Published By: Lumeris
Published Date: Aug 04, 2014
For health plans, health systems and delegated payer operations, or health systems wanting to become their own payer, Lumeris’ turnkey outsourcing offers expert support to design, build, operate, measure, and optimize value-based health plan operations that can drive clinical and financial excellence. This can be evidenced by our ability to help clients achieve higher revenue, lower costs, higher market share, and meeting mandates for medical cost ratio contained in the Patient Protection and Affordable Care Act.
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.