Spotlight July 2020 Archives - Page 3 of 3

Essentials Of Health Care Reimbursement: Understanding Payer Perspectives & Approaches To Value- Based Purchasing (Part 2 Of 5)

Video October 8, 2018

In this presentation Jason Swartz, RPh, MBA, Managed Market Liaison on the Otsuka Pharmaceutical Development & Commercialization, Inc. Field Medical Affairs Team, provides an overview of payer perspectives and approaches… Read More

Essentials Of Health Care Reimbursement: The Evolution Of Health Insurance, Managed Care, & Value- Based Reimbursement (Part 1 Of 5)

Video October 8, 2018

In this presentation Jane Guo, PharmD, MBA, Managed Market Liaison on the Otsuka Pharmaceutical Development & Commercialization, Inc. Field Medical Affairs Team, provides an introduction to health care reimbursement, including… Read More

Four Ps For Leading A VBR Evolution (Or Any Change)

Article September 4, 2018

Be present. Be proactive. Be positive. Be prepared These are the “four Ps” of “change ready” executives according to Kimberly Pack, in her recent Forbes article, “How To Lead In… Read More

The Future Has Arrived For VBR

Article July 19, 2018

“I can’t think of a recent conversation at Anthem that didn’t include value-based care. But, we can’t do value-based payment on an island. All insurance companies are interested in discussing… Read More

VBR Jumping From Hospital-Centric ACOs To Community-Based Players

Article July 13, 2018

The Centers for Medicare and Medicaid Services (CMS) surprised me with their recent announcement of plans for direct value-based reimbursement of provider organizations—a direct provider organization contracting (DPC) model for… Read More

Crawl, Walk, Run To VBR

Article June 18, 2018

Payers and health plans are pushing for reimbursement models that move away from fee-for-service and move to paying for “value.” At a recent institute, our health plan faculty members reiterated… Read More

Consumer Transparency & VBR Changing Best Practice EHR Functionality

Article May 14, 2018

When you talk to many clinical professionals, they talk about their electronic health record (EHR) as something that information “goes in” but rarely comes out of—an enterprise-wide electronic file box… Read More

Pennsylvania Medicaid Moving To Value-Based Reimbursement For Behavioral Health

Article March 22, 2018

On January 1, 2018, the Pennsylvania Medicaid program implemented new requirements for the value-based purchasing (VBP) initiative for the behavioral health HealthChoices program. The requirements, which apply to the counties… Read More

Getting Past The Bumps In The Road To Value-Based Reimbursement

Article January 11, 2018

Based on my work the past six months, I would describe the “path” to value-based reimbursement (VBR) for provider organizations as bumpy. I hear lots of frustrations from health plan… Read More

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