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Dr. Melissa Lim, Chief Medical Officer at Somnology.

3 Ways Health Plans Can Improve Sleep Health for their Members

by Dr. Melissa Lim, Chief Medical Officer at Somnology. 06/20/2022 Leave a Comment

3 Ways Health Plans Can Improve Sleep Health for their Members

Getting a good night’s sleep should have nothing to do with having a great health plan — but it often does.  While some individuals can improve their sleep by making small changes, many who suffer from serious, chronic sleep disorders need a higher level of care and ongoing treatments, and many health plans offer insufficient benefits. For example, Medicare covers sleep diagnostic tests under strict conditions, if patients are referred by a physician. Other health plans have denied
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Breaking Down the Implications of New No Surprises Act Regulations

by Lynne Rinehimer, Esq, GRC Sales Engineer and Compliance SME for symplr 06/17/2022 Leave a Comment

Breaking Down the Implications of New No Surprises Act Regulations

The importance of the No Surprises Act (NSA) cannot be overstated, as surprise medical bills have long been burdensome for patients in the U.S. healthcare system. In fact, more than half of all U.S. consumers have received an unexpectedly large medical bills.  The purpose of the No Surprises Act is to prevent surprise out-of-network bills, often for emergency services. For example, if your appendix bursts while at work, you would be rushed to the nearest hospital for an emergency
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How IoT Data Integration Helps Deliver Improved At-Home Healthcare in 2022

by Patricia (Pat) Black, Director of Technical Solutions at Cardinal Peak 06/16/2022 Leave a Comment

How IoT Data Integration Helps Deliver Improved At-Home Health Care in 2022

When it comes to your health and treatment, hospitals leverage a variety of sensors and instruments to collect the necessary information to monitor and diagnose your health status. With essential health data integrated into one platform, healthcare professionals are able to quickly and easily monitor critical care parameters, which allows them to make decisions and deliver the best possible patient care.  Comprehensive big-picture insight into various health parameters, such as a patient’s
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Unlocking Interoperability with a Blockchain-Powered Network

by Mary Butler-Everson, SVP of Healthcare Product Innovations for PNC Treasury Management 06/15/2022 Leave a Comment

Unlocking Interoperability with a Blockchain-Powered Network

Achieving fluid data interoperability has been a complex and challenging goal for the U.S. healthcare system. The result of which has led to excessive administrative costs, delays in providing care, and significant patient frustration.  According to the Centers for Medicare and Medicaid Services, U.S. healthcare spending grew 9.7% in 2020, reaching $4.1 trillion, or $12,530 per person. This is forecasted to grow to $6.2 trillion by 2028, which will only exacerbate the current spending
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The No Surprises Act: How Payers Can Stay Compliant

by Michael Gardner, Chief Strategy Officer at Virsys12 06/13/2022 Leave a Comment

The No Surprises Act: How Payers Can Stay Compliant

As the healthcare system continues to evolve to adopt a more patient-centric approach, surprise billing has become a topic discussed by consumers and policymakers. Surprise billing can occur when a patient unknowingly receives care from providers that are outside their network. This can result in balance billing, the practice of billing a patient the difference between what their health plan covers and what the provider charges. Unfortunately, these bills are often the result of care provided in
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4 Steps for Operationalizing the FDA’s Call To Improve Health Outcomes for All Patients

by C.K. Wang, Chief Medical Officer of COTA, Inc. 06/10/2022 Leave a Comment

4 Steps for Operationalizing the FDA’s Call To Improve Health Outcomes for All Patients

In April, FDA Commissioner Dr. Robert Califf laid out areas of challenge and opportunity when it comes to improving health outcomes, restoring public trust in science, and making the most of our ongoing investments in data analytics and clinical research. More specifically, Califf made clear that our current healthcare system is “very well aligned to improve outcomes for some people and not others.”  Califf went on to note that we need better mechanisms for evidence generation
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Healthcare Interoperability Has Arrived: 3 Ways to Harness the Potential

by Shawna Koch Mishael, Global Head of Healthcare, Quantori 06/09/2022 Leave a Comment

Healthcare Interoperability Has Arrived: 3 Ways to Harness the Potential

This year’s HIMSS Conference offered some exciting insights and a renewed focus on data-sharing and interoperability. While the healthcare industry has been extolling the virtues of data interoperability for years until recently it has remained one of the biggest obstacles to providing quality healthcare today. Yet, the tides are turning. New government regulations, like the Centers for Medicare & Medicaid Services’ interoperability rules and the Fast Healthcare Interoperability Resources
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Is Telehealth Healthcare’s Biggest Cyber Threat?

by Mike Wilkes, Chief Information Security Officer, SecurityScorecard 06/08/2022 Leave a Comment

Is Telehealth Healthcare’s Biggest Cyber Threat?

It’s time to get used to seeing your doctor from a digital screen, as virtual care is projected to expand well into the future. And while telehealth technology has proven to be highly beneficial in supporting the shift to virtual healthcare, it has also introduced a host of new vulnerabilities and opportunities for security breaches. Cybercriminals have always preyed on the healthcare industry, but with this virtual transition, the substantial increase in connectivity and network exposure has
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Why On-Site Search Should Be A Priority for Healthcare

by Madison Miner, CEO & Founder of WompHealth 06/07/2022 Leave a Comment

Why On-Site Search Should Be A Priority for Healthcare

Healthcare websites are dependably complicated. From finding providers to searching for locations, customers are forced to dig around a growing bevy of care options. To simplify the customer experience, a modern approach to onsite search is needed. The rigid search tools of old are just that – outdated. Customers expect to effortlessly find what they need. And establishing a connection with a customer – at the onset of a visit – starts with a
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Why Health Plans Must Have Next-Gen CAPS Technology for Digital Transformation

by Sagnik Bhattacharya Chief Operating & Product Officer HealthEdge 06/06/2022 Leave a Comment

Legacy vs. Next-Gen Tech: Navigating the Dilemma and Advice for a Smooth Transition

Core Administrative Processing Systems (CAPS) operate as the brains behind a health plan’s business. These systems are critical to the smooth functioning of a health plan. Today, many payers run on decades-old CAPS systems built on legacy technologies. This can be a serious drawback.  Legacy systems may have been efficient based on the technology and best practices of decades past, but have aged beyond their time. They often require an increasing number of workarounds and fixes to try to
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