Confusion & Misunderstanding About Value-Based Care Implementation

Confusion & Misunderstanding About Value-Based Care Implementation

Industry transition to value-based care & reimbursement (VBC/R) is happening. In fact, it’s happening faster than many comfortably predicted just 24 months ago. But in our work helping providers and payers plan and begin implementing various VBC/R strategies over the last 18 months, we have encountered a significant amount of confusion and misunderstanding around some

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4 Payer Strategies to Optimize Specialty Drug Management

4 Payer Strategies to Optimize Specialty Drug Management

Specialty drug management programs are complex by nature with disparate multiple stakeholders. Increasing availability and cost of specialty drugs create an unsustainable financial burden for payers. How do you most effectively integrate and manage the many detailed program components, organizations, and tactics? Combining your core strategies that you previously implemented from our Combat Specialty Drug

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4 Key Strategies for Payers and TPAs to Win in a Disrupted Industry

4 Key Strategies for Payers and TPAs to Win in a Disrupted Industry

In our last post we looked at four key threats to payers from industry devolution with value based reimbursement. These included: Administrative Service Disintermediation Network Management Disintermediation Health Management Disintermediation Loss of Negotiating Leverage Each threat is largely a result of the consolidation of provider organizations of all types into multi-modal comprehensive integrated delivery systems.

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