White Papers

Pediatric care has made many breakthroughs in the 21st century. We are witnessing a progression towards value-based care in pediatrics at a variable pace across the US, and there is a common set of drivers impacting it.

Empowered primary care facilities have long been proposed as a solution to improving care quality and containing soaring costs. Many new cutting-edge approaches and solutions are been leveraged by healthcare executives across the nation.

Value-based contract has emerged as one of the best payment models, given its positive implications on care quality, health outcomes, and costs. Despite the evidence supporting the benefits of value-based care, payers are still resistant to adopting this model. The primary reason behind the apprehension is the data-sharing challenge.

Bundled payments are quickly gaining traction as one of the stepping stones for providers looking to enter Alternative Payment Models (APMs). Although the goal is to boost payer-provider collaboration and foster a better risk-sharing arrangement for achieving value-based care outcomes, providers face multiple challenges in getting accustomed to the new payment models.

Medical coding may sound simple; however, there are quite a few things that can and do go wrong. The sheer volume of manual documentation and paperwork creates opportunities for error, thereby leading to improper payments.

Healthcare consumerism is on the rise, and so is the competition in the health plan market. With the increased number of health plans, consumers have more options to choose from, making them more price-sensitive and less inclined to stick to just one plan. In this competitive landscape, payers need to offer more value to patients. They need to reduce the time spent on disseminating claims and completing unnecessary paperwork and improve the overall member experience.