Editor's Note: Co-written by Scott Herbst, Senior Vice President and General Manager of Provider Solutions and Ryan Miller, Senior Vice President of Strategy & Corporate Development at Availity.Prior authorizations may be as popular among providers as ants at a picnic, but they have become a common and necessary part of the reimbursement process. As a result, being able to manage prior authorizations efficiently is critical to maintaining a healthy revenue cycle and avoiding issues such as
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5 Considerations to Enable a Modern Healthcare Commerce Strategy
Editor's Note: Charles Sweeney is the Senior Director of Strategic Consulting at PROS, Inc., a company that provides price optimization, sales effectiveness, and revenue management SaaS software.The healthcare industry is facing a number of external market forces that are creating the perfect pricing storm. Industry consolidation, regulation and new demands for transparency are putting added pressure on healthcare manufacturers, with many left wondering about how they can profitably compete.
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Population Health Management Means the Whole Population, Not Just the Highest Need
Editor's Note: Carol Clayton, Ph.D. is a Translational Neuroscientist for Relias Learning. Prior to joining Relias, she served as President of Care Management Technologies.Considerable attention has been given to the large proportion of healthcare spending concentrated among a small proportion of patients. This five to 10 percent of the population has been the driving force behind many value-based purchasing models, e.g., chronic health condition management for the high cost, high utilizers, and
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Healthcare Blockchain: How Does It Fit With Health IT?
With the end of the year rapidly approaching, it’s about time for articles making technology predictions for 2018 and proclaiming 2017 “the year of the (this space for rent).”As editors cast about for the healthcare IT story of the current year, they might have a hard time making the case for healthcare blockchain technology based on measurable recent impact, but they’ll have less trouble endorsing blockchain if they look at current hype and future potential.“Blockchain technology is a
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3 Roadblocks to Achieving Interoperability In A Value-based Care System
Editor’s Note: Abhinav Shashank is the CEO & Co-founder at Innovaccer Inc., a datashop integrating complex data across multiple distributed sources to give healthcare organizations greater insights to provider better care.I am sure I am not the only one who has lost count of the times I’ve been asked “Why can’t the systems talk to each other?” or, in more technical terms, “Why don’t we have interoperability?”The numerous health IT solutions that we have around us today were meant to improve
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From Telemedicine to Better Data: How APIs Improved Health in Chile
Editor's Note: Co-written by Soledad Munoz, CIO of MINSAL, Aashima Gupta, Global Head of Healthcare Solutions at Google Cloud and Michael Leppitsch, Digital Strategies for Global Enterprises at Google Cloud. The Chilean Ministry of Health has been grappling with a big first-world problem. A significant proportion of its 18 million people suffer from chronic conditions, including obesity, diabetes, cancer, and heart disease.But implementing a national mandate to improve these statistics is
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3 Healthcare Revenue Cycle Management Drivers to Watch in 2018
One ageless trend emerging for 2018 is the quest of hospitals, larger carriers and clinics to identify new revenue streams; not just managing revenue cycles, but creating them. The healthcare industry is now looking at revenue which can be generated through the interoperability of Annual Wellness Visits (AWV), chronic care and service care transitions between physical and behavioral health services.Hospital systems and other healthcare facilities that can connect these services with technologies
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3 Challenges and Considerations for Measuring Population Health Success
Editor’s Note: George Dealy is the Vice President of Healthcare Solutions at Dimensional Insight, a healthcare data analytics platform that allows healthcare providers to make data-driven decisions, empowering organizations to analyze both financial and clinical data to quickly improve efficiency and patient outcomes.Healthcare organizations across the country are under enormous pressure to improve health outcomes, where the notion of “population health management” has suddenly evolved from a
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Why GE Won’t Sell its Health IT Business
Editor's Note: Signify Research is an independent supplier of market intelligence and consultancy to the global healthcare technology industry whose coverage areas include Healthcare IT, Medical Imaging and management consultants and investors.As John Flannery, the new CEO of GE takes on the task of sweeping cost-cutting at the industrial behemoth, recent market speculation has suggested he may be looking to offload GE’s Healthcare IT business. Here's why we think this won’t happen.Crumbling,
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MACRA: The Yardstick for Quality that Health Systems Need
Editor’s Note: Nancy Pratt is the Chief Operating Officer at AirStrip, a complete, vendor and data source-agnostic, enterprise-wide mobile interoperability platform that advances care collaboration and serves as a catalyst for health system innovation. Prior to AirStrip, she served as Senior Vice President, Chief Quality and Safety Officer at St. Joseph Health. The number of quality initiatives is rapidly rising in the healthcare industry as stakeholders shift their focus toward the value of
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