RECORDED WEBINAR: Mandatory CMS TEAM: Using Simulated Episodes of Care to Evaluate Risk & Opportunity

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 Download Slides CMS’ new mandatory episode-based payment model, the Transforming Episode Accountability Model (TEAM), is scheduled to begin Jan. 1, 2026, affecting reimbursement for five high-volume surgical procedures. Data is key for hospitals to prepare for TEAM and to understand how markets will be impacted throughout the nation. Key takeaways: Join our Mandatory CMS…

RECORDED WEBINAR: Transforming Care Management with AI – Risk Stratification & Predictive Modeling for Better Health Outcomes

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 Download Slides Exploring how AI-driven analytics can transform care management through focus on Population Health Risk Stratification and Predictive Modeling. We will discuss how advanced data science techniques using Electronic Health Records (EHR) and claims data provides us an opportunity to perform risk stratification to help identify high-risk populations, predict adverse health events, and…

RECORDED WEBINAR: Unpacking the mandatory CMS TEAM model: Overcome new rules & challenges

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 Download Slides In August, CMS introduced a new mandatory model: Transforming Episode Accountability Model (TEAM), a bundled payment initiative affecting reimbursement for five key surgical procedures. Key Takeaways:Join our webinar, Unpacking the mandatory CMS TEAM model: Overcome new rules & challenges, on Sept. 24, at 1 p.m. EST. During this one-hour session, you’ll learn:…

RECORDED WEBINAR: The Medicare Advantage HEDIS™ and Star measures review

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 Download Slides This deep dive covers everything you need to know about these measures. Are you struggling to understand Medicare Advantage quality measures and meet your MSO and/or payer requirements? This webinar will cover what you need to know and offer strategies to support you on your path to success. You’ll learn how to…

Value-Based Care and Fee-For-Service: What’s the Difference?

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In an effort to improve care quality and lower costs, the healthcare industry has been working on shifting from fee-for-service to value-based care delivery. The two models differ in the way providers are reimbursed for the care they provide by rewarding them service-by-service or based on overall quality and patient outcomes. In the following article, HealthPayerIntelligence breaks…

Common Utilization Measures That Impact Value-Based Care Efforts

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Quality and quantity have a nuanced relationship in the healthcare system: put simply, payers want to reduce members’ quantity of low-value services while increasing the number of services that produce better quality care. As a result, utilization measures that track the use of high- and low-value care are critical to a value-based structure. The triple aims of value-based…

HEDIS Changes Reflect Focus on Health Equity

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The nonprofit National Committee for Quality Assurance has revised quality measures for health plans in the Healthcare Effectiveness Data and Information Set (HEDIS) for measurement year 2023. NCQA has added race/ethnicity stratifications and made revisions to acknowledge and affirm member gender identity. Collecting race and ethnicity data is key to improving health disparities, NCQA said….

RECORDED WEBINAR: The True Story of How One Health System moved the Patient Experience Needle

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Download Slides Sometimes you just need a little ‘nudge’. Prospect Medical Systems has initiated a digital outreach strategy to positively impact member satisfaction and improve CAHPS scores. In doing so, they learned first hand how their member communications were operating in departmental silos, with each outreaching to members as needed but detached from the member…

Using a Commercial Shared Savings Program to Reduce Care Costs

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A commercial shared savings program equipped with the right leadership, clinical insights, and comprehensive care strategies can help payers save significantly on healthcare costs and produce exceptional beneficiary outcomes. In order to achieve these results, Blue Cross Blue Shield of Arizona (BCBSAZ) has developed a shared savings program with ACO Partner, a Change Healthcare company….