Reinventing Claims Payment For A Value-Based World

Reinventing Claims Payment for a Value-Based World

  • June 6, 2017

Payers need to choose between automated payment and accurate automated payment By Amy Larsson RN, BSN, MBA The U.S. healthcare industry’s claims-payment system is frustrating to providers, payers, and patients alike. Inefficiency and a systemwide tendency for error wastes precious resources, worsens miscommunication and mistrust among all stakeholders, and inhibits the ability to transition to value-based approaches that achieve better outcomes. We need to rethink our industry’s disjointed and siloed approach in order to solve a very integrated problem. Despite billions invested in achieving efficient claims payment, more than 7% of claims are not paid correctly the first time, the…

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In The End, It Will Be Episode Payment

In the End, It Will be Episode Payment

  • May 10, 2017

Horizon Blue Cross Blue Shield of New Jersey is leading the way in transforming cancer treatment reimbursement models to value-based care. Managed Care magazine reports that in 2014, the insurer piloted an episode-of-care program for breast cancer, and it has been successful enough that Horizon will be expanding to treat other cancer types the same way in the near future. Read the article

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McKesson Entity Now Change Healthcare

McKesson Entity Now Change Healthcare

  • May 6, 2017

McKesson Technology Solutions and Change Healthcare have merged to create a new healthcare information technology company. The new Change Healthcare includes all of Change Healthcare's businesses and the majority of McKesson Technology Solutions, and will employ about 15,000 people. Read the article

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Healthcare RCM, Patient Collections Solutions Launch At HIMSS17

Healthcare RCM, Patient Collections Solutions Launch at HIMSS17

  • February 23, 2017

At HIMSS17, healthcare IT companies showcased a range of solutions to manage the changing landscape in healthcare reimbursement. McKesson launched the Healthy Hospital program, which uses analytical tools to benchmark hospital revenue cycles, as well as a payment assurance consulting program that uses data to develop value-based reimbursement strategies. The company also previewed a financial clearance tool that helps revenue cycle management staff manage patient collections with data, and a clinical clearance tool that makes medical record reviews more efficient. Read the article

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Four Steps To Develop, Implement, And Operationalize A Bundled Payment Strategy

Four Steps to Develop, Implement, and Operationalize a Bundled Payment Strategy

  • February 17, 2017

Health plans and hospitals see bundled payment as the fastest growing value-based payment model. They predict that the model will account for 17% of reimbursements in the next five years. But where do you begin? Start with this four-step guide, Bundled Payment 101: A Guide to Getting Started Quickly. The steps include analyzing data to identify episodes of interests, defining quality and savings targets, creating a transparent collaboration between payers and providers, and pulling it all together with a cloud-based claims analytics tool. Read now or download and read later

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McKesson To Launch Analytics-as-a-Service At HIMSS17

McKesson to Launch Analytics-as-a-Service at HIMSS17

  • February 15, 2017

McKesson revealed plans to debut a cloud-based analytics-as-a-service offering at HIMSS17 in Orlando next week. Called HQX Analytics, the consulting service helps providers and payers collaborate to develop successful value-based strategies as they transition from volume to value. Read the article

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