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August 30 2019 Chuck Feerick

Defining High-Performing Networks: Three Core Capabilities of Market Leaders

When looking at creating or optimizing high-performing provider networks, the first thing most payers focus on is provider performance on cost, quality, and utilization. What is often left out of consideration is measuring referral performance; do your Primary Care Physicians (PCPs) refer appropriately, or are they referring out cases they should have treated themselves? Do …

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August 27 2019 Tory Waldstein

Employee Spotlight: Tory Waldstein

1. What is your position at Clarify and what do you do? I am a senior Associate on our Customer Impact team. Part of my role is working directly with our customers to make sure that our solutions are meeting their business needs. I also work on the Total Cost Insights solution team, which is …

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August 22 2019 Robert Lin

How to Break Down a Complex Patient Journey to Achieve Growth

Patient journeys are inherently complex, but solving for them doesn’t have to be. As provider growth becomes a top priority for healthcare executives, mapping the patient journey is crucial to understanding how patients interact with the healthcare system along their entire continuum of care, and how well your organization is doing along each of those …

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August 20 2019 Kara Dennis, SVP and GM Life Sciences

Tackling Challenges Faced by Life Sciences Organizations

Since joining Clarify Health last year, I have been working with senior leaders at life sciences companies to better understand the challenges they face in navigating today’s fragmented and siloed healthcare data ecosystem. Even with my ten years’ experience in the clinical trials industry, these conversations have opened my eyes to the opportunities we still …

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August 19 2019 Erik Fiske

CMS’ New Medicare Payment Models: Deciding with an Edge

In 2017, if Track 1 MSSP ACOs had been operating under the new Pathways to Success rules, 40% of them would have ended the year with losses-owed to CMS. They would have owed up to $270M ($76 avg PMPY) to CMS.1 Conversely, Track 1 ACOs who outperformed their benchmarks enough to earn shared savings collectively …

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August 12 2019 Erik Fiske

CMS’ New Medicare Payment Models: What ACOs Need to Know

With a refreshed menu of Medicare payment models, CMS has now directly answered the question that’s been on the collective minds of all ACOs (and vendors) for a couple of years: What will be the way of the future in population health? CMS overhauled the Medicare Shared Savings Program in December, re-branding it as “Pathways …

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August 09 2019 Robert Lin

Network Referral Intelligence: The Low Hanging Fruit of Provider Growth 

The challenge: Optimizing for provider growth is top of mind for healthcare executives. A recent Moody’s report cited that “Revenue pressures continue to overshadow expense saving initiatives. While the median annual expense growth rate decelerated to 5.7% from 7.1%, the annual revenue growth rate declined faster, to 4.6% from 6.1%.” Providers faced with significant revenue …

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August 07 2019 Jegar Jasani, MD

How to build high performing networks

For decades payers and providers have been building physician provider networks based on limited knowledge and data, and status-quo accounting of benchmarks where “low cost” equals “high performance.” This results in provider networks that don’t deliver the high-quality, individualized care that patients deserve. As the competitive landscape in healthcare continues to shift, competition is growing …

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July 29 2019 Amrita Sehgal

Part I: CMS’ New Payment Models: The Basics

Late last year, CMS overhauled the Medicare Shared Savings Program, re-branding it as “Pathways to Success” and re-designed with a pre-determined path toward downside risk for Medicare ACOs. This spring, CMS followed by unveiling five new payment models with the most advanced opportunities for risk-sharing to date. After a long period of mostly talk, these …

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July 23 2019 Alana Titzler

Employee Spotlight: Alana Titzler

1. What is your position at Clarify and what do you do? As a Senior Data Analyst, I focus on the development, management, and delivery of Clarify’s data offerings. I work closely with many of our internal teams, diving into the nitty-gritty of our data assets to deliver insights. 2. What excites you most about …

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