In the modern health care environment, health care executives must be careful custodians of precious resources. Yet in December 2018, 26 percent of hospitals still lacked an effective healthcare revenue cycle solution. Other research has found that over 60 percent of hospitals and health systems are not realizing optimal value from their electronic health record (EHR ) system, causing the organizations to collaborate with other vendors and outsourcing companies to improve revenue cycle
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Utilization Management
Evolent Health Achieves NCQA Population Health Program Accreditation
- Evolent Health becomes the first company ever to achieve Population Health Program Accreditation from NCQA with the status of Accredited–3 years. - The Population Health Program Accreditation is the third NCQA Accreditation Evolent has achieved in 2019, with Evolent having also earned 3-Year Accreditation in both Utilization Management and Case Management in 2019. - Three years is the longest accreditation time period NCQA designates for organizations.Evolent Health, a company providing an
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John Muir Health to Outsource All Non-Clinical Operations to Optum
John Muir Health has announced a strategic partnership with UnitedHealth Group’s (UHG) division, Optum to outsource their key non-clinical functions, including information technology, revenue cycle management, analytics, purchasing and claims processing. Through Optum’s operational technologies, analytic solutions and tools, and administrative services expertise, the partnership will ensure John Muir Health further advance its clinical and operational performance. The outsourcing agreement will
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Care Management Platform VirtualHealth Closes Series B Round to Fuel Growth
VirtualHealth, a NYC-based care management platform, today announced it has closed a Series B financing round bringing the total amount raised by the company to more than $25 million. Led by Edison Partners and existing investors, the latest funding provides strategic capital to fuel the company’s rapid growth and product innovations.One Platform for the Entire Care TeamFounded in 2012, the VirtualHealth HELIOS solution is the first comprehensive care management platform purpose-built to provide
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Oncology Analytics Raises $21M to Provide Health Plans With Evidence-Based Analytics for Utilization Management
Oncology Analytics, an Atlanta-based digital health startup that provides health plans, providers and patients with an evidence-based, analytics focused approach to utilization management for oncology, today announced it has raised $21 million in Series B funding. The Series B round was led by Oak HC/FT and was joined by new investor McKesson Ventures along with returning investors Blue Cross Blue Shield Venture Partners and Sandbox Advantage Fund. The startup plans to use the capital to expand
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Change Healthcare Unveils Automated Medical Review Process Solution
Today, Change Healthcare announced a breakthrough in utilization management with the release of InterQual AutoReview, the first healthcare solution to automate the medical review process by pulling clinical data directly from the EHR, and producing a medical review within providers' case management systems.Why Does This Matter?InterQual AutoReview brings true automation to the medical review process by enabling data integration with EHR applications and case management systems. AutoReviews can
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Change Healthcare Acquires National Decision Support Company
Change Healthcare announced the acquisition of National Decision Support Company (NDSC), a cloud-based solutions that deliver medical guidelines to the point of care through leading electronic health record (EHR) systems. The addition of NDSC accelerates the efforts of Change Healthcare to leverage evidence-based clinical information and next-generation technologies to reduce cost and help ensure appropriate care. Financial terms of the acquisition were not disclosed. NDSC and the Change
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