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Payment Evolution
How Do You Compare? Leverage Data to Optimize Your Payer Positioning and Value-Based Care Performance
Providers are being asked to take on more financial risk by payers, moving from fee-for-service to value-based care payment models across all lines of business. Following Medicare’s goal of having 100% of traditional Medicare beneficiaries in an accountable care relationship by 2030, other payers such as Medicare Advantage, commercial and Medicaid plans are also placing responsibility on pro...
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Payment Evolution
Five Observations From 2023 Fourth Quarter Earnings Calls: Legacy Payers and VBC Market Entrants
As part of Vizient/Sg2’s value-based care (VBC) and payer-provider alignment analysis and market research, we review the quarterly earnings calls from a subset of publicly traded legacy payers and VBC-focused entrants. The summary is designed to highlight emerging trends and dynamics in these closely related industries, especially as they tie to VBC. The following post draws from recently re...
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Digital Health
Key Takeaways From the HIMSS 2024 Conference
Seeking to outrun the growing shadow of newer conferences like HLTH and ViVE, the 2024 HIMSS Global Health Conference & Exhibition brought together roughly 30,000 attendees to discuss the latest in health care IT trends and product developments. The topics covered were nothing unexpected: AI dominated session headlines and vendor pitches, but there was still plenty of attention spent on other ...
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Payment Evolution
Value-Based Care Disrupters: What Can Health Systems Learn From Their Successes and Failures?
Economic forces such as rising costs, labor shortages, consumerism and demographic shifts are driving the need for change and innovation. The health care industry is not immune to these forces. In fact, health care is further complicated by nonsustainable reimbursement models, digital disruption, an increasingly “sicker” population and rapid changes in ownership models. This has led to...
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Payment Evolution
Five Observations From 2023 Third Quarter Earnings Calls: Legacy Payers and VBC Market Entrants
As part of Sg2’s value-based care (VBC) analysis and market research, we review the quarterly earnings calls from a subset of publicly traded legacy payers and VBC-focused entrants. The summary is designed to highlight emerging trends and dynamics in these closely related industries, especially as they tie to VBC. The following post draws from recently released earnings call transcripts fro...
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Payment Evolution
It’s Time to Refresh Your Value-Based Care Strategy: Six Trends to Consider
Most health care systems by now have defined their strategy for addressing value-based care (VBC)—even if that strategy is to minimize their involvement in VBC arrangements. To stay relevant, strategies require regular evaluation to consider current trends and market conditions. This is especially true with VBC, since VBC touches every aspect of health care financing and delivery. Any market...
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Health Equity
Using Social Drivers of Health to Reduce Admissions for Diabetes Patients, Among Others
As healthcare organizations face unprecedented workforce and financial challenges, much emphasis is placed on capacity constraints with rising acuity and regulatory scrutiny as powerful underlying trends. Many systems struggle to find the right balance between their margins and their missions, and often see their capacity realities outweigh their community's health equity needs. Or, if they've lau...
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Payment Evolution
Partner or Go-it-Alone? Considerations for Working With a Value-Based Care Enablement Company
Health care is dynamic, and external market forces are increasingly volatile. Health systems are beginning to see margins stabilize, but long-term financial strength continues to be top of mind for health care leaders throughout the nation. One way systems can look to diversify financial performance is through enhancing their value-based care (VBC) strategy, but how to best do that may take on man...
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In Memoriam: Henry Soch
It is with great sorrow that we share the passing of Sg2 former imaging expert and beloved friend and mentor Henry Soch on November 16, 2023. He was a leader of Sg2’s clinical technology research, analyzing the impact of medical technologies on care delivery and collaborating with organizations to develop operational strategies. “I am among the many at Sg2 (and in health care in...
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Disruption
Facing the Game Changers: A New Era of Health Care Access
Legacy healthcare, a domain once perceived as an unassailable fortress, now finds itself besieged by unconventional adversaries. Retail powerhouses, tech titans, venture capitalists and insurance providers are collectively reshaping the healthcare terrain. The expansion of these 'game changers,' propelled by mergers and acquisitions (M&As), appears limitless, showing no regard for geographical...