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PPO Offerings to Plummet on 2016 Exchanges




Health Leaders Media


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  November 11, 2015 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

PPO Offerings to Plummet on 2016 Exchanges

Rene Letourneau, Senior Editor for HealthLeaders Media

Because consumers are more sensitive to price than to provider choice, payers are dropping preferred provider option plans in big numbers. They find it is more financially advantageous to offer plans that are based on narrow networks. >>>

 

Editor’s Picks

Cost of Value-Based Plans? Less Transparency

Value-based health plans can cut costs, but not without some challenges for payers, such as getting employers to exercise "network discipline" and helping consumers fully understand their payment structure. >>>

Two-Midnight Rule Saga Lacks Happy Ending

Two of the country’s largest hospital associations are applauding recent changes to the two-midnight rule, but they say the Medicare payment regulation for short hospital stays remains a work in progress. >>>

Everybody’s Getting Smarter About Healthcare Value

A raft of new tools that rely on massive amounts of data are helping employers and their employees demystify the healthcare value equation. Even small employers and their employees are benefiting. >>>

‘Precision Delivery’ Goes Well Beyond Patient Experience

Don’t think of it as "talking a little differently or changing the layout of a space." Precision delivery is not that. "It’s about radically approaching the entire treatment pathway differently," says a healthcare innovation leader. >>>

HCAHPS: Making a Difference While There’s Still Time

Leaders must address organizational deficiencies before 2% of Medicare payments will be at risk in 2017. >>>

CA Providers Report Smooth Transition to ICD-10

The primary concern had been that providers would have multiple claims bounced back from insurers due to errors or unspecified codes. And while that’s happened to some degree, it hasn’t created widespread problems. >>>

Leveraging Resources Through Clinical Innovations

“What has emerged, more and more, are atypical relationships that aren’t focused on ownership; they’re focused on leveraging the strength of our partners,” says one senior executive. >>>

LIVE Webcast

Webcast: Integrating Behavioral Health—Decreasing Costs and Improving Care

Date: November 17, 2015, 1:00–2:00 p.m. ET
In this expert webcast, hear how Carolinas HealthCare System developed a strategy to optimize resources to create a truly integrated model.
Register Today >>>


News Headlines

Arbitrators side with UPMC; Highmark must pay $ 188 million for cancer care

TribLive, November 11, 2015

America’s pregnancy-care paradox: Paying ever more for the same bad results

The Atlantic, November 11, 2015

Unnecessary care at MA hospitals identified

MassLive, November 11, 2015

Health systems dipping into the business of selling insurance

Kaiser Health News, November 10, 2015

Scrutiny falls on failed Obamacare co-op

The Hill, November 10, 2015

Judge: Horizon must explain why it excluded NJ hospital from new plans

NJ.com, November 10, 2015

Universal healthcare amendment qualifies for 2016 CO ballot

Denver Business Journal, November 10, 2015

Person-centered healthcare focuses on patient as individual

PostBulletin.com / Associated Press, November 9, 2015

OHSU made risky $ 50 million loan to health insurer

The Register-Guard / Associated Press, November 9, 2015

White House challenges 20 cities on Obamacare

The Hill, November 9, 2015

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Multimedia/Events

HealthLeaders Media LIVE from Sharp Healthcare: The Pod ED

Date: December 16, 2015 | 11:00–2:00PM ET
In this live e-conference, discover how Sharp Healthcare has realigned its staffing structure to increase flexibility and teamwork, resulting in decreased patient wait times and a greatly enhanced patient experience.
Register Today >>>

From HealthLeaders Magazine

Rural Healthcare and the Challenge of Population Health

The issues facing rural providers are significant, but leaders are creating ways to survive in the changing healthcare environment. >>>

 

Leveraging Resources Through Clinical Affiliations

 

HCAHPS: Making a Difference While There’s Still Time

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ICD-10 Service Offerings

Our ICD-10 Service Offerings

ICD-10 Physician Training

We feel that the practitioners will feel the overwhelming brunt of the impact of ICD-10; they will no longer be able to characterize their patients’ illnesses and conditions the way they have since medical school. Since the 1st Quarter of 2014, TCN has been offering provider ICD-10 training for its clients as a new service. The training is specialty-specific and offered in conjunction with ICD-10 Gap Analysis audits.

ICD-10 Gap Analysis

In the 1st Quarter of 2014, TCN introduced ICD-10 Gap Analysis as a new service. The analysis examines current medical records documentation, verifies the ICD-9 accuracy and provides the ICD-10 codes that would correlate to the documentation. TCN identifies current diagnostic documentation deficiencies that need to be addressed in order to support accurate ICD-10 coding. Once more, we aim to combine the results from the Gap Analysis with the Physician Documentation training sessions.

The post ICD-10 Service Offerings appeared first on The Coding Network.

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