Change Healthcare Value-Based Solutions Now Used By Health Plans Covering 33% Of US Commercially Insured Lives

Change Healthcare Value-Based Solutions Now Used by Health Plans Covering 33% of US Commercially Insured Lives

  • December 6, 2017

Innovative solutions from Change Healthcare are devising care episodes and operating payment programs at plans representing a commercially insured population of 94.3 million Leading health plans representing 33% of U.S. commercially insured clients are now using value-based payment solutions from Change Healthcare to design, scale, analyze, and help ensure accurate payment for innovative alternative payment programs. Change Healthcare solutions such as HealthQx and Episode Management are being used to model and analyze payment programs, scale them from pilot to nationwide deployment, and help payers continuously improve results. These payment programs include mixed- and alternative payment models, such as bundled payment,…

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Transforming Bundled Payments Into Episodes Of Care Can Give Hospitals, Payers An Edge

Transforming Bundled Payments into Episodes of Care Can Give Hospitals, Payers an Edge

  • December 5, 2017

You don't often get to see how a major payer is leveraging value-based care to improve their competitive position. But Healthcare Finance Editor-in-Chief Tom Sullivan did manage to get a look into what’s happening at Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Sullivan spoke at length with Lili Brillstein, BCBSNJ’s Director of Episodes of Care. Brillstein shared how they’re successfully embracing bundled payment efforts, to advance a patient-centered approach with their provider partners. Noting that HealthQX value-based payment software from Change Healthcare is a key part of the effort, the story shows how others can benefit by BCBSNJ’s…

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Transforming Bundled Payments Into Episodes Of Care Can Give Hospitals, Payers An Edge

Transforming Bundled Payments into Episodes of Care Can Give Hospitals, Payers an Edge

  • December 5, 2017

It’s not often that you get to look inside and see how a major payer and their provider network are innovating on the path to value-based care. But Healthcare IT News Editor-in-Chief Tom Sullivan did just that with a rare look into what’s happening at Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Sullivan took a deep dive, speaking at length with Lili Brillstein, BCBSNJ’s Director of Episodes of Care. Brillstein shared how they’re successfully embracing bundled payment efforts, which she prefers to call, fittingly enough, “episodes of care.” Noting that HealthQX value-based payment software from Change Healthcare is…

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Bundles In A Bind? Cardiac Care Models Expected To Prevail

Bundles in a Bind? Cardiac Care Models Expected to Prevail

  • June 30, 2017

Cardiovascular Business reports the Centers for Medicare & Medicaid Services has delayed the launch of a new episode payment model affecting three types of cardiac care, from July 1 to the beginning of 2018. But that doesn’t mean providers and hospitals should ease back on bundles’ preparations. Read the article

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Reinventing Claims Payment For A Value-Based World

Reinventing Claims Payment for a Value-Based World

  • June 8, 2017

The health care industry’s claims payment system is frustrating, inefficient, and prone to errors, according to a new Op-Ed in Morning Consult. But Amy Larsson says one way to overcome these challenges is to start automating disparate payment systems to reduce manual interventions and thus the errors they might introduce. Read the article

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Reinventing Claims Payment For A Value-Based World

Reinventing Claims Payment for a Value-Based World

  • June 6, 2017

By Amy Larsson RN, BSN, MBA The U.S. healthcare industry’s claims-payment system is frustrating to providers, payers, and patients alike. Inefficiency and a systemwide tendency for error wastes precious resources, worsens miscommunication and mistrust among all stakeholders, and inhibits the ability to transition to value-based approaches that achieve better outcomes. We need to rethink our industry’s disjointed and siloed approach in order to solve a very integrated problem. Despite billions invested in achieving efficient claims payment, more than 7% of claims are not paid correctly the first time, the second time, and sometimes even the third time.¹ The remediation process…

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In The End, It Will Be Episode Payment

In the End, It Will be Episode Payment

  • May 10, 2017

Horizon Blue Cross Blue Shield of New Jersey is leading the way in transforming cancer treatment reimbursement models to value-based care. Managed Care magazine reports that in 2014, the insurer piloted an episode-of-care program for breast cancer, and it has been successful enough that Horizon will be expanding to treat other cancer types the same way in the near future. Read the article

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