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Emad Rizk, M.D., President, CEO & Chairman of the Board, Cotiviti

Healthcare’s Uncertain Future: 3 Data-Driven Approaches for Payers

by Emad Rizk, M.D., President, CEO & Chairman of the Board, Cotiviti 06/27/2019 Leave a Comment

Navigating Healthcare’s Uncertain Future: Three Data-Driven Approaches for Payers

Nine out of 10 healthcare leaders expect disruptive pressures to increase tremendously in the year ahead, according to a recent survey. However, fewer than half believe their organizations are prepared to withstand these forces. In an era of transformation—in which traditional business models are continually being revamped in response to pressures such as consumerism, policy changes, and the market entrance of non-traditional healthcare players such as Amazon and Apple—payers face daunting
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Revenue Leakage: 3 Methods to Revive Your Charge Integrity Program

by Rebecca Marsh, VP of Advisory Solutions, nThrive 06/26/2019 Leave a Comment

Three Methods to Revive your Charge Integrity Program

Many consider a strong charge integrity program the cornerstone and heartbeat of the revenue cycle. Without an effective charge integrity program, health care providers run the risk of revenue leakage. According to the Healthcare Financial Management Association, “one percent of net patient revenue is lost due to charge capture errors,” which can add up to multi-millions of dollars for health care organizations. Most providers have not considered or quantified the potential dollars lost when
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Remote Enablement Adoption: The Key to Reshaping Patient Monitoring

by James Caffrey, Leader of Strategic Projects & Ventures, Monitoring & Analytics, Philips 06/25/2019 Leave a Comment

Remote Enablement Adoption: The Key to Reshaping Patient Monitoring

The healthcare industry is facing significant pressures around costs and outcomes as it shifts to a value-based care model. To alleviate these concerns, hospitals are looking to technology to help. Over the years, technology has significantly evolved with more connectivity, advanced algorithms and introduction of machine learning and AI. These advancements have greatly improved efficiencies and outcomes in the healthcare industry, yet, along with these benefits, technology also brings a concern
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Can Artifical Intelligence Solve The Chronic Kidney Disease Epidemic?

by Girish Nadkarni, MD, Assistant Professor in the Department of Medicine, Division of Nephrology, at Mount Sinai, and Co-Founder of RenalytixAI 06/25/2019 Leave a Comment

Can Artifical Intelligence Solve The Chronic Kidney Disease Epidemic?

Chronic kidney disease (CKD) is a growing epidemic worldwide. Currently, there are 850 million individuals suffering from CKD globally, with 40 million in the United States alone. Of these individuals, 96 percent are not aware of having CKD, as kidney disease often exhibits no symptoms until it has progressed to a late stage. As this epidemic continues to grow, healthcare providers and organizations are working to determine how artificial intelligence (AI) can be used to analyze electronic
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Improving Patient/Member Satisfaction through Nurse Triage Services

by Austin Ridgeway, Director of Sales/Business Development for the Healthcare Vertical at HGS 06/24/2019 Leave a Comment

Improving Patient/Member Satisfaction through Nurse Triage Services

Not long ago, viewed members as captive audiences (more or less). Most members obtained their health insurance through their employers or another group and were unlikely to go outside of that option no matter how they actually felt about the health payer. Providers had to be a little more careful since it was easier to change hospitals or doctors, but even then most patients were willing to unquestioningly accept a low level of service as part of the package of obtaining quality healthcare. Not
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Reaching the Healthcare Mainstream: Wearables and Remote Patient Monitoring Market Map

by Healthcare Growth Partners (HGP 06/21/2019 Leave a Comment

Reaching the Healthcare Mainstream: Wearables and Remote Patient Monitoring

Even though 2014 was supposed to be the “year of the wearable” according to Forbes, five years later we are now seeing the wearable reach maturity and mass-adoption.  This increase in adoption has largely been driven by software and hardware stability which is now allowing these devices to be used with confidence to manage an individual’s health and wellness, including chronic condition management. The graphic below from Accenture shows the increase in technology usage across consumers to manage
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5 Things Patients Are Looking For On Your Physician Practice’s Website

by Sahil Saini, Founder of AKOS 06/18/2019 Leave a Comment

5 Things Patients Are Looking For On Your Physician Practice’s Website

Patients have taken a more active role in their healthcare journey, and with more digital options than ever before, their expectations have significantly shifted. More are taking their healthcare-related searches online –– an estimated 80 percent according to a recent report by Doctor.com –– and adopting a consumer-like approach, comparing and contrasting providers to find a practice that fits their needs to a tee. With patient consumerism on the rise, it’s become imperative for providers to
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3 Ways Health Plans Can Leverage Lab Data Analytics

by Hossein Fakhrai-Rad, Founder & President at BaseHealth 06/17/2019 Leave a Comment

3 Ways Health Plans Can Leverage Lab Data Analytics

Payers have long realized the value of leveraging disparate data sets to gain greater insight on patients, with popular data sources including claims, electronic health records, and surveys on social determinants and behavioral health. More recently, health plans have begun to appreciate another source of data that can help them avoid missed revenues, predict emerging conditions and improve risk management: laboratory data. This category includes data on critical health factors such as
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Applied Analytics: Making the Dream of Cost-Controlled Population Health a Reality

by Moshe Starkman, Senior Director, Value Based Reimbursement, nThrive 06/12/2019 Leave a Comment

Applied analytics: Making the dream of cost-controlled population health a reality

Ninety percent of a solution is accurately defining the problem, however, in healthcare, much like nearly every other industry, more time and energy is spent on fixing perceived symptoms rather than identifying root caU.S.es. Today we will explore the contribution that applied analytics has made and continues to make on bending the dramatic U.S. healthcare cost curve. To do this well we will first explore the primary cost drivers (i.e. root caU.S.es), as to why the U.S. spends more on care than
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How Patients Suffer From The Worst Kept Secret in Health IT

by Mark LaRow, CEO of Verato 06/11/2019 Leave a Comment

Recently, articles in The Atlantic and Fortune highlighted a risk that plagues the healthcare system but is rarely talked about. The in-depth pieces uncover real-life patient stories resulting from mismatched and incorrect patient medical records. These tragic stories unfold in the articles and highlight scenarios that include permanent brain damage in a 5-year old; a cancer scare due to an incomplete radiological history; the missed diagnosis of a fatal brain aneurysm in a 47-year old woman;
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