Emad Rizk, M.D., President, CEO & Chairman of the Board, Cotiviti
Medicare Advantage plans need more than consumer-centric design, payer/provider alignment, and strong connections across the continuum of care to drive value. The high-value performance also depends on their ability to use data to make a meaningful difference in members’ health.
With 11,000 people aging into Medicare daily, proficiency in managing Medicare Advantage populations is critical for demonstrating value in a
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Our Thought Leaders
Wearables Could Transform Insurance from Reactive to Proactive
Ryan VanDePutte, Associate Director, Bits In Glass
Insurance policies have existed for thousands of years and were initially invented to protect goods being shipped long distances. Today, the options available to us have expanded tremendously, and it’s even possible for soccer players like David Beckam to insure their legs.
Despite this, the business of insurance and how it’s managed hasn’t evolved as rapidly. And this is understandable, as it’s a highly regulated industry, so reliability
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How Health IT Helped Baptist Health During Hurricane Dorian
Stacey Johnston, MD, VP & Chief Medical Information Officer, Baptist Health
Preparing a hospital to ride out a natural disaster is fairly straightforward when the danger is imminent. You hunker down, secure the facility, and transfer any higher-risk patients to a safer location.
But what happens if there is only a possibility that disaster might strike? That was the dilemma facing us at Baptist Health, our multi-facility health system in Jacksonville, Fla., as Hurricane Dorian
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Practices: Focus More on Patient Relationships and Less on Management
Patient relationship management (PRM) software is taking center stage in the battle to improve the patient experience. Essentially, PRM is customer relationship management (CRM) for healthcare. It helps practices more effectively communicate with and engage patients and tracks those interactions. For example, if a practice needs to improve reminders and recall, PRM can automate sending messages via text, email, and/or phone by pulling data from the practice management or EHR system.Even though
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The Often-Overlooked Role of Provider Data Management in Population Health
Editor’s Note: Erin Jospe, MD is the Chief Medical Officer at Kyruus, a leader in provider search and scheduling solutions, helping health systems optimize patient access enterprise-wide.Health systems today have access to a tremendous amount of data with which to understand their patient populations better. The population health movement represents a paradigm shift away from merely generating data, to now harnessing it as a means through which to understand the factors and determinants
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6 Ways Healthcare Organizations Could Improve Communication in 2018
Editor's Note: Boris Dzhingarov is the founder of Blogforweb.com and MonetaryLibrary.com where he writes for several sites online such as Semrush, Tweakyourbiz and Socialnomics.net.Effective communication is critical to healthcare organizations all over the world. In today's society, there is more need than ever for improved communication within healthcare organizations to improve efficiency and quality of services. Here are six potential strategies that could help improve communication in the
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OpenEMR Security Vulnerability Could Expose Medical Records Impacting 90M Patients
Editor's Note: Sven Krewitt is the Senior Vulnerability Researcher for Risk Based Security, a detailed information and analysis on data breaches and vulnerability intelligence. Krewitt brings 11 years of experience as a security specialist and vulnerability researcher. He has previously worked as a Senior Security Specialist focusing on vulnerability analysis, quality assurance, and training of new employees.The first known medical vulnerability currently on record is from June 1985 and was in a
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3 Key Areas An Automated Prior Authorization Solution Must Address
Editor's Note: Co-written by Scott Herbst, Senior Vice President and General Manager of Provider Solutions and Ryan Miller, Senior Vice President of Strategy & Corporate Development at Availity.Prior authorizations may be as popular among providers as ants at a picnic, but they have become a common and necessary part of the reimbursement process. As a result, being able to manage prior authorizations efficiently is critical to maintaining a healthy revenue cycle and avoiding issues such as
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From Telemedicine to Better Data: How APIs Improved Health in Chile
Editor's Note: Co-written by Soledad Munoz, CIO of MINSAL, Aashima Gupta, Global Head of Healthcare Solutions at Google Cloud and Michael Leppitsch, Digital Strategies for Global Enterprises at Google Cloud. The Chilean Ministry of Health has been grappling with a big first-world problem. A significant proportion of its 18 million people suffer from chronic conditions, including obesity, diabetes, cancer, and heart disease.But implementing a national mandate to improve these statistics is
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The Value of EMRs: Broken Promise or Unintended Consequences?
Editor's Note: Justin Campbell is the VP at Galen Healthcare Solutions, a professional services firm helping healthcare clients migrate from paper to electronic health records. Prior to joining Galen, Justin served as the IT Director for a long-term care pharmacy, leading a paperless initiative, the migration of the Pharmacy Information System (PIS) from a legacy platform, and the integration of the PIS to the pharmacy’s packaging system.In the world of healthcare many are tempted to believe in
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