Healthcare reform regulations, increasing costs, and more competition are driving employers and their health plans to focus more than ever on opportunities to reduce cost trends. For example, the country experienced a 3.0% growth in per capita gross (allowed) medical and pharmacy costs from 2012 to 2013. Truven Health Analytics anticipates those costs in 2014 and 2015 will increase by 4% to 5% or more. By taking a data-driven approach, payers can manage costs and, ultimately, make their benefit programs sustainable in the context of healthcare reform. They can also maximize opportunities to improve population health and productivity and optimize the delivery of care.
Truven Health Analytics™ evaluated the extent to which community need— a measure of the underlying economic and social factors that affect the overall health of a community, including income, cultural/language barriers, education, insurance and housing—is associated with elevated rates of preventable hospitalizations or an increased risk of hospitalization believed to be preventable with quality ambulatory care. The results of this investigation reveal a modest but statistically significant association between community need and an increased risk of hospitalizations that are believed to be preventable with good-quality ambulatory care.
Why do patients so often forget to tell you about their new insurance plans? And what can you do to keep your cash flow running smoothly when it happens? Read this flipbook to learn how to avoid eligibility-related “surprises.”
Healthcare billing and claims handling has become increasingly complex. With the transition to Version 5010 of the HIPAA electronic transaction standards, the expansion of billing codes under ICD-10, and the ever-changing requirements of insurance companies and the Centers for Medicare and Medicaid Services (CMS), it can be nearly impossible for providers to keep up.
In October 2013, S&P Dow Jones Indices (S&P DJI) launched the S&P Healthcare Claims Indices (the indices). This new index series is designed to provide an independent, timely measure of the changes in healthcare expenditures and utilization for individuals enrolled in commercial health insurance plans in the United States.
S&P DJI developed these new indices in conjunction with healthcare professionals at Health Index Advisors (HIA), a joint venture between the premier actuarial and consulting firms Aon Inc. and Milliman Inc. S&P DJI combined its knowledge and experience in developing leading indices with HIA’s experience in the healthcare market to develop the first index series of its kind, based on actual healthcare claims data. These indices seek to increase transparency in the healthcare market and enable the analysis and tracking of changes in healthcare expenditures.
Establishing a startup’s business infrastructure early — that is, establishing support in the areas of legal, accounting, tax, insurance, and human resources (HR) — provides a number of critical benefits for any entrepreneur to consider. This paper discusses suggestions for management teams that will facilitate establishment of an appropriate infrastructure.
Benefits, especially insurance benefits, are extremely important to employees and one of the main things they take into consideration when they make employment decisions. Many employers that offer insurance generally offer a combination of health, dental, and vision insurance. Sometimes dental and vision insurance are offered separately from health insurance, or they may all be rolled into one plan.
"Improving Cyber Resilience in the Insurance Industry
Security automation plays a significant role when maintaining an organization's Cyber Resilience, according to IBM Resilient’s latest report, “The Ponemon Institute Study on the Cyber Resilient Organization.”
Download this latest report to understand the key factors that hinder the ability for efficient and effective Cyber Resilience and gain insights and guidance for improving your security posture."
Trupanion, a Seattle-based medical insurance provider for cats and dogs, needed to find data insights quickly. With only 1% of pet owners insured, the process of evaluating a claim to approve or deny payment was manual and time-consuming. Building accurate predictive models for decision-making required manpower, time, and technology that the small company simply did not have.
DataRobot Cloud, built on AWS, helped Trupanion create an automated method for building data models using machine learning that reduced the time required to process claims from minutes to seconds. Join our webinar to hear how Trupanion transformed itself into an AI-driven organization, with robust data analysis and data science project prototyping that empowered the company to make better decisions and optimize business processes in less time and at a reduced cost.
Join our webinar to learn:
Why you don’t need to be an expert in data science to create accurate predictive models.
How you can build and deploy pr
Published By: e-SignLive
Published Date: Oct 11, 2013
While we tend to think about mobility largely as a consumer phenomenon, it is also changing how the workforce carries
out business. With so much being done beyond traditional office walls, many insurance companies, financial service
organizations and even government agencies are adopting mobile tablets and smartphones as productivity tools for
agents, representatives and personnel, and developing enterprise apps for these devices.
