Specialty pharmaceuticals are one of the most expensive segments within the healthcare costs, wherein the payers seem to struggle to contain these costs. This paper discusses the strategies that are currently available to payers to manage the costs of specialty pharmaceuticals.
SCIO Health Analytics' "Subro-accelerator" solution allows health plans and plan sponsors to minimize avoidable disbursements, thus curtailing the costs of post-payment recovery. To learn more about how our sophisticated pursue-and-pay model could save as much as 40-50% over traditional subrogation models.
As a subrogation/reimbursement software product, MY SOCRATES® deals with end-to-end management of the claims, from receipt to financial recovery. This paper addresses the issues concerning third-party liability, to ensure that the right and responsible party is held financially accountable for recovery in a health claim.
SCIOVantage Reporting™, our care management reporting application, allows health plans and other care management program sponsors to perform consistent reporting of financial, operational and clinical metrics for customers. To learn more about how this robust application enhances credibility of calculated clinical and financial savings results.
This thought-leaders' piece provides insight into the two different methodologies for evaluating population programs within the industry. To learn more about the methodology that may provide a powerful tool to evaluate the financial effect of wellness programs on risk factor reduction.
Care management programs are popular with patients, health plans and employers, all of whom believe that encouraging individuals to lead healthy lifestyles, comply with physician treatment and adhere to best-practice medicine will improve clinical outcomes and lower healthcare costs. This paper discusses how SCIOVantage Opportunity AnalysisTM, our care opportunity assessment application, serves as an important planning tool for those health plans and service providers who want to understand the source and nature of savings from a care management process.
Plans that want to be industry leaders must have a robust strategy to review claims for errors before they are paid. This paper explores the evolution of Payment Integrity and examines methods to achieve superior results through a series of programs and tools.
Value Based Benefit Design is about improving population health and helping individuals become active healthcare consumers. This paper discusses strategies for identifying individuals who are ripe for interventions and designing benefit structures and financial incentives to engage members around meaningful health activities.