Variations on health care costs and quality and the markets themselves are hampering employers’ abilities to get a handle on rising costs and the best value. That’s a takeaway from a panel Thursday afternoon on provider quality data and the use of it by the private companies who pay for the bulk of their employees’ […]
How to Optimize Healthcare Benefits
Based on the trend toward value-based health insurance and reimbursement, health benefit plans are being designed to reduce barriers to maintaining and improving health and to promote higher-value healthcare services. Value-based reimbursement requires providers to track and report a host of adverse events and population health measures, including biometrics, patient engagement and other measures required to […]
The value-based care challenge: Helping employers tap into quality care
The rise of value-based care models, including value-based insurance and value- based reimbursement, has been inevitable as employers strive to find innovative strategies that enable them to offer quality, cost-effective healthcare benefits. Value-based insurance relies upon financial incentives to promote cost efficient healthcare services, enabling health benefit plans to reduce barriers to maintaining and improving […]
3 aspects of value-based care every broker should know
Health Insurance brokers connect employers and other plan sponsors with health care benefits solutions, adding value by matching plan sponsor needs with a range of benefits within budget requirements. Whether seeking fully insured or self-insured solutions, brokers are the primary liaison for plan sponsors with millions of lives nationally — navigating benefits solutions, dealing with […]
Commercial Payers Embrace Bundled Pricing for Cost Containment, Better Outcomes
As commercial payers seek strategies to lower costs and improve care quality, they are paying closer attention to bundled payments. While many payers express concerns about the impact of recent regulatory reversals that removed mandatory requirements for bundled payments, the benefits of bundled pricing still resonate strongly throughout the commercial marketplace. This is evidenced by a […]
Providers partner with payers for bundled payments
Despite the elimination of mandatory bundled payments by the Centers for Medicare and Medicaid (CMS), commercial insurers are investing in this model based upon the positive results they’ve seen from the CMS demonstration models and their own trial experiences. Bundled payment models shift financial and clinical accountability to a single provider-led organization that takes responsibility […]
Commercial payers benefit from bundled pricing
As commercial payers seek strategies to lower costs and improve care quality, they are increasingly paying closer attention to bundled payments. While many payers express concerns about the impact of recent regulatory reversals that removed mandatory requirements for bundled payments, the benefits of bundled pricing still resonate strongly throughout the commercial marketplace. In late 2017, […]
Bundled Pricing: Cost Containment, Better Outcomes Attract Commercial Payers
While mandatory bundled payments have been scaled back by the Centers for Medicare and Medicaid (CMS), commercial insurers are starting to offer bundled reimbursement programs to their customers. Market analysts see government support of voluntary bundles for payment initiatives as a signal that this innovative strategy is here for the long-term. A number of health […]
Demonstrating High Quality Care Becomes Paramount in the Bundled Payment Models
The Centers for Medicare and Medicaid Services’ (CMS) cancellation of the mandatory payment bundles for cardiac care, surgical hip and femur fracture treatment in late 2017 is expected to be replaced in 2018 with a voluntary program, called the Bundled Payments for Care Improvement Advanced (BPCI). CMS also cancelled the cardiac rehabilitation incentive payment model […]
Building an ERM Framework for Value-Focused Health Care
At a Glance The traditional frameworks that healthcare providers used for managing risk in the past under the volume-based payment model are insufficient for managing risk posed by today’s value-based payment models. Under value-based care, a provider can be financially penalized for failing to meet quality standards established for what previously would have been a […]
