What You Should Know:
- Based on prevalence estimates from PINC AI™ data during 2017-2022, an estimated 66 million emergency department (ED) outpatient visits and 760,000 inpatient admissions in the U.S. annually are for patients with the diagnosis of opioid use disorders (OUDs).
- Patients with an OUD diagnosis had 32.5 percent higher cost per ED visit and 8 percent higher cost per inpatient visit than those without an OUD diagnosis. The annual total cost of care for OUD-associated ED
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Medicare Insurance| Regulatory, Policy, Patients Analysis, Insights - HIT Consultant
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
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
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
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
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
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
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
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
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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