October 22, 2012 Mark Hagland
article
A panel of association leaders from the physician, physician group, hospital, health plan, and employer-purchaser worlds uncovers a mix of optimism and trepidation when it comes to moving the healthcare system forward towards new care delivery and reimbursement models.
October 3, 2012 Karthik Ganesh
article
Changes in the industry landscape are forcing health plan leaders to reevaluate their value proposition while continuing to execute effectively on these core competencies. There is additional pressure on health plans to now be the engine that seamlessly powers the all-important patient-provider relationship. This is the perfect time for a health plan to embark on a transformation of its core service model, thereby putting itself in a position to capitalize on the service expectations associated with the changing industry landscape.
September 17, 2012 Mark Hagland
article
At Hunterdon Healthcare, executive leaders are moving forward on a broad range of fronts to implement a variety of initiatives, from the patient-centered medical home model among its physician groups, to health information exchange. And they share what they're learning about the opportunities and challenges to integrated health systems going forward.
September 15, 2012 Mark Hagland
blog
As David Share, M.D. and his colleagues at Blue Cross Blue Shield of Michigan collaborate forward with local providers to master care management and utilization strategies, the criticality of leveraging analytics thoughtfully becomes ever-more-apparent. We’ll be discussing these issues in our upcoming Healthcare Informatics webinar on Sept. 25, and learning from the experiences of some of the most pioneering organizations nationwide.
September 13, 2012 Gabriel Perna
blog
Almost everyone says that changing the way healthcare is delivered is a long-lasting, cultural transformation. When thinking of the recent New York City soda ban, it’s hard not to draw comparisons. However, it’s important to ask, what role does government play in changing behavior, and can it overstep its bounds?
September 9, 2012 Mark Hagland
article
In Michigan, Blue Cross Blue Shield of Michigan has implemented and grown a patient-centered medical home initiative that is already the largest in the country, with over 3,000 physicians involved. What David Share, M.D. and his colleagues are learning has strong implications for PCMH development nationwide.
August 22, 2012 Jennifer Prestigiacomo
article
After a win with the Atlantic City Special Care Center, the Cambridge Mass.-based Iora Health is replicating its care model of intensive primary care management services, aligned incentives, and actionable analytics, across the country. Iora Health's guiding principle is to target the small group of patients who generate the most healthcare costs, and treat them using a global budget, rather than fee-for-service infrastructure.
August 21, 2012 David Raths
article
The journey for statewide HIEs has been slow-going and fraught with challenges of governance, consent, security, auditing structure, and secondary data use. Executive directors of statewide health information exchanges speak about the policy hurdles they have encountered, and those that still lay ahead.
August 20, 2012
news
With its acquisition of the Bethesda, Maryland-based Coventry Health, the Hartford-based Aetna expands its “footprint” in the Medicare Advantage and Medicaid managed care markets, and unites two large health insurers for a total of nearly 42 million covered lives across the United States
August 13, 2012
news
The National Quality Forum (NQF) has endorsed 12 quality measures, promoting effective patient-centered care and effective communication in relation to the disparities and cultural competency of meeting the needs of a diverse patient population. Seven of the measures came from an American Medical Association (AMA) resource, called the “Communication Climate Assessment Toolkit.”
August 10, 2012 Mark Hagland
article
Aetna's Charles Kennedy, M.D., heads up a division of that health insurer focused on collaborative development of accountable care organizations with hospitals and physician groups. He offers his perspectives on where accountable care is going, and what provider IT leaders need to do to move their sector forward.
August 8, 2012 Jennifer Prestigiacomo
article
The payer care management solution market is undergoing a transformation, reflecting the industry's drive toward value-based care, according to a new survey from the Framingham, Mass.-based IDC Health Insights. Providers would be wise take note of this development, as closer integration with health plans is expected in the new era of accountable care, which will rely heavily on core competencies more likely to have been mastered by payer organizations than by providers: population health and analytics.
