Up until now, risk adjustment has been addressed as a mechanism to accurately represent the overall risk profile of a health plan’s membership. A function that will still facilitate a health plan’s payment for taking on at-risk populations is about to go through its first major transformation – the use of risk adjustment data to drive value-based program initiatives. Now that the functional aspects
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Information Blocking Rule: 6 Key Takeaways Since Meaningful Use
Information exchange and data availability are now a cost of doing business but establishing a robust strategy for that exchange and compliance with the new regulation from the Office of the National Coordinator for Health Information Technology takes careful planning. Healthcare organizations can achieve and maintain compliance by following these six takeaways: 1. Understand what constitutes “Electronic Health Information” “Electronic Health Information,” ONC’s new term for the data
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Highmark Health Taps Verily to Build Digital Health Tools for Living Health Model
What You Should Know: - Highmark Health has engaged Verily to build out digital health tools for patients and analytics solutions for Highmark’s clinicians as part of its Living Health model. This marks the first collaboration of its kind for Verily, Google Cloud and a partner. - Highmark Health is a Blue Cross Blue Shield health plan based in Western PA with 4.5 million members and an integrated delivery system (Allegheny) with 9
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Meaningful Use of Genomics Requires Informatics Beyond EMRs
Electronic medical records (EMRs) are widely expected to serve as a cornerstone technology that drives the delivery of modern patient care. But can the EMR alone support all the informatics capabilities required by an ever-evolving healthcare industry? The rapid growth of precision medicine, particularly the use of genetic and genomic information during clinical decision making, is a compelling example that functionality beyond the EMR is required. Not only does genomic data represent a
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For Better Patient Care Coordination, We Need Seamless Digital Communications
A recent Advisory Board briefing examined the annual Centers for Medicare & Medicaid Services (CMS) Readmission penalties. Of the 3,080 hospitals CMS evaluated, 83% received a penalty for payments to be made in 2021, based on expected outcomes for a wide variety of treated conditions. While CMS indicated that some of these penalties might be waived or delayed due to the impacts of the Covid pandemic on hospital procedure volumes and revenue, they are indicative of a much larger
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5 Steps for Interoperability Excellence for Healthcare Providers
As if 2020 couldn’t be any more challenging for healthcare providers, new federal rules on interoperability and patient access, granting patients direct access to their healthcare data, begin taking effect in 2021 and will continue into 2022. These rules, while ultimately beneficial to patients, bring an additional level of operational complexity to many revenue-stressed healthcare organizations. If anything, the 2020 pandemic has illustrated the vast potential of interoperability. For
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5 Myth-Busting New Hospital ADT Notification Requirements
When doctors know their patients have been to the hospital, they can act fast to provide needed support. Widespread use of hospital event notifications is associated with all kinds of health benefits, including a 10 percent decrease in readmissions for Medicare beneficiaries. These event notifications are one of the simplest, easiest (most-bipartisan!), and most impactful changes we can make to improve patient outcomes in U.S. healthcare. To this goal, the Centers for Medicare and Medicaid
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Quartet Health, Blue Cross NC Collaborate on Value-Based Care Payment Model for Mental Health
- Mental health technology company Quartet Health announced a new technology that helps install a value-based quality measurement system for mental healthcare. - Achieved in collaboration with Blue Cross of North Carolina -- an insurer known for being on the forefront of improving mental health access and a tech leader -- Quartet and BCNC are introducing it as the market's first and will serve as a framework for all insurer adoption. Quartet Health, an innovative mental healthcare technology,
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AMIA President & CEO, Douglas B. Fridsma Steps Down
- Douglas B. Fridsma, MD, Ph.D., FACP, FACMI, FAMIA is stepping down as President and CEO of The American Medical Informatics Association (AMIA). - Karen Greenwood, Executive Vice President, and Chief Operating Officer will serve as interim CEO while the Board of Directors begins the search for a replacement. The American Medical Informatics Association (AMIA) has announced the departure of President and CEO Douglas B. Fridsma, MD, Ph.D., FACP, FACMI, FAMIA, effective January 1, 2020.
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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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