Core administrative processing systems (CAPS) serve as the center of the healthcare payer architecture and are essential for efficient business operations. These systems are needed to support administrative and transactional processing and are a significant investment in technology. Selecting a CAPS system isn’t a single purchase, but rather an ongoing partnership that requires maintenance to ensure the system remains up to date to support industry and regulatory changes. Last year, 99% of
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CMS| News, Analysis, Insights - HIT Consultant
Why Speech Therapy is an Effective Treatment to Counter the Health Challenge of Social Determinants of Health (SDoH)
Over recent years, the virtual speech therapy delivery model has intersected with a host of healthcare disruptions -- value-based care delivery, the COVID-19 pandemic and the influence of social determinants of health (SDoH) have reshaped healthcare delivery. There has been a seismic move away from a provider-centric delivery model to a patient-centric model. This innovation has been made much easier with the ever-present catalyst of technology and its increased patient acceptance.
Speech
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Teleradiology Market Primed to Hit $3.7Bn by 2026 – What’s Driving the Surge in Demand?
4.7bn diagnostic imaging procedures were performed globally in 2021, representing a strong recovery over 2020. Healthy demand for teleradiology services resulted in the global penetration of teleradiology reads into diagnostic imaging procedures bouncing back to 1.9%, and the overall teleradiology reading services and IT market revenue elevating past its pre-pandemic level to USD $1.7bn. With a projection for the market to reach USD $3.7bn in 2026, here I explore five drivers fueling this period
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The No Surprises Act is Full of Surprises
The No Surprises Act (NSA) was meant to relieve the financial burden from consumers and help prevent unexpected, and sometimes massive, healthcare bills – a goal that providers, payors and the industry at large can get behind. But a recent survey from Morning Consult found that one in five patients will still receive a surprise bill. Couple this with the scope of changes and many surprises the NSA contains for payors, and providers – and it seems this bill will take some time to live up to its
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How to Empower Patients With Price Transparency
The evolution of e-commerce – led by Amazon – has created an intensely savvy consumer population. Amazon’s platform allows users to easily compare products from different vendors to get the best price. People travel to retail stores to try on clothes and shoes, only to purchase them online for less. Even the longest running game show in television history awards points for knowing how much consumer products cost.
Healthcare, on the other hand, does not engender the same kind of
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How Fines Push Hospitals To Go Beyond CMS Price Transparency Rules
The gamble is over for hospitals that avoided complying with CMS price transparency mandates.
After a slow start since they were implemented more than 18 months ago, CMS has issued 350 warnings for noncompliance, 157 corrective action requests, and finally issued fines to two Georgia hospitals in June. It seems many more will be on the way.
The fines are significant. The first two hospitals faced fines of roughly $880,000 and $214,000. Noncompliant hospitals with 550 beds or
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Nursing Facilities – A Medical Crisis in Need of a Prescription
Nursing facilities have evolved from rest homes to medical facilities over the last 20 years.
Patients are sicker, older, have more medical comorbidities, and are frailer. They require more assistance with activities associated with daily living and have much greater rates of cognitive impairment. People over 85 are the most rapidly expanding demographic and the elderly segment of the American population is expected to double in 2030 from 2010. Even with a shift to providing higher-intensity
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Should I Get Another Booster? How Doctors Can Help Patients Navigate the Next Phase of COVID-19
The general consensus is that COVID-19 in some form is here to stay. As people come to terms with this reality, primary care providers may be getting more questions from patients – especially older and immunocompromised ones – asking for advice on how to handle different situations. Should I get another booster? Can I start traveling? Is it OK to go to a wedding next weekend? How cautious do I need to be in social settings?
The answers to these questions aren’t always clear. A lot depends on
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Should I Get Another Booster? How Doctors Can Help Patients Navigate the Next Phase of COVID-19
The general consensus is that COVID-19 in some form is here to stay. As people come to terms with this reality, primary care providers may be getting more questions from patients – especially older and immunocompromised ones – asking for advice on how to handle different situations. Should I get another booster? Can I start traveling? Is it OK to go to a wedding next weekend? How cautious do I need to be in social settings?
The answers to these questions aren’t always clear. A lot depends on
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When Advancing a Medical Device, Be A Partner First & Seller Second to Hospital Systems
US hospital systems validate the safety, clinical utility, and robustness of newly FDA-approved devices, 510(k) cleared, before adopting them into clinical practice. This work occurs alongside evaluating how to integrate the medical device into the hospital system’s diagnostic paradigms, including in relation to quality improvement programs. Companies can have a role but there are 415 US hospital systems (comprising ~5,000 hospitals), and each has a bespoke process and ever-changing set of
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