The traditional payer business model is fast becoming obsolete. Blues organizations that cling to the status quo or business as usual risk jeopardizing their reputations and business, because people are more than patients.
Increasingly, employers are driving the growing demand for more solutions to engage customers. In response, healthcare incumbents and new entrants are building solutions to address rising costs and meet consumers’ demands for personalization, price transparency, access, and seamless, simple experiences.
Proactive engagement can help your members lead healthier lives while improving outcomes for payers and other players. With 5% of Americans consuming 50% of healthcare costs, identifying and engaging high-risk, high-cost customer segments is essential to sustainability.
Learn how to maximize efficiencies through greater system integration and automation, enable seamless interactions with providers, members and other constituents, and drive increased healthcare value with automated, value-based programs.
The evolving healthcare landscape has created a wealth of fresh opportunities for payers. There is a sense of urgency for payers in leadership roles to leverage technology and successfully transition to a value-driven healthcare system that rewards top performers and high quality standards. Passage of the Patient Protection and Affordable Care Act (PPACA) quickly changed many aspects of payers' business with higher costs, new oversight, more competition and a longer-term promise of millions of new members. Since healthcare insurance reform became law, opponents have vowed changes, if not its outright repeal. While it may be tempting to take as little action as possible and hope that the 2010 mid-term election or 2012 general election will make this all go away, the reality is that repeal is not a likely possibility.
Healthcare mergers and acquisitions and medical group growth have been strong industry trends for years. One reason is the desire for critical mass to gain leverage with payers as reimbursement declines and costs increase. Healthcare mergers and acquisitions may offer benefits for many medical groups; it is not without its challenges. Read this whitepaper to learn how to successfully manage growth of your medical group.
Join RelayHealth for a recorded Healthcare Finance News webinar, Accelerating Service-to-Payment Velocity. With all of the changes happening in healthcare today, some things do remain the same. Your two primary sources of cash are still patients and third-party payers. While patient financial responsibility is rapidly increasing, a large percentage of revenue still flows in via governmental payers and commercial health plans.
Healthcare payers need to think cost effectively to accomplish the goals of recruiting and retaining top talent, providing excellent patient care and consolidating healthcare with partners. Updating talent acquisition tactics and technologies doesn't have to be expensive. Find out how Best-in-Class companies recruit, hire, on board, and retain employees.
In the midst of industry consolidation, shrinking margins, and fierce competition for talent, health care payers are facing increasing pressure to deliver more cost efficient, high-quality patient care. Learn how to succeed in this dynamic healthcare market by integrating financial and HR systems to tackle immediate challenges and create scalability for the future.
Published By: Teradata
Published Date: Jun 12, 2013
This IDC Health Insights Perspective discusses the growing importance of CRM for healthcare payers, its expected benefits and potential challenges, and suggested best practices for harnessing CRM capabilities to drive enhanced value for both payers and end consumers.
"Healthcare payers and providers are under increasing pressure to:
- Provide and report on quality of care across their population
- Embrace new innovations faster
- Reduce costs across the organization
- Use consumer-friendly digital technology
Explore this actigraphic to see if your organization is on the right track for tackling these challenges."
Published By: Delphix
Published Date: Jun 27, 2014
ICD-10 migration projects can make even the Y2K projects of the 90s look small. As the October 2015 deadline looms, the stakes are high as IT teams fight delays and cost overruns. See why 40% of the top healthcare payers in the US use Delphix to improve their time-to-market and implement ICD-10.
Digital healthcare is not an unattainable mirage, but is alive and well in the United States and throughout the world. The goal of digital healthcare is to use technology to efficiently manage and deliver better healthcare—providing greater value and more positive outcomes to patients at a lower cost. The cloud provides the fastest, most efficient, and most economical way to reach that goal.
Ideally, cloud technology makes the delivery of healthcare fast, flexible, and easier for everyone to use—no matter whether you’re ordering supplies, hiring an employee, or reviewing your budget. However, actual results depend on how you implement the technology and on the vendor you choose as your provider. Every healthcare organization—payers and providers—will have a different path that leads them to digital healthcare. The question is, are you there yet?
The changing healthcare environment means that both payers and providers must use all of their available data to ensure that employee productivity goals are met, members and patients receive high-quality service, and compliance is maintained. Unfortunately, many organizations face challenges with disparate systems providing inconsistent data. Find out how leading healthcare organizations are integrating HR and finance systems for one source of truth, and in turn enabling better decisions.
"Successful talent acquisition today puts candidates front and center. To accomplish the goals of recruiting and retaining top talent, providing excellent patient care, and consolidating healthcare
with partners, payers need to think cost effectively. Updating
talent acquisition tactics and technologies doesn't have to be
expensive, though. Take note of how Best-in-Class companies
recruit, hire, onboard, and retain employees. Learn more."
Published By: MuleSoft
Published Date: Apr 15, 2019
The healthcare industry has been affected by disruption and the need for healthcare innovation. Legislative, market, and technology pressures make it imperative for healthcare organizations — including hospitals and health systems, payers, and life sciences companies — to become more agile.
IT teams in the industry are considering a microservices-based architecture as a means of accelerating healthcare innovation and increasing project delivery speed. MuleSoft research suggests that application development productivity increases of up to 10x are possible. Healthcare specifically stands to benefit from this architectural paradigm.
This whitepaper will address:
Why microservices matter for healthcare IT teams and for healthcare innovation
Design principles for a microservices architecture
How Anypoint Platform can help you implement microservices best practices
Throughout the industrialized world, healthcare systems are in crisis. Aging populations and skyrocketing costs are putting unprecedented financial and organizational pressure on healthcare providers and payers. The result is often a decreasing level of care. In response, fundamental changes are taking place. Patient-centric systems are evolving in which the patient's well-being and the responsibility for good health are defining treatment and operational policies.
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