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Healthcare Policy Regulation & Reform | News, Analysis, Insights - HIT Consultant

Why Health Plans Are Vital to Health Equity

by Rachael Jones, SVP of Performance Analytics and Quality at Cotiviti 06/28/2022 Leave a Comment

Why Health Plans Are Vital to Health Equity

In Florida, where Black residents are three times more likely to be hospitalized or die from asthma-related complications than white residents, one researcher’s efforts to “strip away the jargon” related to asthma treatment strengthened patients’ engagement in a year-long clinical trial. The impact: development of an asthma regimen to help combat disparities in asthma management and outcomes. The results are one example of the gains that can be made in addressing health inequities—differences
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What Hospital Success Looks Like Under Value-Based Care

by Mike Ipekdjian, MBA-HM, BSN, RN, SANE, PHRN, NREMT, Head of Clinical & Solution at CarePort, powered by WellSky 06/22/2022 Leave a Comment

What Hospital Success Looks Like Under Value-Based Care

Hospitals are increasingly turning to value-based care initiatives to transform care delivery, lower the total cost of care, and improve patient outcomes. Unlike traditional fee-for-service (FFS) models that reimburse providers based on volume (i.e., the number of patient visits), providers are reimbursed based on the quality of care delivered in value-based care. Ultimately, success under these reimbursement models hinges upon seamless coordination between all stakeholders across the continuum
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Breaking Down the Implications of New No Surprises Act Regulations

by Lynne Rinehimer, Esq, GRC Sales Engineer and Compliance SME for symplr 06/17/2022 Leave a Comment

Breaking Down the Implications of New No Surprises Act Regulations

The importance of the No Surprises Act (NSA) cannot be overstated, as surprise medical bills have long been burdensome for patients in the U.S. healthcare system. In fact, more than half of all U.S. consumers have received an unexpectedly large medical bills.  The purpose of the No Surprises Act is to prevent surprise out-of-network bills, often for emergency services. For example, if your appendix bursts while at work, you would be rushed to the nearest hospital for an emergency
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The No Surprises Act: How Payers Can Stay Compliant

by Michael Gardner, Chief Strategy Officer at Virsys12 06/13/2022 Leave a Comment

The No Surprises Act: How Payers Can Stay Compliant

As the healthcare system continues to evolve to adopt a more patient-centric approach, surprise billing has become a topic discussed by consumers and policymakers. Surprise billing can occur when a patient unknowingly receives care from providers that are outside their network. This can result in balance billing, the practice of billing a patient the difference between what their health plan covers and what the provider charges. Unfortunately, these bills are often the result of care provided in
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Five Types Of Abuse In A Nursing Home

by HITC Staff 06/02/2022 Leave a Comment

Five Types Of Abuse In A Nursing Home

Nursing homes care for the elderly, people with disabilities, or those who are terminally ill. However, abuse can take many different forms in nursing homes and can devastatingly impact the residents. It’s especially true if the abuse is not reported or if it's not taken seriously. The elderly and those with dementia are especially at risk for abuse, as they may not be able to communicate their needs or recognize when they're being mistreated. Implementing some steps can help protect the
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3 Senior Living Providers Merge to Form Curana Health

by Jasmine Pennic 05/04/2022 Leave a Comment

3 Senior Living Providers Merge to Form Curana Health

What You Should Know: - Three leading organizations that provide healthcare services to senior living communities – Elite Patient Care, Provider Health Services, and AllyAlign Health – have joined forces to form Curana Health. Curana Health’s mission is to improve the health, happiness, and dignity of senior living residents. The Curana Health ACO is a value-based care program for original Medicare beneficiaries. - The combined Curana Health organization spans 26 states and over 1000+
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Vytalize Health Raises $50M for Value-Based Care Platform for Seniors

by Fred Pennic 04/11/2022 Leave a Comment

Vytalize Health Raises $50M for Value-Based Care Platform for Seniors

What You Should Know: - Vytalize Health raises over $50 million to advance its value-based care platform for seniors helping primary care doctors strengthen relationships with their patients through data-driven, holistic, and personalized care. - Led by Enhanced Healthcare Partners, the financing round signals an enormous opportunity for Vytalize Health to accelerate the adoption of value-based care programs by providers. Vytalize Health, a leading value-based care platform for
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To Engage and Activate Patients, CRM Alone Isn’t Enough

by Michael Linnert, Founder and CEO of Actium Health 03/09/2022 Leave a Comment

To Engage and Activate Patients, CRM Alone Isn’t Enough

We talk about patient engagement a lot in healthcare today. But the reality is, we often don’t just want a patient to engage with a piece of content or information; we want them to take action. The traditional CRM and marketing automation are great tools for the former – keeping patients and their healthcare providers connected. But it does little to move beyond a digital connection. Today’s patients (or, consumers) expect more from all of their relationships, especially their healthcare
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Signify Health Acquires Caravan Health, Forming Largest Networks of At-Risk Providers

by Fred Pennic 02/10/2022 Leave a Comment

Signify Health Acquires Caravan Health, Forming Largest Networks of At-Risk Providers

What You Should Know: - Today, Signify Health announced it has reached an agreement to acquire Caravan Health, a leader in enabling accountable care organizations (ACOs) to succeed in value-based care payment. Together, the companies form one of the largest networks of at-risk providers in the U.S.  - Together, Signify Health and Caravan Health will be better positioned to enable organizations to manage larger populations covered by value-based arrangements and to
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Why Value-Based Care Requires Value-Based Administration

by Rahul Sharma, CEO & Lynn Carroll, COO at HSBlox 02/03/2022 Leave a Comment

Why Value-Based Care Requires Value-Based Administration

Value-based care (VBC) is finally gaining steam among healthcare organizations as executives look to implement processes that boost patient outcomes and rein in elevated levels of spending. To that end, more than 90% of health system executives say they expect VBC contracts will continue to grow in the coming years.  Despite the widespread popularity of the concept of VBC, making it work is something of an “all-hands-on-deck” approach. VBC relies on the collaboration between many
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