Utilization Profiling for Care Management (and Profitability!)
Although there are many variables influencing healthcare costs, the most important are unit cost and utilization. Unit cost [...]
A Provider’s Primer for Shared Savings Arrangements
Shared savings arrangements have increased in popularity as healthcare shifts towards value-based care. In its most basic form, [...]
Value-Based Care’s Impact on Healthcare Mergers & Acquisitions
Provider reimbursement models are evolving as the healthcare system attempts to combat rapidly rising healthcare costs. A [...]
An Actuarial Guide to Medicare Direct Contracting
On April 1, 2021, the Global and Professional Direct Contracting (GPDC) Model began its first performance year. Effective [...]
Physician Fee Schedules: How Do They Compare and What’s Next?
When you visit your doctor, you will typically be charged a small copay, coinsurance amount, or may not [...]
When is the Right Time to Move to Risk Sharing?
With all of the discussion today about Alternate Payment Methods, Value Based Reimbursement, MACRA, MIPS, etc., talk very [...]