Of the many complexities within the healthcare industry, medical necessity determinations can be the most challenging – and pose one of the greatest barriers to efficient revenue cycle processes and appropriate reimbursement. Complex medical necessity policies that differ between payer, diagnosis, and presentation have muddled utilization review (UR) and revenue cycle processes for years, driving waste and friction between providers and payers that has only intensified since the pandemic.
In
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Making Informed Decisions: What You Need to Know Before Hiring a Software Expert for a Healthcare Project
Hiring professional software experts is crucial for business owners looking to develop or enhance their software systems. However, finding the right vendor is often a daunting challenge that may lead to long-term consequences.This article provides comprehensive guidelines on what healthcare business owners need to know before choosing the right software vendor. By understanding delivery models, the importance of checking references, and paying attention to the details that differentiate between
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The Potential of Generative AI for Value-Based Care
The value-based care market is projected to grow to $174 billion by 2032, according to a MarketResearch.biz report released recently. As the march to VBC accelerates, there are operational, financial, data complexity/accessibility, and technology-related challenges that need to be overcome to implement value-based programs and to scale them for mass adoption.
Existing medical data is not fully exploited for analytics and risk score computation because of three main reasons:
Unstructured
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Breaking Down NLP & Generative AI: How It’s Most Useful to Clinicians Today
Over the last year, the term “Generative AI” has exploded on the healthcare scene, with health and social systems trying to determine if and how they can incorporate the newest tech trend into their day-to-day practice to streamline and improve operations, and ultimately improve patient care.
But most organizations have decided to take a measured approach and see how the hype plays out – they have decided to proceed thoughtfully and with diligence before viewing Generative AI as the panacea
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6 Ways AI is Impacting Cancer Diagnosis, Treatment and Patient Outcomes in 2024
Artificial intelligence (AI) technology is set to transform the field of diagnostics, similar to how X-rays and genetic tests revolutionized healthcare in the past. Reshaping routine diagnostic procedures and treatment decisions and propelling pharmaceutical and research domains into new realms, AI offers significant benefits to clinicians, healthcare systems, researchers, and, most importantly, patients. This is particularly evident in cancer diagnosis and treatment across six key areas:
1.
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Advanced Analytics Can Change the Game for Consumer Healthcare Services
Data has become the lifeblood of healthcare, making it possible to gain granular insights that enable more effective and precise patient-centric care. Yet, we have just scratched the surface of data analytics’ potential impact on optimizing segments of healthcare that need it most, such as the surging arena of consumer health.
Of the four key types of data analytics – descriptive, diagnostic, predictive, and prescriptive – only the first two are effectively used in managing healthcare
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4 Questions for Health Systems Navigating Virtual Care Delivery Challenges in 2024
Dr. Brad Younggren, Chief Medical Officer and President of Care Innovation at 98point6 Technologies
In the face of unprecedented clinical workforce shortages that are only expected to grow larger in 2024, according to a new PWC report, health systems across the country are grappling with the challenges of providing quality care while navigating budget constraints. Hospital leaders face the daunting task of recruiting and retaining clinicians while seeking higher reimbursement
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3 Ways Prescription Tech Will Impact Healthcare Organizations’ Bottom Lines in 2024
As a new year begins, there’s an opportunity on the horizon for health systems: the prescription experience. Every prescription is an opportunity to pull patients through a digital front door and increase patient engagement and retention.
Of the many pressures facing health administrators, the prescription is actionable. It’s the moment in a patient’s health journey where the health system can build sustainable trust with the patient, with the potential to create a relationship that lasts a
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Racing to the Zero Milestone: Accelerating Progress in Cardiac Care with AI-Enabled Analysis
Cardiac Health is Top of Mind. The Quest to ‘Zero’ Avoidable Cardiac-Related Deaths Continues.
Cardiac disease is one of the top health concerns in the United States. According to the Centers for Disease Control and Prevention (CDC), heart disease remains the leading cause of death for both men and women. As this major public health issue affects a large portion of the population, it has led to a significant focus on heart health in the public and private sectors.
Given its
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From Womb to NICU: The Nutritional Challenges of Preterm Babies
Feeding early in life, particularly for a newborn, is typically breast-feeding or a bottle of formula. Infants tend to cry when they're hungry and stop eating when they're full. It's a very natural and important process that tends to have cues as to how well the baby is tolerating its diet, whether that be spit up or colic or other agitations such as gas. While newborn feeding can be route with challenges for both mom and baby it tends to be a simpatico engagement that yields good results
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