A recent report from the HHS Office of the Inspector General (OIG) turned heads across the healthcare industry after pointing to a notable rise in inpatient hospital stays where upcoding was believed to be the culprit. Compliance professionals who have been in the healthcare industry any length of time know what's next: targeted billing reviews by the Centers for Medicare and Medicaid Services (CMS) around hospital stays that are vulnerable to upcoding.
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Implementing Responsible AI to Drive Innovation in Clinical Research & Precision Medicine
Researchers might be skeptical and, with people’s lives at stake, that’s understandable. Here’s how to take advantage of the advances while ensuring safeguards are in place.
As artificial intelligence (AI) and machine learning drive innovation and disruption in clinical trials and precision medicine, questions around the responsible use of AI have moved to the forefront of debates among healthcare stakeholders – patients, providers, regulatory authorities, payors and sponsors. To what extent,
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3 Trends Impacting the Financial Health of Patients and Providers in 2022
It's an unfortunate reality of our times: Healthcare in the United States has become increasingly unaffordable, challenging patients, providers, and pharmacies alike. One in 5 adults reported they can’t afford quality care. Uncompensated care hovers around $40B annually. The COVID-19 pandemic continues to strain the resources of our healthcare system. What lies ahead?
Against a backdrop of growing financial burden, these three trends tell the story of where healthcare affordability is
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Pharmacy Interoperability Challenges and Needs Under the 21st Century Cures Act
As interoperability provisions from the 21st Century Cures Act (Cures Act) enter their enforcement phase, pharmacy leaders within the Pharmacy HIT Collaborative (PHIT), the U.S. Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC), and pharmacy system vendors met recently to discuss the state of pharmacy interoperability. The group detailed various challenges and needs associated with pharmacy interoperability, information
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Enhancing Workflow Automation for Healthcare Professionals
Like employers in most industries, healthcare organizations are battling to fill open positions amid the current tight labor market. And new reports show a growing wave of nursing shortages. This widespread scarcity of healthcare workers is forcing providers to cope by having practitioners handle tasks like data entry along with their normal patient care duties. That loss of time means organizations miss out on opportunities to generate more revenue with their top talent.
Fortunately,
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7 Burning Questions from Life Sciences Companies on Using AI Agents
Each day life science companies respond to numerous medical information inquires – many of which are similar in nature or can be simply addressed. However, as we have seen in the news reports with the Great Resignation and many workers searching for new careers, the number of individuals interested in working in a medical information contact center may be waning. When you combine this with the rising volume of inquiries or medical inquiries and patient expectations for a real-time response to
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Spatial Omics: The Next Wave in the Biological Research Revolution
For decades, biomedical researchers pursued a reductionist strategy, investigating DNA, RNA, proteins and other cellular players in isolation. These studies have been critically important, providing vital parts lists to guide further exploration. Now, however, biology has entered a new age, in which scientists must adopt more contextual approaches to understand the fundamental units of life – cells.
But to truly understand how cells operate, we must explore their relationships in time
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3-Step Ransomware Recovery Strategy for Healthcare Organizations
At some point, the chances are high that ransomware will pierce the defenses you have tried to put in place at your healthcare organization. When that occurs, your healthcare organization needs a ransomware recovery strategy, which enhances your typical backup and recovery processes. Below is a three-step program for ensuring that you can recover from an attack.
Step 1 - Frequent Backups
Ransomware, unlike any other disaster, can strike anywhere. No data center is safe. It can also hit at
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Virtual Primary Care Reimagined With A Virtual First Health Plan
The promise of primary care on improved health outcomes has been proven over time. At the core of this equation is a robust and longitudinal patient-provider relationship. These positive relationships often improve patient satisfaction, yielding higher engagement and utilization of primary care services. However, recent studies suggest people are not engaging with primary care.
In fact, internal Teladoc Health data has shown that 80% of members do not have a strong relationship with a
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3 Ways Real-Time ADT Notifications Will Benefit Payers’ Businesses
Payers and providers share goals around emerging healthcare delivery models such as value-based care and accountable care organizations (ACOs). But inadequacies in current payer/provider communication often disrupt the flow of timely care and lead to unnecessary hospital readmissions and poor outcomes. What’s needed in this partnership is the standardized, fluid, real-time exchange of data to help both parties become even more efficient and effective at providing members the proper care at the
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