Meaningful Measures 2.0 goals are designed to facilitate the ongoing move toward value-based care, which targets issues including person-centered care, safety, chronic conditions, seamless care coordination, equity, affordability and efficiency,…
An abundance of actionable data exists, making it possible for care managers to be as specific as they need to be, whether targeting individual patients or populations to close healthcare…
Recently the Centers for Medicare & Medicaid Services (CMS) outlined an action plan for addressing health disparities; ensuring high-quality, affordable healthcare for everyone, regardless of their background; and driving health…
These four states are taking a boots-on-the-ground approach to addressing social determinants of health. Don’t forget to share this post!
When you can align activities such as prior authorizations, utilization management and operational workflows with regulatory mandates for quality, timeliness, interoperability and reporting, you can improve health plan Star ratings.…
Jane Sarasohn-Kahn explores the importance of embracing an ESG policy in healthcare. Don’t forget to share this post!
DALLAS, TX – April 21, 2022 – Medecision, a leading provider of digital care management solutions and services, announces it has joined the Google Cloud Partner Advantage Program. The new partnership…
Artificial intelligence, including machine learning, can help you analyze and turn mountains of data into actionable insights. This can lead to positive outcomes for patients and your organization. Are you…
How can predictive modeling help support patients through transitions and ensure they continue to receive the care they need, adhere to medication regimens, avoid readmissions and become more actively involved…
When a patient goes outside the network for care, it can have negative consequences for both cost and care. Reducing network leakage should be a top priority. Don’t forget to…
As trust increases, so does the engagement of healthcare citizens with healthcare professionals and services. Don’t forget to share this post!
Utilization management can eat up a lot of time and money—causing frustration and headaches for consumers and friction between payers and providers. With the right tools, however, you can streamline…
Oscar Health chooses Medecision solution to provide leading digital care management for its members. Don’t forget to share this post!
When care management teams become more proactive, they can help keep members on the right track and prevent setbacks rather than react to them. Don’t forget to share this post!
Digital care management company adds Jacob Jesson as EVP and chief revenue and experience officer. Don’t forget to share this post!
Better care coordination? Check. Better outcomes? Check. Better reports and data analysis? Check. Medecision’s HITRUST CSFⓇ-certified software-as-a-solution, AerialTM, gives care managers a 360-degree video of each individual’s health, making care…
Social distancing is great. Medical distancing? Not so much. Doctor visits are still necessary for ensuring good health. Don’t forget to share this post!
How can care managers improve performance metrics in addition to member outcomes? Don’t forget to share this post!
Everyone knows that diet, lifestyle choices like alcohol consumption and smoking, exercise, and genetics play a role in your overall health. But experts suggest that social determinants—that is, the conditions…
What if there was a next-generation care management solution that helped health plans manage risk and empowered care managers to provide the highest-quality service and care to members? A solution…
Inflated prices for household products, food and utilities can stretch already thin budgets, leaving many Americans wondering how to pay bills and causing what may amount to be a healthcare…
By focusing care management activities on areas with the potential for the greatest impact and making high-value decisions, care managers can optimize patient outcomes. Don’t forget to share this post!
Are care managers unsung heroes by helping control healthcare costs? Don’t forget to share this post!
Healthcare consumers feel more empowered to weigh their options, share their opinions and expect more out of their healthcare experience—which is why many healthcare organizations are making 2022 the year…
The key determinants of healthcare for 2022 are rooted in our experiences from 2021. Don’t forget to share this post!
Clinical informatics is leading the way in the much-needed transformation of healthcare. Don’t forget to share this post!
Today’s consumers increasingly expect healthcare to meet them where they live, work and play, and that means big changes for care management. Don’t forget to share this post!
Amid healthcare payers’ heightened financial pressures and members’ increased needs, it might be time to change the definition of care management. Don’t forget to share this post!
In 2020, Medecision began supporting a clinical informatics fellowship at ChristianaCare. Meet the first two fellows to go through the program. Don’t forget to share this post!
Optimizing healthcare workflows has both obvious and not-so-obvious benefits. Don’t forget to share this post!
