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Check out the latest sponsored content from key thought leaders and industry-leading solutions providers.

Articles

Smarter Provider Network Monitoring for Blues

Good enough provider network compliance monitoring is no longer good enough. You need faster, more accurate insight into provider eligibility for MA and Medicaid network participation. You need more reliable provider data and secure integrations. Find out how smarter provider network monitoring can deliver better business value.

Sponsored content by Provider Trust.

Innovating How We Communicate with Seniors, Powering Digital Outreach through learning

As the world continues to move online, health plans must adapt their marketing and communications strategy to reach their current and prospective member population via digital channels. Innovations in machine learning and marketing technology enables health plans to interact with the senior population in a targeted and meaningful way for increased engagement and enrollment.

Sponsored content by Advantasure.

AIM Clinical Guidelines: Translating Medical Evidence and Real-Life Application Into Best Practices

Go behind the scenes with AIM physician leaders to explore how we translate medical evidence and real-life application into best practices that ensure a high standard of care for health plan members.

Sponsored content by AIM Specialty Health.

Why Today’s Approach to Behavioral Health is Failing 

Today’s “check-the-box” approach to behavioral health is failing as 50% of patients referred to a specialist don’t make their first appointment. See the difference in a “connect-the-dots” approach to care that keeps the individual firmly at the center of mental and physical health in this helpful infographic from NeuroFlow.

Sponsored content by NeuroFlow.

Navigating a Path to Better Outcomes

Community pharmacists are trusted local healthcare providers, accessible and well-positioned to delivered needed services in a timely manner. For health plans, pharmacists offer an invaluable connection to patients, interfacing with members on a monthly basis. In the last two years, EMS has touched more than 41 million patients by supporting the largest integrated network of community pharmacists. Learn how to bridge the gap between health plans and members by optimizing care coordination with community pharmacies.

 

Sponsored content by Enhanced Medication Services.

The Road to Telemedicine: Are We There Yet?

Over the past year, telemedicine has taken off but is it the golden ticket to improve healthcare access? This four-part series, written by industry expert Dr. Bill Lewis supported by Quest Analytics, explores telemedicine's current status, its historical journey, and what's next on the horizon. 

 

Sponsored content by Quest Analytics.

Empowering Choice: Health Insurance Products Meet Consumerism

Over the past year, demand for consumer choice has increased in every industry creating the need to accelerate consumerization in healthcare. For payers, this market shift creates an opportunity to  empower choice by designing products that cultivate a financially-sound, consumer-centric business model. Capitalizing on this shift opens up market expansion opportunities as payers establish a strong foundation in their business that embraces consumerism. Learn more about how health plans need to craft innovative product strategies to meet market demand including a perspective on the future of health plan product from a notable Payer IT Research Analyst. 

 

Sponsored content by HighRoads.

Disrupting the "Black Box" Model of Claim Auditing

Disrupt the very ambiguous concept of Black Box claim reviews and address the convoluted process for healthcare payers with logical solutions.

 

Sponsored content by ClaimLogiq.

Four Capabilities of an Effective Customer Analytics Solution in Health Insurance

Today, the consumerism of healthcare and a shift toward value-based care indicate that health insurance members expect transparency and knowledge from their coverage providers. To navigate changing member expectations, insurers should focus on the member experience and the elements that impact it.
By analyzing the data that already exists across customer feedback and interaction channels, organizations can monitor health outcomes, identify and prioritize improvements, reduce costs, and increase retention.

To help these companies achieve their member experience objectives, Clarabridge offers an advanced analytics solution that’s equipped to deliver tangible value and direct results. This eBook explores four ways that Clarabridge enables health insurance companies to meet member expectations including how to:

• Meet the Demand for Value-Based Care
• Address the Role of Consumerism in Healthcare
• Maintain Regulatory Compliance and Minimize Complaints
• Increase Contact Center Efficiency

 

Sponsored content by Clarabridge.

White Paper: 5 MSK Trends & 5 MSK Care Strategies for 2021

The pandemic caused a fundamental shift in the way employers deliver healthcare benefits in 2020. What are some of the new musculoskeletal (MSK) trends during COVID? Based on these trends, how can employers redefine back and joint pain care post-COVID and optimize medical spend in 2021?
In this white paper, you’ll learn:

1. 5 MSK trends during COVID & beyond
2. 5 innovative MSK benefit strategies to redefine MSK care in 2021

Sponsored content by Hinge Health.

