The Accountable Care Organization (ACO) Investment Model (AIM) saved the Centers for Medicare & Medicaid Services (CMS) more than $48M in its first year while promoting improved health care in rural and underserved areas, according to a new study from Abt Associates.The new study reveals that after accounting for the $82.4 million provided to ACOs, AIM reduced CMS expenditures by $48.6 million. Decreases in the number of hospitalizations and use of institutional post-acute care contributed
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Medicare Insurance| Regulatory, Policy, Patients Analysis, Insights - HIT Consultant
How Medicare Advantage Plans Reduced Their Disenrollment Rates by 30% Through Welltok
The average Medicare Advantage plan turns over about 10% of its members every year, and for a 100,000 member plan, that can equate to about $110 million in lost premium reimbursements as well as a decline in Star ratings. This is why retaining members is a top priority among health plans. Welltok’s Medicare Retention Solution has helped leading Medicare plans reduce disenrollment rates by up to 30%, improve disenrollment-related Star ratings from 2.5 to 4 and retain up to $97 million
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6 Considerations For Creating A Robust Healthcare Data Analytics Program
Healthcare organizations are increasingly turning to data analytics to solve their toughest business challenges. As information becomes less siloed, and technology systems do a better job of both generating and sharing data, organizations are seeing the need to more precisely identify patterns to predict patient needs, anticipate resources and improve processes. There is now as much emphasis on making the data work as there was on collecting data, so it can affect change.
Unfortunately,
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Innovaccer Launches Data Solution to Enable ACOs’ Seamless Transition to Value-Based Care
A survey suggests that 71% of accountable care organizations would rather quit the Medicare Shared Savings Program than assume down risks. Although ACOs are leading the transition from volume-based care to value-based care, a lot of them face the lack of confidence in meeting the quality and cost benchmarks. When ACOs don’t have adequate knowledge and control over the network, earning shared savings can be quite challenging. Data from disparate sources such as EHRs, payer claims, PMS and HIEs
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Pilot Study: Lark Health’s AI-Driven Diabetes Management Program Decreased A1c by 1.1 Points
Lark Health, a chronic disease prevention and management platform has released initial results from a pilot study of its Diabetes Management Program (Lark DMP). After an average of four months, the Lark DMP users reported a significant reduction in A1c levels of 1.1 points, from 8.5 to 7.4 percent.Lark Diabetes Management Program OverviewThe Lark DMP, which uses conversational artificial intelligence (AI), rather than live telephonic nurses, was developed with the collaboration of industry and
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Carenet Health Acquires Engagement, Telehealth Subsidiary of Citra Health
Carenet Health, a San Antonio, TX-based provider of healthcare engagement, clinical support, advocacy and 24/7 telehealth solutions, has acquired the engagement and telehealth solution subsidiary of Citra Health Solutions. The acquisition is the second acquisition of its kind by Carenet in a span of seven months. Financial terms of the acquisition were not disclosed.The recent acquisition complements Carenet’s ongoing commitment to delivering high-quality, cost-effective, on-demand telehealth
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AMA Grants New CPT Code for KidneyIntelX to Support Medicare & Reimbursement
The American Medical Association (AMA) has granted a CPT® Proprietary Laboratory Analyses (PLA) Code for Renayltix AI’s lead product, KidneyIntelX. The new code, 0105U, has been approved and published by the AMA CPT Editorial Panel, and is scheduled to become effective on October 1, 2019.Medicare Price for New CPT CodeA payment rate for the new code will be established for Medicare patients through the 2019 Clinical Lab Fee Schedule (CLFS) Annual Public Meeting process. Renayltix AI will shortly
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How Can Providers Support Meaningful Price Transparency to Address Consumerism in Healthcare?
The word “consumerism” and its derivatives have been tossed around the broader healthcare industry for the greater part of a decade. How we define consumerism and look at consumer behavior in relation to our institutions, systems, and programs seems key to unlocking the door to better outcomes and higher margins. However, in a landscape with more disruption than ever—greater vertical integration, technology, and regulation—we still lack the answer to these fundamental questions: What do patients
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J.D. Power to Publish First-Ever Telehealth Satisfaction Study Focused on 3 Categories
J.D. Power, a global leader in consumer insights, advisory services, and data and analytics announced its plan to launch its first-ever Telehealth Satisfaction Study in November 2019.Why Telehealth Satisfaction?As new value-based payment models continue to re-define the consumer healthcare experience, the use of telehealth as a lower-cost form of medical consultation has skyrocketed in popularity. Among the commercially insured, telehealth visits increased 261% between 2015 and 20171 and the
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Healthcare’s Uncertain Future: 3 Data-Driven Approaches for Payers
Nine out of 10 healthcare leaders expect disruptive pressures to increase tremendously in the year ahead, according to a recent survey. However, fewer than half believe their organizations are prepared to withstand these forces.
In an era of transformation—in which traditional business models are continually being revamped in response to pressures such as consumerism, policy changes, and the market entrance of non-traditional healthcare players such as Amazon and Apple—payers face daunting
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