Assessing ACO Performance
As more health plans utilize Accountable Care Organizations (i.e., ACOs) as part of their network operations, ACO performance [...]
Case Study in Problem Solving: The Case of the Uncompetitive ACO
I love a good challenge—particularly one that doesn’t have a clear path forward and seems daunting from the [...]
Republican Health Care Reform and Its Impact on Health Insurers
Presidential Candidate Donald Trump promised to repeal and replace the Affordable Care Act (i.e., ACA or Obamacare). “On [...]
Medical IBNR; Traditional Approach with a New Twist
Medical claims reserving has remained relatively unchanged for decades. The traditional approach to calculating IBNR reserves, that will [...]
Annual ACA Check Up: Stabilizing the New Marketplaces
Recognized as a firm deeply engaged in the regulatory and technical aspects of the Patient Protection and Affordable [...]
Implementing Value-Based Reimbursement – Pathway to Success
A health plan’s transition from fee-for-service to value-based reimbursement (i.e., VBR) can be very challenging. This article provides [...]
Actionable vs. Actuarial Data
How good medical cost data can help you shape future results Quality medical cost data can be hard [...]
Measuring Hospital Savings / Waste
As part of its ongoing health care research and consulting activities, Axene Health Partners, LLC (i.e., AHP) [...]
Population Based Reimbursement: Optimizing A Primary Care Network
Primary Care Networks (PCNs) have been used for many years to provide clinical oversight of patient care and [...]
Population Based Reimbursement: Building an Effective Reimbursement System
As more and more health systems consider population based reimbursement, pursue the development of ACOs, and consider value [...]