Medecision was recently honored by Modern Healthcare for its virtual health marketing campaign. Don’t forget to share this post!
The consumer experience in healthcare is becoming more important. Health economist Jane Sarasohn-Kahn shares how healthcare ranks among other industries. Don’t forget to share this post!
Data is king in healthcare. There are multiple sources of data coming in from EMRs, home health devices, physician offices and more. So how does Aerial help care managers take…
Chris LaVictoire Mahai and a team of executives from Medecision and Aveus recently attended the HLTH 2021 conference and came back with insights on a variety of pressing topics. Don’t…
Appropriate care and better outcomes are the goals of utilization management, including prior authorization. But the processes to achieving these goals need to become more efficient. Don’t forget to share…
Health economist Jane Sarasohn-Kahn shares what the healthcare industry can learn about improving the consumer experience from three other organizations. Don’t forget to share this post!
Clinician burnout isn’t a new trend, but the COVID-19 pandemic has exacerbated the issue, with many healthcare workers reporting that they are experiencing high levels of depression, exhaustion and burnout.…
Entertainment, hospitality, financial planning and aviation have important ideas for improving the member and patient experience. Don’t forget to share this post!
At Medecision, we understand the importance of healthcare partnerships and collaboration. When we work together, we can improve healthcare for everyone. Don’t forget to share this post!
As we return to normal life, we must not forget the lessons learned during the pandemic. Don’t forget to share this post!
Women’s health was dramatically impacted by COVID-19. Health economist Jane Sarasohn-Kahn shares how the pandemic changed all aspects of women’s health—and how we must improve it. Don’t forget to share…
Nancy Green, senior vice president at Aveus, sat down with Julie Barnes, founder of Maverick Health Policy, and Debbie Hill, vice president of product management at Medecision, to discuss changes…
Health equity has become something of a catchphrase, but it’s an important one to know. At Medecision, we’re deeply committed to working toward a healthcare system that gives every person…
Many health systems are investing in population health management strategies, which help them understand target populations while identifying risks and unmet needs. Digital tools such as Aerial by Medecision can…
At Medecision, we are committed to staying at the forefront of discussions about industry-wide issues—such as pharmaceutical drug pricing. Health economist Jane Sarasohn-Kahn gives her insights into the recent conversations…
The U.S. Department of Health and Human Services has prioritized efforts to contain the COVID-19 pandemic over enforcing HIPAA rules. Don’t forget to share this post!
America is in the midst of a mental health crisis—but hospitals and community-based organizations can partner together to identify and diagnose mental health issues before they worsen. Medecision is committed…
At Medecision, we are committed to improving healthcare and health equity for all and feel it’s important to highlight the voices championing an equitable healthcare system. That’s why we’re happy…
The COVID-19 pandemic put consumer trust to the test in 2020 and early 2021. Health economist Jane Sarasohn-Kahn shares how the healthcare industry can help rebuild trust among health citizens.…
A game-changing revision to CMS rules for Star ratings puts Medicare Advantage plans under extra pressure to deliver an excellent customer experience. At Medecision, our solutions and services help health…
At Medecision, we understand the value of virtual care. But until we make the processes easy and accessible, we’re not going to change the ability of all people to access…
Guest blogger Jane Sarasohn-Kahn shares how recent acquisitions of telehealth companies means telehealth and virtual care is now a regular form of healthcare delivery. Don’t forget to share this post!
Medecision is committed to helping the healthcare system achieve the Quadruple Aim, and a key component of that is improving the patient experience. During this National Patient Experience Week, we…
Terry McInnis, MD, MPH, CPE, president of Blue Thorn Inc. and member of the Medecision Advisory Board; and Terri Steinberg, MD, MBA, FACP, FAMIA, Medecision’s Group Senior Vice President of…
Vaccine hesitancy is not uncommon in rural America. But the healthcare industry can’t forget about rural communities. Don’t forget to share this post!
We saw a housing crisis in America this past year—and we quickly learned how important safe housing is to healthcare. Don’t forget to share this post!
