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Jul 1, 2020

The role of efficient contact tracing in 2020 and beyond

According to a recent article in The Guardian, “As soon as a vaccine is approved, it’s going to be needed in vast quantities. In a best-case scenario, mass manufacture probably won’t arrive before 2021 – and many of the organisations in the Covid-19 vaccine race simply don’t have the necessary production capacity.”

Jun 22, 2020

Four ways real-time benefit supports value-based care

In a post-COVID world, it will be more important than ever for health plans to embrace a value-based care transformation that helps to achieve the quadruple aim (1. cost control, 2. improved clinical outcomes, 3. member satisfaction, 4. provider satisfaction). Health IT is at the heart of this transformation, but transformative technologies and systems such as artificial intelligence, machine learning and interoperability are still catching up with value-based goals and aspirations. 

Jun 16, 2020

As Value-Based Care accelerates, plans must master analytic-based compensation

Recently, I began looking for a cardiologist only to learn there are over 390 of them in my city. I thought about how I could determine who would provide the most value for my dollar. Should I look at who delivers the best outcomes, the highest efficiency and the most satisfied patients? And, on the flip side of this coin, shouldn’t providers who produce better health value be paid more than those who don’t?

Jun 15, 2020

Managing through disruptive events with excellence: A new option for health plans

Members depend on you for safe access to medical and pharmacy care no matter what is going on in the world, so health plans like yours are in the business of dealing with unexpected events. Even so, disruptions can strain your teams and resources despite comprehensive contingency planning. The COVID-19 pandemic has shown us how quickly and dramatically events outside the realm of “business-as-usual” can pile up for health plans, creating new challenges around maintaining daily operations amidst multiple, serious disruptions.

Jun 10, 2020

Solving paper in operational use cases with AWD & Vidado

As every operations manager knows, paper can bring even the most finely-tuned workflow to a screeching halt. Despite decades of “paperless” pushes, insurance, healthcare and financial services companies are still heavily dependent on paper-based workflows. Everything from new applications to claim forms still generate significant amounts of incoming paper, requiring special rules and routing. These additional steps add time, introduce a greater potential for errors, and increase the risk of security breaches – which means more manual work for the operations department and a reduction in straight-through processing metrics.

Jun 5, 2020

Leveraging adherence data for maximum benefit in a value-based world

U.S. healthcare stakeholders have been operating in COVID-19 crisis mode since early March, including health plans. Since the Centers for Disease Control (CDC) recommended people stockpile several weeks of medications, plans have been encouraging 90-day prescriptions and waiving early refill limits so that members can comply.

May 19, 2020

Final interoperability regulations: five areas for compliance by Jan 2021

In 2021, health plans providing Medicaid, Medicare, CHIP and coverage under the Federal Exchange must expand the sharing of individual PHI data beyond written communication to provide electronic claims and clinical data to members’ phones, mobile devices and web applications.  The final CMS “Interoperability and Patient Access” rule released on March 9th is the first nationwide interoperability requirement for health plans and states administering coverage under government programs to generate individual and plan data in this manner

May 12, 2020

5 Keys to Business Continuity Success in the New Normal

In these challenging times, businesses both large and small have made, and are continuing to make, adjustments to how they work on a daily basis. Through speedy work-from-home transitions and major process overhauls, SS&C AWD clients are continuing to maintain business-as-usual operations while providing the highest levels of customer service.

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