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AHA Knowledge Exchange

Aligning Payers and Partners for Value-based Care

AHA Knowledge Exchange
As value-based care models grow, hospitals, providers and payers need to align goals and incentives to improve patient outcomes and reduce costs.
Access & Health Coverage, Quality & Patient Safety, Value-based payment, Current & Emerging Payment Models, Payer Relations, Reducing Healthcare Disparities
AHA Knowledge Exchange

Managed Medicaid: Ensuring Quality Health Care Delivery

AHA Knowledge Exchange
Data-driven strategies to combat Medicaid managed care organization (MCO) denials and ensure quality health care delivery for Medicaid enrollees.
Medicaid, Prior Authorization, Payer Relations, Quality & Patient Safety, Access & Health Coverage, Access to Care in Vulnerable Communities
AHA Knowledge Exchange

Strengthening Financial Performance in Rural Hospitals

AHA Knowledge Exchange
Hospitals are assessing revenue-cycle management performance, employing best practices and using analytics and automation to ensure financial health.
Payer Relations, Financial Management, Leadership, Operational Excellence, Patient-Centered Care, Rural Workforce, Business Analytics
Fact Sheets

Fact Sheet: Reference-based Pricing

Fact Sheets
Some employers are moving away from offering traditional coverage with a provider network and instead are using reference-based pricing for some or all of services they cover. Under reference-based pricing, the employer (supported by a third party administrator [TPA] or other vendor) pays a set a price for each health care service instead of negotiating prices with providers.
Access & Health Coverage, Health Insurance, Current & Emerging Payment Models, Payer Relations