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Medicare Insurance| Regulatory, Policy, Patients Analysis, Insights - HIT Consultant

Edifecs and VirtualHealth Partner to Automate Prior Authorization

by Fred Pennic 02/01/2023 Leave a Comment

Edifecs and VirtualHealth Partner to Automate Prior Authorization

What You Should Know: - Today, Edifecs and VirtualHealth, a medical management company, announced a new partnership automated prior authorization to VirtualHealth’s HELIOS® platform for healthcare payer and provider clients. - The Edifecs solution will automate and optimize the prior authorization process across HELIOS to significantly reduce the administrative burden, alleviate friction between payers and providers, and ultimately expedite patient care. Growing Need for Automated Prior
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Prisma Health Moves to the Innovaccer Health Cloud

by Jasmine Pennic 01/31/2023 Leave a Comment

Prisma Health Moves to the Innovaccer Health Cloud

What You Should Know:  - South Carolina’s largest health system, Prisma Health selects the Innovaccer Health Cloud to be its primary value-based care platform for analytics, workflow, and Snowflake data platform management. - With the Innovaccer Health Cloud’s data and analytics platform, Prisma Health can integrate disparate EHRs and other healthcare systems to create a unified patient record.  Primsa Health Background Prisma Health provides healthcare services to nearly
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Upstream Healthcare Selects Innovaccer to Scale Value-Based Care Model Nationwide

by Jasmine Pennic 01/27/2023 Leave a Comment

Innovaccer Expands into Public Sector to Accelerate Public Health Transformation

What You Should Know: - Innovaccer Inc. announced that UpStream Healthcare, one of the fastest-growing value-based primary healthcare provider solutions in the country, has entered into a multi-year partnership agreement to more than double its population on Innovaccer’s cloud-native platform over the next year, and will use it to scale UpStream’s unique value-based care model nationwide. - The expanded relationship between the two companies comes on the heels of UpStream’s recent $140
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Mighty Health Raises $7.6M for Daily Health Program for Medicare-Aged Adults

by Fred Pennic 01/26/2023 Leave a Comment

Mighty Health Raises $7.6M for Daily Health Program for Medicare-Aged Adults

What You Should Know:  Mighty Health, the first all-in-one daily health program designed for adults ages 50 and up, today announced $7.6M in new financing co-led by Will Ventures and GFT Ventures. - Mighty Health has built the modern home for healthy living for 50 on up, offering aging adults access to personalized and holistic health guidance through joint-friendly workouts, chronic condition-specific programs, custom nutrition plans, and 1-on-1 health coaching.
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Study: Increased Transparency Between Payers and Providers at the Point-of-Care Improves Risk Capture and Quality Measures

by Syed Hamza Sohail 01/25/2023 Leave a Comment

Study: Increased Transparency Between Payers and Providers at the Point-of-Care Improves Risk Capture and Quality Measures

What You Should Know: - IllumiCare, a pioneer in point-of-care healthcare information technology, today released a new report detailing how increased data transparency between health plans and providers on care and coding gaps results in higher compliance, process improvement, and positive behavior changes among network providers.  - The report demonstrates, across multiple plans, that placing previously unavailable yet actionable information on quality gaps, HCC (Hierarchical
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9 Executive Revenue Cycle Predictions/Trends to Watch in 2023

by Fred Pennic 01/23/2023 Leave a Comment

Executive Revenue Cycle Predictions/Trends

Nate Maslak, the co-founder/CEO of Ribbon Health Price Transparency: In 2022, we saw CMS’s Transparency in Coverage rule go into effect, requiring non-hospital entities like health plans and providers to publish publicly available rates for care. In 2023, we’ll see this price transparency data become more mainstream as it finally makes its way into the hands of patients, empowering them to find the best care for them, reevaluate their care choices, and shop around for the best possible care
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How Will The Inflation Reduction Act Impact Healthcare in 2023? 6 Trends to Know

by Syed Hamza Sohail 01/23/2023 Leave a Comment

How Will The Inflation Reduction Act Impact Healthcare in 2023? 6 Trends to Know

What You Should Know: - As the world prepares for the Inflation Reduction Act’s landmark policy changes, healthcare stakeholders realize that its wide-ranging effects will require new approaches to drug pricing, health plan design, and investment. - Avalere’s ‘2023 Healthcare Industry Outlook’ examines how community-wide healthcare will be affected by a recent court ruling, and consider data’s role in addressing health disparities. Key Trends in Healthcare in 2023 The main insights
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8 Executive Pharmacy Predictions/Trends to Watch in 2023

by Fred Pennic 01/18/2023 Leave a Comment

Executive Pharmacy Predictions/Trends 2023

Frank Harvey, CEO at Surescripts Community pharmacists trusted to deliver care: In 2023, pharmacists will play an integral role as part of the team managing patient care for diseases like diabetes, hypertension, or multiple comorbidities. And to support this work, I predict that we will see more activity between payers, pharmacists, the government and technology organizations to ensure that pharmacists are able to perform these important activities and be reimbursed for their work. Greg
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Sharecare Launches Virtual Model of its Medicare-Reimbursable Cardiac Rehab Program

by Jasmine Pennic 01/18/2023 Leave a Comment

Sharecare Launches Virtual Model of its Medicare-Reimbursable Cardiac Rehab Program

What You Should Know: - Sharecare, the digital health company that helps people manage all their health in one place, today announced Ornish Lifestyle Medicine by Sharecare, the company’s Intensive Cardiac Rehabilitation (ICR) program, is now available through a virtual delivery model. - Reimbursable through Medicare and many commercial plans, Ornish Lifestyle Medicine by Sharecare is the first and only ICR program scientifically proven in randomized controlled trials to often reverse the
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Study Reveals Current Landscape of FHIR Apps

by Syed Hamza Sohail 01/16/2023 Leave a Comment

Study Reveals Current Landscape of FHIR Apps

What You Should Know: - A study led by Regenstrief Institute Research Scientist Titus K. Schleyer, DMD, PhD, is among the first to survey the current landscape of FHIR® apps, providing a snapshot of how the innovative standard is used to enable the flow of health information - FHIR apps can pull in data from most electronic health record systems, facilitating secure movement of information when and where needed. Expanding the Horizon of Patient Data Security Via FHIR Apps FHIR,
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