Blog Posts

Capitalize on chaos: How to zero in on opportunity with population health

Mary Kay Plona Mary Kay Plona

“In the midst of chaos, there is also opportunity.” –Sun-Tzu Healthcare is full of chaos today: regulatory reform, political uncertainty, rapid technological change, vast amounts of clinical and financial data, and the growth of alternative payment models. Yet the quote above is both powerful and true: chaos does breed opportunity. What healthcare organizations need to


[WEBINAR] Population Health Issues and Opportunities: Spotlighting High Blood Pressure

Don Casey Don Casey

Impacting nearly half of all adults in the U.S., more than 100 million Americans have high blood pressure, according to recent estimates from the American Heart Association. In addition to high costs of care, consequences of inadequate treatment include risk of cardiovascular disease, stroke, renal failure and early death. Health system teams committed to improving


HBR Idea Watch: Finding the Perfect Pace for Product Launches

Ellen Dalton Ellen Dalton
EVP, Chief Marketing & Customer Experience Officer

What’s the optimal number of new products to launch in a given time frame? Does it matter whether the launches are spread out or bunched together, and whether a new product is similar to the rest of a company’s portfolio? To answer those questions, researchers studied 1,904 new drugs launched by U.S. pharmaceutical firms from


From program to business model: Using population health management to drive value-based care

Tamara Cull Tamara Cull
Senior Vice President, Aveus

What does “population health management” really mean? Many healthcare organizations think of population health management in terms of condition-specific programs designed to improve care and reduce costs for at-risk patients. Medicare’s bundled payment initiatives for joint replacements and cardiac care may come to mind, for instance. Very often organizations launch programs like these in response


ED Utilization: Addressing the Ongoing Industry Challenge

Ian Chuang, MD Ian Chuang, MD
SVP, Chief Analytics Officer

The appropriate utilization of an emergency department (ED) as a place of health care services remains an ongoing industry challenge. The reasons and circumstances for this persistent issue are varied for consumers, providers and payers. The appropriateness of an ED visit inferred from administrative claims data after the fact is often too categorical in nature,


Next-generation Care Management: The Importance of Data Collection and Member Engagement

Pam Brooks Pam Brooks
Senior Director, Care Management Applications

What if you could build care plans for your members that were tailored to the whole person, instead of just a specific clinical condition or two? What if you could get members more engaged in their overall health by asking them fewer — but more targeted — questions that resonate with their personal situations? What


Strengthen your network through automated appeals and grievances

Debbie Hill Debbie Hill
Sr. Director, UM Product Applications

Most health plans with Medicare Advantage, Medicaid and dual eligible populations know they need to be prepared to respond quickly to CMS audit requests – including a full account of appeals and grievances history, activity and status. After all, two of five Star Ratings factors can be tied to appeals and grievances processes, and noncompliance