This article was published by Knowledge@Wharton on July 31, 2014. A study of Blue Cross insurers released on July 9 by the plans’ trade association reported that health insurers are slowly moving toward “value-based” payments to doctors and hospitals. Instead of basing payments on the number of tests and procedures performed,<span. . .
Community acquired infections (CAI) are among the most common reasons for admission at regional safety net hospitals. CAI is emblematic of the types of choices that hospitals must make every day, there is variation in: patient risk factors; severity of symptoms on presentation; and the ultimate
Event: First Illinois Chapter HFMA, Spring Summit 2014 Date: April 10-11, 2014 Presenters: Ngan MacDonald and Walter Linde-Zwirble On April 10, 2014, Trexin’s Healthcare practice leadership delivered a conference seminar entitled “How to Leverage Analytics to Transform Healthcare Delivery: Lowering the Cost of Care” at the First Illinois Chapter Healthcare<span. . .
As we step into the post-ACA world, where the economic consequences as well as the clinical value of interventions need to be understood, the biggest missing pieces of information are usually the general pattern of resource use and the associated overall cost of care for a condition under current
Compared to other developed nations the US spends approximately twice as much per capita on healthcare and the total cost seems to be spiraling out of control. And while many other countries have placed a number of types of controls on payers, prices or the availability of services, the US<span. . .
We conducted a preliminary analysis of outcomes and resource utilization for Medicare beneficiaries with AML first diagnosed in 2003 or 2004, using Medicare Public Use Standard Analytic claims files. The purpose of this analysis was to better understand the patterns of resource use in connection
The advent of the Affordable Care Act created a new type of private nonprofit health insurer, called a Consumer Operated and Oriented Plan, or "CO-OP.” These plans are directed by their customers and designed to offer individuals and small businesses more affordable, consumer-friendly, and
For most of this young decade, we have debated as a nation the pros and cons of the US healthcare system and ways to fix it. There are several innovative programs that are being incubated across the country. Even with all that, I believe there is an opportunity, at the<span. . .
Dramatic changes in healthcare laws, technologies, and consumer behaviors have created a window of opportunity for innovative healthcare service organizations. Our Client, a regional hospital association, launched two new ventures in response to these opportunities: a health information exchange
The US healthcare system is undergoing significant change in both the regulatory framework under which it operates as well as the marketplace in which its participants must compete. To address both the threats and opportunities associated with this type of disruptive industry change, a large