What You Should Know:
- Cohere Health partners with health insurer Humana to modernize
the prior authorization process for musculoskeletal treatment across 12 states.
- In addition, the company has closed an additional $10M
in funding led by Flare Capital Partners and Define Venture, bringing the
company’s total funding to $20M.
Health insurer Humana has signed an agreement with healthcare collaboration company Cohere Health to improve the prior authorization process for
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Waystar Acquires Medicare RCM Company eSolutions at $1.3B Valuation
What You Should Know:
- Revenue cycle management provider Waystar acquires eSolutions, a provider of Medicare and Multi-Payer revenue cycle management, workflow automation, and data analytics tools at a $1.3B valuation.
- The acquisition will create the first unified
healthcare payments platform with both commercial and government payer
connectivity, resulting in greater value for providers.
Waystar, a provider of healthcare payments software, today
announced a definitive
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How Times of Crisis Spur Needed Change in Healthcare Delivery
As the COVID-19 pandemic continues to change healthcare operations in the world, foundational systems are being adapted to meet these new demands. Sometimes it takes extreme circumstances to see the cracks in a system. COVID-19 has exposed areas with more room for improvement in the healthcare system, such as optimizing operational efficiency. Organizations and individuals have changed their interactions, processes, ways of working, treatment plans, and even foundational technology. As the
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Cohere Health Launches with $10M to Increase Transparency Across Care Journey
What You Should Know:
- Boston-based health IT start-up Cohere Health announced the official launch of its company with a $10 million Series A funding round led by Flare Capital Partners.
- The company’s patient journey-focused platform improves the notoriously difficult prior authorization process and replaces an existing patchwork of legacy, siloed processes, and antiquated technologies that contribute to the enormous administrative burden for physicians and health plans.
- The end
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4 Ways Healthcare Organizations Can Establish Partnerships to Drive Innovation
With public and private healthcare spending significantly outpacing that of other countries, U.S. hospitals face intense pressure to find new ways to capture greater value. More and more, organizations are finding that partnerships with existing vendors can help unlock next-level performance gains in a transformative environment.
Take Nebraska Medicine, for example. In the early 2000s, the health system created multidisciplinary committees to boost revenue integrity and adopted new revenue
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Why Outsourcing is the Best Approach to Prior Authorizations
Mohammed Ahmed, VP, Authorizations and Sales Enablement at Availity
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
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CVS Health, UCLA Health Partner to Bolster Hospital Capacity for COVID-19
What You Should Know:
- CVS Health announced it is working with hospitals and providers, including major systems like UCLA Health, to support their solutions for creating much-needed hospital bed capacity during the pandemic.
- Hospitals around the country are expanding their capacity to meet the anticipated needs as a result of the COVID-19 pandemic.
- Current estimates project that hospitals nationwide need to increase capacity by more than 36,000 hospital beds.
- In addition,
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3 Ways to Build a Back-to-Basics Approach to Revenue Cycle Management
Deborrah Short Rodrick, Chief Outcomes Officer, The SSI Group
Sixty-nine percent of healthcare revenue cycle leaders say they will put more money toward technologies that boost revenue integrity, eliminate human error and unlock greater efficiency in the year ahead, an HFMA/Navigant analysis found. But for many organizations, the biggest untapped opportunity to improve performance comes down to a single word: data.
For all the buzz at about the ways in which digital innovation and
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HHS Issues Strategies & Recommendations to Mitigate EHR-Related Clinician Burden
- HHS issues new report outlining the key sources of EHR-related burden, as well as strategies and recommendations to achieve burden reduction goals for healthcare providers.
- The HHS report reflects additional input from the more than 200 comments submitted in response to the draft strategy and recommendations.
As part of the
ongoing efforts to strengthen the relationship between patients and their
doctors, the U.S. Department of Health and Human
Services (HHS) issued
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CAQH CORE Approves Two-Day Rule to Accelerate Prior Authorization Process
- CAQH CORE participating organizations--consisting of healthcare providers, health plans, vendors, government entities, associations and standard-setting organizations--have come together to pass a national two-day time limit for plans to request additional info and make final decisions on prior authorization requests.
- Prior authorizations are the most costly, time-consuming administrative transaction for providers. And when the process takes too long, it can delay patient care.
- Over
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