Five things to know about the role of GPOs in the healthcare …
WEBSep 14, 2017 · Based on our analysis, the following are 5 things to know about GPOs, their business model and role in the supply chain, and their impact on healthcare costs and competition: 1. GPOs source and negotiate prices for products and services. GPOs help source and negotiate prices for drugs, medical devices, and other products and services on …
How Capitation Contracts Benefit Providers, Payers and Patients
WEBMay 11, 2023 · Capitation contracts can benefit providers, payers, and patients. But they require thoughtful planning, careful alignment between PCPs and specialists, a commitment to optimizing the patient/member experience within a narrower network of providers, and a robust digital infrastructure. Lynn Carroll is the chief operating officer of HSBlox, an ...
Beyond the Big Three PBMs - Managed Healthcare Executive
WEBDec 19, 2022 · But beyond the big three PBMs is a swarm of some 60 smaller, up-and-coming PBMs. Even if they are operating in a small slice of the pie relative to the towering dominance of the big three, the PBM pie is growing rapidly. The global PBM market is projected to increase from $495 billion in 2022 to $740 billion by 2029 (a 50% jump), according to a ...
Managed Care – a Path to the Future - Managed Healthcare …
WEBFeb 26, 2021 · Managed care providers are beginning to recognize the opportunity for ROI that comes from supporting practitioners’ back-end systems. Investing in IT capabilities—along with teaching employees how to use new systems to generate reports and analyze data—would streamline the process of collecting electronic clinical quality data.
Press Ganey Acquires SPH Analytics - Managed Healthcare Executive
WEBMay 27, 2021 · Press Ganey, the national leader in healthcare consumer and workforce engagement, recently announced the acquisition of SPH Analytics (SPH), the national leader in member experience measurement and engagement for the health insurance industry.Through this acquisition, Press Ganey will combine its industry-leading patient experience data with SPH’s rich member experience data to bring ...
Contact Us - Managed Healthcare Executive
WEBManaged Healthcare Executive provides C-suite executives at health plans and provider organizations with news, analysis, insights, and strategies to pursue value-driven solutions.
Five Key Steps for Better Healthcare Coordination
WEBJun 5, 2020 · Step 1: Champion Your Patient-Centric Mission and Vision. Great care coordination means executing on a mission of meeting patients’ needs, first and foremost. It’s about everyone in a patient’s care team collaborating, no matter their specialty, role or location. Make your patient-centric mission and vision for care coordination specific ...
Why Social Determinants of Health Are a Critical Factor for …
WEBJun 27, 2022 · Medicaid managed care organization (MCOs) may be better equipped to address social determinants of health (SDOH) and health equity than payers who use fee-for-service models because SDOH are central to many requirements for MCOs, including those pertaining to population health management, health equity and care coordination.
Implications of CMS’ New Antibiotic Stewardship Rule
WEBNov 18, 2019 · CMS released revised conditions of participation for hospitals and critical access hospitals, which require the development and implementation of antimicrobial stewardship programs (ASPs) to help reduce inappropriate antibiotic use and antimicrobial resistance.. This is an expansion of a previous ruling in 2016, which required all nursing homes to establish an ASP at their facilities.
High-deductible health plans: a brief history
WEBSep 22, 2015 · The share with very high-deductible plans, those of $3,000 or more, climbed to 11% in 2014, up from 1% in 2003. In the health insurance marketplace, close to 60% to 80% of plans are HDHPs. These deductibles tend to be higher than those of HDHPs offered through employer-sponsored insurance, says Amelia M. Haviland, PhD, Carnegie Mellon ...