ISPOR Europe; A distinctive opportunity at the forefront of great change

In approximately 2 weeks, 3,800 global researchers and thought leaders will be coming together in Amsterdam to explore “New Challenges for Improving European Health Care” at the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) 17th Annual European Congress, November 8-12. The conference is a great opportunity for us to interface with clients, partners and [...]
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Four steps to population health management: Step one — optimize network management

In our last blog, we talked about what it takes — a combination of claims and clinical data — to lay a solid foundation for population health management, or PHM. Now let’s take a look at the four steps of PHM, starting with the first step, optimizing network management. Value-based organizations should consider the referral [...]
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The four steps of population health management

Providers making the transition to value-based care are looking for new ways to deliver appropriate, cost-effective care and optimize their performance. Population health management, or PHM, is one strategy they’re using to get there. By transitioning from acute, episodic care to a more coordinated, long-term approach, they’re helping patients stay healthier while controlling costs. But [...]
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Payers understanding the provider perspective in a rapidly converging marketplace

As you’ve witnessed, rising medical costs and developing regulations have led to new initiatives to target clinical quality outcomes and manage financial risk. These and other market forces are transforming the way we [payers, providers and consumers] interact: Payers are accelerating risk-contracting efforts. Plan distribution is moving to direct-to-consumer. Care models are increasingly consumer oriented. [...]
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Make a game plan to better manage patient populations

Providing better care at a lower cost requires a strategic plan to identify at-risk patients who are the most likely to benefit from early interventions. But to do that, health care organizations need the most comprehensive insights and expert-level predictions possible. Analytics let organizations segment their population by clinical risk or by utilization. This makes [...]
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Research shows health care costs are slowing. Will the trend continue?

There’s good news on the health insurance cost front: According to a recently released employer health benefits survey by the Kaiser Family Foundation, health costs for employers increased only 3 percent last year. And it’s the second straight year the growth rate has slowed, according to Kaiser. Get the full story in this article that [...]
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Bend the administrative curve cost with payment integrity best practices

Health plans transforming their business models to accommodate new markets and new lines of business may experience a strain on their payment integrity programs resulting from fluctuations in membership, business complexities and regulatory mandates across all areas of claims processing. Without a vigorous payment integrity program in place, these pressures can create competing or misaligned [...]
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The hospital of tomorrow will focus on population health

The rate of change in health care seems to be accelerating each year, and provider organizations such as Aurora Health Care are challenged to keep pace with the change. Aurora’s Sylvia Meltzer, MD and Laura Spurr MS will be discussing at the U.S. News Hospital of Tomorrow Forum how their organization is using big data to transform for [...]
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Payer IT paradigm shift needed to support customer-centric approach

With health plans focusing their organizations more on customers, it’s critically important that we ensure IT applications and infrastructure are modernized to better collect, store, analyze and produce more specific customer information. The IT implications are significant because plans’ administrative systems have historically focused on policy administration. While administrative systems are good at handling transactions, [...]
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Manage clinical and financial risks with analytics

Until now, managing risk in health care has largely been an exercise that was left to the payers. Provider organizations haven’t needed to accurately calculate the clinical and financial risks associated with caring for patients, because they didn’t bear the liability. But the rise of value-based care and big data is changing the face of [...]
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