In 2022, the Center for Medicare and Medicaid Services (CMS) established health equity as a pillar of its future work. Program integrity staff from every state Medicaid program, and federal program staff working on Medicare, must consider the roles of both program integrity and analytics when combatting fraud, waste, and abuse (FWA)in the healthcare system.
CMS defines health equity as "the attainment of the highest level of health for all people, where everyone has a fair and just
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Health IT & Digital Health-Opinion | Op-Eds | Guest Columns | Analysis, Insights - HIT Consultant
Think Retail: What the Medical Supply Industry Can Learn from the Marketplace Revolution
Through years of disruption and advancement, the retail industry has evolved tremendously to meet the increased demands of a broadening consumer base. However not every industry – and most notably healthcare — has progressed with the times and buyers’ needs.
The healthcare supply chain specifically must expand beyond its antiquated roots to better serve buyers. Just as in retail, where the U.S. has seen exponential growth over the last 20 years, according to the U.S. Census Bureau, the
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Top Security Certifications Required for Data Protection
How secure is your data? If your organization does not have the right security certifications in place, it’s not a matter of if a data breach will occur – but when. A lack of regulatory compliance, network and technical vulnerabilities, unencrypted information, unsecured mobile devices, and weak credentials all play a part in putting a healthcare organization at risk for a data breach.
Today, the cost of a data breach comes with a hefty price tag – an average of $9.44 million in the
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Why It’s Time for Intelligent Prior Authorization
The Centers for Medicare & Medicaid Services (CMS) recently proposed a new rule to advance interoperability and improve the prior authorization (PA) process for Medicare and Medicaid patients. Specifically, the rule stipulates that health plans adopt electronic prior authorization processes, adhere to shorter turnaround times, clearly communicate denial reasons, publish key metrics annually, and implement the Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface
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FHIR Adoption and Implementation Challenges
The Fast Healthcare Interoperability Resources (FHIR) standard was introduced by HL7 in 2014 as a significant replacement for the HL7 V2 and V3 standards. An open standard called FHIR, which was initially drafted in 2011 makes it easier than ever for legacy systems and new apps to exchange data. FHIR was created to not only increase communication efficiency and interoperability compared to earlier standards but also to facilitate implementation by giving clear specifications and allowing
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Why Researchers Should Explore New Apps of Machine Learning
As the amount of real-world data (RWD) in the pharmaceutical industry continues to grow, so does the usage of machine learning (ML) to analyze that data and gain insights. In fact, in a recent survey, 95% of life sciences executives said they expect to utilize ML in the next few years to generate real-world evidence (RWE) from this data.
With such a large and growing volume of data available, researchers may be wondering how they can take advantage of all of it to enhance and expand the
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5 Key Trends in Women’s Health Technology for 2023 to Watch
Women's healthcare faces an uphill battle after centuries of being ignored. Yet, ironically enough, women currently share half of the consumerism market, hold power over 80% of household financial decisions, and make 70% of healthcare-related choices in their families.
Despite this, their access to proper healthcare often comes up short.
But with the market for women's healthcare predicted to be worth over $47 billion, changes are starting to occur. And with the recent attacks and laws on
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Electronic Transactions Can Benefit Partnership Among Physicians, Insurers and TPAs
The patient is at the center of the healthcare experience, and rightfully so. However, a strong case can be made to place the physician at the center. After all, it’s the physician who diagnoses and treats the patient.
Insurance companies and third-party administrators (TPAs) also have critical roles to play in the care experience, bringing together networks of physicians, specialists, surgery centers, hospitals, ambulatory care centers, and more to create a comprehensive care experience for
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The New “Front Door” to Healthcare Can Only Open Fully with True Interoperability
Some people think of retail pharmacists as standing behind the counter bottling pills, answering insurance questions, or discussing side effects with a customer.
But the COVID pandemic fundamentally changed the role of the neighborhood pharmacist, from primarily dispensing medication to increasingly being the source of urgent and primary care for patients. With the successful administration of more than 300 million COVID vaccinations, an ongoing doctor shortage, and
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Develop, Partner, Acquire or Avoid – Where’s Investment for Digital Pathology Headed in 2023?
News of Fujifilm’s recent acquisition of software provider Inspirata’s digital pathology assets was met with much interest last month, following on from robust industry debate at Global Engage’s Digital Pathology and AI Congress: Europe a few weeks prior. Their discussions centered around the progress of the market and its inevitable future developments.
Whilst our in-depth analysis of the implications of Fujifilm’s specific deal will be released soon as a part of our Premium Insights
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