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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Payers| Payer Industry Impact for Patients, Clinicians, and Healthcare Organizations | News, Analysis, Insights - HIT Consultant
COVID-19 Pandemic: The Surprise Catalyst for Telemedicine Adoption
It is no secret that technology adoption in healthcare often lags adoption in other sectors. Often, the slow pace of adoption makes sense. While technology can drastically improve both cost and quality in healthcare when implemented correctly, it can also cause physician burnout, increased administrative workload, and worsen patient outcomes if a new technology fails to live up to the hype.
Historically, the slow pace of IT adoption in healthcare was nowhere more apparent than in the
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COVID-19 Crisis Makes Complying with Data Interoperability a Priority
With healthcare organizations focused on battling COVID-19, the recent federal healthcare regulation requiring data interoperability may have become an afterthought. However, compliance with this rule will create a powerful tool for fighting COVID-19 recurrences and future pandemics.
If interoperability had gone into effect earlier this year as originally scheduled, many insurance companies and the federal government would now be able to securely share the data they have for most of the
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Wellth Lands $10M for Behavioral Economic Platform to Improve Health Outcomes
What You Should Know:
- Digital behavior change startup Wellth closes $10M in Series A funding led by Boehringer Ingelheim and yabeo - DaVita, and others will help drive care plan adherence for high-risk patient populations
- Powered by a behavioral economics engine paired with an intuitive, consumer-grade smartphone experience designed to motivate and delight, Wellth rewards members with daily financial incentives for verifying adherence to prescribed care plan.
Wellth,
a platform
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Change Healthcare Buys Back Pharmacy Network for $213M in Cash
What You Should Know:
- Change Healthcare buys back pharmacy network eRx Network (eRx) for $212.9 million-plus cash on the balance sheet.
- eRx Network runs a network connected to about 59,000 pharmacies that process more than 1.5 billion transactions annually and also markets insurance verification, e-prescribing, and claims billing services, among others.
Change
Healthcare buys
back pharmacy unit eRx Network (“eRx”),
a leading provider of comprehensive, innovative,
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Leveraging Big Data for Real World Clinical Analytics
Recently, as the world has watched the coronavirus crisis unfold, the power of big data to track, illustrate, and inform has taken center stage. A compelling example is the near real-time map created by Johns Hopkins Center for Systems Science and Engineering (CSSE) that shows all the cases as the disease spreads across the globe.
With far-reaching implications for healthcare, big data enables deep analysis of data from a myriad of sources – electronic medical records (EMRs), claims,
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COVID-19 Heat Map Offers County-by-County Picture of Community Risk & Health Disparities
What You Should Know:
- COVID-19 Community Risk & Health Disparities Map reveals proactive identification of emerging hot spots of vulnerable populations at risk for severe outcomes from COVID-19.
- The publicly available tool provided by EXL Healthcare pinpoints where to focus and scale resources, inform proactive scenario planning, and develop community COVID-19 initiatives.
Governors across the U.S. are considering whether to extend stay-at-home orders or allow businesses,
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How AI-Driven Insight Could Fuel Medicare Advantage Success
Medicare Advantage plans need more than consumer-centric design, payer/provider alignment, and strong connections across the continuum of care to drive value. The high-value performance also depends on their ability to use data to make a meaningful difference in members’ health.
With 11,000 people aging into Medicare daily, proficiency in managing Medicare Advantage populations is critical for demonstrating value in a competitive market. Enrollment in these plans is growing significantly,
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The Technological Ironies of the Current State of Value-Based Care
Even though many think of 2008 as the first time CMS began emphasizing quality over quantity via the Medicare Improvements for Patients and Providers Act (MIPPA), the truth is that we’ve been on a 30-plus-year journey to get to this point.
It really started when managed care became a hot trend, but eventually, the friction between payers and providers was too high and patients were caught in the middle. Then came accountable care, which while still important today, ultimately isn’t creating
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Health IT’s Vital Role in Controlling The Spread of COVID-19
The healthcare system in the United States is becoming overwhelmed as a result of COVID-19 and there is no doubt that this epidemic will test the limits of healthcare delivery systems from end to end. Of course, at the present moment, everyone’s focus is (and rightly should be) on ensuring hospitals and healthcare workers have the appropriate equipment and protective gear they need to stay safe and adequately treat patients. That said, there are other IT considerations that should be taken into
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