Crossing the Payer/Provider Chasm – Getting to Shared Risk, Shared Data

I recently read an article in New England Journal of Medicine (NEJM) Catalyst[i] that showed that the “alignment” between providers...

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The Catalyst: Data Analytics and the Evolution of Modern-Day Health Plans

As the healthcare industry shifts to outcomes-based financial models, coupled with requirements to improve the member experience of healthcare, plans are turning...

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Opportunity for Payers – There’s clinical data out there that you may need, but don’t know it

My colleagues and I recently hosted a breakfast roundtable at the AHIP – National Conferences on Medicare, Medicaid & Duals...

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Claims are so yesterday — What is your clinical data strategy?

I am the first to admit the value of claims for analytics and reporting.  Many years ago when I managed...

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Redefined Relationships: Information Sharing Among Frenemies

Co-opetition. Frenemies. Co-opertition. We are coining new terms all the time to describe collaborative relationships among those who might otherwise...

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From Opposition to Cooperation: Payers Join the Care Team

Back when I was in medical training a decade ago, patient rounds were usually conducted by a group composed entirely...

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