Your Partner to Improve Quality and Financial Performance

 
Value Based Care Insights
Prior authorization or prior approval, is a decision from a health insurance plan that a service, treatment, prescription, or medical equipment is medically necessary, adheres to benefits provided and is within the members’ network of providers. It's a way for insurance companies to track and ensure that requested services are appropriate and necessary for a patient's care.

Learn about Prior Authorization and how health plans can make it a higher value activity.
Read the article by Carlene Zincke, RN and
Jerry Frank, MD
Read article
Access to total cost of care data is invaluable for IPAs, ACOs and individual practices to help understand how well they are performing in a risk-bearing environment. It paves the way to help optimize networks, identifying high performing practices and those requiring improvement relative to their peers, track where costs are coming from and helping to correct them. It also of course informs gap to goal for financial success in value based payment agreements.

Learn more about total cost of care.
Read the article by Carlene Zincke, RN and
Jerry Frank, MD
Read Article
 
Some providers participating in Medicare Accountable Care Organizations (ACOs) have done so under the umbrella of an ACO aggregator. These aggregator organizations form risk-bearing entities, contract with CMS, and then recruit physician groups to participate in their ACO. Learn why those considering ACO participation should avoid such detrimental arrangements and the value of going direct.
Read the article by Boris Alexandrov
and Allen Miller
Read Article
Learn how we helped our client leverage its strong performance in the MSSP ACO program to retain a larger portion of its shared savings and build additional infrastructure to generate even greater upside.
Read Case Study
  
COPE Health Solutions (CHS) is proud to announce it has met additional program standards. Organizations that earn Certified Data Partner designation undergo a rigorous assessment. Validation activities include a virtual site review with staff interviews and a review of documentation, queries and systems.
Read Press Release
 
We look for to connecting with you!

Connect with our experts at events, both virtual and in person, across the country. You can register for some of them by clicking on the event name (if available). See you soon!
 
February 24-28, 2025 Check out our panel, Total Cost of Care Strategies in Value-Based Payment on February 27 at 1:30 PM ET with Hawaii Health Network, Sun River Health and Sendero Health Plans during Value-Based Payments Summit Special Edition: Held In Conjunction With The Fourth Health Care Value Week
February 28, 2025 Connect with our Principal and CEO, Allen Miller at Health Evolution Connect 2024 Summit Fellowship Edition in Laguna, CA.
Text him at (310) 386-5812 if you want to connect while there.
March 4, 2025 Attend our upcoming panel and networking event at the Los Angeles Athletic Club in Downtown Los Angeles, co-hosted with ACHE Southern California - Value Based Payment: Changes in 2025
 

    About COPE Health Solutions


COPE Health Solutions (CHS) is a national tech-enabled services firm powering success for health plans and for providers in risk arrangements. Our comprehensive population health management platform and highly experienced team brings deep expertise, experience, proven tools, and processes to improve financial performance and quality outcomes for all types of payers and providers. CHS de-risks the roadmap to advanced value-based payment and improves quality and financial performance for providers, health plans and self-insured employers.

For more information, visit copehealthsolutions.com.
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COPE Health Solutions
1150 South Olive Street · Suite 1200 · Los Angeles, CA 90015 · USA