Healthcare costs

Population health management program development

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• How healthcare providers can reap the benefits of an actuarial mindset

  By Lindsy Kotecki | 11 April 2018

  Healthcare provider organizations can benefit in many ways from adopting actuarial approaches, which can help them improve financial security, strengthen leverage in negotiations, and advance clinical liabilities.

• Socioeconomics and morbidity: What can consumer data tell us about social risk factors?

  By Ksenia Whittal, Alexandra Weaver | 22 March 2018

  This paper explores relationships between lifestyle factors and morbidity that the authors encountered in their experience working with consumer and administrative claims data.

• Rising risk: Maximizing the odds for care management

  By Ksenia Whittal, Abigail Caldwell | 22 March 2018

  This analysis examines predictive models to determine if an enhanced model can better identify individuals with rising risk relative to traditional prospective risk adjustment models.

• Opioid use disorder in the United States: Diagnosed prevalence by payer, age, sex, and state

  By Stoddard Davenport, Katie Matthews | 09 March 2018

  Over 25 million American adults report suffering from daily chronic pain. The increasing use of opioids in recent years has taken a human toll, leading to a rising number of overdose deaths and diagnoses of opioid use disorder.

• Is your provider organization maximizing its performance in value-based care programs?

  By Rod Martin, Laurie Lingefelt | 06 March 2018

  As the use of value-based reimbursement programs and the associated financial impact increases, it is important for providers to be educated on the mechanics of the program and to understand the analytical, operational, and clinical requirements to ensure success.

• Genomic testing: Cost-savings or cost-inflating for payers

  By Didier Serre, Joanne Buckle | 02 March 2018

  There is still some uncertainty regarding the future uptake of genomic testing and the levels of sophistication of new tests, and this article discusses some relevant considerations that can support a greater appreciation of the risks and gains to payers involved in funding these tests now.

• Complex/high-risk patient targeting case study

  By Lalit Baveja, Tanya Hayward | 23 February 2018

  This article discusses a clinic-based community intervention designed to improve access and quality of care for high-utilising, high-risk patients over the course of three years.

• Managing healthcare costs for 2018

  By David Stoddard | 13 February 2018

  Trustees and administrators should keep a number of topics in mind when planning for 2018 and beyond.

• Potential economic impact of integrated medical-behavioral healthcare: Updated projections for 2017

  By Stephen P. Melek, Doug Norris, Jordan Paulus, Katie Matthews, Alexandra Weaver, Stoddard Davenport | 12 February 2018

  This report uses healthcare cost and utilization data to project spending estimates for people with chronic medical and comorbid behavioral conditions in 2017.

• Five ways the Amazon / Berkshire Hathaway / JPMorgan Chase deal could change healthcare in the U.S.

  02 February 2018

  Amazon, Berkshire Hathaway, and JPMorgan Chase bring a fascinating variety of perspectives to the challenges of healthcare.

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