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 engagem...


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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 imp...

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 account...

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 a...

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-...

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 domina...

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...

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...

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...

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 tr...

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 provider...

CMS Sparks Mixed Reactions with Interoperability, Data Blocking Rules

HealthITAnalytics CMS and the ONC dropped a moderate bombshell on the healthcare industry this week by releasing their information blocking and interoperability proposals on the eve of HIMSS19. A conference that typically focuses on forward-thinking innovati...

How Network Segregation, Segmentation Can Stop Ransomware Attacks

HITInfrastructure Ransomware attacks against healthcare organizations have been on the rise in recent years, with sometimes devastating results.* From EHR downtime to compromised patient data, these cyberattacks can significantly disrupt the operations of he...

What Is Cyber Insurance for Healthcare Organizations?

HealthITSecurity The healthcare sector has been a prime target for hackers over the last few years. Attacks have increased in sophistication, shifting at times from the obvious ransomware attacks to subtle, credential-stealing cyberattacks that hide in the ...

How eConsults Can Offer a Virtual Care Connection to Specialists

mHealthIntelligence Using a telemedicine platform to connect primary care providers with specialists can improve care management and care coordination for patients.  These services, called eConsults, can serve as a cost-effective way to expand access to c...

Preventing Physician Burnout from Impacting the Patient Experience

PatientEngagementHIT The healthcare industry is undergoing a period of rapid technical and clinical innovation as it moves away from episodic, reactive care.   While data-driven decisions and holistic approaches to patient management can bring significant ...

Patient Financial Experience the New Focus for Revenue Cycle Tech

RevCycleIntelligence Hospitals and practices have traditionally relied on public and private payers to cover the bulk of patient charges and costs for their services. Everything from their revenue cycle technologies to billing workflows has been tailored to cre...

Consumers, AI Will Challenge Health IT Infrastructure Leaders in 2019

HITInfrastructure As part of the healthcare industry’s ongoing transformation, health IT infrastructure is undergoing rapid change. Seamless, future-proof health IT infrastructure development will become increasingly important as the use of artificial ...

How Healthcare Blockchain Can Help Overcome IT Barriers

HITInfrastructure The excitement surrounding blockchain’s possibilities for enterprise IT has predominantly centered on financial services. However, healthcare blockchain could also provide solutions to IT challenges facing healthcare organizations and...

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