Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Patient Engagement

60% of Medicare Advantage Members Feel Little Motivation from Plans

January 10, 2019 - Medicare Advantage (MA) plans are not doing enough to motivate their members to improve their personal health, according to a new survey from HealthMine. Sixty percent of members participating in the poll said that their MA plans do not offer any incentives for engaging with healthcare providers or making lifestyle improvements, leaving individuals on their own to meet their wellness...


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Humana Tops List for Member Satisfaction, Net Promoter Score

by Jennifer Bresnick

Customer service has been a perennial pain point for the health insurance industry, but a renewed focus on personalized experiences, member satisfaction, and consumer engagement appears to be paying off for some of the nation’s...

Member Engagement for Payers Should Focus on Simplicity

by Jesse Migneault

For payers, an effective member engagement strategy can lead to better member health, lower claims cost, and improved product loyalty.  To achieve these goals, payers should start by identifying pain points and implementing processes...

Patient Incentives from Payers Encourage Preventive Care Visits

by Jesse Migneault

To reduce payer claim costs, would you pay members to go see their doctor once a year?  That’s the premise for a wave of patient incentive programs currently being offered by health insurance companies. For healthcare insurance...

How the Affordable Care Act has Impacted Health Payers

by Vera Gruessner

The Affordable Care Act has  brought a significant reform toward the health insurance industry. This particular legislation has given the majority of American people healthcare coverage, which has put greater strain on health...

Concierge Medicine Model Impacts Population Health Management

by Vera Gruessner

The concierge medicine model is becoming more and more prominent around the nation, as healthcare providers continue to adopt the new payment system. While many hospitals and physicians are finding medical payment reform and the move...

Price Transparency May Lower $27 Billion in Healthcare

by Vera Gruessner

Price transparency in the healthcare industry is becoming more and more pertinent and sought after. Research has shown that there is still insufficient price transparency within the medical field including hospital services. However, a new...

Cost Transparency, ‘Consumer-driven Healthcare’ Impacts Payers

by Vera Gruessner

Cost transparency remains a vital aspect of healthcare reform among both providers and payers. Uninsured consumers and those who have employer-sponsored health coverage are continually finding the costs of premiums, deductibles, and...

Star Ratings System Created for Medicaid Home Health Services

by Vera Gruessner

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) established a final rule that alters the Medicaid home health services definition to include additional requirements for home care services which expands beyond...

Patient Engagement Cuts Healthcare Spending among Payers

by Vera Gruessner

Within both federal and state health insurance exchanges, payers are seeking methods for reducing cost in order to avoid profit loss and dropping out of the exchanges much like UnitedHealthcare’s move away from the marketplace. One...

Key Steps toward Affordable Health Insurance Platforms

by Vera Gruessner

The average insured consumer is facing a whole new landscape when it comes to managing the costs of care. The prices surrounding health insurance plans and coverage options are rising steadily while wages and inflation rates remain...

Why a Competitive Health Insurance Plan Matters to Employees

by Vera Gruessner

It seems that benefits and a health insurance plan majorly influence employment decisions of many Americans. An online survey completed by Harris Poll on behalf of the software company Collective Health shows that more than 75 percent of...

85% of People with Expensive Copays Prefer Email Communication

by Vera Gruessner

One study stemming from Kaiser Permanente and published in The American Journal of Managed Care illustrated that one-third of patients who use email communication as their primary method of contacting their doctor reported better health....

HHS Announces $157M for Accountable Health Communities Model

by Vera Gruessner

Earlier this week, the Department of Health and Human Services (HHS) announced new funds available of as much as $157 million to develop an Accountable Health Communities Model, which will show whether testing beneficiaries on social needs...

How Care Management Strategies Could Reduce Medical Costs

by Vera Gruessner

When it comes to managing the treatment and financial implications of complex medical conditions, health payers and providers will need to work together and have effective cross-industry communication. A strong relationship between payers...

How to Design and Support an Accountable Care Organization

by Vera Gruessner

When a large establishment wants to bring more care coordination and greater organization among multiple medical facilities including primary care offices, hospitals, and specialty entities, there are specific steps to take and certain...

How Payers Can Improve Websites of Health Insurance Exchanges

by Vera Gruessner

In order to better serve their customer base, state health insurance exchanges along with the federal website HealthCare.gov could take a number of steps to improve their web pages and expedite the purchasing of health insurance...

Why Population Health Data is Integral for Value-based Care

by Vera Gruessner

The study of population health data could be relevant for both payers and providers, as it could affect reimbursement for healthcare services. As hospitals and clinics continue to promote wellness programs, improve patient safety, and...

Beneficiary Incentive Programs Advance Patient Engagement

by Vera Gruessner

Did you know that between the years 1975 to 1985, average annual Medicare spending for each beneficiary rose from $472 to $1,579? This is an increase of 12.8 percent per year, according to The Commonwealth Fund. It is no surprise that...

Patient Engagement High Priority for Millennial Patients

by Sara Heath

Patient engagement proves to be of high priority in the ever-evolving healthcare landscape, and providers and payers are seeing shifts in how patients purchase healthcare and health insurance because of patient engagement. This shift is...

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