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Population Health Management (PHM) in Healthcare | News, Analysis, Insights - HIT Consultant

Empowering the Aging Population with Tech-Driven Care in 2025

by Heath Sampson, President and Chief Executive Officer of Modivcare 01/02/2025 Leave a Comment

Empowering the Aging Population with Tech-Driven Care

By 2030, one in six people will be 60 years old or over, increasing the demand for care and intensifying the burden on an already strained healthcare system. These pressures require healthcare leaders to identify more sustainable solutions that deliver optimal care to the growing senior population. An AARP report found that technology use amongst older adults has significantly increased since the pandemic. This population’s adoption of digital solutions opens the door for more tools to reduce
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How Medicare Advantage Programs Can Address Social Risk and Improve Health Outcomes

by Brian Norris, Managing Director of Strategic Consulting at MedeAnalytics 12/23/2024 Leave a Comment

How Medicare Advantage Programs Can Address Social Risk

There are almost 33 million people enrolled in eligible Medicare programs. Nearly half are enrolled in Medicare Advantage (MA) plans, and that number is expected to continue its climb. While many MA plans offer services that align with social determinants of health (SDOH) goals, there are still gaps in how these services reach and support vulnerable populations. This challenge is multifaceted. Critical issues include:  An incomplete understanding of how MA services impact different SDOHs
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Optimizing MIPS Value Pathways (MVPs) for Oncology Practices in 2025

by Erin Crum, Sr. Director of Quality Strategy and Innovation, The US Oncology Network and McKesson 12/12/2024 Leave a Comment

Optimizing MIPS Value Pathways (MVPs) for Oncology Practices in 2025

The Centers for Medicare and Medicaid Services (CMS) introduced the MIPS Value Pathways (MVPs) as part of its ongoing revisions to the Merit-Based Incentive Payment System (MIPS) program, which was established in 2017 to encourage ongoing and consistent quality, efficiency, and improvement in medical practices. The MVP framework was designed to ease the burden imposed on clinicians and their administrators who participate in the MIPS program. Traditionally, MIPS scores have been calculated based
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Systems Thinking: The Future of Equitable, Efficient, and Effective Population Health Management

by Holly Urban, MD, MBA, VP of Business Development and Strategy for Clinical Effectiveness at Wolters Kluwer Health 12/11/2024 Leave a Comment

Systems Thinking: The Future of Equitable, Efficient, and Effective Population Health Management

Healthcare in the United States consists of a tangled web of complex interconnected drivers, including payment models, regulations, processes, and facilities. However, the lack of a cohesive system design has resulted in less than optimal care industry for the US population and highlighted the need for a more comprehensive approach. Year over year, data from the Commonwealth Fund demonstrates that despite high costs for healthcare, the patients in United States experience worse outcomes with
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Medical Home Network and Instacart Partner to Address Food Insecurity

by Fred Pennic 12/06/2024 Leave a Comment

Medical Home Network and Instacart Partner to Address Food Insecurity

What You Should Know:  - Medical Home Network (MHN), an organization supporting value-based care in federally qualified health centers (FQHCs) forms a collaboration with Instacart, the North American grocery technology leader, to integrate Instacart's SNAP eligibility screener into MHNConnect, its care management platform.  - The strategic partnership aims to address food insecurity among vulnerable populations and improve health outcomes. Tackling Food Insecurity in
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Unpacking Medicare Advantage Terminations and How Plans Can Navigate Them

by David J. Sand, MD, MBA Chief Medical Officer at ZeOmega 11/26/2024 Leave a Comment

Unpacking Medicare Advantage Terminations and How Plans Can Navigate Them

The U.S. healthcare system has been undergoing its own stress test. Stakeholders are currently experiencing a variety of pressures with a primary focus on finances, including administrative costs. The COVID-19 pandemic is often used as a convenient delimiter for the emergence of these problems, but in reality, tensions were brewing long before now and were caused by a variety of factors. Medicare Advantage (MA) is facing the headwinds of these issues – and as a result, MA
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Food is Medicine: Thrive Global and Blue Shield of California’s Cookbook Initiative

by Syed Hamza Sohail 11/26/2024 Leave a Comment

Food is Medicine: Thrive Global and Blue Shield of California's Cookbook Initiative

What You Should Know: -    Just in time for the holiday season, Arianna Huffington's Thrive Global will be releasing a new budget friendly, healthy-eating cookbook tomorrow, Tuesday, Nov. 26, in partnership with Blue Shield of California Promise Health Plan.  -    At a time when rates of chronic diseases including obesity and diabetes are rising, and many people struggle to afford and access healthy food, the Thrive Global Cookbook does more than just share recipes- it reflects Thrive
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Millions of Americans Remain Uninsured or Underinsured Despite ACA Gains

by Fred Pennic 11/22/2024 Leave a Comment

Millions of Americans Remain Uninsured or Underinsured Despite ACA Gains

What You Should Know:  - A new report from the Commonwealth Fund reveals that despite significant progress in expanding health insurance coverage under the Affordable Care Act (ACA), millions of Americans still lack adequate and affordable healthcare.  - The report highlights the prevalence of coverage gaps, high out-of-pocket costs, and the burden of medical debt, underscoring the need for further policy action to achieve truly universal coverage. Uninsured and
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Bed Shortages: How AI Can Help Reduce Length of Stay in Hospitals

by Michelle Wyatt, Senior Director of Utilization Review Services, Xsolis 11/22/2024 Leave a Comment

Bed Shortages: How AI Can Help Reduce Length of Stay in Hospitals

Length of stay management in acute care facilities represents a critical frontier for providers and payers to improve their own bottom lines, and also improve patients’ experience with the healthcare system.  Let’s take a closer look at how today’s systemic inefficiencies arose, and how collaboration within provider networks, and between payers and providers, might improve length-of-stay procedures and inefficiencies in the future. Acute care facility bed shortages, and how they
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Revitalizing Medicare Advantage: How The Push to Streamline Prior Authorization Will Impact Senior Care

by Steve Kim, CEO of Valer 11/21/2024 Leave a Comment

Revitalizing Medicare Advantage: How The Push to Streamline Prior Authorization Will Impact Senior Care

As a physician, the odds that you’ve had a negative experience related to the prior authorization process are (unfortunately) highly likely. According to the American Medical Association’s (AMA) 2023 Prior Authorization Physician Survey, 1 in 4 physicians report that prior auths “have led to a serious adverse event for a patient in their care.” Think about the toll that this takes on professionals whose primary job is providing lifesaving care, and the thing preventing this care is outside their
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