Managing Clinical Workflow with all the Right Information Tools
To effectively manage care, care team members need to have access to the right information at the right time. Without access to relevant data at the point of decision, however,…
Encountering Hurdles on the Road to Pricing Transparency
When it comes to pricing transparency, the healthcare industry should be in a copasetic state. That’s far from the reality.
Access to Comprehensive Data Empowers Health Plans to Improve Medication Management
When patients don’t follow doctors’ orders, the consequences are dire. Health plans can help by understanding the specific challenges that members are facing – and then intervening to enable them…
“Utilization Management” is all about saving health plans money. Or is it?
Until recently, Utilization Management was all about how health plans determine preauthorization. But that definition is fast becoming outdated.
Utilization management: What’s it got to do with population health?
What does Utilization Management have to do with Population Health? The answer: everything.
Addressing Access to Care Challenges in Rural America
Access to healthcare in rural settings is a true challenge. Americans living in rural areas are more likely to die from five leading causes than their urban counterparts. How should…
Deborah Gage: What it Takes to Have a Fearless Approach
Several years ago at a national healthcare conference, Chris LaVictoire Mahai, now the President of Aveus, a division of Medecision, joined a small breakout group discussion and met Deborah Gage,…
Getting Social: Why Health Plans Need to Go Beyond Clinical and Claims Data
In addition to leveraging claims and clinical data, insurers are now relying on social determinants of health data to paint a better picture of their member populations, create meaningful interventions…
3 Benefits of Participation in BPCI-Advanced
The open window to apply for CMS’ Bundled Payments for Care Improvement (BPCI)-Advanced closed on June 24, 2019, but there’s still plenty of opportunity for health systems to move forward with value-based care and care management initiatives — and the care…
Next-Generation Engagement Gets Personal to Drive Better Health
One-to-one transactions do not really constitute holistic engagement. Payers should take a fresh look at what it really means to engage consumers by providing solutions that empower their consumers to…
