Resources

Concurrent Review Bottlenecks: How Administrative Burdens Hurt Outcomes

For health plans navigating value-based care, the concurrent review process is essential to utilization management - making sure members receive appropriate care during their stays in skilled nursing facilities (SNFs) and other post-acute settings. Yet, for all its importance, concurrent review often falls victim to administrative bottlenecks, slowing down care, draining staff resources, and ultimately harming both outcomes and member satisfaction. This article examines the roots and impact of these bottlenecks, and explores how the new generation of care coordination technologies are modernizing workflows, streamlining communication, and helping health plans reclaim efficiency and quality.

Are You Ready for Required Downside Risk? Why Every Provider Must Act Now to Protect Revenue and Thrive

CMS is mandating downside financial risk for nearly all new and revised payment models starting in 2025, with the Transforming Episode Accountability Model (TEAM) launching in January 2026 as an immediate priority. This shift means providers, regardless of size or setting, will be directly accountable for total cost and quality outcomes, facing financial penalties if benchmarks are missed. Failure to prepare with modern care coordination and analytics will lead to severe consequences like lost revenue, missed contracts, and competitive disadvantage, emphasizing the urgency for organizations to act now and adopt solutions like Olio Health's platform to protect their revenue and future.

The Rising Cost-Cutting Pressures on Payers

Payers face increasing pressure to cut costs, but traditional methods like slashing provider contracts and restrictive utilization management are no longer effective. The industry must move towards integrated, proactive, and relational care management, leveraging real-time data to coordinate care across all levels.

The $12B Behavioral Health Challenge: Why Health Plans Must Prioritize Care Coordination and Value-Based Care Today

Health Plans managing behavioral health (BH), mental health (MH), substance use disorder (SUD), and reentry programs face mounting pressures. The stakes are high—not just for the vulnerable populations they serve, but for the plans themselves. Poor care transitions, lack of measurable outcomes, and outdated processes cost $12B annually while jeopardizing state contracts and competitive bids. As value-based care (VBC) becomes a cornerstone of healthcare reform, the time to act is now. Health Plans must adopt a care coordination strategy that ensures seamless transitions across all levels of care while establishing meaningful benchmarks to drive accountability and success.

Longitudinal Member Management: A Game-Changer for Health Plans

Fragmented care coordination costs Health Plans millions in unnecessary expenses and missed opportunities to improve health outcomes. According to a study by the Agency for Healthcare Research and Quality (AHRQ), nearly 20% of Medicare beneficiaries experience care transitions that are not well-coordinated, resulting in higher rates of readmission and complications. Discover how Longitudinal Member Management can transform your organization's approach to care coordination.

Transforming SNF to HHA Referrals: Discover How to Achieve Seamless Care Transitions

The healthcare landscape faces significant challenges in seamlessly transitioning from skilled nursing facilities (SNFs) to home health agencies (HHAs). Mr. Johnson, an 85-year-old patient, experienced a preventable hospital readmission due to a disorganized referral process, where incomplete information sharing between the SNF and HHA resulted in delays in receiving necessary medical equipment. Too often, this scenario is a reality. This blog explores the critical issues surrounding the referral process and the steps in resolving them.

The Cost of Inaction: Why Safe Returns Matter for the Success of Skilled Nursing Facilities

Safe returns are critically important for Skilled Nursing Facilities (SNFs), which face challenges and consequences from unsafe transitions. A comprehensive approach is necessary to ensure patient safety and compliance with regulatory guidelines. By implementing a robust, safe return process, SNFs can protect patients, safeguard their financial stability, and maintain a strong reputation.

How Banner Plans & Networks Discovered Patient Co-Management with Olio

Banner Health, an integrated healthcare system based in Phoenix, turned to Olio to help them better manage patients with their network providers. The end result is simple-to-use patient co-management that offers real-time information and comprehensive data, allowing Banner to scale quickly and efficiently.

Revolutionizing Care Coordination: Insights from Oak Street Health and Olio

In an enlightening webinar, leaders from Oak Street Health and Olio shared their innovative approach to post-acute care management, highlighting the transformative impact of their partnership on patient outcomes and healthcare delivery.