Posts Tagged ‘Payer’

21 Predictions About Digital Health in 2021: Part 3

21 Predictions About Digital Health in 2021: Part III

In my previous posts, I looked at five macro-themes as well as five implications for hospitals. In this post, I want to focus on health plans and I’ve enlisted a co-author – Priyal Patel, Director of Health Plan CX at Perficient. These predictions for health plans are in light of the five themes I see […]

21 Predictions About Digital Health in 2021: Part 1

21 Predictions About Digital Health in 2021: Part I

I want to kick off 2021 by record on the changes we could see in the year ahead. While 2020 was “unprecedented,” with a Democrat-led federal government, I expect a lot to change healthcare. In fact, I’ve come up with 21 digital health predictions about 2021 – and this first set is focused on the broad market themes that will be felt by every player.  […]

Gartner ITxpo: Healthcare Payers Practical Digital Strategy

This year at Gartner IT Expo, Mandi Bishop, Senior Director and Analyst at Gartner, discussed the (mostly) hype-free plan to digital strategy.  She was very focused on a pragmatic approach.  Digital strategy to her is about optimization 2017 and 2018 was about “learning how to pedal”  2019 is about optimizing the motion.  Your digital business […]

2016 Connected Health Trends: Mega Merger Meets Member Experience

Creating the Connected Health trends report requires us to, among other things, mine through approximately 30,000 news coverage points per year. Circulating through the news in 2015 we found much on the topic of the new world of health insurance. Big news on this front was the industry consolidation under a string of potential mergers. […]

ACA and QRS – Shoot for the Stars Part 3

In ACA and QRS – Shoot for the Stars Part 1, I laid out the overall domains that are going to be used to score QHP plans offered through the Marketplace. In Part 2, I discussed some factors to consider for the data derived measures. In this blog, we will take a closer look at […]

HC Data

ACA and QRS – Shoot for the Stars Part 2

In ACA and QRS – Shoot for the Stars Part 1, I laid out the overall domains that are going to be used to score QHP plans offered through the Marketplace. In this blog, we will take a closer look at the data derived measures and what factors a QHP issuer should consider to achieve […]

Shoot for the stars!

ACA and QRS – Shoot for the stars! Part 1

Last month I posted “ACA’s Quality Rating System – An opportunity to gain market share”, which explained how QHP issuers can gain market share in the individual space. In that blog I mentioned that, as part of the Quality Rating System, plans offered on the Marketplace will receive a “Star” rating based on a 5 […]

Key Components to Collaboration between Payers and Providers

There is no doubt that the relationship between payers and providers is beginning to change, evolving from challenging and adversarial interactions into more collaborative exchanges. Kurt Allman, in his article in Healthcare Payer News this week, outlines 3 components for this relationship to be successful: Data collection “Payers collect a lot of data, which can […]

ACO: “If you build it, they will come”. Really? Not without a Payor Marketing Plan.

There is an ACO belief out there that “if you build it, they will come.” This belief is all based on honorable intentions for the patient and our communities. I just want to know what marketing plan and mobile application was used to contact all the baseball fans to go to Iowa in the movie […]