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...

Why Cloud, Virtualization Are Key to Healthcare Infrastructure Strategy

HITInfrastructure The healthcare industry’s transformation isn’t just taking place in consult rooms, retail clinics, or EHR developers’ office buildings.   Health IT infrastructure - the engine that drives clinical, operational, and administrative...

Leveraging Primary Care Telehealth for Convenience and Quality

mHealthIntelligence At its heart, the telehealth or telemedicine platform is all about connecting the patient to the doctor for primary care services. That’s where it all began: a virtual connection to treat a nagging cough or cold, a sinus infection or earache...

Using Visual Analytics, Big Data Dashboards for Healthcare Insights

HealthITAnalytics The need to make sense of big data is quickly becoming an imperative in the healthcare industry, demanding a degree of time, skill, attention, and resources that many providers simply do not have to spare.  While changing payment models...

Good Data, Better Value-Based Care Can Boost Population Health

RevCycleIntelligence With just 5 percent of patients accounting for nearly one-half of the nation’s healthcare spending, hospitals and health systems have a significant opportunity to address a large proportion of their costs by improving the health of a relatively...

How HIPAA Regulations Apply to Key Patient Data Access Situations

HealthITSecurity Individuals have an inherent right to access their own health information. Patient data access can be a critical tool for proper care, but both providers and patients often face confusion about how HIPAA regulations impact the exchange and release...

How Open Source Software Benefits Health IT Infrastructure

HITInfrastructure Health IT infrastructure forms the foundation for everything that happens in a healthcare organization, from quality improvement and patient safety to financial sustainability and business intelligence. While many different health IT strategies...

What Are the Social Determinants of Population Health?

HealthITAnalytics Financially and clinically successful population health management programs must take much more into account than what happens to a patient while she is sitting on the exam table.  As the healthcare system’s responsibility expands...

Key Strategies for Succeeding with Healthcare Bundled Payments

RevCycleIntelligence Healthcare bundled payments are a value-based reimbursement model that uses a single, comprehensive payment to address an entire defined episode of care. This alternative payment model has become a critical stepping stone for providers as they...

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