As the country begins open enrollment this month, many plans have ramped up their communications to members in an effort to stay top of mind for those who might be shopping for a new plan. In particular, plans are working to expand their Medicare Advantage membership because of their stability and their growth potential as more Baby Boomers retire. Since 2010, Medicare Advantage enrollment has grown 71% to cover 19.0 million beneficiaries and is expected to continue on this upward trajectory
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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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5 Reasons Why Mobile Medication Management is Critical to Your Practice in 2018
No one disputes that properly managing a person’s medications is key to effective treatment, including reducing adverse reactions. Unfortunately, physicians aren’t always able to take advantage of all available information when making clinical decisions because they are grappling with siloed data, disconnected workflows and incomplete information. For example, physicians often must go through tedious and time-consuming steps to log into multiple systems on their office computers in order to
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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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5 Considerations to Enable a Modern Healthcare Commerce Strategy
The healthcare industry is facing a number of external market forces that are creating the perfect pricing storm. Industry consolidation, regulation and new demands for transparency are putting added pressure on healthcare manufacturers, with many left wondering about how they can profitably compete. Over the last three decades, more than 1,000 healthcare manufacturers have been acquired due to competitive consolidation. The catalyst for this volatility can be attributed to the lack of
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Population Health Management Means the Whole Population, Not Just the Highest Need
Considerable attention has been given to the large proportion of healthcare spending concentrated among a small proportion of patients. This five to 10 percent of the population has been the driving force behind many value-based purchasing models, e.g., chronic health condition management for the high cost, high utilizers, and health home models for care coordination and management services. A recent thought piece (March, 2017) in the The New England Journal of Medicine, “Focusing on
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3 Roadblocks to Achieving Interoperability In A Value-based Care System
I am sure I am not the only one who has lost count of the times I’ve been asked “Why can’t the systems talk to each other?” or, in more technical terms, “Why don’t we have interoperability?”The numerous health IT solutions that we have around us today were meant to improve not just the delivery of care, but also enhance patient outcomes as the care continues across multiple practices. At the most basic level, I suppose we can define interoperability as two or more systems communicating with each
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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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3 Challenges and Considerations for Measuring Population Health Success
Healthcare organizations across the country are under enormous pressure to improve health outcomes, where the notion of “population health management” has suddenly evolved from a “nice-to-have” to a necessity. This prominent care initiative involves grouping patients together based on certain characteristics - age, gender, chronic conditions come to mind, just to name a few - and working to improve the health status of that group by monitoring, analyzing and improving the health of the
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Why GE Won’t Sell its Health IT Business
As John Flannery, the new CEO of GE takes on the task of sweeping cost-cutting at the industrial behemoth, recent market speculation has suggested he may be looking to offload GE’s Healthcare IT business. Here's why we think this won’t happen.Crumbling, but not to the coreGE's health IT portfolio has been compiled from many acquisitions, creating a complex and sometimes disjointed product set. At its center is a core set of software and services focused on clinical IT. GE’s products that support
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