Insurance is a part of an environmental contractor’s and consultant’s daily work life. Are you over extending your insurance policy? Are you opening yourself up to multiple lawsuits? Do you have the correct coverage? Find out in this whitepaper.
Case management frameworks built on business process management platforms help IT solutions architects deploy case-handling applications and offer an alternative to specialized case management applications and custom coding. According to Gartner, the complex architecture required to support case management has relegated it to the status of a niche application, typically addressed by specialist, commercial off-the-shelf application providers and system integrators. Case management as a process style is being applied in many sectors beyond government, legal and insurance, including healthcare, banking, higher education and retail. Industry and cross-industry case management frameworks are now available. "Adaptive case management" hype exceeds the reality of what buyers need. Gartner evaluated 12 vendors including Pegasystems against nine critical capabilities in four use cases.
Download this Gartner analysis and gain a better understanding of the case management frameworks solutions offe
When augmenting the benefits package for your organization, it’s natural to focus on traditional perks that employees have come to
expect: PTO, health insurance, and maybe a tuition assistance credit here or there. But if you’re looking for creative and effective ways to stimulate employee engagement while also driving business results, you’ll want to consider the powerful impact of offering language-learning opportunities.
Where’s the connection? And how can you reproduce these benefits within your organization? This playbook offers a deeper look at why language learning has such a positive influence on employee engagement and business performance, as well as step-by-step instructions for implementing a language-learning program in your organization.
While the Affordable Care Act (ACA) increased the number of Americans with access to health insurance, U.S. employers and employees continue to struggle with rising health care costs and changing workforce demands. Recent Aon research shows that 20% of health care consumers cite high health care costs as the major reason they have either declined health care coverage, stopped taking medications, or avoided care altogether. If the U.S. health care system is to succeed, stakeholders across the health ecosystem must influence change in each market—employer, individual, and government (Medicare, Medicaid, and Tricare).
While each part of the three-legged stool is important, this paper focuses on five strategies Aon believes will strengthen the employer-based system—a system that provides health care coverage to well over half of Americans (61%, or 177 million).
2017 Trends in Financial Services and Insurance: Customer is Priority
The FSI sector is progressing with a digital, data-driven, marketing mentality, all centered around prioritizing customer experience and taking a more personal approach.
The 2017 Digital Trends in Financial Services and Insurance compiles the information shared by over 800 FSI respondents to see what opportunities and obstacles are shaping the future of FSI.
Read this report and find out:
How data and personalization drive digital transformation
How fintech is leading the FSI chase
Tips to help future-proof your FSI business
Adobe article that condenses/highlights key findings from the Econsultancy Digital Marketing in the Financial Services and Insurance
Sector 2017 Study, an in-depth, 5000+ word report covering FSI executives’ opinions on:
– General trends in retail banking, investment banking, and insurance
– Internal structures their companies are using to execute digital transformation
– The biggest threats/disruptions in the industry
– The biggest priorities in 2017 (leaders are focusing on both customer retention and customer acquisition, mainstream is focusing just
on customer retention)
– Main sources of sales and leads (digital + mobile are steadily increasing sources)
– Digital marketing budgets & investment areas (leaders are investing more in digital marketing automation and analytics)
– Use of the cloud and AI to automate analysis and marketing
– The importance of multichannel personalization
– Innovation in the types/formats of products/services provided (leaders are focusing on i
As of May 2017, according to a report from The Depository Trust &
Clearing Corporation (DTCC), which provides financial transaction and data processing services for the global financial industry, cloud computing has reached a tipping point1. Today, financial services companies can benefit from the capabilities and cost efficiencies of the cloud. In October of 2016, the Federal Deposit Insurance Corporation (FDIC), the Office of the Comptroller of Currency (OCC) and the Federal Reserve Board (FRB) jointly announced enhanced cyber risk management standards for financial institutions in an Advanced Notice of Proposed Rulemaking (ANPR)2. These proposed standards for enhanced cybersecurity are aimed at protecting the entire financial system, not just the institution. To meet these new standards, financial institutions will require the right cloud-based network security
platform for comprehensive security management, verifiable compliance and governance and active protection of customer data
Having local expertise on each side of the water helped to address the customer’s concerns and data center requirements at each level of its decision making process. How do you go about finding the right provider for your business?