Pressure to develop new payment models and innovative plan designs is rapidly changing the face of health insurance. Health plans that fail to embrace health information exchanges (HIEs) — which are a cornerstone of industry reform — are likely to be left in the dust. Managing benefits soon will come down to real-time decisions made with clinical data across the spectrum of a patient’s care. But determining exactly how to incorporate HIEs is a major challenge for health insurers and providers.
Health insurers are beginning to see HIEs as essential tools that can help them build new payment models and forge provider alliances that reduce waste and incent physicians to keep members out of the hospital.
For insurers, HIEs offer the potential for greater connectivity with network providers. But while HIEs and other efficiency-improving technologies can create value by reducing utilization, such as duplicate tests and unnecessary treatments, such reductions translate to lost revenue for providers, so health plans must tread carefully.
During the webinar,
• How insurers can transition from claims-based data to HIEs when measuring provider quality.
• How to use HIEs to build new payment models and forge provider alliances that reduce waste and incent caregivers.
• The pros and cons of buying or building an HIE system, or contracting with an existing one.
• How companies such as Aetna and
• How insurers can use HIEs to integrate financial risk underwriting with clinical care management.
• How to use HIEs to complete Healthcare Effectiveness Data and Information Set (HEDIS) requirements.
Visit http://aishealth.com/marketplace/c2m22_062612 for more details and registration information.
AIS develops highly targeted news, data and strategies for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. Learn more at http://www.AISHealth.com.
Read the full story at http://www.prweb.com/releases/2012/6/prweb9515088.htm
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