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Member News

    Eight Ways to Reduce Healthcare Administrative Costs

    Managed Healthcare Executive
    Wendy Karsten, president of Care N’ Care Health Plan in Fort Worth, Texas, and other health insurer and hospital executives discuss ways to reduce healthcare administrative costs.

    Autism coverage offered by Avera Health Plans and Sanford Health Plan

    Avera Health Plans (DAKOTACARE)
    Governor Kristi Noem, in conjunction with Avera Health Plans and Sanford Health Plan, has announced health insurance coverage options that include Applied Behavioral Analysis (ABA) therapy in the South Dakota insurance market for 2020.

    Leveraging an Integrated Population Health Model to Improve Costs, Quality, and Satisfaction

    Sharp Health Plan
    Cary Shames, DO, CHCQM, ABQAURP, vice president and chief medical officer, Sharp Health Plan, discusses using an integrated population health model to drive better quality and satisfaction of care while lowering costs at the National Association of Managed Care Physicians 2019 Fall Managed Care Forum, held October 10-11 in Las Vegas, Nevada.

    Geisinger, Cerner Partner to Boost Population Health Management

    Geisinger Health PLan
    Geisinger will use actionable insights and innovative tools from the Cerner platform across its patient network, accountable care organization (ACO), and Geisinger Health Plan. The partnership will use open standards and integration capabilities to provide a seamless user experience.

    Intermountain Ventures Invests in Omada Health to deliver digital diabetes prevention services via physician referral

    Intermountain Healthcare is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes and sustainable costs. The not-for-profit system of 24 hospitals, 215 clinics, and more than 2,500 physicians and clinicians in Utah, Idaho and Nevada and a health plans division called SelectHealth has received recognition for its investment in value-based, clinically-effective preventive care.

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    BLOG: Flying solo? The top reason to join the flock plus 5 key traits to maximize the benefits

    Dennis Bolin, Health Plan Alliance
    What conditions need to be present to ensure your organization benefits from being a part of the flock – both internally between teams and externally between other health care providers?

    BLOG: Growing where you are already planted

    Kristin Rodriguez, Health Plan Alliance
    How delivery systems can become a hub for health and healthcare in the future by shifting their focus from buying and building hospitals to leveraging their existing platforms to generate growth and often more profitable streams of revenue.

    BLOG: Why health plans should think more like Netflix

    Kristin Rodriguez, Health Plan Alliance
    Netflix's success didn't come from one dramatic market play. It came from a thousand little choices their leadership made in reaction to new opportunities and a changing landscape. Using this approach, maybe health plans could create a health care experience consumers value as much as family movie night.

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Business News

    What healthcare executives must know about the interoperability and patient access rules

    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.

    An Aging American Population Requires a Change in Care Delivery

    Landmark Health
    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.

    Evolution of Claims Auditing

    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.

    Cathy Eddy joins as newest member of Discovery Health Partners Strategic Advisory Board

    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.

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