Posts Tagged ‘prior authorizations’

Infographic: Understanding Prior Authorizations

May 31st, 2019 by Melanie Matthews

Designed as a safety and cost-savings measure, prior authorizations by health insurance companies determine if they will cover a prescribed procedure, service or medication. While the process is intended for safety and cost-savings, they can delay patient treatment and lead to negative patient outcomes, according to a new infographic by Infinx.

The infographic looks at why prior authorizations are needed as well as their impact on patients, providers and the healthcare industry in general.

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS SuccessA laser focus on population health interventions and processes can generate immediate revenue streams for fledgling accountable care organizations that support the hard work of creating a sustainable ACO business model. This population health priority has proven a lucrative strategy for Caravan Health, whose 23 ACO clients saved more than $26 million across approximately 250,000 covered lives in 2016 under the Medicare Shared Savings Program (MSSP).

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS Success examines Caravan Health’s population health-focused approach for ACOs and its potential for positioning ACOs for success under MSSP and MACRA’s Merit-based Incentive Payment System (MIPS).

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Infographic: Relieving the Burden of Prior Authorizations

June 27th, 2018 by Melanie Matthews

Prior authorizations are necessary and unavoidable, costing healthcare organizations time and money and contributing to physician burnout, according to a new infographic by athenahealth, Inc.

The infographic provides options for managing prior authorizations and best practices for handling them.

Proactive Care Management in a Top-Performing ACO: Closing Quality and Care Gaps in High-Risk, High-Utilization PopulationsAs one of 2016’s top 10 performing MSSP accountable care organizations, UT Southwestern Accountable Care Network (UTSACN) generated nearly $17.5 million in shared savings.

Proactive Care Management in a Top-Performing ACO: Closing Quality and Care Gaps in High-Risk, High-Utilization Populations divulges some of the secrets behind UTSACN’s success in the Medicare Shared Savings Program (MSSP) for ACOs. Winning strategies of the UTSACN ACO include a commitment to data analytics to inform programming and improve utilization and quality as well as holding its healthcare providers accountable for clinical and fiscal decisions. Click here for more information.

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Have an infographic you’d like featured on our site? Click here for submission guidelines.