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Aetna has achieved a high level of success through its accountable care organizations in the last few years--but that accomplishment hasn't come by accident. The insurer is keen on implementing...
You know how when you go on a first date, you're careful not to divulge too much nitty-gritty information about yourself? Instead, most experienced daters prefer to reveal tidbits of their personal lives slowly, so as not to scare their dates off too early with tales of rough childhoods and embarrassing habits. They key to successful dates and early relationships often is a delicate give-and-take balance of sharing some information, but not too much. That's kind of how payers and providers are acting toward each other as they navigate the accountable care waters. Payers don't always want to spill all their beans, disclosing too much information too quickly, closely guarding their long-held secrets. And providers don't want to move forward with their dates if they remain tight-lipped about important information.
Highmark has taken a major step toward coordinating patient care, lowering health costs and shifting from a volume- to value-based payment system. Pennsylvania's largest insurer announced Thursday that it's launching an "accountable care alliance" that will pay a network of about 500 hospitals and doctors up to 30 percent more in reimbursements for keeping patients healthy.
Providers are beginning to sound alarms that some payers aren't providing adequate or high-quality claims data, making that information unusable.
Maya Angelou and health insurance companies are rarely--if ever--associated with one another. But I would like to bridge that extremely wide gap and even declare that payers can learn some very...
In the last year and a half, Florida Blue has expanded its Medicare and Medicaid operations, reached new agreements with providers, bought a provider group and decided to sell policies through a new private health insurance exchange.
Provider consolidation as a result of accountable care organizations and high out-of-network provider fees are causing healthcare costs to continue to rise at exorbitant levels.
Texas has been the focus of accountable care organizations for both Aetna and Cigna as the insurers roll out new cost-saving collaborative programs in the state.
Blue Cross Blue Shield of Texas has formed one of the largest accountable care organizations in the country, partnering with healthcare provider Texas Health Resources to improve quality and decrease costs.
As accountable care organizations continue cropping up throughout the country, including 106 new collaborations with Medicare announced Thursday, some healthcare experts predict the payer market could be severely disrupted.
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