Welcome to the latest #DataRX Report, a weekly digest of interesting news and trending topics in the healthcare industry. Every Friday we're pulling together the best articles and insights to keep payors and providers informed, engaged and up to date on the headlines that are impacting the industry.
How do healthcare prices and use in the U.S. compare to other countries?
Despite having fewer office visits and shorter average hospital stays, the U.S. spends twice as much per person on healthcare than comparable countries. Read more to find out why.
Prescription for Payors
Quality Analytics, Risk Adjustment Tools Prep Payers for Success
KLAS found that quality reporting technologies continue to provide significant value to health plans of all sizes, but more so for smaller health plans that need to maximize the use of quality data. KLAS interviewed 84 health plans to determine which technology vendors were able to use to best support predictive analytics, risk adjustment and care quality intervention strategies. See which tools made the cut.
Missing the whole story: Behavioral health slow to adopt new pay models
Dr. Bozic’s practice now screens all patients for behavioral health conditions like anxiety and depression that could be contributing to pain prior to surgery. Since his practice made the change in 2016, they have reduced the number of orthopedic procedures by nearly 50%, while increasing the number of patients treated using different modalities. Find out what caused the switch in Dr. Bozic’s practice.
Insurers need to aim higher in targeting individuals for Medicare coverage
Health plans may be missing 20 to 40 percent of buyers who are not ready to sign up for Medicare coverage. Each Medicare Advantage member is worth about $11,000 in government premium reimbursement a year, so health plans that don’t change their marketing efforts could lose millions. Learn more about why health plans are missing buyers and what you can do differently to avoid the same mistakes.
Prescription for Providers
How Technology is Changing the Way We See Claims Data Analysis
Technological advances in healthcare have created a new perspective on data, including claims data. How prepared are you today for the healthcare of tomorrow?
Healthcare financial executives say that data interoperability must improve in the next three years to ensure the success of value-based care. The survey suggests that data sharing and interoperability issues have slowed down value-based care implementation. The adoption was projected to increase to 50% by 2018, but since 2015 the adoption has only grown from 12% to 24%. Find out why here.
One of the biggest challenges faced by healthcare executives is implementing value-based reimbursement. Overall, 56% of survey participants have either not yet started value-based payment initiatives or have only started a few initiatives. Find out the other challenges that executives at health systems, health plans and more are facing and what they expect from the near future.