Provider credentialing is an essential part of healthcare. A provider cannot work or get paid without a proper license or credential, and yet this highly complex process is still done on paper (also sticky notes on file cabinets, Excel spreadsheets—you get the idea) by many healthcare organizations. Manually credentialing providers adds to an already lengthy process. One expired certificate or a delayed privileging request can prevent a provider from seeing patients for more than 60
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Payers| Payer Industry Impact for Patients, Clinicians, and Healthcare Organizations | News, Analysis, Insights - HIT Consultant
Provider Burnout Has Leveled Out in 2022; Staffing Shortages Rises, KLAS Reports
What You Should Know: - Value-based care (VBC) has been established as a priority among healthcare organizations and payers as participants have gained more experience in managing their quality metrics and contracts, ultimately realizing returns on their investments. - For their latest report, KLAS talked to 54 healthcare executives—including CEOs, CFOs, CIOs, CMIOs, COOs, VPs and directors of population health, and VPs of analytics—to gauge how they are moving beyond
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3 Seismic Shifts Transforming Women’s Health – FemTech
My company recently celebrated its 10th anniversary, which prompted me to reflect on the progress of the women’s health sector over the last decade. There has been so much change, so many technological innovations and clinical breakthroughs. And yet, two things haven’t changed all that much. Our outcomes in the U.S. have not improved; in fact they are in decline. This is true whether you are measuring maternal mortality, health equity, or complication rates. And as an industry, we’ve yet to
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Prior Authorization Reforms Don’t Address the Real Problem. Here’s How AI Can Help.
After waiting weeks for an open appointment, John finally gets in to see the orthopedic surgeon to evaluate his acute knee pain. He’s already been off work for over two months and has barely been able to leave the house, popping anti-inflammatory and pain medicine to manage the pain every day. Suspecting a torn meniscus, the doctor orders an MRI to verify the diagnosis and plan his treatment approach. The nurse begins the process by calling John’s insurance carrier to verify coverage,
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3 Reasons the Cloud is Critical for Ensuring Patient-Centered Care
As the healthcare sector embraces value-based care, the patient – not the procedure – is the central focus for providers. But the move to patient-centered care requires several significant deviations from the status quo. For example, more personalized treatment is required through information sharing and collaborative decision-making among providers, patients and their families. There is also a greater need to focus on overall physical, mental and emotional well-being of patients, as
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Edifecs Partners with Empowered-Home to Deliver Automated Prior Authorizations
What You Should Know: - Edifecs and Empowered-Home announced a partnership to provide automated prior authorizations to medical associations, Accountable Care Organizations (ACOs), Independent Physician Associations (IPAs), medical groups, and home health care agencies. - The Edifecs prior authorization solution combined with the clinical decision support system of patient management software company, Privis Health, forms the backbone of Empowered-Home’s ecosystem. Empowered-Home is
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HLTH22: Turquoise Health Launches Price Transparency Data Solution
What You Should Know: - Turquoise Health, an end-to-end healthcare pricing platform, today announced Simple Extracts, its first price transparency data product for specialty healthcare businesses. Simple Extracts allows anyone to request and receive precise searches from both the hospital and payer rates data warehouses. - This new product eliminates the cost and technical barriers specialty businesses encounter by delivering data to customers directly within the Turquoise Health platform.
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The $2.8M Medicine: How Data Can Help Insurers Pay for Life-Changing Therapies Without Breaking The Bank
Advanced medical research has brought us to the point where many serious conditions can potentially be treated and even cured - with people who have essentially faced a lifetime of being incapacitated finally able to conduct normal lives. Many of these treatments are drug-based gene therapies–- but they come with an extremely high price tag. The latest example–and most expensive medication to date– is bluebird bio’s recently-approved $2.8 million gene therapy to treat a rare blood
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HLTH22 Day 1 News Summary: Google, Maven, Highmark, LG, Others
Venture Capital, Private Equity Funding Maven Clinic Secures $90M to Advance End-to-End Family Care Platform Maven Clinic, the largest virtual clinic in women’s and family health raises $90 million Series E funding bringing its total funding to $300M. Maven plans to use the latest round of funding to advance its end-to-end family care platform to enable deeper personalization to meet the diverse needs of women and families everywhere. Curavit Raises $5M for Digital Therapeutics
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HLTH22: Maven Clinic Secures $90M to Advance End-to-End Family Care Platform
What You Should Know: - Maven Clinic, the largest virtual clinic in women's and family health, today announced that it has raised a $90 million Series E funding round led by General Catalyst, with participation from CVS Health Ventures, La Famiglia, and Intermountain Ventures, as well as existing investors Sequoia, Oak HC/FT, Icon Ventures, Dragoneer Investment Group, and Lux Capital. This brings Maven's total funding to $300 million and highlights the growing demand for women's and family
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