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...


More Features

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...

Pay-for-Performance Strategies for Independent Physicians, Small Practices

RevCycleIntelligence Pay-for-performance models aim to reward providers for high-quality care at lower costs. However, value-based reimbursement structures tend to require substantial upfront and ongoing investments and put practice revenue at risk, straining the...

Laying the Foundation for Strong Healthcare Risk Management

HealthITSecurity With cybersecurity threats becoming more sophisticated each day, healthcare organizations must implement necessary policies and procedures to keep sensitive data secure. A current and comprehensive healthcare risk management plan is a key component...

What are Precision Medicine and Personalized Medicine?

HealthITAnalytics Since the beginning of recorded history, healthcare practitioners have striven to make their actions more effective for their patients by experimenting with different treatments, observing and sharing their results, and improving upon the efforts...

Effective Nurse Communication Skills and Strategies

PatientEngagementHIT In healthcare facilities, nurses can be found nearly everywhere -- at patient screenings, in nursing stations, and, most importantly, with the patient in the exam room or at the bedside. Nurses are on the front lines of patient care, making nurse-patient...

Is Project ECHO the Telemedicine Model That Healthcare Is Missing?

mHealthIntelligence A telemedicine platform developed about 15 years ago in New Mexico is now helping thousands of doctors across the country learn from specialists and manage care for patients with complex conditions. Project ECHO (Extension for Community Health...

Meeting the Challenge of Healthcare Consumerism with Big Data Analytics

HealthITAnalytics As the remarkable, eventful year of 2017 lumbers to its cold and snowy close, healthcare organizations may feel as if they are starting 2018 on an unstable footing. From tragic natural disasters and devastating ransomware attacks to the first...

Pros and Cons of PACS, VNAs for Medical Image Data Storage

HITInfrastructure As healthcare providers invest in new medical imaging technologies that produce increasingly large and complex data files, organizations need to implement infrastructure tools that can support the storage and appropriate access of necessary patient...

Understanding the Basics of Clinical Decision Support Systems

HealthITAnalytics Clinical decision support systems are quickly becoming essential tools for healthcare providers as the volume of available data increases alongside their responsibility to deliver value-based care. Reducing clinical variation and duplicative...

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