Trends in Healthcare Payments Eleventh Annual Report: 2020

Every year, the Trends in Healthcare Payments Annual Report is distributed to start a conversation in the healthcare payments industry with the hope of being a catalyst for change and improvement. In 2020, the conversation and change needed are unlike any seen in the report’s decade plus history. The COVID-19 pandemic will have far-reaching impacts on the administrative side of healthcare, and all stakeholders experienced rapid change. All stakeholders – consumers, providers and payers alike – must prioritize these trends that create opportunity for future growth, including streamlined payments, to accelerate recovery.
 

Sponsored content by InstaMed, a J.P. Morgan Company.

Healing the Healthcare System in a Time of Crisis 

How Mercy Health’s mission-driven approach puts them at the forefront of healthcare innovation by providing the highest-possible level of patient personalization.
 

Sponsored content by Adobe.

Identifying High-Risk Patients & Engaging Providers With a Value-Based Model

Read how your peers at Horizon BCBSNJ are applying a layered approach to value-based care by incorporating population health management, quality analytics, and care planning and management to achieve 400 average annual hours saved per full time employee. 
 

Sponsored content by Cadalys.

Health Savings Accounts

2021 Fact Sheet.
 

Sponsored content by Fidelity Investments.

Legato Health Technologies: Where Business and Technology Meet to Revolutionize Healthcare

Legato Health Technologies is focused on the strategic use of technology to add capabilities and drive innovation. This article showcases how Legato’s expertise in the area of automation and machine learning was effectively utilized to enhance client operations, save time and improve costs.
 

Sponsored content by Legato Health.

Three ways Health Plans can bring patient insights into focus 

Fortunately, there are new and innovative approaches to care management that leverage health IT tools.
 

Sponsored content by Surescripts.

Misguided from the start: The critical impact of radiology on healthcare's highest-spend categories

Misdiagnoses in healthcare are both more common and more costly than patients and payers have previously appreciated. Fortunately, new approaches are proving that common errors that lead to misdiagnoses can be reduced—if their causes are addressed head-on.
 

Sponsored content by Covera Health.

Vida Polychronic Care Platform: integrated care for physical + mental health

Point solutions miss the point — chronic conditions never stand alone. Our platform treats the whole person — and a whole population — by bringing together mental and physical healthcare through the best of technology and the human touch of therapists and coaches.

Sponsored content by Vida Health.

Relationship between eGFR Decline and Hard Outcomes after Kidney Transplants

This publication concluded that greater than 30% decline in estimate glomerular filtration rate (eGFR) between years 1 and 3 after kidney transplant. This is common and strongly associated with risks of subsequent death and death–censored graft failure. AlloSure donor-derived cell free DNA illustrates a more accurate method to eGFR from serum creatinine.

Sponsored content by CareDx.

How Health Plans Are Using a Phased Approach to Value-Based Care

Savvy health plans are building provider engagement with a phased approach to value-based care. To read four health plans examples, download the white paper, How Health Plans Are Using a Phased Approach to Value-Based Care. 

Sponsored content by Geneia.

A Different Perspective to Core Administrative Platforms; Relevance for Evolving Payer Challenges

Now more than ever, the challenges brought about by the pandemic have tested healthcare payers speed-to-market delivery of consumer-oriented products and services. Payers must have a full end-to-end solution that includes:

• Increased footprint in self-service portals
• Population healthcare management
• Value-based benefit design
• Access to virtual visits in a secure manner
• Meaningful analytics

This white paper outlines market requirements and specific capabilities necessary for an experienced or emerging payer to understand the key factors for identifying which health payer platform features are the best match for their needs.

Sponsored content by Companion Data Services, LLC.

CX Blueprint

Healthcare is vast, it’s unique, and it’s complex — and it has its own set of rules and standards. But, one thing is certain — at the center of the healthcare ecosystem should always be consumers and their experiences. At Zipari, this is at the heart of everything we do. We have pioneered digital CX in healthcare to help payers achieve the most impactful consumer experiences for their members, providers, employers, and brokers.

Sponsored content by Zipari.

How to Differentiate Yourself in an Increasingly Value-Focused Ecosystem

Learn 6 proven best practices for forward-thinking health plans, and how you can start focusing on prospective value instead of retrospective cost. Gain insight into how you can ensure your ASO value proposition resonates with employers—and stands out from the competition. Bonus feature: How one national insurer differentiated on value to achieve savings and win & retain ASO business.

Sponsored content by Certilytics.