Submitting and paying claims is the financial underpinning of the U.S. healthcare system, a system plagued with inefficiencies that create disconnects between health plans and health systems. As a result, revenue cycles and claims systems are clogged, the patient and member experience is disrupted, care quality is suffering, and innovations in care delivery are constrained.
The solution? Modernization.
Modernizing the healthcare ecosystem reduces wasteful administrative
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Health IT & Digital Health-Opinion | Op-Eds | Guest Columns | Analysis, Insights - HIT Consultant
Responsible AI in Medicine for Underserved Populations
Artificial intelligence (AI) is making a tangible difference in healthcare today. It's not about science fiction or flashy gimmicks. It’s not about deep fakes or plagiarized term papers. AI is being responsibly used to prevent medical errors, enhance clinical decision-making, expand access to care, and lower costs. While there's certainly overenthusiasm and misleading claims about AI, we can't ignore the many instances where it's making healthcare more efficient, effective, and
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How Virtual Primary Care Can Enrich Your Practice
The COVID-19 pandemic made the word “virtual” a part of our everyday lexicon. Many services that were previously done in person—even schools—quickly made the transition to being virtual. Today, our world is forever changed as many services that once were only in-person continue to be virtual due to convenience, accessibility, and technological advancements that enable everything online.
Primary care has also benefited from virtualization of services. According to a study published in
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AI-Assisted Diagnostic’s Intersection with Risk Assessment: The Future of Medical Device Technology
From predictive analytics to personalized treatment plans, we’ve probably all heard about AI's potential to revolutionize medical diagnostics and treatment. As discussed in a recent NIH study, “more recently, state-of-the-art computer algorithms have achieved accuracies which are at par with human experts in the field of medical sciences.”
However, as AI algorithms increasingly integrate into medical devices and become more influential in diagnoses, ensuring the safety of the patients they
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Why Wastewater Monitoring is Being Tapped to Prevent an Avian Flu Pandemic
When the Biden Administration announced its plan of action to respond to the threat of avian H5N1 flu, most of the steps being taken were similar to previous threats – targeted patient and animal screenings, bolstered laboratory capacity, and regular communications with and updates for the public and policymakers. But one item on the list may have struck people as newer than the rest – the incorporation of wastewater monitoring into an emergency response. The federal government allocated $3
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Cracking the Nutritional Puzzle: A Path Out Of Dallas’ Food Desert
Recently, I was shocked to hear that North Texas is one of the hardest-hit areas of the country for food insecurity. Shocked, but not surprised. As having been a registered dietitian and part of the Dallas Accountable Health Community (DAHC)[1] program, I have seen Dallas County’s food depravations firsthand, and while this food desert may seem trackless, I believe that by using data, we have ways to create oases.
It turns out that Dallas County has the highest rate of food insecurity
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Navigating the Final CMS Medicaid Managed Care Rule (CMS-2439-F)
On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) released the final rule, Medicaid Program; Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality. The rule aims to promote consistency and transparency, with an increased focus on improving access, driving quality, and advancing equity for Medicaid beneficiaries. CMS has been moving in this direction for several years, and states managed care organizations, and providers have
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Strengthening Healthcare Resilience: A Vendor Checklist for Data Security and Business Continuity
In the aftermath of the cyber-attack on Change Healthcare by the BlackCat ransomware group, a renewed interest has emerged in protecting operations and ensuring contingencies are in place. For impacted providers, the financial fallout from the attack is estimated at $500 million to $1 billion per day and climbing, driving home the fact that business continuity is everything in the aftermath of a cyber-attack.
Presently, many healthcare organizations remain in limbo after the
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Vendor Sprawl: The Hidden Barrier to Effective Patient Engagement
Patient engagement is a critical priority for modern healthcare organizations. Yet, the path is often obstructed by the unintended consequences of vendor sprawl. A profusion of disparate technology solutions creates a fragmented patient experience, hinders operational efficiency, and can even put patient data at risk. To combat this challenge, healthcare organizations need a unified patient engagement strategy. This strategic approach will help providers streamline their technology stack, create
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Home-Based Care Software: Why Partnerships are Key to Success
The home-based care sector is undergoing a significant surge in demand. As more patients choose the comfort of their own homes for treatment, the demand for innovative solutions grows exponentially. However, creating effective software for this industry requires a unique approach. Technology developers can’t simply build solutions in a silo and expect them to succeed. The complex ecosystem of home-based care demands a deep understanding of the daily challenges and opportunities faced by
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