Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Features

How Payer Philanthropy Can Address Social Determinants of Health

Rising healthcare costs associated with an increase in chronic diseases have led many payers to seek out strategies to get ahead of the spending curve while improving the overall health of their member populations.   As population health management becomes more important for financial success on the provider side, payers are taking a similar approach to preventive, proactive engagement...


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How Payers Can Improve HEDIS Quality Measure Performance

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 improvement...

Key Steps for Payer Success in Accountable Care Organizations

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 accountable...

The Progress and Challenges of the Affordable Care Act

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 and...

How Medicare, Medicaid, and CHIP Guide the Health Payer Industry

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 value-based...

How Health Insurance Mergers Could Change the Payer Industry

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 dominate...

How Payers Could Succeed in ACA Health Insurance Exchanges

State and federal health insurance exchanges stemming from the Patient Protection and Affordable Care Act (ACA) offer medical coverage for families and individuals that would have otherwise had little opportunity to obtain a health plan and healthcare...

How Payers Should Prepare for Value-Based Reimbursement

Value-based reimbursement is a new payment strategy between insurers and providers meant to foster higher quality care by incentivizing strong performance with shared savings, bonuses, or other financial rewards. This diverges from the more traditional...

How to Overcome the Challenges of Bundled Payment Models

Bundled payment models are a form of reimbursement between payers and providers that adheres to an episode of care instead of payment for a particular medical service. This reimbursement system was created to transition healthcare providers from...

How the Affordable Care Act Changed the Face of Health Insurance

The Patient Protection and Affordable Care Act (ACA) has revolutionized the health insurance industry in a number of ways. Its impacts have been vast and wide. One of the most significant impacts of the landmark legislation is the upward trajectory...

What Are the Benefits of Accountable Care Organizations?

Accountable care organizations (ACOs) are provider and payer arrangements established to improve care coordination between primary care physicians, hospitals, specialists, and public or private health payers. The Centers for Medicare &...

Time, Commitment Required for ACO, Value-Based Care Success

In healthcare, as in so many other areas of life, patience is a virtue. Providers and payers pursuing ACO development will need to have plenty of it before their care transformation efforts pay off with significant cost savings. As providers...

Using Shared Decision-Making to Improve Patient Engagement

PatientEngagementHIT As healthcare professionals face changing consumer demands and calls for increased patient engagement, many organizations are turning to shared decision-making as a key strategy for activating patients in their own treatment. According to the...

What Is the ONC Health IT Certification Program?

EHRIntelligence Health IT companies and innovators offer a number of different types of EHR technology and EHR-integrated health IT solutions to the provider community. These tools include everything from patient portals to voice recognition software, and they...

Artificial Intelligence Promises a New Paradigm for Healthcare

HealthITAnalytics The speed with which artificial intelligence has become an inescapable component of every new technology offering is either highly encouraging or deeply troubling, depending on the observer’s zeal or trepidation around the notion of integrating...

Defending Against Healthcare Ransomware Attacks

HealthITSecurity Healthcare ransomware attacks have become a security nightmare for many organizations over the last couple of years. Ransomware is a type of malware that prevents or limits users from accessing their systems, either by locking the systems’...

Using Health IT to Meet Medicaid Population Health, Socioeconomic Needs

HealthITAnalytics Despite the fact that one out of every five members of the United States population is covered under Medicaid, providers dedicated to serving this segment of the market can often feel as if they are operating in a slightly separate world....

Maximizing Provider Revenue with Payer Contract Management

RevCycleIntelligence Ensuring correct reimbursement in a timely manner is always at the top of a healthcare provider’s mind. But many provider organizations could be leaving money on the table with inefficient and infrequent payer contract management. Payer...

Reconciling the Opioid Crisis with Delivering Quality Patient Experience

PatientEngagementHIT Every day, 115 Americans die after overdosing on an opioid. The rate of opioid-related deaths increased nearly threefold between 2002 and 2015, and heroin-related overdose deaths increased more than six times over during that same time period....

Picking The Right Telehealth Platform For a Small or Solo Practice

mHealthIntelligence For a small practice or solo physician, launching a virtual care platform might seem like a waste of time and money, especially in a climate where both are in such short supply. But telemedicine offers vital operational and clinical benefits...

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