The rapid growth of retail clinics and urgent care centers presents an opportunity to deliver certain types of care in a more appropriate setting than the emergency department (ED). In addition, several state Medicaid agencies, including California and Washington, have developed lists of non-emergency diagnoses for use in quality assessment and, in some cases, limiting payments to providers. As a result, payers are showing increasing interest in understanding the extent to which non-emergency conditions drive ED utilization.... Read More
Unfortunately, it is all too easy to find a news story about the devastating impact of opioid abuse as the epidemic continues to spiral out of control and ravage lives across the country. From babies born to opioid-addicted mothers—and children ignored while parents overdose—to the music superstar Prince dying suddenly from an accidental fentanyl overdose, the plethora of stories that have surfaced in recent years is truly tragic. According to the CDC, more than 183,000 people died in the United States from 1999 to 2015 from overdoses related to prescription opioids, with the number of victims quadrupling over that same period.... Read More
Whether your provider organization is just getting started on its population health journey or looking for a change from its current solution, there are many potholes to avoid along this challenging road—along with several side trips that could easily become a distraction from your ultimate goal. Check out our infographic below to help you steer in the right direction when it comes to choosing the tools you’ll need.
Verscend is celebrating the 20th anniversary of DxCG, the leading risk adjustment and predictive modeling tool in the industry. We recently published a new white paper, “The Evolution of DxCG, the Gold Standard in Risk Adjustment and Predictive Modeling.” In the white paper, we take a look at DxCG’s history and its importance in advancing the science of risk adjustment and predictive modeling in healthcare.... Read More
Healthcare technology is constantly evolving and improving. Although risk adjustment and predictive models have long been established in the industry, their power and accuracy cement their status as a cornerstone for healthcare strategy and operations. Risk adjustment and predictive models provide critical insight into risk, utilization, and cost, as well as ensure fair comparisons between populations. Developments in modeling advance these fundamentals and provide new insights into healthcare trends that propel value-based care strategies.... Read More
The Society of Actuaries (SOA) recently published “Accuracy of Claims-Based Risk Scoring Models,” a study of commercial risk adjustment and predictive models. This study includes analysis of DxCG Intelligence models from Verscend Technologies. Here, we provide a quick glimpse into the results.... Read More
Verscend is celebrating the 20th anniversary of DxCG, the leading risk adjustment and predictive modeling tool in the industry. We recently published a new white paper, “The Evolution of DxCG, the Gold Standard in Risk Adjustment and Predictive Modeling.” In the white paper, we take a look at DxCG’s history and its importance in advancing the science of risk adjustment and predictive modeling in healthcare. For this week’s and next month’s industry influences blog we are featuring content from the white paper, which can be viewed in its entirety on our knowledge bank.... Read More
In April, Verscend’s Sam Stearns co-authored an article in Employee Benefit News titled, “5 ways employers can optimize the value of maternity care for employees.” We recently sat down with Sam and his team to discuss their research and expand on the recommendations in the article, and provide information that will benefit employers and providers managing the health of their employee population.
Providers across the country are working to ensure that they are delivering high quality care that addresses the unique needs of each patient while driving clinical and financial outcomes. Requirements from payers and government entities focused on quality and outcome reporting, coupled with growing risk-based contract arrangements, requires providers to develop an accountable care strategy. But, many providers may wonder what steps they need to take in order to be successful. For providers with self-funded employee populations, building a population health management strategy around the employee population is a practical way to establish a foundation of skills, solutions, and knowledge that can extend to patients.... Read More
Top-rated employers use claims and other employee-related information as a foundation for managing employee health and productivity, just as they use data to manage their core businesses. However, employers relying on carrier reports are often challenged in analyzing credible data when making actionable healthcare decisions. By better integrating big data and analytics into healthcare, the industry could potentially save $300 billion per year, the equivalent of reducing healthcare costs for every man, woman, and child by $1,000 per year.... Read More