Accurately predicting STAR scores in real-time for a health plan can be difficult without the proper tools in place. Learn how the Change Healthcare Consulting staff helped a payer predict proper STAR scores and utilize them for their advantage.
Data iSight is a patented, defensible alternative to U & C or Medicare-based reductions for out-of-network charges Using publicly available claim data and a unique benchmarking process, it calculates fair reimbursement that is cost-based for facilities and median reimbursement-based for practitioners — and acceptable to providers and able to achieve savings for medical payers.
Medical Risk Managers, Inc.
If you are a Health Plan considering a Stop Loss offering, this will be of interest to you.
Care N’ Care and Vital Decisions Partner on Plenary Session at C-TAC Summit on Advanced Illness Care
Care N’ Care health plan partners with Vital Decisions to discuss innovations in serving individuals and their families in advance care planning processes at the 2019 C-TAC Summit on Advanced Illness Care.
Listen to Change Healthcare’s Thomas Laur, Executive Vice President, discuss Revenue cycle management (RCM). RCM is more than simple claims management and bill processing. Today, RCM is a rapidly changing, multi-billion dollar market with a complex set of challenges and a growing roster of healthcare IT (HIT) vendors promising to solve them.
With the support of Verily and Sanofi, Onduo is working towards a better way to manage diabetes by creating a virtual clinic that personalizes patient member care plans and collaborates with providers to extend care, allowing healthcare systems to effectively take advantage of rapidly changing innovations to address individual member needs.
With the MA Annual Enrollment Period (AEP) in full swing, plans are seeing the early results of their 2020 product placement and benefit decisions. In analyzing the 2020 product details, Pareto Intelligence will show there are many new and continuing trends as the MA market continues to see more entrants and greater competition.
While not the first thing thought of when thinking about advanced illness, Vital Decisions shares how MI can foster discovery, communication and documentation of wishes to align care and lead to better member, family and health plan outcomes. Read the attached Executive Insight and tune into this webinar.
CMS has launched a user-friendly Medicare Plan Finder tool designed to give beneficiaries more choices when comparing various Medicare pricing options, while allowing healthcare companies to see what their competitors are up to. Please read the article to learn more.
Finding more efficient ways to meet time-sensitive data processing, analysis and compliance requirements is essential to the success of your Medicare Advantage, Managed Medicaid and Commercial Exchange Plans. Discover how Cognizant can help and learn about the exclusive pricing Cognizant is now offering through the Alliance Group Purchasing Organization.
Mobile providers and medical house calls are becoming a staple in primary care to meet cost, quality, and access demands of the most complex patients. Read more about Landmark Health’s story as you may be considering a solution to address the high cost of the complex, chronic population.
Data Saints Auditing
The relationship between the Claims Auditing industry and Payers has not changed much over the last 20 years. Data Saints Auditing thinks that is a bad thing and is making changes that are shaking up the industry.
Discovery Health Partners
Discovery’s Strategic Advisory Board is charged with guiding the company in advancing its industry-leading solutions portfolio to help health plans proactively avoid costs, improve the accuracy of claims payments, and protect the erosion of premium revenue through emerging technologies, services, and best practices.
Interoperability for payers is on its way. Read why HealthSparq's VP of Product thinks we should let the data flow.
Centauri Health Solutions
You’ve probably heard of Section 1332 waivers. But do you know what they are or how they may impact organizations, patients or health plan members? Section 1332 introduced State Innovation Waivers, now also referred to as State Relief and Empowerment Waivers. To learn more please click the link below.