funded employer health plans is that this approach enables health systems (…)

Author: Eric Wallace, Vice President, Lumeris Regardless of the uncertainty with the Delivery System Reform Incentive Payment Program (DSRIP), the New York state healthcare market has already begun the process of transitioning its business models to support value-based care. The use of the program’s incentive dollars to support improved population health efforts for Medicaid patients (…)

Authors: Ben Alexander, Vice President, PHSO Product and Solutions and Chief Medical Officer, Population Health Analytics The healthcare industry is abuzz with talk about how information technology is transforming the practice of healthcare. Indeed, health systems, payers, and other players are gathering copious amounts of data that hold the promise of improving not just patient (…)

Authors: Matt Farnum, Vice President, Health Plan Accounts David Corrigan, Vice President, Expansion and Operations As value-based care gains traction, provider groups and health systems are finding that managing populations effectively requires tightly aligned business and care delivery models. To be successful, providers require a collaborative payer to support the operational capabilities required to manage (…)

by Debbie Zimmerman, MD Corporate Chief Medical Officer, Lumeris and Essence Healthcare The U.S. healthcare system’s ongoing transition to value-based care represents the most significant change in a generation in how health systems are reimbursed for the services they deliver. As a result, health system leaders across the country are searching for insights on how (…)

At a conference with leading health system CFOs last week, participants shared valuable ideas, successes and struggles with their peers. Open discussions and panels provided thought-provoking insights for CFOs navigating today’s rapidly changing marketplace. Here are our four key take-aways: 1. Healthcare is dragging down the economy—and new players are entering to drive change One (…)

Physician alignment is essential as health systems move toward value-based models. Surveyed leading health systems point to several strategies they use to work with their providers as they change the way care is delivered, such as developing clinically integrated networks (CINs), supporting employee culture, developing communication and governance processes, and incorporating contract metrics around quality (…)

I travel a lot. In fact, I fly so much that the airlines I frequent actually treat me fairly well. In my role I get to engage with provider organizations across the country and come to understand the unique dynamics of each market I visit. While it can be argued that the uniqueness of each (…)

This Perspectives series looks at the challenges provider-sponsored health plans (PSHPs) can face. Part 1, Why Provider-Sponsored Health Plans Fail, examined the market dynamics motivating provider organizations to launch health plans. Part 2 discusses the need to focus on the key factors at launch that will drive success for a PSHP. When health systems look (…)