With healthcare costs, aging populations, patients with chronic conditions and overbilling schemes all on the rise, payment integrity is more important than ever. As such, payers need to make sure that they have payment integrity basics down – while also striving to implement audit innovations that deliver benefits more expediently with reduced administrative burden and greater success.
During a recent webinar entitled, “Outcomes-Based Contracts Between Pharma and Payers: Preparing for the Future, Now!”, John Pagliuca, Vice President, Life Sciences at SCIO Health Analytics, examined the ins-and-outs associated with outcomes-based contracts between payer organizations and pharmaceutical companies – and explained how these contracts could benefit all involved.
The pace toward value-based care delivery and contracting is quickening and gaining momentum at an increasing rate. Consider the following: The number of Medicare Shared Savings Program Accountable Care Organizations (ACOs) has grown from just 100 in 2012 to 480 in 2017.1 And, enrollment in Medicare Advantage has grown from 24.1% of beneficiaries in 2010 to 31.7% in 2017.2 The challenge for your healthcare organization? Ensuring you stand on solid ground when looking to assume and manage the risk across your organization.
During a recent Webinar entitled “5 Ways to Use Data for Advanced Analysis,” Eileen Cianciolo, Chief Product Officer at SCIO Health Analytics, explored how healthcare organizations can use advanced analytics to succeed under value-based care models. By using advanced analytics to create a 360-degree view, healthcare organizations can understand their current situation, predict what will happen in the future – and take the actions that will enable them to succeed.