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

Health Plan Mergers: 5 Steps for Harvesting IT Integration Savings

by Our Thought Leaders 08/18/2015 Leave a Comment

Editor's Note: This post is written by Albert Ghafari, a founding partner and Bryan Komornik, a Senior Manager in the management consulting practice at Invoyent, a Chicago-based consulting firm dedicated to helping payer and software clients transform the healthcare industry by delivering clear, market-driven strategies that serve their customers and improve the lives of members.  The Aetna-Humana and Cigna-Anthem merger announcements represent a growing trend toward consolidation in
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athenahealth Updates Its Patient-Centered Medical Home Accelerator Program

by Jasmine Pennic 08/12/2015 Leave a Comment

athenahealth Acquires RazorInsights to Enter Hospital Market

athenahealth a provider of cloud-based EHR services and mobile applications for medical groups and health systems has announced updates to its Patient-Centered Medical Home (PCMH) Accelerator Program. Awarded an outstanding 35.25 automatic credits and 45.5 practice support points by the National Committee for Quality Assurance (NCQA), athenahealth ® streamlines providers' pathway towards formal NCQA PCMH Recognition. Practices using athenahealth's EHR, athenaClinicals ®, and patient
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5 Best Practices To Ensure A Smooth, Expedient ICD-10 Transition

by Jasmine Pennic 08/11/2015 1 Comment

The ICD-10 Compliance date is looming and it is imperative that healthcare providers be prepared to make the transition. It affects everything from claims processing, physicians’ workflow, and patients’ access to care. Many organizations may be rallying employees and resources in order to make the switch from the ICD-9 to the ICD-10 coding for medical diagnoses and inpatient hospital procedures before the implementation date of October 1, 2015. To make matters worse, the transition is not
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Blue Cross and Blue Shield of Illinois to Launch New Value-based Care Model

by HITC Staff 08/07/2015 Leave a Comment

Blue Cross and Blue Shield of Illinois (BCBSIL) has signed an agreement to launch an innovative new value-based care model with DuPage Medical Group (DMG), the largest independent physician practice in the Chicago area, with more than 425 doctors. Traditionally in a fee-for-service delivery model, reimbursement is based on specific services provided to patients; rewarding providers for the volume of services they provide.  In value-based care, payment to providers is associated with meeting
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WEDI ICD-10 Survey Reveals Physician Practices Lagging Behind

by HITC Staff 08/04/2015 Leave a Comment

WEDI Survey Reveals ICD-10 Delay Negatively Impacted Provider Readiness

While much of the industry is getting closer to ICD-10 readiness, only about 20 percent of physician practices have started or completed external testing and less than 50 percent responded that they were ready or would be ready for Oct. 1, according to recent Workgroup for Electronic Data Interchange (WEDI) industry preparedness survey results.  In a letter sent to the Health and Human Services (HHS) Secretary, WEDI shared findings from its June 2015 ICD-10 Industry Readiness Survey, strongly
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Report: Multimedia Patient Engagement Programs Increases HCAHPS Scores

by Fred Pennic 07/23/2015 Leave a Comment

Emmi Solutions, a provider of outcomes-driven patient engagement, analyzed nearly 100,000 HCAHPS surveys from multiple service lines in 29 hospitals across the country and demonstrated that patients who viewed one of the company’s web-based, interactive programs reported higher patient satisfaction scores when compared with patients who had not. Patient satisfaction scores have always been important to providers but now that the Centers for Medicare & Medicaid Services (CMS) are tying
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5 Elements of Successful Patient Engagement

by Fred Pennic 07/17/2015 Leave a Comment

In recent years, there has been a great deal of discussion about how to engage patients in their care. Patient engagement has always been considered a good thing in practices and health care organizations. Today it is vital to the business of delivering care. Why the shift? Patient engagement is an essential strategy for achieving the “triple aim” of health care: • Improving the patient experience. Patients are expecting and demanding greater control over their care. Provisions in the
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5 Lessons the US Can Learn from Canada’s ICD-10 Transition

by Fred Pennic 07/07/2015 Leave a Comment

Canada ICD-10 Transition

Like it or not, the clock is ticking down to ICD-10 transition. Despite physician angst and political pushback, ICD-10 coding will soon be underway. While the uncertainty of any grace-periods for providers remain, the question persists: Will October 1, 2015 be a day of progress for U.S healthcare or its day of reckoning? According to the CDC, the new coding system that promises to improve data quality and streamline reimbursements will have nearly 19 times the procedural codes and five times
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CMS, AMA Partner to Help Providers Get Ready For ICD-10

by HITC Staff 07/06/2015 Leave a Comment

With less than three months remaining until the ICD-10 transition, The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) are announcing efforts to continue to help physicians get ready ahead of the October 1 deadline. In response to requests from the provider community, CMS is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD- 10
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Aetna to Buy Humana for $37B, Largest Insurance Deal Ever

by Fred Pennic 07/03/2015 Leave a Comment

Aetna

Health care-insurance giant Aetna has agreed to acquire smaller rival Humana for $37 billion in cash and stock making it the largest ever deal in the insurance industry.  The rapid consolidation in the U.S. health care industry. brings together Humana’s growing Medicare Advantage business with Aetna’s diversified portfolio and commercial capabilities to create a company serving the most seniors in the Medicare Advantage program and the second-largest managed care company in the nation. Under
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