Successful value-based contracting between healthcare insurers and care delivery organizations is critical to the transition towards a more sustainable healthcare system. As healthcare costs continue rising, there is an urgent need to realign payment models to reward providers for efficiency and optimal patient outcomes rather than fee-for-service care volume. Value-based…
Health insurance payers’ original function as financiers of care has evolved over the decades. In the current healthcare environment, payer roles range from risk manager to health navigator to provider of care. Across these roles, the importance of their subscribers’ health outcomes remains at the forefront.
A few short months after Google came under fire for not being forthright about Project Nightingale – its data-sharing partnership with Ascension – EHR vendor Epic Systems warned hospitals that it would halt further work with the company’s cloud-based system, aligning itself with the many individuals who felt the partnership…
In a last-ditch attempt to preserve their historic practice of charging whatever the market will bear, almost always after the fact, U.S. hospitals filed a lawsuit against the Trump administration over its proposed Transparency in Coverage rule. The suit, brought by the American Hospital Association (AHA) trade group, isn’t surprising.…
Driven by unsustainable cost increases, increased public and regulatory scrutiny, as well as shifting alliances, healthcare is undergoing a radical transformation. New competitors, value-conscious employers and consumers, new technologies, changing payment models, and shrinking reimbursements are altering where and how care is delivered. As a result, healthcare organizations are under…
Hospitals keep making preventable mistakes, and patients continue to pay the ultimate price for them. Just before the new year, an update of the investigation by The Wall Street Journal found that more than 100 psychiatric hospitals hold their accreditation despite safety violations, 16 percent of them severe. Why is this…
