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Mary Bacaj, Ph.D., President of Value-Based Care at Conifer Health Solutions

Reduce Medical Costs by 5.3%: Active Member Engagement for Employers

by Mary Bacaj, Ph.D., President of Value-Based Care at Conifer Health Solutions 04/25/2024 Leave a Comment

Leveraging Personal Health Nurses to Connect the Dots Across the Care Continuum

Employers incur approximately $575 billion each year due to their employees’ poor health, and the number of employees who spend at least $100,000 a year on medical care rose by 50% between 2013 and 2021., Much of these costs are driven by fragmented care, improper benefits utilization, and poor health literacy. Today, members have greater choices regarding where they receive their care. In a single year, they may use an urgent care center, a pharmacy clinic, a retail clinic, a specialist, and
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The Future of Human Health May Require Unlocking Access to Our Health Data

by Cambron Carter, Co-founder and Chief Technology Officer at Pearl 04/23/2024 Leave a Comment

The Future of Human Health May Require Unlocking Access to Our Health Data

The synergy of artificial intelligence (AI) and medical imaging has opened new horizons for healthcare. AI-mediated computer vision has been in use in oncology for more than 20 years; however, its arrival in other medical fields, notably dentistry, is more recent. Dentistry is particularly notable here, because while relatively few people have seen an oncologist, almost everyone sees a dentist at least every few years. The application of AI in dentistry, thus, extends to a much broader
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Interoperability: How Hospitals Share Healthcare Data Can Cost Lives, We Can All Do Better

by Dan Torrens, CEO of eHealth Technologies 04/22/2024 Leave a Comment

How Hospitals Share Healthcare Data Can Cost Lives

Patient data interoperability sounds like industry jargon, but it’s a vital piece of providing timely and accurate patient care. Since 1996, when the Health Insurance Portability and Accountability Act (HIPAA) became law, there have been good advances in patient data interoperability, but as a whole, the industry has not embraced them.  Sharing data through faxing and CDs is still very common. As recently as 2023, between 30  and 47 percent of hospitals across all sizes reported still
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Putting 2024’s Split/Shared Services Billing Regulations into Practice

by Shanta Lewis, CPC, CRC, CPC-I, Product Owner at MDaudit 04/19/2024 Leave a Comment

63% of Consumers Perceived Medical Billing as Challenging

Medicare providers in hospitals and skilled nursing facilities (SNFs) are adjusting to new split/shared services documentation and billing regulations rolled out by the Centers for Medicare and Medicaid Services (CMS) as part of the 2024 Medicare Physician Fee Schedule (MPFS) final rule. The most notable change within the new regulations, which took effect on Jan. 1, 2024, is the finalization of CMS’s definition of the “substantive portion” of a split/shared evaluation and management (E/M)
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Maximizing Provider Directory Data to Improve Care Access and Quality

by Eric Demers, CEO Madaket Health 04/17/2024 Leave a Comment

Maximizing Provider Directory Data to Improve Care Access and Quality

In 2022, the Centers for Medicare & Medicaid Services (CMS) proposed the creation of a centralized physician directory. The proposal sought to address three pressing challenges facing both healthcare providers and patients within the United States healthcare system: Fix the pervasive issue of inaccuracies and inconsistencies in provider directories. Studies have consistently revealed high error rates in directory listings, with inaccuracies ranging from incorrect contact information to
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The AI Blueprint: An Implementation Guide for Revenue Cycle Leaders

by Michael Gao, MD, CEO and co-founder of SmarterDx 04/16/2024 Leave a Comment

The AI Blueprint: An Implementation Guide for Revenue Cycle Leaders

Applying artificial intelligence (AI) solutions in hospitals and health systems can be overwhelming for leaders due to AI’s complexity (it’s not one technology, but several) and rapid proliferation. This is in addition to the usual technology hurdles within healthcare that include data quality and accessibility, interoperability, and clinical validation and adoption. Finally, with any new solution, there’s the concern of return on investment: Will implementing the latest solutions pay off for my
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JAPAC Drug Development: Navigating Safety & Regulatory Requirements

by Dr. Jayawant Fuke, Senior Director of Lifecycle Safety, IQVI & Hye Jin Choi, R. Ph., Sr. Director of Regulatory Affairs and Drug Development Solutions, IQVIA Asia Pacific 04/15/2024 Leave a Comment

Navigating Safety and Regulatory for JAPAC: Distinctions and Challenges

The biopharmaceutical market within the Japan and Asia-Pacific (JAPAC) region has grown consistently since 2010, specifically for emerging biopharmas (EBPs). In fact, in 2018, 80% of all biopharma pipeline projects in JAPAC were EBPs, accounting for 75% of the total clinical trial volume in the region. This growth benefits contract research organizations, pharma organizations and patients alike, but several factors must be considered for drug development safety and regulatory operations in JAPAC
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Digital Health Apps Graveyard: Why 53% Fail and How to Succeed

by Shameem C Hameed, Founder and CEO of blueBriX 04/11/2024 Leave a Comment

Digital Health Apps Graveyard: Why 53% Fail and How to Succeed

The digital market is flooded with health apps. Over 90,000 offers were introduced to patients and healthcare providers alike in 2020 alone, with this number continuing to rise in response to mounting healthcare system pressures.  It therefore comes as little surprise to learn that 53% of all digital health apps are uninstalled within 30 days of download. People are more than happy to trial them but fail to achieve continued adherence, oftentimes because the app hasn’t provided them with
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Establishing Effective Payer Benefits Strategies for Health Equity

by Brandi Hodor, Sr. Healthcare Analytic Advisor at Merative 04/10/2024 Leave a Comment

Establishing Effective Payer Benefits Strategies for Health Equity

Health equity helps ensure all individuals have equal access to healthcare. According to the Centers for Disease Control and Prevention, health equity means everyone has a fair and just opportunity to attain their highest level of health. To address the benefit needs of underrepresented population groups, payers can develop “more equitable approaches to healthcare benefits design that recognize and meaningfully address access and affordability concerns,” according to a
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Combatting Physical Therapy Burnout: Can Digital Health Help?

by Patrick Tarnowski, Chief Commercial Officer, OneStep 04/09/2024 Leave a Comment

Combatting Physical Therapy Burnout: Can Digital Health Help? Addressing the 15K Person Challenge How Unique Technologies Support a Shrinking yet Essential PT Workforce

The physical therapy profession, encompassing both Physical Therapists (PTs) and Physical Therapist Assistants (PTAs), is navigating through a period of unprecedented challenge. Recent data highlights concerning trends - not only did the sector see the departure of 15,000 PTs, or 11% of the existing workforce, between 2021 and 2022, but there has also been a consistent 5% annual decrease in applicants to PT programs over the last three to four years. These developments signal an urgent need for
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