Analysis: Optum to empower its physicians via advanced analytics to improve care and coordinate referrals
Once OptumHealth links its physician network to data it gleans from its data analytics engine, referrals from Optum employed and aligned providers will move from high-cost providers to lower-cost, more conservative ones.
Analysis: Health plans, physician practices align to manage population health and reduce total cost of care
A discussion of strategies health plans are deploying to align with physicians, manage referrals, improve outcomes and reduce the total cost of care as the U.S. healthcare system transitions to population health-based payment models.
Navigant Consulting, Inc.: Hospitals and Health Systems Prepare to Assume More Risk
: This research highlight discusses key takeaways from a May 2019 HFMA study of hospital and health system senior financial executives about their organizations’ interest in and capabilities for assuming risk.
Analysis: Details about CVS/Aetna’s 2 new pilot programs
HFMA’s Chad Mulvany reviews the details of CVS/Aetna’s two new pilot programs focused on improving outcomes for its members.
Analysis: UAW provides direct primary care to manage healthcare costs
A review of the benefits for both healthcare providers and unions when they partner to offer union members direct primary care.
Analysis: Medicare reference-based pricing — down but not out
Although it appears North Carolina is abandoning its efforts to implement Medicare reference-based pricing for state employees, it’s likely not the last time a large employer tries to use this cost-cutting measure.
Analysis: Musculoskeletal issues are a pain in employers’ . . . wallets
A discussion on how actions by some employers to mitigate the impact from the cost of musculoskeletal issues could create opportunities for some health systems and risks for others.
Why private equity firms see the appeal of healthcare finance expertise
Finance leaders of traditional healthcare providers may have opportunities to pursue positions with private equity firms, says a CFO with a leading healthcare startup.
Analysis: What CVS’s paid membership expansion means for healthcare
A review of the details of CVS’s new nationwide paid membership program and what this could mean for the healthcare industry.
Analysis: Deadline passes for NC state employee Medicare reference pricing contract
An overview of the North Carolina Clear Pricing Project, its contract deadline passing and how North Carolina’s hospitals have reacted to the CPP.