Provider data management is usually discussed from the provider perspective: the busy staff, the needless paperwork amid a pandemic, the faxing, emailing and uploading of data. In these scenarios, the health plans are often painted as the villains for their bureaucratic processes and unique requirements. But the reality is that health plans aren’t totally to blame.
Payers and providers share a common goal: to provide the best quality care for their patients. The amount of data, including
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Affordable Care Act
COVID-19 Pandemic Further Exposes Systemic Racism…
This will be ugly and sad. Racism has cost this country $16 trillion over the last twenty years according to a recent Citigroup report. Much of this loss ($13 trillion) was attributed to discriminatory lending practices and the 6.1 million fewer jobs created as a result, while disparity in wages ($2.7 trillion) and discrimination in housing policies and lost income due to restricted access to higher education accounted for the balance. The report estimates that if these gaps were to be
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Rural Hospital Execs Can Beat COVID-19 By Shifting From Reactive to Proactive Care
The COVID-19 virus is ravaging the planet at a scale not seen since the infamous Spanish Flu of the early 1900s, inflicting immense devastation as the U.S. loses more than 200,000 lives and counting. According to CDC statistics, 94% of patient mortalities associated with COVID-19 were simultaneously suffering from preexisting conditions, leaving a mere 6% of victims with COVID-19 as their sole cause of death. However, while immediate prospects for a mass vaccine might not be until 2021, there is
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Why COVID-19 Underscores The Importance of Social Determinants of Health
Google “Social Determinants of Health” and one will quickly discover a kind of litany of data pointing to a certain definition of “health” defined by the World Health Organization (WHO) as “A state of complete physical, mental and social well-being not merely the absence of disease or infirmity,” and socioeconomic barriers, which may prohibit equitable access to good health and wellness (Healthcare) more completely among diverse populations.
Nevertheless, the heart of the matter
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Why Government-Supported Health Plans Must Make Encounter Submissions A Top Priority in 2020
Encounter data such as diagnosed clinical conditions and services, or items delivered to healthcare consumers to treat these conditions is the key to success for all healthcare organizations participating within the government space. Whether doctors or hospitals are submitting data for medical services rendered under Medicare Advantage, the Affordable Care Act’s state exchanges or Medicaid, encounter data is used for payment reimbursement and reconciliation between the health plan and the
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3 Trends Driving Healthcare Mergers & Acquisitions (M&A) Activity in 2020
Livingstone’s
Ryan Buckley shares insights behind the prevalent healthcare M&A trends of
2020 and its impact on U.S healthcare.
The New
Year often brings with it an essence of transformation. This year, U.S.
healthcare’s metamorphosis is now more than a decade old, as it continues to
shed its antiquated legacy systems and siloes to embrace a different kind of entity—one
that hopes to establish weight in value-based care at a scale robust enough to
substantiate it.
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Executive Insights: Top Healthcare Predictions & Trends to Watch in 2020
As we close out the year, we asked several healthcare industry executives to share their predictions and trends for 2020.
Robbie Hughes, Founder, and CEO, Lumeon
“Following the announcement of the Trump administration's price transparency requirement – and the ensuing backlash from hospital groups – the issue of price transparency will dominate the healthcare industry next year. Regardless of the outcome of the lawsuit, I expect we'll see more attention around the importance of the
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88% of Hospitals Plan to Invest in Remote Patient Monitoring Solutions to Support Value-Based Care
- 88% of health systems and hospitals surveyed have invested or plan to invest in remote patient monitoring solutions to support their organizational transitions to value-based care, according to the latest Spyglass Consulting Group report. - Healthcare provider investments in RPM solutions are being driven by several underlying market factors including exploding healthcare costs, a rising aging baby boomer population, the increased prevalence of chronic disease, and continuous healthcare
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10 Considerations for Success In A Post-MACRA Value-Based Healthcare Reality
The first two years of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program (QPP) are in the books and many organizations are wondering if their strong performances will ever be met with a significant upside adjustment.
Year 1 (2017) enjoyed very high participation levels, 95% of eligible clinicians, but very low upside adjustments. Between the Test Pace option, artificially low bar (3 points) for an upside adjustment, and numerous opportunities to score
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Health Catalyst IPO Journey: Future Opportunities & Challenges to Watch
Last week saw Health Catalyst common stock begin trading on the Nasdaq Global Select Market. This marks the culmination of a journey that started 11 years ago and provides a great illustration of a start-up that has maximized the potential of the move in healthcare to value-based care. However, the IPO comes at a time where there is some uncertainty gripping the markets it targets and there are several key challenges for Health Catalyst to overcome in order to drive future success. Here’s our
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