What does the new interoperability and prior authorization rule mean for the patient experience? Julie Barnes, founder and principal of Maverick Health Policy, and Sarah Dencker, vice president of Network…
The healthcare appeals process can be difficult to navigate. How can we ensure that patients easily understand the process and their healthcare coverage? Don’t forget to share this post!
In 2020, Aveus partnered with Second Harvest Heartland to work toward their strategic initiative to become a more trusted partner. Don’t forget to share this post!
The COVID-19 pandemic has resulted in more people on Medicaid. It’s more important than ever before for the healthcare industry to do its part to ensure compliance with privacy and…
Effectively engaging with and serving vulnerable populations is made even more difficult during the COVID-19 pandemic, when trust in healthcare systems has been eroded. Don’t forget to share this post!
Although many Americans are lining up for their COVID-19 vaccine, we’re still far from herd immunity. But experts are hopeful that more Americans will start to resume medical care services.…
We loved this conversation about bold leaders that Chris LaVictoire Mahai, president of Aveus, had in 2018 with Coreen Dicus-Johnson, president and CEO of Network Health. Coreen shared how she…
Medecision’s Campus Partnership Program identifies top talent at colleges across the nation—and it’s proven to be beneficial. Don’t forget to share this post!
How will the future of healthcare change under the Biden-Harris administration? Don’t forget to share this post!
What are the top priorities for the Biden administration? Combating the COVID-19 crisis, improving livelihoods and setting the American ship on the right track. Don’t forget to share this post!
How can organizations respond to racial injustice in humility and action in a sustainable way? Don’t forget to share this post!
The COVID-19 pandemic has forced healthcare organizations to adapt—and adopt alternative ways of delivering care to patients. Artificial intelligence and the Internet of Things promise to revolutionize healthcare. Thank you…
New rules will ease administrative burden, speed up reimbursement and remove fears of accidental violations. Don’t forget to share this post!
No one would deny that 2020 was a hard year. But the coronavirus-plagued year proved that we are more resilient than we realize. Don’t forget to share this post!
It has been a long year, full of challenges and obstacles. But there are five gifts from the pandemic that we should be thankful for, says Jane Sarasohn-Kahn. Don’t forget…
Increased attention is being paid to treating the whole person, addressing social determinants of health and recognizing the value of virtual care. Don’t forget to share this post!
By mid-July, 53% of adults had reported their mental health had been negatively impacted by the coronavirus—and research shows that poor and disadvantaged populations are most affected by mental health…
What changes can we expect to see to healthcare policies during the Biden administration? Don’t forget to share this post!
The future is virtual, especially for older people. Health economist Jane Sarasohn-Kahn explores how the industry is seeking out ways to serve older adults at home, especially in the midst…
Even before COVID-19, many Americans expressed interest in virtual health. Now, virtual health technology is being used to expand access to more healthcare services. Don’t forget to share this post!
After painstaking research, health economist Jane Sarasohn-Kahn has pinpointed five trends that are shaping the American people as a result of COVID-19. Don’t forget to share this post!
The holiday season is a time for loved ones. If in-person gatherings aren’t possible this year, here are some alternative ways to celebrate together and keep the spirit alive. Don’t…
Dr. Terri Steinberg shares how Medecision’s Aerial platform helped ChristianaCare’s CareVio program achieve success. Don’t forget to share this post!
Medecision’s Aerial platform makes virtual care a greater possibility. Don’t forget to share this post!
Not only have grocery stores remained open during the COVID-19 pandemic, but many have emerged as innovative leaders in addressing food insecurity. Don’t forget to share this post!
Disparities clearly exist, and it is our responsibility to figure out why and how to address them, for the good of everyone. Don’t forget to share this post!
Fall is finally here, but COVID-19 may interfere with some favorite activities. But it’s still possible to enjoy the cooler weather. Don’t forget to share this post!
As Americans, we must claim our collective health citizenship, and act on it together. Don’t forget to share this post!
How can the healthcare industry acknowledge racial disparities and strategically work to reduce them? Don’t forget to share this post!
