In the ongoing transition to value-based care (VBC), provider contracting poses challenges for health plans and providers. In my past role as the VP of Quality at a large health plan, I was part of the team that reviewed provider contracts that included risk around quality. Adding my role to the review process reduced the frustration of the Network and Quality teams because I could identify the reporting requirements that the health plan couldn't meet and create alignment with measure
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8-Step Strategy to Prevent EHR-Driven Physician Burnout
These days, technology plays a vital role in improving the quality of life, impacting various sectors, including healthcare. Electronic Health Records (EHR) have revolutionized the way medical professionals access and manage patient data, leading to streamlined processes, improved patient care, and increased cost-efficiency. However, with the rapid adoption of EHR, several challenges have arisen, including physician burnout associated with EHR systems. In this article, we will explore a
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2024: The Year of Smarter Automation and AI in Healthcare Revenue Cycle
Artificial intelligence (AI) dominated the headlines in 2023. It was the topic of countless articles, reports and even court cases. Some may be fatigued by it, or even afraid of it, but the reality is AI is here to stay in 2024. The best thing we can all do is learn how to leverage it to make our jobs easier.
In fact, after decades of slogging through manual processes, healthcare organizations are joining the movement and implementing automation and AI solutions to improve revenue cycle
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8 Common Physician Credentialing Mistakes to Watch in 2024
Artificial intelligence (AI) dominated the headlines in 2023. It was the topic of countless articles, reports and even court cases. Some may be fatigued by it, or even afraid of it, but the reality is AI is here to stay in 2024. The best thing we can all do is learn how to leverage it to make our jobs easier.
In fact, after decades of slogging through manual processes, healthcare organizations are joining the movement and implementing automation and AI solutions to improve revenue cycle
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Pharma & Influencer Marketing: Can They Coexist Ethically?
Influencer marketing in the pharmaceutical industry is a complex issue with reasonable arguments on multiple sides. On the one hand, leveraging individual patients' personal experiences and narratives may help bring an authentic voice to product messaging. This could increase trust and resonance for some audiences skeptical of more traditional promotional content. However, legitimate concerns about transparency and potential conflicts of interest exist if affiliate relationships or sponsored
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Elevating Healthcare Through Risk Stratification: Lessons from North Carolina’s Value-Based Initiatives
As the healthcare landscape continues to evolve, there's a clear trend towards value-based care (VBC). This significant shift, which places a premium on patient health outcomes, diverges from the traditional fee-for-service approach. The aftermath of the COVID-19 pandemic has mainly catalyzed the adoption of VBC models, highlighting the importance of care quality and effectiveness rather than the sheer volume of services. This change reshapes healthcare, aligning it more closely with patient
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Myth Busting Today’s Most Common Nutrition Misconceptions
Whether it’s on TikTok, WhatsApp, Instagram or Facebook, the latest “diet” trends are hard to escape. There’s paleo, keto, macros, intermittent fasting, vegan, Mediterranean, low-carb and so many other programs inundating individuals every day, and many turn to their favorite social media influencers for “expert” opinions on what works and what doesn’t. In fact, social media is so prevalent today that one study showed 85% of people relied on it as a source for trusted health information.
But
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4 Key Ways QHINs Will Improve Healthcare Interoperability
Like tales of Bigfoot and UFO sightings, talk of Qualified Health Information Networks (QHINs) has been met around the health industry with some skepticism, with some in health IT asking, “Are QHINs real?”
Though the question was posed partly in jest, doubts about the reality of QHINs have been somewhat understandable. QHINs were created as part of the Trusted Exchange Framework and Common Agreement (TEFCA), a set of regulations designed to improve healthcare interoperability by establishing
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Top 7 Healthcare Focus Areas for Mastering Modern CPQ Technology in 2024
In an era where the precision and timeliness of healthcare delivery are paramount, digital transformation is not a business want, but a business requirement. This transformation must span the entire continuum of care, from the patient to the payer, to ensure seamless healthcare delivery.
Enter Configure, Price, Quote (CPQ) technology. While the term 'CPQ' might seem distanced from direct patient care, these tools are, in fact, pivotal for a modern, patient-centric healthcare system. Far from
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Unlocking Patient Insights with Conversational AI in Healthcare
Healthcare leaders should champion human-AI collaboration by having people work with AI to validate insights and develop engagement strategies. Organizations can — and should — implement conversational AI because it allows leaders to identify actionable areas of change and protects individuals’ privacy and identities.
Yet while these organizations recognize the merit of sharing these conversations enterprise-wide, many worry that doing so will compromise data privacy and compliance. But
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