Artificial intelligence (AI) captured the imagination of many in 2023. AI gets a lot of attention but little understanding or appreciation of what it can do to move revenue cycle management (RCM) forward, improve the patient experience, and answer the question, “Are you receiving the appropriate reimbursement?”
More than 3 of 5 companies are still experimenting with AI, according to a recent survey by Accenture. Only one in four are innovating or achieving stated objectives) and
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Health IT | News, Analysis, Insights - HIT Consultant
HFMA and FinThrive Launch Revenue Cycle Management Technology Adoption Model
What You Should Know:
- The Healthcare Financial Management Association (HFMA) has announced a strategic alliance with FinThrive, Inc., a healthcare revenue cycle management (RCM) software-as-a-service (SaaS) provider, to co-launch a peer-reviewed, five-stage Revenue Cycle Management Technology Adoption Model (RCMTAM).
- The RCMTAM is designed to help health systems leverage industry benchmarks to assess their current state of RCM technology maturity and build best-practice plans to
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Clover Health Exits CMS ACO REACH Program to Focus on Medicare Advantage
What You Should Know:
- Clover Health, a physician enablement company committed to bringing access to great healthcare to everyone on Medicare announced that it has delivered notice to the Centers for Medicare and Medicaid Services (“CMS”) that it will exit the CMS ACO REACH Program at the end of the 2023 performance year.
- Written notification will also be sent to all participating physicians in accordance with CMS requirements.
- The decision will have no impact on its ACO REACH
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Anthem Expands Access to Primary Care in Virginia Through Collaboration with Aledade
What You Should Know:
- Anthem Blue Cross and Blue Shield in Virginia and Aledade, the nation’s largest network of independent primary care, today announced an expansion of their collaboration to provide more Virginians with access to high-quality primary care.
- The expanded strategic partnership will impact more than 80 practices, 15 health centers, and 25 rural health clinics across Virginia and covers Medicare Advantage, commercially insured, or Medicaid members.
- Aledade is
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M&A: Experian Acquires Wave HDC to Enhance Healthcare Coverage Identification and Automation
What You Should Know:
- Experian acquires Wave HDC, a healthcare technology leader that offers AI-enhanced data curation solutions to identify unknown insurance benefits coverage and critical patient demographics at the start of a patient's healthcare journey.
- The acquisition bolsters the Experian Health business portfolio with more comprehensive and faster healthcare coverage identification and automation capabilities.
Wave HDC's AI-Powered Solutions
Wave HDC offers several
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Trilliant Health’s Market Explorer App Provides Healthcare Provider’s Market Share
What You Should Know:
Trilliant Health, the healthcare industry’s leading analytics firm, today released its Market Explorer, a point-and-click application that provides a more accurate understanding of network performance at the local market level.
Obtaining Key Insights of Network Performance Within the Local Market
Market Explorer combines Trilliant Health’s proprietary Provider Directory containing more than 2.9M providers with its national all-payer claims
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Cigna and Humana Merger Talks Could Face Antitrust Scrutiny
What You Should Know:
- Cigna and Humana are in talks to merge in a deal that would create a US health insurance giant worth $140B and provide a significant test for antitrust authorities.
- A combination between Cigna and Humana would help the companies compete with larger rivals such as UnitedHealth Group and Elevance Health, formerly known as Anthem. The two companies have hired advisers who have been discussing a cash and stock deal for more than a month. They hope to get the
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RSNA2023: Aidoc Invests $30M to Develop Clinical AI Foundation Model
What You Should Know:
- Aidoc, the leading provider of clinical AI solutions, announced a significant investment of $30M to create a groundbreaking comprehensive clinical AI foundation model.
- This cutting-edge technology is poised to revolutionize the way medical imaging is used to diagnose and treat patients worldwide.
Unleashing the Power of Clinical AI
A recent study revealed that hospitals currently utilize only 3% of their available medical imaging data, leaving a wealth of
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RSNA: GE Healthcare Awarded FDA Clearance for Pneumothorax Detection Algorithm
What You Should Know:
- GE Healthcare (Nasdaq: GEHC) announced the US FDA 510K clearance of Critical Care Suite 2.1, featuring an innovative pneumothorax (PTX) detection algorithm that helps clinicians quickly and accurately identify and localize PTX, a potentially life-threatening condition.
- This industry-first technology represents a significant advancement in X-ray imaging, providing clinicians with real-time insights to expedite patient care and improve outcomes.
Early Detection
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PayGround Secures $19.7M to Expand Healthcare Fintech Payments Platform
What You Should Know:
- PayGround, a Gilbert, AZ-based healthcare fintech payments platform, announced closing a $19.7M oversubscribed Series A financing led by SixThirty with participation from Rally Ventures, IA Capital Group, FCA Venture Partners and Plug and Play Ventures.
- The funding will bolster the company’s rapid expansion into hospitals and health systems, building on its success in the ambulatory market, as well as grow its senior leadership
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