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Newest Updates

investment strategy

4 ways to optimize your community health investment strategy

Population health leaders are extending more and more care model interventions into the community to address patients’ unmet social needs. However, many are still unclear on how to allocate the limited resources across possible community investments in the best possible ways. There are three significant obstacles that hinder a strategic approach to investment in community-based interventions. Investments are unsystematic due to an overwhelming set of priorities to pursue. Projects are not implemented with a data-informed approach. Lastly, the projects have a lack of sustainable funding.

You can use the four following strategies to take a more strategic approach to community investments that advance population health goals.

qualitative data input

  1. Back key community health needs and strengths with quantitative and qualitative data input – Community health investments should be implemented with the same rigour as clinical investments: well-backed by data and continuously assessed for efficacy. This means building a comprehensive community-based health needs assessment. The approach can source information from government public records, a dedicated advisory board, an open-access data set and patients and community members. The process will narrow down the number of core measures to be considered.
  2. Prioritize community health needs with a standardized, evidenced-based framework – Organizations generally identify too many community health priorities in the data-gathering step to feasibly address. Progressive organizations, on the other hand, prioritize investments keeping in mind the availability of resources to address needs and the size of the improvement opportunity. They create a systematic ranking system to narrow down where to focus their efforts. Criteria include alignment with broader organizational goals to support the business case for investment, how to integrate psychosocial risk factors into ongoing care, the feasibility of short- and long-term success to ensure a return on investment; and ability to offset investment requirements.

 

  1. Solidify high-quality community partnerships with compacts – Community partnerships are vital to address community health needs at scale and gain access to disengaged populations But this is only possible if all concerned parties carry out their respective responsibilities. Partnership success also depends on common goals and commitment to resources. When building community partnerships, always select partners with the best cultural and strategic fit and formalize expectations across stakeholders using a partnership compact.
  2. Focus on sustainable investment through performance evaluation – Those investing in community-based interventions assess process and outcome metrics to determine if the program will be a success. Short-term process measures need to demonstrate growing improvements to sustain the leadership of promising initiatives. Long-term outcomes measures need to indicate an ROI to meet the system criteria for funding at scale.

 

Health Insurance

4 ways to apply for coverage in the Health Insurance

Health insurance is something that covers your medical expenses. Just like auto insurance covers your car if you get into an accident, health insurance covers you if you get sick or injured. Health insurance also includes preventive care, that is, doctors visits and tests before you get sick. Health insurance usually does not always cover 100% of your costs. It is created to split costs with you up until a particular point which is known as the out-of-pocket limit. After you hit this out-of-pocket limit, health insurance pays 100% of your healthcare expenses.

There are a number of ways through which health insurance companies might share costs with you, and they make up a significant part of your health insurance plan that you have to be aware of. These are your deductible, your coinsurance, your copayment, and your out-of-pocket limit.

 
All health insurance plans have to cover the ten essential benefits. In addition to these ten essential benefits, health insurance plans must also meet specific affordability standards, as well as other rules that vary on a state-by-state basis, to be included on a government-run health insurance exchange. Off-exchange plans, so-called because they are not sold on government-run exchanges, must also cover the ten essential benefits and meet specific federal standards to be considered a qualifying health coverage. These consumer protections have closed loopholes that caused several financial problems for policyholders in the past.

Usually, there is only one period of time in which you are allowed to shop for a new health insurance plan on the Obamacare marketplace. This period is called the open-enrollment period. You can’t buy a health insurance plan outside of this open-enrollment period unless you qualify for a special-enrollment period.

Health insurance companies are mandated to cover people regardless of preexisting conditions. The Affordable Care Act mandated that everyone has to buy health insurance, even if they believe that they are healthy and do not need health insurance. Premiums from healthier customers who do not use a lot of health care services help balance the cost of covering people who need to use more health services.

healthier customers

Now, there are four ways to apply for coverage in the Health Insurance Marketplace:

  1. Apply online – You can visit this page and select your state and plan to get started.
  2. Apply by phone – You can call up health insurance providers and apply for health insurances over the phone.
  3. Apply in person – You can visit a trained counsellor in your community to get information, apply, and register.
  4. Apply by mail – You can complete a paper application and mail it in.