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.
Today’s financial services organizations recognize that success starts with strong relationships built on trust and transparency. In a competitive market, a company’s employees can make or break these crucial relationships through their interactions with customers. That’s why businesses — from wealth management and insurance firms to banks and credit unions — are investing in automated workforce solutions to help them attract, engage, and retain top talent while controlling costs and driving exceptional service.
Managing a diverse workforce of exempt and nonexempt employees across back-office, contact center, and frontline operations is no easy feat. Finding and keeping best-fit employees is challenging enough, but you also need to optimize day-to-day functions like time and attendance, scheduling, payroll, labor cost and productivity tracking, and compliance management to stay competitive and profitable. Given this complexity, it is not surprising that management teams are not alway
The insurance industry stands on the precipice of change, with waves of innovation and disruption driving new possibilities across all departments, including pricing, underwriting, claims, and fraud.
This webinar recording of a live panel debate is ideal for insurance professionals wanting to understand how best to unlock the possibilities created by advanced analytical techniques such as Artificial Intelligence (AI), Machine Learning (ML), and others.
This TIBCO and Marketforce webinar on “The Fourth Industrial Revolution in Insurance” includes speakers Ian Thompson, chief claims officer at Zurich; David Williams, chief underwriting officer at AXA; and Clare Lunn, GI fraud director at LV=. The panel discusses:
Moving towards the algorithmic insurer: the opportunities created by AI and ML
How insurers can become more agile in the face of new innovations and disruptive technologies
How the industry can turn structured and unstructured data into insights
The Insurance industry continues to undergo significant transformation, with new technologies, business models, and competitors entering the market at an increasing rate. To be successful in attracting and retaining the most valuable customers, insurance companies must innovate and increase the speed at which they respond to customer demands. Traditionally, the insurance software market was dominated by a handful of specialist vendors with products that were initially expensive, difficult to deploy, costly to maintain, and did not provide the speed needed for today's market.
Now there has been a shift away from these "black box" applications to platforms that allow insurers to make their algorithmic IP available to business users, allowing much faster response to business demands. The algorithmic platform approach also comes at a fraction of the cost of black box solutions, while delivering advanced analytical techniques like Machine Learning and Artificial Intelligence (AI).
AA Ireland specializes in home, motor, and travel insurance and provides emergency rescue for people in their homes and on the road, attending to over 140,000 car break downs every year, 80% of which are fixed on-the-spot.
Euler Hermes is the world's leading provider of trade credit insurance. Its credit and accounts-receivable insurance enables companies of all sizes to trade with confidence at home or abroad. Its credit intelligence network enables analysis of the financial stability of more than 40 million businesses across the globe.
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