Dr. Gary Call, Chief Medical Officer at HMS
As healthcare spending continues to rise, so too does the inherent risk for bad actors to take advantage. Today, the United States is estimated to spend nearly 18 percent of its GDP, or $3.6 trillion, on healthcare, and is expected to increase to one-fifth of GDP within the next decade, according to the latest data. This alone provides ample motivation for fraud and abuse. While the full extent of healthcare fraud is difficult to measure,
The
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Medicaid | Medicaid Patients | Medicaid Reform | Regulation, Policy, Analysis, Insights - HIT Consultant
Net Health Acquires Post-Acute Analytics Platform PointRight – M&A
What You Should Know:
- Net Health acquires post-acute market analytics platform PointRight to deepen the company’s analytics capabilities, post-acute presence, and support for SNF networks.
Net
Health, a provider of cloud-based software for specialty medical providers
across the continuum of care, today announced that it has acquired
PointRight Inc., a leading provider of
analytics and data-driven tools for the post-acute market. The acquisition adds
to Net Health’s expanding
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COVID-19 Deferrals Lead to 3 Major Conditions Payers/Providers Must Address in 2021
What You Should Know:
- COVID-19 care deferrals lead to three major boomerang
conditions that payers and providers must proactively address in 2021,
according to a newly released report by Prealize.
- COVID-19’s hidden victims—those who avoided or deferred
care during the pandemic—will increasingly return to the healthcare system, and
many will be diagnosed with new conditions at more advanced stages. Healthcare
leaders must act now to keep this boomerang from driving worse outcomes
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20 COVID-19 Predictions and Trends for 2021 – Executive Roundup
Dr. Justin Graham, Chief Medical Officer, GYANT
The rapid development of a COVID-19 vaccine is a monumental achievement, but it does nothing to address our extremely fragmented healthcare system. In 2021, policymakers must create and extend incentives to providers to work together to keep patients healthy rather than maximize profit. The pandemic has devastated the traditional fee-for-service budgets of many healthcare systems, and it isn't clear they will ever be able to catch up without
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12 Telehealth & Virtual Care Predictions and Trends for 2021 Roundup
Dr. Paul Hain, Chief Medical Officer of GoHealth
Telehealth is Here to Stay in 2021
Prior to the pandemic, telehealth was a limited ad-hoc service with geographic and provider restrictions. However, with both the pandemic restrictions on face to face interactions and a relaxation of governmental regulations, telehealth utilization has significantly increased from thousands of visits in a week to well over a million in the Medicare population. What we’ve learned is that telehealth allows
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30 Executives Share Top Healthcare Predictions & Trends to Watch in 2021
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models
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Humana Taps Vida Health to Power Virtual Diabetes Management for Kentucky’s Medicaid Population
What You Should Know:
- Humana Healthy Horizons™ in Kentucky announced it has selected Vida Health’s virtual diabetes management program to serve Kentucky’s Medicaid population.
- Vida’s diabetes management program
achieves lasting results for participants. Because chronic conditions like diabetes,
obesity, and hypertension often occur simultaneously, Vida’s unique program was
built from the ground up to treat multiple conditions at the same time.
- The new partnership, which will
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For Better Patient Care Coordination, We Need Seamless Digital Communications
Catherine Thomas: Co-Founder and VP, Customer Engagement, careMESH Peter Tippett MD, PhD: Founder and CEO, careMESH
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
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As Telehealth Surges, Are Seniors Being Left Behind?
Anne Davis, Director of Quality Programs & Medicare Strategy at HMS
A global health crisis has thrust us into a scenario in which lives quite literally depend on the ability to virtually connect. Telehealth has rapidly emerged as a vital tool, enabling continuity of care, allowing vulnerable individuals to access their physician from home, and freeing up resources for providers to treat the most critical patients. The acceptance of telehealth and expansion of covered services for the
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Despite COVID-19: Providers Should Not Lose Sight of MIPS Compliance
Courtney Tesvich, VP of Regulatory at Nextech
When 2020 began, no one anticipated that complying with the Merit-based Incentive Payment System (MIPS)—the flagship payment model of the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP)—would look so different halfway through the year. Like many other things, the COVID-19 crisis has delayed, diverted, or derailed many organizations’ reporting efforts and capabilities. Lower procedure volumes, new remote work
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