When health plans and Medicare propose controlling the cost of specialty care, expect that bundled payments will be the next suggested solution. With the introduction of every new specialty-focused payment model, an episode-based bundled payment model is involved. But let’s say you’re an ACO with no interest in bundled payments arrangements. You may not even […]
Video: How to Improve Specialty Spending for ACOs
Referral networks drive a huge part of ACO spending. Cut through the data to find how you can reduce costs through actionable information. Learn more about how your ACO should evaluate specialty referrals and costs using seven key analytics for procedural episodes of care. Founded in 2002, Roji Health Intelligence guides health care systems, providers […]
Seven Key Analytics to Direct Your ACO’s Specialty Strategies for Risk
As ACOs become subject to Risk arrangements, especially global capitation, specialty costs should be one of the first areas to examine for long-term savings potential. Optimal use of specialists and engagement with specialty providers will prove essential for cost management. This is new territory for providers who have decentralized most decisions about specialty referrals and […]
Video: Cost Transparency Gives ACOs a Competitive Edge Under Risk
While your ACO isn’t subject to CMS’s new rules about cost transparency, you’d be well advised to adopt this method to succeed under Risk through your own modified approach. As your organization establishes mutually beneficial relationships with providers, you can’t avoid the choice to achieve savings by prioritizing strategies to focus on cost variations and […]
ACOs, You Probably Think Cost Transparency Isn’t Your Problem. Think Again.
ACOs have largely sidestepped the cost transparency dispute raging between Medicare and medical providers, especially hospitals, due to CMS rules requiring providers to give consumers coverage-based cost estimates. If you’re an ACO, you probably assume that cost transparency is not your problem. So you probably won’t like to hear that your ACO should be helping […]
Video: Create Effective Partnerships with Physicians for Value-Based Reimbursements
Physicians were trained to be scientific problem-solvers. Reach your potential under Risk by tapping into their overlooked talent to find the balance between best practice and costs. Learn Three Fixes for ACOs’ Physician Engagement Strategies here. Founded in 2002, Roji Health Intelligence guides health care systems, providers and patients on the path to better health […]
Three Fixes for ACOs’ Physician Engagement Strategies
ACOs know that reducing costs is the key goal for Value-Based reimbursement. But strategies on how—or even whether—to engage physicians in that goal have not always been successful, to the detriment of all involved. Part of the problem is that provider revenues still stem from Fee-for-Service payments. Physicians are still rewarded based on meeting volume […]
Video: The Right Data for Value-Based Success
Claims data isn’t all you need to succeed under capitation. Here’s why provider EHR clinical data should be added to identify variation in care and engage providers. Founded in 2002, Roji Health Intelligence guides health care systems, providers and patients on the path to better health through Solutions that help providers improve their value and succeed […]
Straight Talk for Providers Adopting Capitation: Don’t Fly Blind Without the Right Data
Value-Based Reimbursement—once focused on incentives and shared savings—now more often means capitation. Whether adopting Medicare Alternative Payment Models (APMs) or contracting with health plans, physician groups and health systems have signaled greater willingness to adopt these new Risk payment models with their guaranteed payments for attributed patients. But here’s the problem: If you don’t have […]
Video: Specialists and Value-Based Reimbursements
With specialists driving a significantly large share of ACO costs, consider how to use episode-based inquiries in your ACO strategy. The higher the financial risk for ACOs, the more critical it is to incorporate specialty episodes and other features effectively. Read more here. Founded in 2002, Roji Health Intelligence guides health care systems, providers and […]