Read more about the article Keeping an Eye on Value-Based Care – 3 Things to Watch

Keeping an Eye on Value-Based Care – 3 Things to Watch

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“Work smarter, not harder.” This age-old philosophy is the mantra behind value-based health care. After all, more health care doesn’t necessarily mean better outcomes – this much has been proven by evidence-based medicine time and again. As the fee-for-service model of health care slowly fades away, true value-based care (and all the benefits that come with it) is finally becoming a reality. Better coordination of patient care, communicating with patients, decreasing unnecessary and/or duplicate services – and incentivizing those who truly improve care (and not just those who deliver more) is happening across the country as health systems and providers shift models of care while desperately trying to preserve their reimbursement.

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Read more about the article With Telehealth on the Rise, Policy & Payers Are Catching Up

With Telehealth on the Rise, Policy & Payers Are Catching Up

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Telehealth is a key element of our country’s health care transformation – and health care providers, payers and patients are getting on board today more quickly than ever. After all, getting timely and convenient medical diagnosis and treatment using your computer, phone or tablet – anywhere, anytime, is of incredible value in our busy, technology-driven lives.

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Read more about the article Why the Government is Outsourcing (and You Should, Too)

Why the Government is Outsourcing (and You Should, Too)

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The data is clear – policymakers are making every effort to reduce healthcare costs, particularly as states struggle with significant budget deficits across the country. To do this, many state governments have elected to outsource the management of Medicaid and Medicare programs to managed care companies. According to Modern Healthcare, 34% of Medicare beneficiaries are now enrolled in a Medicare Advantage plan, which is administered by a private payer. Similarly, 77% of Medicaid beneficiaries are enrolled in some form of managed care plan.

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Read more about the article Encounter Data & Why Getting It Right is More Important Than Ever

Encounter Data & Why Getting It Right is More Important Than Ever

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Earlier this month, CMS announced changes to future payments for Medicare Advantage plans that will take effect in 2020. While a pay raise is part of the plan, what’s causing a stir is that payment will now be based on a higher percentage of patient encounter data (up to 25% from 10%). Many (especially payers) have argued that encounter data is often incomplete and inaccurate when compared to diagnoses, since encounter data relies on provider documentation.

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