3 Strategies for Taking Control of Payer Management
Three strategies can help hospitals and health systems prioritize payer contract management.
Your To-Do List When Health Plan Contracts Change
Six steps can help revenue cycle leaders manage health plan changes effectively.
Ask the Experts: Calculating Contract DRGs
What is a simple way to accurately determine my current base DRG rate?
Own, Partner, or Contract?
There are seven important options hospitals and health systems should consider when contemplating ownership of a post-acute network versus a partnership or contractual arrangement.
Contracting for Primary Care and Value Improves Patient Outcomes and Lowers Costs
Humana offers primary care practices four types of value-based contracts, but also customizes plans that emphasize population health or other initiatives.
Value Initiative for IPA Performance Proves Its Worth
John Baackes, CEO of L.A. Care Health Plan, describes the plan’s approach to assessing the value of independent practice associations to ensure high-quality member service.
The ‘Narrow Network’ Trap—and How to Avoid It
Establishing protocols for checking eligibility and benefits for every patient is one way that physician practices can avoid the traps posed by narrow networks. Insurance eligibility is getting even more complicated. Since the advent
Advancing Contracting Strategy in a Complex Environment
Providers should approach their contracting portfolios with the intent to drive value creation across all payers and products. Likely challenges will be narrow networks and tiering and the transition from fee-for-service to value-based care.
Ask the Experts: Managed Care Contracting Benchmarks
I am trying to find benchmarking information regarding managed care contracting.
Managing and Measuring Payer Performance
Healthcare providers should have a contract management system as the framework for managing the four components of the governance/communication processes―contract analysis and modeling, payment calculations, variance monitoring workflow, and payer scorecard and reporting.