More Features
Exploring Two-Sided Financial Risk in Alternative Payment Models
RevCycleIntelligence As value-based care becomes the name of the game in healthcare, public and private payers are pushing providers to take on more financial accountability for their services through alternative payment models. In a fee-for-service world,...
How Payers Can Improve HEDIS Quality Measure Performance
HealthPayerIntelligence HEDIS quality measures have a significant role in the healthcare industry regarding closing gaps in care and decreasing the use of costly acute care through preventive services. By placing a greater focus on value-based care and quality...
Balancing Patient Portal Privacy and Access for Pediatric Care
PatientEngagementHIT Patient portals are an important regulatory requirement, with industry professionals touting their ability to better engage the patient and help all participating parties manage patient health. While pediatric and adult patients tend to use...
Using Risk Scores, Stratification for Population Health Management
HealthITAnalytics Population health management requires providers to maintain a delicate balance between taking a long view of generalized patient trends and focusing personal attention on the individual and the distinctive circumstances that will influence...
Why Application Programming Interfaces Are Key for Healthcare
HITInfrastructure Healthcare organizations seeking to create interoperability between internal apps, EHRs, and other data exchange tools, are increasingly turning to application programming interfaces (APIs) to manage the flow of information between...
Key Steps for Payer Success in Accountable Care Organizations
HealthPayerIntelligence In recent years, healthcare reforms have set out to reduce constantly rising medical costs, improve coverage for the many Americans who lacked primary care access, and advance population health outcomes. Over the past few years, the...
Top Revenue Cycle Management Vendors and How to Select One
RevCycleIntelligence As value-based reimbursement models, such as the upcoming Quality Payment Program, break down the walls between care quality and healthcare payments, more providers have set their sights on implementing vendor-sponsored revenue cycle...
What Providers Should Know to Improve Patient Access to Healthcare
PatientEngagementHIT Patient engagement, consumer satisfaction, and patient access to healthcare are three of the most critical pieces of the value-based care puzzle. As outcomes, satisfaction, and patient loyalty become more important to financial security for...
Understanding HIPAA-Compliant Cloud Options for Health IT
HITInfrastructure Healthcare providers looking for HIPAA-compliant applications, storage, and networking options are increasingly turning to the cloud, which has quickly become a low-cost way to develop the complex infrastructure required to support a...
What a Trump Presidency Means for Value-Based Care and the ACA
RevCycleIntelligence Love it or loathe it, the United States is headed for four years of drastic policy changes under a Donald Trump administration, giving lawmakers another good chance to repeal, replace, or revise the Affordable Care Act. The landmark...
The Progress and Challenges of the Affordable Care Act
HealthPayerIntelligence Before the Patient Protection and Affordable Care Act (ACA) became law on March 23, 2010, the healthcare industry faced a number of obstacles particularly in terms of providing medical care and health insurance to many low-income families...
How to Maximize Revenue with Improved Claims Denials Management
RevCycleIntelligence Claims denials may be a part of life for healthcare revenue cycle managers, but a prevention-focused denials management strategy may be able to significantly reduce the number of times billing staff are faced with unpaid claims. Recent...
How Healthcare Can Prep for Artificial Intelligence, Machine Learning
HealthITAnalytics The term “artificial intelligence” often conjures up visions of apocalyptic landscapes decimated by hyper-intelligent machines with a penchant for destroying societies foolish enough to place their trust in autonomous robots and...
CMS Timelines for Stage 3 Meaningful Use, MACRA Implementation
RevCycleIntelligence For Medicare providers, CMS has set the pace for quality improvements and healthcare payment reform through Stage 3 Meaningful Use and the Quality Payment Program (under MACRA implementation). The programs are designed to put providers on...
How Medicare, Medicaid, and CHIP Guide the Health Payer Industry
HealthPayerIntelligence Medicare, Medicaid, and CHIP, the three major public insurance programs overseen by CMS, often set the tone for the large private health payer industry. CMS is using all three programs to actively encourage the movement towards...
How Will MACRA Impact Patient Engagement, Care Coordination?
PatientEngagementHIT In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) with an overwhelming bipartisan majority. The complex piece of legislation has a number of provisions, each of which affects different areas of the...
How Health Insurance Mergers Could Change the Payer Industry
HealthPayerIntelligence During the summer of 2015, Aetna and Humana, as well as Anthem and Cigna, started a merger process that would reduce four of the nation’s largest insurers down to just two. If the mergers are successful, only three payers would...
How to Get Started with a Population Health Management Program
HealthITAnalytics Healthcare providers are well aware by now that there is no magic solution to the incredibly complex conundrum of systemic reform. Depending on who you ask, the answer to the puzzle of the Triple Aim is either more technology, less...
What Is the Role of Natural Language Processing in Healthcare?
HealthITAnalytics For many providers, the healthcare landscape is looking more and more like a shifting quagmire of regulatory pitfalls, financial quicksand, and unpredictable eruptions of acrimony from overwhelmed clinicians on the edge of revolt. The...
