What You Should Know: - Value-based care (VBC) has been established as a priority among healthcare organizations and payers as participants have gained more experience in managing their quality metrics and contracts, ultimately realizing returns on their investments. - For their latest report, Value-Based Care Reimbursement 2022, KLAS talked to 54 healthcare executives—including CEOs, CFOs, CIOs, CMIOs, COOs, VPs and directors of population health, and VPs of analytics—to gauge how
Read More
HLTH22 Day 3 News Summary
DispatchHealth Raises $330M for Hospital-at-Home Care DispatchHealth, a provider of in-home medical care raises $330M led by Optum Ventures with support from current investors such as Humana (NYSE: HUM), Oak HC/FT, Echo Health Ventures and Questa Capital. New investors included Adams Street Partners, the Olayan Group, Silicon Valley Bank, Pegasus Tech Ventures and Blue Shield of California. Patients and their care partners can request DispatchHealth medical care via phone, mobile app, or
Read More
Edifecs Partners with Empowered-Home to Deliver Automated Prior Authorizations
What You Should Know: - Edifecs and Empowered-Home announced a partnership to provide automated prior authorizations to medical associations, Accountable Care Organizations (ACOs), Independent Physician Associations (IPAs), medical groups, and home health care agencies. - The Edifecs prior authorization solution combined with the clinical decision support system of patient management software company, Privis Health, forms the backbone of Empowered-Home’s ecosystem. Empowered-Home is
Read More
Innovaccer Launches ACO Compare to Help ACOs Lower Costs & Increase Care Quality
What You Should Know: - Innovaccer, the Health Cloud company, introduced ACO Compare 4.0, the latest version of the company’s popular free tool that enables ACOs to analyze and compare their performance against national and regional benchmarks to help them enhance cost savings and increase the quality of care. - The updated tool is available for ACOs to use at no charge and includes several new features that help providers identify cost drivers that can impact their risk-adjusted per
Read More
Why Health Systems Need a New Transition Strategy to APMs
There is an adage that change in healthcare moves at the speed of tectonic plates. The slow adoption of Alternative Payment Models (APMs), the central feature of value-based care, is a good example of constraint despite immense pressure to control costs. Data from 2020 demonstrate almost zero change from 2018 in the proportion of straight Fee-for-Service (FFS) reimbursement. Other results show a slight uptick in APMs with or without downside risk at 34.6 percent. However,
Read More
SDoH: Today’s Health Systems Are Ill-Equipped to Meet SDOH Demands
Today’s youth understand the role SDoH plays in their health outcomes. But health systems are woefully ill-equipped to meet this growing demand. That needs to change. And with the right technology, it can. A true social revolution began on August 1, 1981. That’s the day teens and tweens everywhere started telling their parents, “I want my MTV!” Music Television (MTV)—streamed via satellite and a proprietary set-top box 14 years before the Internet was a glimmer in the consumer’s
Read More
How Actionable Data and Expert Analysis Supports Service Providers, Fosters Better Care and Ensures Financial Benefits
Approximately 42% of Medicare beneficiaries are enrolled in Medicare Advantage plans—a segment projected to reach 46% by 2025. Due to rapid growth of the 65-and-older portion of the population, Medicare expenditures are forecast to reach $1,559.4 billion in 2028, with spending per enrollee reaching $20,751. Key trends are influencing this growth, including: - An aging population - Continued increase in overall Medicare costs - Government support and benefit flexibility (e.g.,
Read More
Analysis: Is Oracle Cerner Planning to Build A National EHR?
Earlier this month Oracle closed its $28.3B acquisition of Cerner and shortly after Oracle founder and CTO, Larry Ellison, outlined Oracle’s vision for Healthcare IT post-acquisition. The key elements of this vision included: - Developing a solution for a national EHR database. - Leveraging this solution, and similar smaller-scale connected EHR initiatives, to provide life science, pharma and other users with a rich environment for research, clinical trials and drug
Read More
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
Read More
Interoperability: A Powerful Solution to Staffing Challenges Continues to be Overlooked
In our ever-changing world, clinicians nowadays must find more efficient ways to operate with fewer resources. Increased patient loads, reimbursement changes, rule and regulation adjustments and thin margins, all while being short-staffed can be compared to a smoldering bonfire that reignites every time the wind blows. As if that weren't enough, post-acute providers will begin to feel even more heat if they don’t embrace interoperability. Our global demographics simply will not be able to
Read More
