The Centers for Medicare & Medicaid Services (CMS) recently proposed a new rule to advance interoperability and improve the prior authorization (PA) process for Medicare and Medicaid patients. Specifically, the rule stipulates that health plans adopt electronic prior authorization processes, adhere to shorter turnaround times, clearly communicate denial reasons, publish key metrics annually, and implement the Fast Healthcare Interoperability Resources (FHIR) Application Programming Interface
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CMS| News, Analysis, Insights - HIT Consultant
FHIR Adoption and Implementation Challenges
The Fast Healthcare Interoperability Resources (FHIR) standard was introduced by HL7 in 2014 as a significant replacement for the HL7 V2 and V3 standards. An open standard called FHIR, which was initially drafted in 2011 makes it easier than ever for legacy systems and new apps to exchange data. FHIR was created to not only increase communication efficiency and interoperability compared to earlier standards but also to facilitate implementation by giving clear specifications and allowing
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Biden Admin Builds on Cancer Moonshot with 13 More Initiatives
What You Should Know:
- One year ago, President Joe Biden and First Lady Jill Biden reignited the Cancer Moonshot, setting an ambitious, achievable goal: to reduce the death rate from cancer by at least 50 percent over the next 25 years, and improve the experience of people and families living with and surviving cancer, ultimately ending cancer as we know it today.
- The Cancer Moonshot has spurred tremendous action across the federal government and from the public and private
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9 Executive Revenue Cycle Predictions/Trends to Watch in 2023
Nate Maslak, the co-founder/CEO of Ribbon Health
Price Transparency: In 2022, we saw CMS’s Transparency in Coverage rule go into effect, requiring non-hospital entities like health plans and providers to publish publicly available rates for care. In 2023, we’ll see this price transparency data become more mainstream as it finally makes its way into the hands of patients, empowering them to find the best care for them, reevaluate their care choices, and shop around for the best possible care
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How Will The Inflation Reduction Act Impact Healthcare in 2023? 6 Trends to Know
What You Should Know:
- As the world prepares for the Inflation Reduction Act’s landmark policy changes, healthcare stakeholders realize that its wide-ranging effects will require new approaches to drug pricing, health plan design, and investment.
- Avalere’s ‘2023 Healthcare Industry Outlook’ examines how community-wide healthcare will be affected by a recent court ruling, and consider data’s role in addressing health disparities.
Key Trends in Healthcare in 2023
The main insights
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80% of Healthcare Execs Want Complete Clinical Data From Other EHRs
What You Should Know:
- Health Gorilla, a Health Information Network and interoperability provider, released it's inaugural 2023 State of Interoperability report today to understand how healthcare decision-makers are approaching their clinical data strategies in light of patient privacy concerns and new federal regulations.
- The study, conducted in collaboration with Flexpa and the Health Management Academy, found that 60% of health systems report duplicative or incomplete data retrieved
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Study Reveals Current Landscape of FHIR Apps
What You Should Know:
- A study led by Regenstrief Institute Research Scientist Titus K. Schleyer, DMD, PhD, is among the first to survey the current landscape of FHIR® apps, providing a snapshot of how the innovative standard is used to enable the flow of health information
- FHIR apps can pull in data from most electronic health record systems, facilitating secure movement of information when and where needed.
Expanding the Horizon of Patient Data Security Via FHIR Apps
FHIR,
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Healthcare Payment Integrity: Insourcing vs. Outsourcing
Faced with shifting regulations, growing administrative complexity, high-dollar claims, and the looming potential of audits, payment integrity is an increasingly important priority for payers. Payers realize that when they make the correct payments to providers initially, they increase trust, reduce provider abrasion, and lower appeal rates.
Traditionally, many health plans have outsourced payment integrity work to vendors who perform reviews, and then return the results to those health
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20 Executives Share Health IT Predictions to Watch in 2023
We asked several healthcare executives to share their health IT predictions and trends for 2023.
Nate Maslak, the co-founder/CEO of Ribbon Health
Data Personalization: 38% of consumers want more personalized and inclusive healthcare options. In 2023, we’ll see a greater shift towards healthcare enterprises prioritizing this personalization, by innovating their current data infrastructure to show a range of information that lets a patient make an educated care decision based on what
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Digital Health Funding Reaches $15.3B in 2022 Across 572 Deals, Rock Health Reports
What You Should Know:
- In a downtrodden market climate, things don’t need to feel doom and gloom, according to Rock Health’s Annual 2022 digital health funding report. 2022 was a necessary reminder that investment is cyclical and that strong players build resilience in weathering funding climate changes.
- Analysts expect that 2023 will be built up on slow, steady, and maybe even boring strategies for healthcare startups and enterprises alike: managing cash, restructuring to accommodate
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