Medical loss ratio (MLR) rebates hit a record $1.3 billion in 2019 because health plans spent too little on medical claims and too much on administrative costs. How can health plans leverage their utilization management programs to better balance their medical and administrative expenses?
During a CTO and CIO roundtable discussion at Medecision’s Liberation conference this past year, some of the industry’s brightest technology leaders discussed how modern technology is changing the healthcare landscape. Srini Gurrapu, vice president of products and design at Claris, discussed how big tech and artificial intelligence are disrupting healthcare.
As the healthcare industry shifts to a value-based reimbursement model, healthcare organizations are focusing their attention not just on making patients better—but preventing them from getting sick in the first place. Gaining a better understanding of the social issues that affect a person’s health is one of the first steps in doing so.
Ellen Dalton, chief marketing and customer experience officer at Medecision, and Shoshana Ungerleider, MD and founder of End Well, discussed mortality and personal empowerment at Medecision’s annual Liberation conference in October 2019.
Liberation is more than just a philosophy—it’s also about taking action. That’s why this year’s Liberation 2019 was such an exciting event for those eager to identify and actualize strategies for transforming care in the real world. One session where these ideas emerged was led by Jane Sarasohn-Kahn, health economist, author and trend-weaver.
Non-optimized medication regimens cost 275,000 lives and $528 billion every year. The Get the Medications Right Institute (GTMRx) is issuing a call to action and convening a panel of healthcare policy leaders this February to address the problem.
High-risk populations often have complicated chronic diseases and behavioral health conditions, and social issues such as employment, food insecurity, lack of transportation and education can have a negative impact on health. What can the healthcare industry do to get to the root causes of these issues?
More state Medicaid programs are now addressing SDOH through managed care plans and Section 1115 demonstration waivers. However, while these Medicaid programs offer states the ability to experiment and innovate through various approaches, several compliance and regulation challenges must be reconciled.
In October 2019, Medecision acquired health delivery system transformation pioneer GSI Health. GSI Health has been an innovator in driving change in the industry since 2003. The GSI Health population health platform, HealthCoordinator, will become part of Medecision’s Aerial solution.
The future is uncertain—even with 2020 vision. Jane Sarasohn-Kahn shares key uncertainties about politics, economics, technology and social factors that healthcare stakeholders should keep in mind when planning for the new year.
Public trust in healthcare institutions is ranked as one of the nation’s lowest sectors, according to the Edelman Trust Barometer. We explore how health systems and hospitals can work to build trust in their organization.
Some states are working with their Medicaid managed care organizations and community partners to coordinate care for justice-involved individuals prior to release with the goal of improving continuity of care and smoothing community transitions.
In his “Automating Compliance in the Cloud” session during the CTO Roundtable at Liberation 2019, Gerry Miller, the founder and CEO of Cloudticity, discussed the inherent benefits and challenges of digitizing medical data and automating compliance in the Cloud.
Addiction is a national crisis. Deaths from drug overdose, suicide and alcoholic liver diseases—referred to as “diseases of despair”—are at the highest levels in U.S. history. Read one father’s personal experience with the loss of his son and his efforts to ensure that addiction is treated with the same efficacy as other chronic diseases.
In February 2019, the Centers for Medicare and Medicaid Services (CMS) issued new requirements for Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans, mandating they provide enrollees with immediate electronic access to health data by 2020. So what do these new requirements mean for those payers?
Patients are more responsible for healthcare costs now than ever. And this election season, they’re speaking up about price transparency in the healthcare industry—both with their ballots and their choice of provider.
Some of the most enthusiastic feedback from this year’s Liberation event came in response to our world-renowned keynote speaker, Eric Topol, MD. Dr. Topol is recognized as one of the leading innovators in medicine today.
Research shows that social determinants of health (SDoH)—such as housing, transportation, access to healthy food and more—are linked to patient outcomes. Managed care organizations are partnering with community and social support providers to address SDoH to deliver better health outcomes.
Data can help health plans identify medically at-risk members and intervene with the appropriate prevention and wellness programs to keep them as healthy as possible and avoid a costly trip to the doctor or emergency room.
In rural areas, doctors are like a revolving door, rarely staying in one place for long. There are disparities in healthcare access in rural America, but technology may be a solution to increasing healthcare access.
Several years ago at a national healthcare conference, Chris Mahai, now the President of Aveus, a division of Medecision, joined a small breakout group discussion and met Deborah Gage, CEO of Medecision, across the table.
The open window to apply for CMS’ Bundled Payments for Care Improvement (BPCI)-Advanced closed on June 24, 2019, but there’s still plenty of opportunity for health systems to move forward with value-based care and care management initiatives — and the care redesign they represent.