Tag: ACA

Will Value-Based Care Drive Better Clinical Outcomes in Behavioral Health?

As the scope of behavioral health has expanded to include chronic conditions and substance abuse, so has its approach to payment models. Since the ACA, in particular, America has witnessed its health care system shift from a predominately pay-for-service model to one with various reimbursement models that focus on long-term improvements, promoting efficiency and reducing […]

The Evolution of Health Plans

The health plan you purchase today may not resemble the plan of your parents or grandparents at all. For decades, Americans received healthcare under the traditional fee-for-service system. Insurance companies reimbursed patients or payers based on every service provided to patients. This seemed logical on the surface, yet problems became clear as the industry realized […]

The Consumerization of Healthcare

Healthcare has changed drastically in the last six years, but these changes are not all due to the Affordable Care Act (ACA). Prior to changes in the way we purchase health insurance, advancements in technology and evolving patient preferences began to move the healthcare industry toward a more consumer-oriented landscape. This consumerization of healthcare is […]

Reimbursements Driving Better Clinical Outcomes in Behavioral Health

Over the past few years, America has witnessed its health care system shift from a predominately pay-for-service model to one with various reimbursement models that focus on long-term behavioral health improvements, promoting efficiency and reducing costs. It may seem like a tall order for physician payment methods to improve patient care, but the industry agrees […]

How Has the Affordable Care Act Affected IROs?

How Has the Affordable Care Act Affected IROs? A crucial consumer protection in the Affordable Care Act — the right to appeal to an outside entity when an insurance company denies payment – received relatively little public attention -but it’s creating noteworthy opportunities and challenges for independent review organizations (IROs). The Affordable Care Act (ACA) carves […]