Strategies For Reducing Gap and Chase Time Frames

Strategies For Reducing Gap and Chase Time Frames

Author: Sponsored by HealthEdge September 1, 2022 Duration: 17:11
“It’s essential to accelerate the speed and time for gaps to identify them faster and proactively.” In the context of risk adjustment gaps, there are two overarching goals—to identify and accurately predict member conditions. To do this, health plans are reliant on the amount and quality of the data they have—primarily sourced from clinical and claims data. Plans need this data to produce intelligence and directives to providers on how best to proceed on a proactive care path. Due to CO...

Tune in to Current Trends For Payers for a grounded conversation about the forces reshaping health insurance and government-sponsored health plans. Sponsored by HealthEdge, this podcast moves beyond surface-level news to examine the operational backbone required to navigate today's complex landscape. Each episode features direct dialogue with industry experts who understand that real progress hinges on the infrastructure behind the scenes. You'll hear specific discussions on practical areas like leveraging BPaaS and new technology, strengthening data security, and refining core administration processes. We also delve into the critical human elements of care management and member engagement, alongside the metrics that matter, including risk adjustment and HEDIS and Star quality measures. Whether it's strategies for start-up growth or adapting to regulatory shifts, the focus remains on actionable insights that can lead to better business outcomes and, fundamentally, a higher quality of care for members. This is a resource for professionals seeking a deeper understanding of the systems and trends that define success in the payer space.
Author: Language: en-us Episodes: 44

Current Trends For Payers
Podcast Episodes
Digital Tactics For Member Engagement [not-audio_url] [/not-audio_url]

Duration: 10:34
“There’s a whole new range of possibilities for interacting with members through digital medium.” Marketing and communications in the Medicare Advantage space have evolved significantly in the past five years. Leaving be…
Next Generation Care Management Technology [not-audio_url] [/not-audio_url]

Duration: 21:15
"The only way to proactively identify and manage members with rising risk is by connecting care teams with real time data, analytics, and predictive models." In this episode, we explore the origins of care management, re…
Future of Stars [not-audio_url] [/not-audio_url]

Duration: 11:51
“Maintain the spirit of continual improvement across the organization. Even though there is uncertainty, CMS rewards heavily for improvement year over year.” 2021 was the first year that CMS shifted away from clinical me…