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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4 Patient Flow Challenges Contributing to Provider Burnout
There has been frequent reporting about the problem of provider workforce shortages within hospitals and health systems and the related burnout experienced when working in high-stress situations during the COVID-19 pandemic. There are pre-existing and contributing patient flow challenges that have been exacerbated by the pandemic, which can lead to burnout, and therefore are worth discussing.
Exposing the Problem
The extent of provider burnout over the course of the pandemic is well
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Racist Events Can Have Spillover Effects, Triggering Mental, Physical Health Responses Beyond Immediate Victim
This article is excerpted from the Hurdle Health Research Report “Voices of a Collective Experience: Vicarious Racism and its Effects on Black Mental Health.”
In the Brooklyn mural, an American flag undulates behind him. The one in Gaza City, Palestine crowns him with two hands—one Black, one White—making the shape of
a heart. In Naples, Italy, he weeps blood, reminiscent of religious artwork of Jesus and the Virgin Mary. Another, in Los Angeles, drapes red tape with the words “I
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Outdated Pain Models & The Rise of New Science on Chronic Pain
More than 50 million adults in the United States – more than 20% – suffer from chronic pain, and more than 19.6 million adults have pain that interferes with their lives more days than not. The estimated cost of chronic pain is $635 billion – more than heart disease and cancer combined – due to the number of days missed from work, treatment costs, and other factors. Chronic pain is the leading cause of disability, but the current pain treatment system isn’t working. This is because it hasn’t
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Is It Finally Time for Hospital-at-Home or is Time Up?
All the signs point to a bright and expansive future for hospital-at-home programs, which have been growing steadily since the Centers for Medicare and Medicaid (CMS) created the Acute Hospital at Home waiver program in November 2020. As of March, nearly 100 health systems and more than 200 hospitals in 34 states had been approved for the program. Meanwhile, Forrester predicts the number of hospitals delivering acute care at home will triple in 2022. The reasons why are compelling: a study
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Taking the Pulse on eCME – What’s Next for Continued Medical Education
Over the past two years, we’ve witnessed the massive digital disruption in healthcare that was spurred by the pandemic. The most frequent example tends to be in the rapid adoption of technology like telemedicine, but this disruption has touched even the most seemingly small pieces of the healthcare ecosystem and will have long lasting consequences.
Just consider the conferences that once used to draw large crowds of physicians seeking to attain their continuing medical education (CME)
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Data-Driven Healthcare Operations Will Transform Outcomes
You don’t need another story urging you to “get to the cloud.” That’s old news for healthcare executives, who’ve long understood the necessity of rebooting the way their organizations operate in the digital era.
In a recent McKinsey study, 19 of the 22 healthcare leaders the company interviewed described digital healthcare solutions as “highly relevant” or “relevant” to their businesses. They get it.
In fact, digital healthcare has already become the minimum table stakes: 93% of
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Buried Under Dirt or Under Debt: Can Patients Survive the Struggle of Getting Care?
New patients at a cancer center in Michigan receive a 79-page handbook when their treatments commence. The handbook includes needed advice on what to eat and the side effects of chemotherapy drugs. One double-sided page features information about how to navigate the financial aspects of cancer treatment, including who to contact for help with medical bills.
For Leslie Vreeland-Corpe of Michigan, one double-sided page couldn’t contain all the information she needed. After being diagnosed
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Interoperability: A Powerful Solution to Staffing Challenges Continues to be Overlooked
In our ever-changing world, clinicians nowadays must find more efficient ways to operate with fewer resources. Increased patient loads, reimbursement changes, rule and regulation adjustments and thin margins, all while being short-staffed can be compared to a smoldering bonfire that reignites every time the wind blows. As if that weren't enough, post-acute providers will begin to feel even more heat if they don’t embrace interoperability. Our global demographics simply will not be able to
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How Patient Movement Benefits from Standardized Acuity Scoring
Nurses and providers typically assess patient acuity and volume at the beginning of their shift, whether formally or informally. Managers use patient acuity to balance nursing assignments, and nursing staff uses it to determine which patient care action should be prioritized next. Taking a standardized approach to acuity assessments not only provides more objectivity, but also gives hospitals the data they need to make a variety of tactical and strategic decisions, from daily unit staffing to
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