. Using literature review and interviews, AJMC has identified 8 shared attributes of programs, such as accountable care organizations, readmission initiatives, special needs plans, care transition programs, and patient-centered medical homes, that successfully treat high-need, high-cost patients.
According to a new report from the McKinsey Center for US Health System Reform, there are currently 64 insurance plans led by providers like hospitals or healthcare systems available through the health insurance marketplaces. Next year, there will be 72.
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 (…)
Senior vice president and head of markets, Carol Murdock, shares insights on how other organizations work to make accountable care a reality.
Essence Healthcare, Lumeris’ pioneer client, has just received an extraordinary rating from the Centers for Medicare and Medicaid Services (CMS), 5-Stars, for the quality of services it delivers to its Medicare Advantage (MA) members, placing it in the 98th percentile of all MA plans.
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 (…)