Featured Articles: Risk and Compliance

Payer to Provider Transfer of Risk

Thursday, May 09, 2013   (0 Comments)
Posted by: Joy Ingram
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by Jeffrey Lunn CPCU, Coverys Insurance Services

Healthcare reform and the re-emergence of capitation

A new era of reform is emerging in the American healthcare system which brigs with it unprecedented changes for physicians, hospitals and all providers. Healthcare reform is proving to be a process of payment and delivery reforms driven by both the public and private payers such as Medicare, medicaid, Blue Cross Blue Shield, UnitedHealthcare, etc. The cost and quality of healthcare in the United States as compared to other western nations has created two simultaneious and strategic imperatives: bend the healthcare cost curnve downward and improve the quality of care delivered.

Topics covered in this article:

  • Accountable Care and ACOs
  • Payer to provider transfer of risk
  • Population health management
  • Clinical and financial integration
  • "Managed care exposures"
  • Managed Care Redux? IS this the same as the 1990s?
  • Moving forward

Download entire article here.




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