COE As The Path To Value

Payers and health plans are looking for increased “value” from provider organizations—but the parameters that define that “value” are changing. Their focus is increasingly shifting to reducing re-hospitalization and unnecessary use of emergency rooms, low total cost of care per member, HEDIS and CMS Stars scores, and consumer satisfaction and member retention (see It’s About The Customer…).

But success with these new value measures is more than a generic “one-size-fits-all” approach. Five percent of the population accounts for nearly half of all health care spending in any given year and 50% of the population . . .