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Medicaid | Medicaid Patients | Medicaid Reform | Regulation, Policy, Analysis, Insights - HIT Consultant

PatientPing’s Network of Next Generation ACO Partners Generates Over $150M in Savings

by Jasmine Pennic 02/04/2020 Leave a Comment

PatientPing's Network of Next Generation ACO Partners Generates Over $150M in Savings

PatientPing’s national network of Next Generation Accountable Care Organizations (ACO) partners generated over $150 million in savings under the CMS Next Generation ACO for the year 2018. PatientPing's national network includes thousands of providers across hospitals, health systems, health plans, post-acute, and other entities, all of which are working together to collaborate with one another on their shared patients.PatientPing, a Boston, MA-based care collaboration platform announced that its
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Why Government-Supported Health Plans Must Make Encounter Submissions A Top Priority in 2020

by Abhinav Aggarwal, Sr. Director, Encounter Submission and Risk Adjustment Solutions at Edifecs 01/27/2020 Leave a Comment

Why Government-Supported Health Plans Must Make Encounter Submissions A Top Priority in 2020

Encounter data such as diagnosed clinical conditions and services, or items delivered to healthcare consumers to treat these conditions is the key to success for all healthcare organizations participating within the government space. Whether doctors or hospitals are submitting data for medical services rendered under Medicare Advantage, the Affordable Care Act’s state exchanges or Medicaid, encounter data is used for payment reimbursement and reconciliation between the health plan and the
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Validic, Humana Launch Health Incentive Program to Support Device Connectivity

by Fred Pennic 01/22/2020 Leave a Comment

Validic, Humana Launch Health Incentive Program to Support Device Connectivity

- Validic and Humana form partnership to launch a health incentive program to support Medicaid and Medicare communities with device connectivity. - As part of this engagement, Humana and Validic plan to expand the devices and data points available in Humana’s Go365 wellness and rewards program to address additional health barriers, such as nutrition, smoking cessation, mental health and more.Humana Inc., a health insurer company and well-being company and Validic, the market leader in platforms
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Trinity Health ACO Delivers $22.4M in Share Shavings, 98% Quality Performance Score

by Fred Pennic 01/16/2020 Leave a Comment

Next Generation Accountable Care Organization (ACO),

- Trinity Health ACO achieved a nearly 98 percent quality performance score and $22.4 million in shared savings in the performance year 2018. The Next Generation ACO Model was created by the Centers for Medicare & Medicaid Services (CMS) and is in its fourth year.- Trinity Health ACO provides coordinated care to patients in Illinois (Loyola Medicine), Michigan (Mercy Health – Michigan), New Jersey (Summit Medical Group) and Ohio (Mount Carmel Health System).Trinity Health ACO, a Next
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How Multi-Payer Portals Incent Providers to Better Manage Their Data

by Mark Martin, Director of Payer solutions, Provider Data management for Availity 01/14/2020 Leave a Comment

Prior Authorizations: A Single Source of Truth for Provider Data Management

Mark Martin, Director of Payer Solutions for Availity Value-based healthcare demands meaningful payer-provider collaboration. However, burdensome administrative processes and inefficient solutions stunt the ability of payers and providers to share data, manage risk, validate credentials, process claims, control costs and optimize the consumer experience. These information bottlenecks are most acute in the area of provider data management (PDM). Each year, payers and providers spend more than
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How Software Solutions Can Help ASCs Maximize the Revenue Cycle in 2020

by Tara Vail, Chief Operating Officer, HST Pathways 01/09/2020 Leave a Comment

How Software Solutions Can Help ASCs Maximize the Revenue Cycle

In the modern health care environment, health care executives must be careful custodians of precious resources. Yet in December 2018, 26 percent of hospitals still lacked an effective healthcare revenue cycle solution. Other research has found that over 60 percent of hospitals and health systems are not realizing optimal value from their electronic health record (EHR ) system, causing the organizations to collaborate with other vendors and outsourcing companies to improve revenue cycle
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3 AI Trends for 2020: Moving Beyond Dazzle to High-Impact Collaboration

by Jordan Bazinsky, EVP and Administrative Officer for Cotiviti 01/03/2020 Leave a Comment

3 AI Trends for 2020: Moving Beyond Dazzle to High-Impact Collaboration

From the first artificial skin to driverless cars that navigate busy streets with ease, 2019 brought a dazzling array of artificial intelligence (AI) discovery. In 2020, the progress made toward AI-fueled collaboration will be as critical as AI innovation—especially in healthcare. We’ve reached a point where AI has proven its utility. In radiology, for example, AI is well-oriented to interpret diagnostic imaging studies, with FDA approval given to AI algorithms that diagnose a collapsed lung or
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Executive Insights: Top Healthcare Predictions & Trends to Watch in 2020

by Fred Pennic 12/31/2019 Leave a Comment

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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Mayo Clinic Appoints Rita Khan as First-Ever Chief Digital Officer

by Jasmine Pennic 12/30/2019 Leave a Comment

Mayo Clinic Appoints Rita Khan as First-Ever Chief Digital Officer

- Mayo Clinic appoints Rita Khan as the health system’s first-ever chief digital officer to lead Mayo Clinic’s digital health transformation strategy. - Khan most recently was senior vice president of consumer digital at UnitedHealthcare, where she directed enterprise-level digital strategy.  Mayo Clinic has named Rita Khan chief digital officer, Mayo Clinic where she will help guide Mayo Clinic's strategy as it prepares for transformative changes in the digital space. As Mayo Clinic's
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Top 60 Health IT/Digital Health Mergers & Acquisitions in 2019

by Fred Pennic 12/27/2019 Leave a Comment

Kareo Sells Managed Billing Services Business to Health Prime International

- From Google's acquisition of Fitbit to Philips acquisition of Carestream Health's health IT business, here is a look at some of the biggest health IT/digital health mergers & acquisitions in 2019 by each quarter. Q1 M&A Activity Johnson & Johnson Acquires Auris Health for $3.4B to Expand Digital Surgery Portfolio Johnson & Johnson acquiresAuris Health, a developer of robotic technologies for $3.4 billion in cash. Auris Health is a privately-held developer of
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