The Collaborative Forum

Earlier this month, CMS announced that enrollment in Medicare Advantage plans will climb an estimated 5 percent next year. Conversely premiums are expected to drop on average.

It’s really no surprise to any of us in the healthcare industry that with reform come significant challenges to health plans. Health plans are being forced to dramatically change how they do business to remain profitable.

In my ongoing conversations with health plan leaders, they confirm that Medicare Advantage plans, Special Needs plans (SNPs) and Medicaid are faced with a very large challenge: How to maintain profitability in this new era of healthcare.

It seems to us that taking the correct approach to medical management is the key. Read the rest of this entry →

In May, I first wrote a post that discussed the Beacon Community Program, the new program from the Office of the National Coordinator for Health Information Technology (ONC) that’s designed to actually encourage innovation to transform and improve healthcare delivery in this country.

As part of the program, the ONC has allocated $235 million to develop cooperative agreements with communities to build and strengthen their health IT infrastructure and health information exchange capabilities. Looking for measurable improvements in health care quality, safety, efficiency and population health, the ONC is funding 17 of these awards to different communities across the country.

The challenge with past chronic care management pilots/demonstrations is that even with the best of intentions, the stringent design and methodology actually stifled innovation and destined many of these projects to fail. However, through the advanced use of IT the Beacon Communities are set to tackle specific goals of improving health care and population health status.

Next week, in partnership with the Care Continuum Alliance, Pharos Innovations is presenting a webinar on Wednesday, October 26, at 1 PM, EDT that carefully discusses and considers the Beacon Community Program. As the newly elected Chair of the Government Affairs Committee of the Care Continuum Alliance, I am honored to be participating in this webinar.   Read the rest of this entry →

Pharos Innovations is a long standing and proud member of the Disease Management Association of America, which as of today, ceases to exist as the DMAA. Today, the organization has changed its name to the Care Continuum Alliance (CCA) to better align its name with its ongoing work on behalf of organizations and individuals that provide healthcare at all stages of well-being.

The organization’s decision to change its name away from one that focuses on disease management reflects our industry’s evolution toward care across the continuum of health. This is a move away from a disease focus to a more comprehensive, patient-focused approach. Read the rest of this entry →