Employers typically aim to hold health insurance investment costs down while also enhancing employee health programs to experience improved recruitment/retention, employee productivity and overall satisfaction.
This post originally appeared on SmartBrief's Leadership Blog.
It seems simple. Health insurers receive a bill for medical care and make the payment. Yet, payment integrity has long posed a challenge in health care. Although health plans have made substantial progress, in 2014, they were still over- or under-paying claims 9.5% of the time. Consequences include health care provider abrasion, wasted spending and investment in resources to recoup excess payments.
During a recent webinar entitled “Key Levers to Manage The ‘Risk’ in Your Risk-based Contracts,” Rose Higgins, President, SCIO Health Analytics, described how healthcare organizations can succeed under value-based care arrangements by identifying/closing care gaps, implementing population health programs and optimizing network performance. And, Linda Pantovic, Director of Compliance & Risk Adjustment at Scripps Health Plan Services, offered an up-close look at how Scripps is mitigating risk across their organization by focusing on key documentation and coding best practices.
Electronic communication is all pervasive in today’s world. Not surprisingly, healthcare organizations and their patients/ members want to communicate via smartphones and other mobile devices. What they don’t want, however, is a lot of electronic noise.