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Nurse Care Navigators' Value to the Self-Insured Health Plan

Nurse Care Navigators' Value to the Self-Insured Health Plan

To nurse care navigators, care management is exactly that – managing people with care. 

Mentoring clinicians and health plan professionals in learning how to guide and support people, wherever they are on the healthcare continuum, is my opportunity to pass on the secrets of population health management that so many wonderful professionals have shared with me.

Making a difference in people's health, while optimizing resources so that people and health plans get the desired results, is my idea of success.   

Data: Your Secret Weapon

Data: Your Secret Weapon

So, where are your hidden health-related cost centers? The same places they’ve always been: In plain sight. But for the lack of data transparency and integration of data tools and services, they remain elusive to spot. To uncover these cost centers, consider partnering with an analytics firm that not only can access data sets from everywhere patients access healthcare, but also combine them to create nuanced action lists.

Part 3 - The Cost of Dialysis and TPA and Medical Management Best Practices

Part 3 - The Cost of Dialysis and TPA and Medical Management Best Practices

Joy McGee-Cory - Senior Vice President, Advanced Plan for Health & Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health

Dialysis is big business.

In fact, according to the National Kidney Foundation®, “the annual Medicare spending to treat kidney failure in the U.S. is approximately $31 billion”.

Unlike the private-sector health plans, Medicare has a “Most Favored Nation” clause which means that providers cannot give a discount on billed charges to health plans or others that is greater than what they give to Medicare.

3 Quick Tips: Open Enrollment

3 Quick Tips: Open Enrollment

We are now in the midst of open enrollment season, which probably means you have been bombarded with health insurance plan options and are now ready or nearly ready to make a choice. Employer’s want to make sure you choose the plan that not only makes sense to you and your lifestyle, but to the company’s bottom line as well.

Here are a few quick tips to consider in choosing the health plan that works best for both parties.

Wellness: Better Data, Better Buy-in, Better Savings

Wellness: Better Data, Better Buy-in, Better Savings

Population health has many definitions which are often pigeonholed to fit a specific market or agenda. Its end goal, however, is unequivocal: to manage the health of a given patient population to improve outcomes and keep costs in check. And without recent advancements in health technology, data aggregation and data analysis, case managers, data scientists and benefits managers alike would not have the tools and actionable intelligence necessary to make lasting improvements to the populations they manage. Wellness programs would not improve a health plan or reduce costs as effectively if case managers were missing crucial data sets of the population. 

Prospecting, Networking and Lead-Gen at 2017 Hottest Shows: Employee Benefit News (EBN), America's Health Insurance Plans (AHIP) and International Foundation of Employee Benefit Plans (IFEBP)

Prospecting, Networking and Lead-Gen at 2017 Hottest Shows: Employee Benefit News (EBN), America's Health Insurance Plans (AHIP) and International Foundation of Employee Benefit Plans (IFEBP)

Every year a vast selection of healthcare conferences, expos and tradeshows are carried out throughout the country. Undeniably, some of these shows provide greater target-rich environments for prospect8ng and lead-gen, opportunities to showcase or advertise your product, and to establish your company or brand as a leader in the industry. Let’s look at some of the top shows for Population Health, Health Benefits, and Health Plans for 2017.

Lead Recycling: 3 Suggestions to Warm Up Cold Leads

Lead Recycling: 3 Suggestions to Warm Up Cold Leads

Inevitably, leads go cold - it’s their nature. And let’s face it, for many companies in niche B2B markets, good leads are a finite commodity. Because there are only so many leads available in such markets, recycling leads properly holds added importance. But there is a difference between a cold lead and a frozen one, and it’s important that you don’t push a cold lead into the frozen tundra of no-return by soliciting. Instead, if you follow these simple suggestions, chances are you’ll be able to warm up some of those cold leads.

20 Daily Minutes of Stress-Free Recreation in the Workforce and What It Could Mean to Employers

20 Daily Minutes of Stress-Free Recreation in the Workforce and What It Could Mean to Employers

In the above quote, TV powerhouse Oprah Winfrey, is discussing the positive effects of one type of wellness activity that has shown promise in the workplace: meditation and how it can promote a healthier, and compliant employee population.

The Benefits to Brokers, Self-Funded Employers of Leveraging Healthcare Quality Transparency

The Benefits to Brokers, Self-Funded Employers of Leveraging Healthcare Quality Transparency

When the success and shortcomings of these healthcare providers and facilities is made public, it helps to foster an arena for constant competitive improvement in the marketplace. Providers and facilities are made more accountable and healthcare consumers get the proverbial “bigger bang for their buck."

3 Effective Ways to Channel Your Nerves and Help Close a Deal

3 Effective Ways to Channel Your Nerves and Help Close a Deal

The best way to be confident is to be prepared. Below you will find a few helpful techniques to prepare for the important meetings in your life.