How Capitation Contracts Benefit Providers, Payers and Patients
WEBMay 11, 2023 · Capitation contracts can benefit providers, payers, and patients. But they require thoughtful planning, careful alignment between PCPs and specialists, a commitment to optimizing the patient/member experience within a narrower network of providers, and a robust digital infrastructure. Lynn Carroll is the chief operating officer of HSBlox, an ...
Beyond the Big Three PBMs - Managed Healthcare Executive
WEBDec 19, 2022 · But beyond the big three PBMs is a swarm of some 60 smaller, up-and-coming PBMs. Even if they are operating in a small slice of the pie relative to the towering dominance of the big three, the PBM pie is growing rapidly. The global PBM market is projected to increase from $495 billion in 2022 to $740 billion by 2029 (a 50% jump), according to a ...
MHE Publication - Managed Healthcare Executive
WEBMHE April 2022. Volume: 32. Issue: 4. View Issue. |. Download Issue. 1 2 3>. Managed Healthcare Executive provides C-suite executives at health plans and provider organizations with news, analysis, insights, and strategies to pursue value-driven solutions.
PBMs are Creating GPOs, and Stirring Debate as to Why
WEBJul 12, 2022 · PBMs are Creating GPOs, and Stirring Debate as to Why. The Big Three all set up group purchasing organizations recently, but some industry observers question the timing of the move and who will benefit. In 2019, Express Scripts PBM (pharmacy benefit manager) formed Ascent Health Services GPO (group …
Six Healthcare Technologies Coming in the Next 10 Years
WEBFeb 2, 2019 · 2. Deeper AI infusion. Artificial intelligence has been a part of the healthcare for years, but experts believe in the next decade it will be a regular part of the industry. A survey of 200 healthcare professionals by Intel Corporation, released in July 2018, found that 37% of respondents were using AI in limited ways, and 54% believe that ...
Anthem-Aspire Acquisition: 5 Takeaways - Managed Healthcare …
WEBJun 2, 2018 · Here are five takeaways from the Anthem-Aspire acquisition: It is not yet clear if all the M&A activity by established insurers with national footprints can deliver on the local level, or if they will be outmoded by some disruptive startup. “What is clear is that the pursuit of value creation, either by vertical integration or adding ...
Five Key Steps for Better Healthcare Coordination
WEBJun 5, 2020 · Step 1: Champion Your Patient-Centric Mission and Vision. Great care coordination means executing on a mission of meeting patients’ needs, first and foremost. It’s about everyone in a patient’s care team collaborating, no matter their specialty, role or location. Make your patient-centric mission and vision for care coordination specific ...
The Biggest Issues Facing Healthcare Today - Managed Healthcare …
WEBSep 26, 2019 · The Biggest Issues Facing Healthcare Today. Healthcare executives rank the top 10 transformational themes for 2020. More than 100 C-suite and director-level executives voted on and then ranked the top 10 critical challenges, issues, and opportunities they expect to face in the coming year, during the 2019 HCEG Annual Forum.
Seven risk-sharing mistakes to avoid in healthcare
WEBMar 1, 2016 · What both sides need to realize is that they’re aligned in terms of trying to minimize the cost of care, getting better rates for premiums, improve quality, and create better relationships that will drive patients to the provider. Here are six more mistakes to avoid when embarking on a risk-sharing agreement: 1. Overestimating your partner.
Understanding Both Sides of the Copay Accumulator Debate
WEBMay 1, 2019 · The idea of copay accumulation is simple. Under such a program, health plans no longer need count copay assistance programs, copay cards, manufacturer coupons, or other copay assistance that patients may use to help them afford brand name medications toward a patient’s deductible. With so many pharmacy benefit managers (PBMs) assigning ...
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