What You Should Know:
- SCAN Health Plan, a Medicare Advantage insurer known for its expertise in keeping older adults healthy and independent is launching SCAN Affirm partnered with Included LGBTQ+ Health (HMO), a first-of-its-kind Medicare Advantage plan developed exclusively for LGBTQ+ older adults, in collaboration with Included Health, the only integrated virtual care and navigation platform.
- SCAN Health Plan will offer the SCAN Affirm plan to members in
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Medicare Insurance| Regulatory, Policy, Patients Analysis, Insights - HIT Consultant
Healthfirst and MediSys Launch FHIR Platform, Hyphen
What You Should Know:
- Healthfirst and The MediSys Health Network announced today they are using Hyphen to connect longitudinal data from claims, quality measures and electronic health records (EHRs) to identify gaps in care, making it easier for clinicians to address patient needs in real-time.
- Hyphen is a cloud-based platform that uses Fast Healthcare Interoperability Resource (FHIR) standards to share member data directly into provider or hospital EHR systems, along with patient- and
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Digital Fax Solutions Alleviate Administrative Burden and Reduce Costs
At the LeadingAge Illinois 2022 Annual Meeting, Elizabeth McLaren, VP of Reimbursement and Community-Based Services, along with Steven Wermuth, MPA at Strategic Health Care, presented their analysis on the top billing mistakes. What did they find? Within long-term care providers, 8-10% of Medicare Advantage claims were denied. Shockingly, the 10% denial rate impacted revenue by $200 million! They also found that 80% of denied claims are due to missing or incorrect information used during intake
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The Botched COVID-19 Response and What We Can Learn from It
The COVID-19 pandemic has completely transformed the World Order and exposed striking realities of the global healthcare infrastructure by revealing the tendencies of various countries to deal with public healthcare emergencies. It has further raised the curtain on global hegemons like the U.S.A., which lacked the capacity and finances to counter this disaster. This has intensified the need for reforms and strong legislation to mitigate the pandemic’s devastation on healthcare facilities.
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Grow Therapy Raises $75M to Expand Insurance Coverage for Mental Healthcare Nationwide
What You Should Know:
- Behavioral health company, Grow Therapy secures $75 million in series B funding to expand insurance coverage including Medicare and Medicaid in all 50 states.
- This round of funding was led by TCV, co-led by Transformation Capital, with support from existing backers SignalFire and SVB.
Medicare/Medicaid Coverage Expansion
Specifically, the areas that the company will focus on are: expanding commercial insurance and Medicare and Medicaid coverage (which are
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Rippl Launches with $35M to Transform Mental Health for Seniors
What You Should Know:
- Rippl, a new mental health startup focused on caring for seniors with dementia and other neurocognitive conditions, launched today with $32M in seed round funding led by ARCH Venture Partners and General Catalyst. The round also includes investment from GV, F-Prime Capital, and Mass General Brigham Ventures.
- Rippl will use its seed funding to hire and train a team of clinicians, build technology, and open a Washington state-based clinical support center to launch
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Edifecs Launches Solution to Automate Prior Authorization at the Point of Care
What You Should Know:
- The full automation of prior authorization at the point of care leads to improved member experiences, enhanced outcomes, ongoing compliance, and reduced administrative burden. Edifecs’ automated prior authorization solution integrates with electronic health records (EHR) and leverages artificial intelligence (AI), natural language processing (NLP), and industry standards such as FHIR to instantly deliver authorization.
- This innovation comes on the heels of
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Why Now is the Time to Double Down on Virtual Care
For an industry that traditionally embraces change at a glacial pace, the pandemic has been a wake-up call for healthcare. Once COVID-19 struck, the shift to video, telephone engagement and remote patient monitoring spiked seemingly overnight.
This surging demand for virtual care resulted, in many cases, in increased provider efficiency, provider-patient interactions, and satisfaction. One national telehealth organization covering 2,000 hospitals and 81,000 doctors, for example,
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Castlight + Vera Appoints New CEO; Rebrands as Apree Health
What You Should Know:
- Vera Whole Health, Inc. and Castlight Health, Inc. appoints former Cerner President Donald Trigg as chief executive officer (CEO)
- In addition, the companies have rebranded as apree health that will be combine Castlight’s healthcare navigation platform with Vera’s advanced primary care solutions to improve patient outcomes and transform the healthcare industry.
Donald Trigg Background
Donald Trigg most recently served as president of
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AI-Powered Pop Health and SDOH – The Good, The Bad and The Best Practices
Artificial intelligence (AI) has emerged as a powerful tool for making population health analytics more accurate and interventions more effective. Not all AI-powered pop health tools are created equal, and while many still exhibit different types of bias that limit their ability to accurately identify issues affecting certain populations, we have learned a lot about the sources of bias in AI and how to eliminate them. AI shortcomings aside, pop health analytics have advanced to the point that we
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