The saying “you cannot manage what you cannot measure” applies to all aspects of healthcare delivery, but it is especially true in value-based care. After all, payers, providers, and the patients they care for need to know what high-value care looks like at an individual level – and how it can be applied at the population level.
Delivery and technology infrastructure. All too often, data is captured in disparate systems, forcing administrative staff – or, worse, physicians and nurses – to
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Payers| Payer Industry Impact for Patients, Clinicians, and Healthcare Organizations | News, Analysis, Insights - HIT Consultant
SDoH: The Power of Proactive Social Care
As we emerge from a public health crisis that magnified and exacerbated health disparities, the need to address social determinants of health (SDOH) has reached a pivotal moment. In both social and healthcare, the pressure is mounting to address key drivers of health and amplify value-based care models.
To succeed, these models need to be effective and measurable as we work to build trust with all stakeholders (e.g., at-risk individuals, health plan members, community
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New athenahealth Research Finds that Telehealth Fills Care Gaps
What You Should Know:
- Increased usage of telehealth, driven by COVID-19, not only remains substantially above pre-pandemic levels but has also emerged as both a key diagnostic tool and treatment vehicle, according to new research from athenahealth.
- The findings, announced today by athenahealth, a leading provider of network-enabled software and services for medical groups and health systems nationwide, suggest that telehealth is now integrated across the care continuum. The findings
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3 Steps to Powering Data Innovation with Analytics & AI
A hot topic we see and hear a lot in healthcare is leveraging big data. Little known fact, we don’t yet have big data in healthcare, so the industry hasn’t had the opportunity to use big data. Healthcare has been in the “little data” game because much of the healthcare experience has yet to be digitized. In addition, interoperability issues leave much data siloed on disparate databases across the healthcare ecosystem.
This is all changing, and this change is accelerating. We’re quickly
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Digiceuticals: Driving Growth Through Digital Health Services
There was tremendous interest in telemedicine before 2020. However, the COVID-19 pandemic made it a reality triggering unprecedented disruption across the industry. For instance, digital-first healthcare aggregators had been testing programs for telemedicine but, since 2020, the demand for telehealth services has exploded across the globe. Despite stabilizing forces such as vaccine rollouts, telehealth utilization remains 38 times higher than it was in the years before the pandemic (1). Health
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Lyfegen Raises $8M for Value-Based Contracting for High-Cost Drugs
What You Should Know:
- Lyfegen, a global health tech SaaS company driving the world’s transition from volume to value-based healthcare for high-cost drugs raises $8M in Series A financing round led by aMoon, with additional participation from APEX Ventures and others.
- Lyfegen’s value-based contracting software is used by healthcare payers and leading pharma companies, including Novartis, Roche, MSD, Bristol Myers Squibb (BMS) and Johnson & Johnson.
Value-Based
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4 Factors Driving Healthcare Transformation in 2022 to Watch
As the healthcare industry becomes more interconnected in response to a wide range of economic and societal factors, the landscape is changing for all parties involved, including payers, providers, and patients.
In a dynamic time for the industry, here are four of the main factors driving the changes and what they mean for the primary stakeholders:
The lines between traditional and digital are blurring
As startups and traditional providers race to meet their patient's
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Inflation Could Result in Additional $370B in Healthcare Costs by 2027
What You Should Know:
- McKinsey & Company’s latest report reveals inflation could result in $370 billion in an additional increase above the baseline in healthcare costs by 2027, causing the government, employers and consumers to burden the cost.
- The piece showcases the impact healthcare inflation will have over the next five years without immediate action, threatening affordability and access to care for consumers, and posing a material risk to profitability for providers, payers,
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Report: The State and Science of Value-Based Care
What You Should Know:
- Providers believe 96% of payment is now value-based in some capacity, and 58% believe their EHR vendor won’t be able to support the data strategies required to thrive under value-based care, according to a new study conducted by Morning Consult and Innovaccer.
- The 37-page national research study uncovers key IT infrastructure issues healthcare leaders said are impeding or essential for progress towards accelerating their transformation to value-based
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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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