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There are 5 item(s) tagged with the keyword "Network".

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Targeting Doctor Shopping, Prescription Abuse With Analytics: Population Health Lessons from the Front Lines

In recent years insurers and brokers have had to adapt to rising healthcare costs without much say in the matter. This is in part because brokers and employee benefit managers often have too much on their plates to sleuth out and address the costliest “blind spots” in health coverage. This has left many struggling to find a way to remain competitive in an increasingly technology-driven industry.

Tags: Doctor Shopping, Prescription Abuse, Population Health, Healthcare, Data, Data Analysis, Health Insurers, Benefits Design, Population Health Management, Member Population, PHM, Health Events, Cut Costs, Health Events, Prevention, Brokers, Employee Benefit Managers, Health Insurance Brokers, Predictive Analytics, Actionable Insight, Health Plan, Health Plan Member, Doctors, Duplicate Therapy, Poindexter, Predictive Modeling, Healthcare Costs, Self-Insured, Employer, Pharmacy, Rx, Data Analytics, RFP, Network, Data Reports, Lab Costs, Technology, Chronic Pain, High Cost Claimants, Addiction, Opioid, Cost Centers, Behavior, Behavioral Analytics, Phenotyping
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.

Tags: Open Enrollment, Health Insurance, Health Plan, President-Elect, Healthcare, Policies, Administration, Wellness Program, Benefits Plan, Wearables, Discounts, Premiums, Physical Examination, Healthcare Costs, Deductibles, Stop Loss, Co-Insurance, Chronic Condition, Primary Care Physician, Network, Generic, Brand Drugs, HR Department, Meditation
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.

Tags: Data, Analytics, Population Health Management, Metabolic Syndrome, Chronic Condition, Intervention, Hospitalization, High Level, Trend Analysis, Individual Metrics, Healthcare Cost Curve, Health-Related, Cost Centers, Access, Transparency, Patients, Healthcare, Action, Medications, Employees, Non-formulated, Specialty Drug, Cost Saving, PCP, Primary Care Physician, Behavior, Pharmacy, Specialists, Network, Employee, Chronic Care, Reduce Cost, Preventable, Emergency, Inpatient, ER, Urgent Care, Copay, Health Plan, Bottom Line, Utilization, Predict, Consult, Drill Down, Follow Up, Biometric, Outliers, High Risk, Wellness Program, Medicine, Case Manager, Patient Population, Poindexter, Advanced Plan for Health, Predictive Modeling
Informed and Healthy Employees Make for Healthy Benefit Plans

Employers have found that it is not only the catastrophic conditions inherent in the high risk employee cohort, but also individuals who have reached the high risk group as a result of many different health issues (co-morbidities), lacking a personal physician, and inappropriately using the hospital or emergent care services for preventable problems. Plan members who are bouncing from one physician to another, because they may not understand what they need or where to obtain the requisite services, also present opportunities to improve clinical and financial metrics.

 

Tags: Population Health Management, Healthcare, Wellness, Health Status, Health, Behavior, Education, Support, Employers, Health Plan, Nurse Care, PHM, Healthcare System, Illness, Diagnose, Cancer, Chronic Condition, Diabetes, Dementia, Network, Treatment Plan, Provider, Medicines, Treatments, Physician, Health Plan Members, Clinical Metrics, Financial Metrics, Health Awareness, Data Analytics, Predictive Analytics Engine, Costs
Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations

Dr. Rutkowski is a Medical Management Professional with more than twenty years of experience in operations, integrated medical management for Medicare and self-insured employers, hospital and managed care quality, and employee development.

Tags: Medical, Management, Professional, Integrated Medical Management, Medicare, Self-Insured, Employers, Hospitals, Managed Care Quality, Employee Development, Strategic Business, Health, Systems, Consulting, Organizational Development, Leadership, Team Building, Network, Risk, Clinical, Credentialing, Reinsurance, Regulatory Compliance, Wellness, Disease Management, Utilization, MedisGroups, Outcomes, Design, Development, Vice President, Nursing, University of Florida, Doctor, Education, Indiana University, Registered Nurse, American Journal of Nursing, Chamber of Commerce, Health Care Excel, Operations, Masters of Science

Displaying: 1 - 5 of 5