Healthcare Payers News and Resources for Healthcare

93% of Payers, Providers Say Predictive Analytics are the Future

June 9, 2017 - Healthcare organizations will not be able to navigate the financial and clinical challenges of the future without investing in predictive analytics tools, said more than 90 percent of respondents to a Society of Actuaries (SOA) survey. The vast majority of payers and providers participating in the February 2017 poll believe predictive insights will be critical for the future of their businesses,...

Humana Refines Diabetes Risk Stratification Tool Using ICD-10

April 28, 2017 by Jennifer Bresnick

In an effort to improve the delivery of targeted chronic disease management services to diabetes patients, Humana has revamped its Diabetes Complications Severity Index (DCSI) risk stratification tool to use ICD-10 codes, the payer detailed in...

Why an “Empty Desire” for Big Data is Inhibiting Value-Based Care

April 20, 2017 by Jennifer Bresnick

For the most part, the healthcare industry has embraced the idea that access to big data is a critical part of doing business in the modern care environment. But there’s a major difference between having big data and leveraging it...

95% See Population Health as Critical, but Worry about Payment

February 01, 2017 by Thomas Beaton

While the vast majority of healthcare organizations view population health management as a critical part of their financial future, providers are experiencing several challenges as they try to implement these strategies, including policy and...

Can Blockchain Give Healthcare Payers Better Analytical Insight?

December 06, 2016 by Jennifer Bresnick

Blockchain may be starting to settle in to the financial industry as a secure methodology for tracking and approving transactions, but its use cases for other sectors, including the healthcare market, are not yet quite as clear. Population health...

Value-Based Care Starts with Basic Population Health Management

November 16, 2016 by Jennifer Bresnick

Healthcare organizations and their payer partners are learning very quickly that the transition from volume to value-based care is significantly more complicated than signing on the dotted line to switch reimbursement rates from one payment model...

97% Say Big Data Analytics Crucial for Healthcare Benefit Choices

October 12, 2016 by Jennifer Bresnick

Ninety-seven percent of human resources professionals believe that big data analytics are “essential” for making organizational decisions about healthcare benefits and wellness programs, according to a new poll from Geneia and the...