Mark Weber’s Post

Discover the latest insights shaping healthcare payer strategies! Our Health Plan Roundtable, hosted by Verato with Fierce Healthcare, featured industry experts from Change Healthcare / Optum, L.A. Care Health Plan, and The California Health Care Foundation Health Innovation Fund. Here are the top 5 takeaways. https://bit.ly/4atODrJ #Healthcare #DataManagement #hMDM

To build a more efficient and affordable healthcare system, we're diving deep into spending growth trends. For the first time, we’ve gathered three years of comprehensive data from all major Utah insurers—an ambitious effort made possible through strong partnerships. This data sheds light on overall trends in healthcare spending, highlighting key areas like primary care, behavioral health, pharmacy rebates, and payer investments in performance incentives. These insights will guide collaborative efforts aimed at addressing efficiency and making costs more affordable and sustainable, bringing us one step closer to a better healthcare system for Utahns.

Did you know? For over a decade, we've spearheaded the shift from pay for volume to pay for value in healthcare. With innovation, data, technology, and clinical expertise, we empower providers to thrive in value-based care delivery. Together, we've achieved: 💰 $232M in value-based revenue (2013-2022) 🏆 Ranked in the TOP 10 in the US (2020, 2021, 2022) for earned shared savings in the Medicare Shared Savings Program (MSSP) Partnering with us at Health Select Services means more lives impacted through value-based care. #HealthcarePartnerships #ValueBasedCare

Learn more about how you can take advantage of new reimbursement codes for implementation of a closed loop referral system for improving the health equity of your patients or customers.

Are you part of the nearly half of health plans struggling to navigate the complexities of value-based care? The Becker's Healthcare May Briefing provides insights into critical challenges such as network visibility and fragmented data—key issues pivotal to improving healthcare delivery. Notably, the survey reveals that 43% of payers are finding it difficult to implement coordinated care effectively, a fundamental component of value-based care. Just this week, we had a rewarding Joint Operating Committee meeting with one of our very large & long-time payvider partners. It was enlightening to hear their feedback on how WellSky solutions are successfully addressing these exact challenges and it was fantastic to discuss their impressive results in reducing readmissions and increasing transitional care management visits. If you're involved in healthcare management, or simply interested in the future of healthcare, understand these challenges is the first step towards crafting impactful solutions. Our meeting this week underscored the critical role of partnership in driving healthcare innovation. If you are experiencing similar challenges, don’t hesitate to reach out. Let’s explore how we can collaborate to achieve remarkable outcomes in your organization too. #HealthcareInnovation #ValueBasedCare #SuccessfulPartnerships 🔗 https://lnkd.in/gwweyyRF What are top barriers to executing value-based care?

As the Midwest winter unfolds, bringing its characteristic gray skies, we've found a silver lining in the keen interest from employers in ImagineMD's approach to advanced primary care. This enthusiasm serves as a welcome distraction and highlights a positive shift in the healthcare market towards primary care models that not only promise but deliver better care at more affordable costs. This shift, driven by innovative benefits consultants, is reshaping expectations and outcomes in healthcare. Contrary to skepticism, models like reference-based pricing are making a significant impact here. Together with our partners at ClaimDOC and Connor & Gallagher OneSource we're consistently demonstrating that such approaches are not only viable, but also highly effective in reducing healthcare costs. The success stories we're accumulating are a testament to the power of innovative healthcare solutions. For employers who are grappling with the relentless rise in healthcare expenses and seeking a way out, we offer a proven solution. Our model is designed to address and mitigate these challenges head-on. If the increasing cost of healthcare is a concern for you, we invite you to reach out. Let us show you how ImagineMD's model can make a difference for your organization.

Why is it so hard to get paid for healthcare? Challenges from payers, policymakers, providers, and patients have made the U.S. healthcare system one of the most complex in the world. "20 Reasons to Rethink Revenue Management", hosted by Jonathan Wiik, VP of Health Insights, provides an overview of the “20 reasons” why RCM needs to evolve into RM and a few ideas about how to rethink RM at your organization. Register for this on-demand webinar here: https://hubs.li/Q02F3NmS0

Value Based Healthcare transforming care delivery

I spent the earlier part of this week listening in on amazing panel discussions at TD Cowen Inc.’s 44th healthcare conference. Several insights stood out to me, one of them being the need for a more integrated approach to healthcare technology. It's become increasingly clear that for digital health solutions to be truly effective, they must not only offer innovative capabilities but also seamlessly integrate into the existing healthcare ecosystem. In the absence of this, we risk creating innovations that disrupt, rather than enhance the patient care continuum at worst, and at best innovations that fail to serve the very people we purport to. The efficacy of these solutions shouldn't solely be measured by their adoption rates but rather by their impact on reducing the necessity for invasive procedures. For instance, if the proliferation of digital MSK solutions does not correspond with a decrease in surgical interventions, one would wonder about the true effectiveness of these solutions. At least, I would hope we would ask those questions, taking a result-oriented approach in evaluating digital health solutions as opposed to merely aiming for technological advancement. With the Centers for Medicare & Medicaid Services (CMS) increasingly incorporating digital health solutions into their coverage, the emphasis on evidence-based outcomes and seamless integration with traditional care models has never been more critical. Special thanks to the amazing team at TD Cowen Inc. who put in a ton of work to make for an amazing experience!

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