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CMS| News, Analysis, Insights - HIT Consultant

Patients Are Not Consumers. Healthcare Is Not A Typical Business

by Irv Lichtenwald , CEO of Medsphere Systems Corporation 08/21/2019 Leave a Comment

Medsphere CEO Talks Affordable Healthcare IT and Future of EHRs

Let’s say, for the sake of argument, that I have an extreme Diet Coke emergency. (I never have, but that’s beside the point.) At 2 AM on a Wednesday I awake with an unforgiving need to drink Diet Coke. I dress and head out to find the nearest 24-hour convenience store, where I can satisfy my damnable craving by paying a bit more for Diet Coke than I would at a grocery store. I pay slightly more for a few reasons related to the cost of convenience, the lack of more affordable options at 2 AM, the
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Only 11% of Acute-Care Providers Use An Integrated EHR, Study Finds

by Jasmine Pennic 08/20/2019 Leave a Comment

Only 11 percent of acute care providers use an integrated electronic health record (EHR), according to PointClickCare’s results of its 2019 Patient Transition Study. The study reveals that acute care and long-term post-acute care patient coordination remains largely manual through paper, email, and fax processes.Conducted in partnership with Definitive Healthcare, c-suite executives from acute and post-acute care facilities provided input on data sharing, concerns about interoperability, and
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10 Considerations for Success In A Post-MACRA Value-Based Healthcare Reality

by Moshe Starkman, Senior Director, Value-based Reimbursements, nThrive 08/20/2019 Leave a Comment

MACRO

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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Maine Health, Anthem Form Joint Venture to Offer Medicare Advantage Plans

by Jasmine Pennic 08/19/2019 Leave a Comment

Maine Health, Anthem Form Joint Venture to Offer Medicare Advantage Plans

 Anthem Blue Cross and Blue Shield in Maine and MaineHealth today announced the two organizations will be collaborating on a joint venture to offer Medicare Advantage health insurance plans for 2020 under the Anthem | MaineHealth brand. This joint venture effort, named AMH Health, LLC, will bring together the core strengths of the region’s leading health care system and health insurer, their brand recognition, as well as their expertise in providing a comprehensive approach to care that will
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Why Real-Time Health Data Is a Requirement in Today’s Health System

by Sara Radkiewicz, Head of Product, CarePort Health 08/14/2019 Leave a Comment

Why Real-Time Health Data Is a Requirement in Today’s Healthcare Environment

Thanks to technological innovation in the industry and CMS’ push for interoperability, today there’s more patient health data being collected than ever before. The problem is that the data is either not easily accessible to providers or it’s claims based and therefore not timely. The lag time between the collection and sharing of health data makes it difficult, and in some cases impossible, for providers to get a complete picture of their patients’ health, to appropriately treat ongoing
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Health Catalyst IPO Journey: Future Opportunities & Challenges to Watch

by Alex Green, Director at Signify Research 08/02/2019 Leave a Comment

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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CMS Launches Pilot to Give Clinicians Direct Access to Claims Data

by Jasmine Pennic 07/30/2019 Leave a Comment

Survey: Hospital Cost of Following-up on Late Insurance Claims Higher Than Estimated

New CMS Pilot program gives clinicians direct access to claims data, putting patients over paperwork and at the center of their care.Today, at the White House Blue Button Developers Conference (BBDC), the Centers for Medicare & Medicaid Services (CMS) announced a new pilot program for clinicians called “Data at the Point of Care” (DPC). DPC is based on an industry-standard application programming interface (API), and is part of the MyHealthEData Administration-wide initiative that is
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Innovaccer Launches a Single Data System to Empower Medicare Advantage Plans

by Jasmine Pennic 07/18/2019 Leave a Comment

Innovaccer launches a Single Data System to Empower Medicare Advantage Plans

To assist Medicare Advantage plans in eliminating these complications and achieve the top Star Ratings, Innovaccer Inc., a San Francisco-based data activation company, has strengthened its solution for Medicare Advantage plans. The solution for MA plans is a comprehensive suite of solutions designed to solve all grassroots challenges to empower MA plans to ensure healthier patients and increased profits.Rise in Medicare Advantage EnrollmentThe CMS has projected that Medicare Advantage enrollment
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ACO Investment Model Reduced CMS Expenditures by $48M

by Fred Pennic 07/15/2019 Leave a Comment

Revenue Integrity Dysfunctional Patient Billing Major Distraction for Patients & Clinicians 6 Metrics to Improve Hospital Revenue Cycle ROI_revenue cycle makret

The Accountable Care Organization (ACO) Investment Model (AIM) saved the Centers for Medicare & Medicaid Services (CMS) more than $48M in its first year while promoting improved health care in rural and underserved areas, according to a new study from Abt Associates.The new study reveals that after accounting for the $82.4 million provided to ACOs, AIM reduced CMS expenditures by $48.6 million. Decreases in the number of hospitalizations and use of institutional post-acute care contributed
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6 Considerations For Creating A Robust Healthcare Data Analytics Program

by Dr. Anunaya Jain, VP, IKS Health 07/10/2019 Leave a Comment

6 Considerations For Creating A Robust Healthcare Data Analytics Program

Healthcare organizations are increasingly turning to data analytics to solve their toughest business challenges. As information becomes less siloed, and technology systems do a better job of both generating and sharing data, organizations are seeing the need to more precisely identify patterns to predict patient needs, anticipate resources and improve processes. There is now as much emphasis on making the data work as there was on collecting data, so it can affect change.  Unfortunately,
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