Penn Medicine, University of Pennsylvania Health System’s Post

The current payor playbook: talk about removing roadblocks to good care, then implement more roadblocks to good care. It's nothing but wasteful rent-seeking. Providers and health systems must stand up strong for their patients.

Weekend Read 📚: What investments are healthcare executives making in 2024? The answers range from #AI to talent. What's our answer? Venteur is investing in our customers and bringing much-needed relief to those impacted by rising health insurance costs. Thanks to Becker's Healthcare for including us on this list! https://lnkd.in/ghRctQdC

Magicians don't use smoke and mirrors as well as lobbyists for PBMs do! Despite it's very awesome title of the bill = "Lower Costs, More Transparency Act". It's actually is a bad thing for those of us who want to help consumers lower Rx costs! Why? "The pending Lower Costs, More Transparency Act would erode these pillars by expanding the use of price estimates for hospitals, eliminating billing codes and other identifiers for health insurers, and enabling third-party administrators, insurers and provider networks to restrict access to critical claims information that employers need" 🤯🤢🤮 Scripta Insights Ashley Moyer Ferrin Williams, PharmD MBA #drugpricing #healthcarecosts https://lnkd.in/euU_Bt4t

You deserve quality medical care, and that starts with having the right Primary Care practitioner! With the new year(and possibly new healthcare plan), consider if the person you see when something goes wrong is actually the right person for you! https://lnkd.in/eayVAMcC ID: Image has a light blue border around it. The top half is a picture of a doctor holding up the end of a stethoscope in his hand. The picture is close-cropped, only showing him from face mask to chest. The lower half is text, starting with the title "Selecting A Primary Care Physician" Below that, in smaller text "A Primary Care Physician is often your primary source of healthcare. Ensure they will be your best advocate and support in your health and wellness journey by selecting your best option." Below this is a green rectangle with the text "follow link for post" across it in white.

Most employers erroneously think that if a carrier, like UnitedHealthcare, lowers reimbursement rates to providers and hospitals, or denies claims, that their profit goes up. After all, in every other industry, the lower your underlying expenses, the more your profit goes up. But not in health care and certainly not in health insurance. Part of this is rooted in the Medical Loss Ratio provision of the Affordable Care Act. As further proof, UnitedHealth Group, through its Optum subsidiary, has quietly become the LARGEST employer of physicians in the US. My question to employers is this.....if both the Physcian employers make more money as reimbursements go up, and the insurer also makes more money as reimbursements go up, what happens when those two entities are one and the same, and go into contract negotiations with each other? Emma Fox, CHVA Doug Hetherington Doug Aldeen Dave Chase, Health Rosetta-discovering archaeologist Morgan Smith Jarred Pierce

Another thought-provoking article that got my neurons fired up once again- this article highlights the need for comprehensive healthcare reform that addresses the root causes of high healthcare costs. In addition, these efforts should prioritize health equity and address disparities in access to care and health outcomes. Another significant gap we consistently witness is the siloed approach to care coordination and the gap in incentivizing preventive care. IMHO this is all interrelated. Transitioning to value-based care models offers an opportunity to incentivize high-quality, cost-effective care while promoting health equity and addressing gaps in care coordination. We need to integrate these principles into healthcare reform initiatives, towards a more preventable, equitable, and sustainable healthcare system for all. Despite recognizing the potential value-based care offers for cost savings and improved patient outcomes, its implementation faces significant challenges related to incentive alignment, data infrastructure, care coordination, provider engagement, and regulatory & policy barriers. What do you see as the biggest barrier to implementing value-based care in today's healthcare system, and how can we overcome it to realize the potential benefits for payers and providers alike?

#ValueBasedCare models have been at the core of #healthcare improvement efforts for decades. By improving quality of care, reducing costs, and eliminating a range of health disparities, new payment and delivery system transformation models continue to demonstrate their power to address the most intractable #healthcare challenges across public and private healthcare programs. #HealthcareValueWeek

Why not profit or price cap the health insurers like they do in Germany, Switzerland and Japan and several other democracies to enable access for all citizens to quality affordable private insured and private FFS manufactured medical care? It’s called the Bismarck Model. Bismarck has more private insurers and hospitals competing per capita with better outcomes and costs than in America.

CVS Health is feeling the squeeze! One of the nation’s biggest health insurers is grappling with skyrocketing medical costs and an avalanche of demand for procedures. They’re shuffling the corporate deck to keep shareholders happy, but what’s that mean for you? Higher premiums and even fewer services. Awesome, right? But wait, there’s a better way! At Mezocare, we see this chaos as an opportunity. Why not rethink healthcare delivery altogether? We can team up with CVS Health to create something that’s actually good for your wallet and your health. Imagine the convenience and trust of CVS Health paired with Mezocare’s affordable, high-quality medical services. Together, we could offer a new kind of healthcare experience—one that doesn’t drain your bank account. So, CVS Health… let’s get creative and make something amazing happen. Ready to chat? https://lnkd.in/gjYpa4Nc #HealthcareRevolution #MedicalTourism #CVSHealth #Mezocare #AffordableCare

Becker's Healthcare Payer Issues highlighted two things that we are tremendously passionate about at Blue Cross and Blue Shield of Illinois: people and value-based care. "Growth for our healthcare delivery organization will be focused primarily on two things: people and value-based care. We have to take care of our people because they are the ones who take care of our members. Without a concrete focus on people, career pathing, succession planning and overall professional development, we will not be creating or keeping the workforce we need to remain successful. Without a focus on value-based care strength, we will continue as a country to pay more and more for healthcare without demonstrable, quantifiable improvements in quality care. Both of these areas are critical for our continued growth and progress forward." #beckershealthcare #beckerspayer