James Worsham

Albert Einstein once said, “Setting an example is not the main means of influencing others, it is the only means.” Having been involved in healthcare technology since the early 2000’s, I have seen budgets drained and projects shelved due to a lack of buy-in – starting at the top. The software is often the scapegoat […]

The shortage of behavioral health providers is a major public health concern in our country. According to a report from the Health Resources and Services Administration, the supply of workers in selected behavioral health professions will be about 250,000 workers short of the projected demand by 2025. The shortage is especially severe among psychiatrists. More […]

As the health care industry moves toward value-based care, we are all experiencing an influx of articles and presentations on the latest and greatest methods for practice transformation. Health plans and other payers want to incentivize physician practices to implement changes that will improve quality and reduce the cost of care. At the core of this effort […]

The relationship between physician practices and health plans is complicated. Each party has its own priorities and agendas to remain financially viable, and sometimes those priorities conflict. Yet health plans and physicians are inherently dependent on each other for survival, especially with the continuing evolution of value-based reimbursement. At the heart of any good partnership is effective […]

Private health plans as well as Medicare and Medicaid have used risk adjustment for years to evaluate the health outcomes and costs for treating their enrollees. Risk adjustment is an equalizer. It is designed to ensure that health care providers and health plans are compensated according to the risk of their patient populations. It also […]