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August 12 2019 Erik Fiske

CMS’ New Medicare Payment Models: What ACOs Need to Know

With a refreshed menu of Medicare payment models, CMS has now directly answered the question that’s been on the collective minds of all ACOs (and vendors) for a couple of years: What will be the way of the future in population health? CMS overhauled the Medicare Shared Savings Program in December, re-branding it as “Pathways …

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August 09 2019 Robert Lin

Network Referral Intelligence: The Low Hanging Fruit of Provider Growth 

The challenge: Optimizing for provider growth is top of mind for healthcare executives. A recent Moody’s report cited that “Revenue pressures continue to overshadow expense saving initiatives. While the median annual expense growth rate decelerated to 5.7% from 7.1%, the annual revenue growth rate declined faster, to 4.6% from 6.1%.” Providers faced with significant revenue …

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August 07 2019 Jegar Jasani, MD

How to build high performing networks

For decades payers and providers have been building physician provider networks based on limited knowledge and data, and status-quo accounting of benchmarks where “low cost” equals “high performance.” This results in provider networks that don’t deliver the high-quality, individualized care that patients deserve. As the competitive landscape in healthcare continues to shift, competition is growing …

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July 29 2019 Amrita Sehgal

Part I: CMS’ New Payment Models: The Basics

Late last year, CMS overhauled the Medicare Shared Savings Program, re-branding it as “Pathways to Success” and re-designed with a pre-determined path toward downside risk for Medicare ACOs. This spring, CMS followed by unveiling five new payment models with the most advanced opportunities for risk-sharing to date. After a long period of mostly talk, these …

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July 23 2019 Alana Titzler

Employee Spotlight: Alana Titzler

1. What is your position at Clarify and what do you do? As a Senior Data Analyst, I focus on the development, management, and delivery of Clarify’s data offerings. I work closely with many of our internal teams, diving into the nitty-gritty of our data assets to deliver insights. 2. What excites you most about …

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July 16 2019 Michelle Chiu

SBDoH Webinar: Separating Signals from Noise

Social and behavioral determinants of health (SBDoH), while not new, have recently garnered increasing media attention as being critical to the improvement of healthcare quality and outcomes. It is widely understood that SBDoH are a primary driver of health and that changes in SBDoH often precede health deterioration, yet much of the industry remains focused …

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July 02 2019 Manisha Shetty Gulati

Addressing Today’s Healthcare Challenges Using Precision Analytics

Last month Clarify Health released several new predictive analytics solutions to address the critical challenges payers and providers face as they work to optimize patient care, manage risk, and improve outcomes. Health plans today lack the necessary insights on performance to build high-performing provider networks. Currently, they rely on a small sliver of market data …

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June 19 2019 Jordan Nodal

Employee Spotlight: Chase Micciche

1. What is your position at Clarify and what do you do? I am currently on the Business Development team here at Clarify Health. My role includes educating the market and engaging with prospective clients on the power of our solutions. I love being one of the first people prospective customers speak to and on …

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May 23 2019 Amrita Sehgal, Charles Sauter, Josh Loehrer

Why every provider should apply for BPCI-A

The CMS Bundled Payments for Care Improvement (BPCI) – Advanced program offers participants the opportunity to take on episodic risk on 37 different clinical episode types. Current participants have realized tremendous value in the BPCI-A program through the potential to earn a bonus payment and the experience navigating value-based care programs. The BPCI-A program creates …

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May 10 2019 Amrita Sehgal, Charles Sauter, Josh Loehrer

TAVR Case Study: Uncovering complexities in BPCI-A rules

BPCI-A TAVR BACKGROUND: On April 24, 2019, CMS announced that it will include five new clinical episodes for BPCI-A Model Year 3: Outpatient TKA, Bariatric Surgery, Inflammatory Bowel Disease, Seizures, and TAVR. TAVR (Transcatheter Aortic Valve Replacement) is a minimally invasive procedure that replaces narrow aortic valves. Given the complexity of cardiac procedures and a recorded …

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