Abhinav Aggarwal, Sr. Director, Encounter Submission and Risk Adjustment Solutions at Edifecs
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
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CMS| News, Analysis, Insights - HIT Consultant
Beyond Healthcare Data; Shifting the Focus to Non-Healthcare Data
Drew Ivan, EVP of Product and Strategy of Rhapsody
The recently proposed information blocking rule from the ONC and CMS has thrust interoperability into the spotlight like nothing has in recent years, making it a hot topic for media fodder, and a major concern for organizations — necessitating renewed attention to data-sharing practices.
The conversation surrounding this new rule has implied that information blocking is the result of healthcare organizations intentionally withholding data.
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Trinity Health ACO Delivers $22.4M in Share Shavings, 98% Quality Performance Score
- Trinity Health ACO achieved a nearly 98 percent quality performance score and $22.4 million in shared savings in the performance year 2018. The Next Generation ACO Model was created by the Centers for Medicare & Medicaid Services (CMS) and is in its fourth year.- Trinity Health ACO provides coordinated care to patients in Illinois (Loyola Medicine), Michigan (Mercy Health – Michigan), New Jersey (Summit Medical Group) and Ohio (Mount Carmel Health System).Trinity Health ACO, a Next
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MiHIN Partners with CarePort Health to Improve Care Quality Statewide
- Michigan Health Information Network Shared Services (MiHIN) is partnering with CarePort Health to lower costs of care, improve care quality and outcomes for Michigan’s state-wide patient population through better care coordination. - The partnership allows CarePort to leverage data flowing through MiHIN to provide higher quality data to participating payer and provider organizations, enabling more cost-effective management of patient populations. CarePort Health, a Boston, MA-based provider of
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How Multi-Payer Portals Incent Providers to Better Manage Their Data
Mark Martin, Director of Payer Solutions for Availity
Value-based healthcare demands meaningful payer-provider collaboration. However, burdensome administrative processes and inefficient solutions stunt the ability of payers and providers to share data, manage risk, validate credentials, process claims, control costs and optimize the consumer experience.
These information bottlenecks are most acute in the area of provider data management (PDM). Each year, payers and providers spend more than
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How Software Solutions Can Help ASCs Maximize the Revenue Cycle in 2020
Tara Vail, Chief Operating Officer, HST Pathways
In the modern health care environment, health care executives must be careful custodians of precious resources. Yet in December 2018, 26 percent of hospitals still lacked an effective healthcare revenue cycle solution. Other research has found that over 60 percent of hospitals and health systems are not realizing optimal value from their electronic health record (EHR ) system, causing the organizations to collaborate with other vendors and
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Healthgrades Acquires Consumer & Physician Engagement Company Evariant
- Healthgrades acquires Evariant, a leading healthcare consumer and physician engagement company to create the most comprehensive consumer website to help educate consumers and connect them with a physician.- The acquisition signals a major shift in our industry, where health systems are moving towards a more consumer-centric system of care. Healthgrades, a Denver, CO-based resource that connects consumers, physicians and health systems, today announced it has acquired Evariant, a Farmington,
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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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What Will It Take To Build The Uber of Medical Records? 3 Critical Steps to Consider
Josh Douglas, Chief Technology Officer at Bridge Connector
Our healthcare system has struggled with data silos and clumsy, antiquated data sharing practices forever and a variety of stakeholders will need to work together to achieve anything close to an “Uber of medical records.”
It’s well documented and understood that the healthcare industry has historically been slow to adopt new technology while other business sectors have welcomed it with ease. For example, while most industries
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Bright Health Lands $635M to Expand Medicare Advantage Plans to More Markets
- Bright Health, a diversified consumer-focused healthcare company announced it has raised $635M in Series D funding led by NEA. - The funding will be used to support Bright Health's aggressive growth and hiring as the company continues to strategically expand across products, geographies and consumer bases.- With this round, Bright Health has raised over a billion dollars in equity financing since early 2016, reaching "unicorn status" with a valuation of over $1B. Bright Health, a diversified
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