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Payers| Payer Industry Impact for Patients, Clinicians, and Healthcare Organizations | News, Analysis, Insights - HIT Consultant

How Social Determinants of Health Will Impact the Future of Benefit Coverages

by Kevin Riley, SVP and General Manager, Vlocity Health 06/18/2020 Leave a Comment

How Social Determinants of Health Will Impact the Future of Benefit Coverages

Do you have access to healthy foods, transportation to a doctor, high-speed internet for telemed appointments, or a roof over your head? These are assumptions that most of us take for granted, and are not the questions that insurers usually take into consideration. But, as they look to increase member outcomes and foster long-term customer loyalty, considering the changing needs of many consumers in the face of today’s current affairs, it’s time they did. In fact, forward-looking health plans
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Unite Us Acquires SDoH Data Analytics Company Staple Health to Expand Capabilities

by Fred Pennic 06/16/2020 Leave a Comment

Unite Us Acquires SDoH Data Analytics Company Staple Health to Expand Data Analytics

What You Should Know: - Unite Us acquires social determinants of health (SDoH) analytics company Staple Health to greatly expand its valuable predictive data analytics capabilities. - Predictive analytics and outcome data are essential as Unite Us supports local communities, addressing needs and providing proactive social care infrastructure where it is lacking. - The acquisition of Staple Health brings 10 years of data experience and a database of 270M individuals, with notable
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Backed by Northwell, Conversa Health Raises $12M for AI-Powered Chatbots

by Fred Pennic 06/11/2020 Leave a Comment

Backed by Northwell, Conversa Health Raises $12M for AI-Powered Chatbots

What You Should Know: - Conversa Health raises $12 million in Series B funding round to expand its AI-powered chatbots enabling health systems, payers and pharmaceutical companies to engage patients and collect patient-generated health data and patient-reported outcomes. - Conversa plans to use the funding to scale its virtual care and communication platform—97 percent of patients who have used its chatbots say they can better manage their care with Conversa.  - Murray Brozinsky
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The New Normal: Rethinking Healthcare Delivery in a Post-COVID World

by Mansoor Khan, Sc.D., co-founder and CEO of Persivia 06/11/2020 Leave a Comment

The New Normal: Rethinking Healthcare Delivery in a Post-COVID World

It’s becoming clearer that, while we are all hoping that things are going to go back to the way things were at the beginning of the year, the COVID-19 crisis will result in a new normal. That’s especially true in healthcare, due to four issues that are being wildly amplified by the COVID-19 crisis. Namely:  1. The US government has huge deficits, and healthcare is a major driver of the unsustainable increase in these deficits. 2. Addressing the demand for healthcare as a right (not a
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Applying Social Determinants of Health to Improve Care Coordination

by Allie Freed, Consultant, Freed Associates 05/26/2020 Leave a Comment

Applying Social Determinants to Improve Care Coordination

In today’s era of value-based care, providers must focus more than ever on ensuring that patients get the care they need, when they need it, across the entire care continuum, including in non-traditional health care settings. This is important not only as it relates to patient outcomes, but also to providers’ bottom lines. However, when patients lack access to basic care-centric needs like proper housing, food, transportation, and a support system, they’re unable to get the right type of care
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AI Can Identify Unseen Sufferers of COVID-19 & Enable Proactive Care

by Linda T. Hand, CEO, Prealize 05/21/2020 Leave a Comment

AI Can Identify Unseen Sufferers of COVID-19 & Enable Proactive Care

As the nation’s eyes focus on COVID-19, another healthcare crisis is unfolding out of sight. Hidden from view, millions of Americans who don’t have COVID-19 are suffering healthcare crises in their homes. These unseen individuals are facing major challenges, on multiple levels: acute, chronic, and preventive. Patients are waiting longer at home before coming to the hospital for acute illnesses like appendicitis, stroke, or heart attack. Patients with chronic diseases are not receiving
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RCM Myth: Healthcare Billing Is Just A Back-Office Job

by Marvin Luz, Sr. Director of Greenway Revenue Services at Greenway Health 05/18/2020 Leave a Comment

RCM Myth: Healthcare Billing Is Just A Back-Office Job

Historically, there was a belief in healthcare that revenue cycle management (RCM) was only a job for the back office. But today, medical practices are well-aware all staff members are critical to the revenue cycle. This responsibility extends through every aspect of a practice, from the front office to back office with the clinical staff in between.  The front office, for example, plays a role in generating revenue, because they can optimize scheduling and collect patient and insurance
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Innovaccer Launches FHIR Enabled Data Activation Platform to Power Innovation to Care as One

by Jasmine Pennic 05/13/2020 Leave a Comment

Innovaccer Launches FHIR Enabled Data Activation Platform to Power Innovation to Care as One

What You Should Know: - In accordance with ONC's latest interoperability rule, 21st Century Cures Act, Innovaccer has launched its FHIR® Enabled Data Activation Platform. - The platform provides a rich set of capabilities from scalable FHIR application programming interfaces (APIs), optimized FHIR data lake, best-in-class API gateway, hundreds of analytical enrichments like HEDIS scores, and cloud infrastructure. - The platform is already deployed at several of our customer sites
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KLAS: COVID-19 Guide to Telehealth Virtual Care & Remote Care Platforms

by Fred Pennic 05/13/2020 Leave a Comment

AmericanWell Telehealth

What You Should Know: - New KLAS telehealth reports aims to aims to provide high-level COVID-19 guidance helpful to healthcare organizations on the virtual care and remote care platform vendor landscape. - Includes high-level overviews of validated vendors’ current customer satisfaction, key questions to consider in building a strategy, and a consolidated view of KLAS’ previously published telehealth reports. Telehealth adoption in healthcare until recently had been increasing at a
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Why Outsourcing is the Best Approach to Prior Authorizations

by Mohammed Ahmed, VP, Authorizations and Sales Enablement at Availity 05/11/2020 Leave a Comment

Why outsourcing is the best approach to prior authorizations

Doctors didn’t attend medical school to spend their waking hours managing or waiting for prior authorizations (PA), but these days it feels like that’s all they are doing. A recent American Medical Association survey found that 90 percent of responding physicians believe that the “administrative burden related to PA requests has risen in the last five years, with most saying it has ‘increased significantly.’” As healthcare continues its acceleration toward value-based reimbursement models,
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