Value-Based Payment Can Reduce Need for Preauthorizations
BlueCross BlueShield of Western New York has removed prior authorization requirements for more than 500 therapies, services, and procedures in conjunction with its move to value-based payments for primary care providers.
Using a Lab Formulary to Improve Value
In an effort to improve the value of the care it delivers, Vanderbilt University Medical Center uses a multidisciplinary committee to determine which lab tests to make available to providers.
Your To-Do List When Health Plan Contracts Change
Six steps can help revenue cycle leaders manage health plan changes effectively.
Primary Care Clinic Increases Access Without More Providers
Saint Louis University General Internal Medicine primary care clinic reduced patient call and appointment wait times and added an average of 218 appointments per month after implementing an automated phone system and outsourcing scheduling.
Success Factors for Getting High-Cost Drugs Approved
The University of Rochester Medical Center’s high-cost drug manager works to help patients get access to appropriate drugs and mitigates the financial risk associated with buying and administering them.
Health System Demonstrates Meaningful Price Transparency Is Possible
Baptist Memorial Health Care’s online Expense Navigator allows patients to estimate out-of-pocket expenses according to their insurance status and check their eligibility for financial assistance.
Providence St. Joseph Advances Online Scheduling
The Providence St. Joseph Health system sees healthcare delivery through consumers’ eyes. “We are trying to learn when patients want to see us, what they are looking for, and what kind of friction do they encounter when they interact with us in the traditional way?” says Sunita Mishra of Express Care, the health system’s retail clinic arm.
Marshfield Clinic Finds Success with Home Recovery Care
Marshfield Clinic’s home-hospitalization program is replicating the results that other hospital-at-home initiatives have shown: high patient satisfaction, good clinical outcomes, and significantly lower costs of care.
Payer access to EHR data improves cash flow
Sharp Healthcare gives some payers limited access to their members’ EHR data, which reduces the time-consuming cycle of level-of-care authorization denials, appeals, and ultimate approvals.
Colorado Healthcare System Increases Price Transparency for Self-Pay Patients
SCL Health shows self-pay prices in two ways—an average for a specific service and the range of prices charged in the past year. This helps set realistic expectations when prices are above average based on varying factors.