Payers and Insurers

Payers & Insurers

Assuring provider success through high-quality education

Bridging the gap between payers and providers using targeted education,
to align and meet organizational goals

Successful payers and insurers differentiate themselves by investing in their providers’ success,
which drives better health outcomes, increases patient satisfaction, and reduces unnecessary costs.

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Driving Positive Patient Outcomes and Satisfaction

Ensure that your providers understand different elements of whole-person care, including social health, to deliver better care.

Social Determinants of Health

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Building Internal Expertise Around Integrated Care

Prepare providers in all settings to effectively treat co-occuring physical and behavioral health conditions.

Opioid Abuse

Value-Based Purchasing

Reducing Costs Related to Chronic Diseases

Accurately assess, treat, and manage complex clients with multiple chronic diseases, while working together in effective care teams.

Chronic Diseases

Your Industry

Select your industry to learn more

Medicaid Managed Care Organizations

Accountable Care Organizations

State Medicaid
Agencies

Commercial Payers and Insurers

Chronic Disease Management

Invest in comprehensive chronic disease management to improve performance while reducing costs

Educate Providers on Individual and Co-Morbid Conditions

With healthcare transitioning more and more to value-based models, invest in areas that impact significant cost drivers and key performance measures. One of those areas is chronic disease management, the single highest cost driver in healthcare for payers, providers, and patients alike.

However, educating on individual chronic diseases is no longer enough with increasingly present behavioral health conditions. Staff and providers, also need to be well-versed in how comorbidity plays a factor into the presenting conditions to treat the whole person.

 

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Up-to-date Compliance Regulatory Training & Reporting

Effectively and consistently deliver provider communication and training

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Don't Settle for Traditional Methods for Compliance Tracking

Are you relying on that voluntary “website click” to meet your mandatory CMS requirements? Knowing the steep legal and monetary consequences of compliance failures and errors, what if there was a better way to mitigate the risks, while reporting on attestations?

Easily push out compliance training and essential communication to improve the overall alignment of your network through a dedicated provider LMS. Manage contracts more easily and reduce time intensive and costly methods of keeping providers informed and compliant.

Our new Compliance & Regulatory Training Package consists of comprehensive online courses that cover the mandatory CMS training requirements and the courses are updated and maintained by Relias Learning!

 

The Art and Science behind Adult Learning

Interactive and engaging courses ensure better learner comprehension and retention

High-Quality, Relevant Training Improves Provider Performance

According to the Father of Adult Learning, Malcolm Knowles, adults learn differently from children. Therefore, to be successful, adult learning must incorporate 4 elements:

  1. Adults need to be involved in their education plan
  2. Prior experiences must be leveraged and referenced
  3. Learning needs to be relevant and applicable
  4. Material must be specific

Using these principles, our courses are designed to be engaging and effective, so that information is retained and immediately applied during care delivery. Relias Learning has also developed innovative tools such as, game elements, micro-learning and simulations.

 

 

Relias PATHS™ for Your Providers

Prescriptive training for improving provider performance

Relias PATHS for Payers

Focus your learning programs on activities designed to change provider habits, improve clinical outcomes and reduce cost exposure.

Providers whose practice patterns fall outside of targets and parameters are often associated with the risk for poor outcomes, and can have negative effects on financial performance. Relias PATHS helps payers mitigate this risk by focusing training on gaps in performance and strengths, and assessing improvement.

PATHS is prescriptive and includes pre- and post-assessment to measure growth as well as scenario-based content to test learning. PATHS targets and assesses competencies by focusing on key performance indicators to identify gaps. Training is then assigned in areas of need to providers not performing well in specific areas.

  • Social Determinants of Health (SDoH)
  • Avoidable Readmission Reductions
  • Preventing Opioid Misuse and Abuse
  • Patient Experience
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Partnerships

We work with industry-leading partners to create high quality content to ensure our training meets your needs.

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ABHW
CMS Training - Understanding Medicare
Understanding Medicare provides an overview of the Medicare program.
CMS Training - Medigap
Discusses how Medigap policies work with Medicare, what Medigap policies cover, how they are structured, and when to buy a Medigap policy.
CMS Training - Coordination of Benefits
Discusses how the coordination of benefits works when people have Medicare and certain other types of health coverage.
CMS Training - Medicaid and CHIP
Provides an overview of Medicaid and the Childrens Health Insurance Program.
CMS Training - Medicare Preventive Services
This course explains which preventive services are covered, who can receive them, when said services are covered, and how much you pay.
Medicare and Medicaid Fraud and Abuse Prevention
This module explain Medicare and Medicaid fraud and abuse prevention, detection, recovery, and reporting.
CMS Training - Medicare for People with ESRD
This is a CMS course explaining how people living with ESRD can take advantage of Medicare.
CMS Training- Medicare and Other Programs for People with Disabilities
This training discuss Medicare and other programs for people with disabilities.
Medicare Advantage and Other Medicare Plans Resource
The lessons in this module explain Medicare health plan options other than the original Medicare.
Social Determinants of Health: Practice Scenarios
This course tasks learners to go through two patient scenarios, identifying and addressing the social determinants of health related to each visit.

Resources for Payers

Browse resources curated for insurers and payers

Webinar

November 07 , 2017

Health and Human Services Payers Value-Based Performance Management

Improving Care Coordination in a Value-Based World

Learn how to implement better care coordination within your organization and discover three simple steps you can take to actionize care coordination improvement.

Webinar

September 19 , 2017

Payers Opioid Addiction

Balancing Therapy and Harm: Treating Pain and the Opioid Epidemic

This webinar discusses the details of pain management today and strategies payers can take to help their providers address the opioid crisis with actionable plans.

Webinar

September 07 , 2017

Health and Human Services Payers Social Determinants

How Social Determinants of Health Influence Reimbursement and Patient Experience

Watch this webinar as we discuss and learn about the social determinants of health and how they can impact the patient experience and how this, in turn, determines provider reimbursement.