‘Unplugging,’ staying connected remotely, helping with child care and being vulnerable are among the ways to fight worry, stress and burnout. Don’t forget to share this post!
In many cities and states, workplaces are beginning to open their doors again and employees are returning to the office. What precautions should employers take to keep their employees safe…
Even before COVID-19, working-age Americans struggled to afford healthcare coverage. Now, in the event of an economic downturn, the situation could worsen. Health economist Jane Sarasohn-Kahn explores the findings of…
In April, Dr. Terry McInnis explained what researchers were learning and studying about the coronavirus. Now, five months later, Dr. McInnis shares even more information about testing, the risk of…
How can parents help support the mental health of their kids and ensure the upcoming school year is a positive one—no matter where “school” is or what it looks like?…
Grief is a normal response to loss. We’ve all lost something during COVID-19, and it’s OK to grieve that loss. Don’t forget to share this post!
Telehealth usage surged because of COVID-19. Now, our customers are shifting gears to use virtual health technology—and we’re here to help. Don’t forget to share this post!
Shoshana Ungerleider, M.D., founder of the End Well Project, discusses the importance of communications skills and palliative care when discussing end-of-life issues with patients. Don’t forget to share this post!
The hospital-at-home concept isn’t new, but the COVID-19 pandemic has accelerated its usage. Don’t forget to share this post!
Payers and providers need to examine all activities, not just medical activities, that impact the care of a population. That’s why population health analytics are so critical. Don’t forget to…
How can the healthcare industry best care for the mental health and well-being of frontline providers and clinicians? Don’t forget to share this post!
What do today’s consumers want in a healthcare experience? Personal involvement is at the center of it all. That points to an increased role for virtual health—and, with COVID-19 showing…
Moving forward, Fast Healthcare Interoperability Resources (FHIR) will be used for the digitalization of HEDIS quality measures. Don’t forget to share this post!
The healthcare industry is typically immune to recessions and nationwide economic struggles—but not this time. How will the pandemic impact the healthcare economy? Don’t forget to share this post!
Technology is a part of our everyday lives. But how is our privacy affected when personal information is readily available on digital devices? Don’t forget to share this post!
We’re living in a time of uncertainty, and many people are feeling stressed, anxious and panicked. Babette Apland, managing director of Call to Mind, an initiative started by American Public…
How has COVID-19 affected healthcare in rural areas? People in rural communities are typically spread out by distance already—but some could be more at risk for certain conditions because of…
The COVID-19 outbreak has motivated hospitals, manufacturers and even the government to come up with alternative solutions to the challenges we face. Don’t forget to share this post!
How does virtual health help us take a step forward in humanizing healthcare? It works within and around a person’s life, as opposed to their sickness, to deliver care when,…
Telehealth usage skyrocketed during COVID-19. But it also revealed inequities in the healthcare system. Don’t forget to share this post!
Can there really be positive news in the midst of a pandemic? Yes, if you look closely! Don’t forget to share this post!
In January 2019, Medecision launched a yearlong process to achieve MARS-E compliance. Here’s how we did it. Don’t forget to share this post!
States are beginning to reopen, and more healthcare systems and hospitals are allowing elective surgeries and nonessential procedures. As we move into a post-COVID-19 environment, how can providers continue using…
In October 2019, CMS proposed changes to the Stark Law, which was enacted in 1988 to prevent physicians from prioritizing financial concerns over patient care. Now, CMS says that changing…
In the COVID-19 fight, let’s not overlook our most vulnerable populations and those who care for them. Don’t forget to share this post!
Virtual health is having a heyday right now—and many experts suggest that it is here to stay long term. Don’t forget to share this post!
COVID-19 has turned our world upside down. It’s changed so many aspects of our lives – how and where we work, how we obtain healthcare services, how we engage with…
We are deeply saddened by the recent displays of injustice in America—and the systemic racism that continues to plague our nation. Don’t forget to share this post!
Dr. Jan Berger is a tri-sector healthcare executive with a background in public, private and government sectors. In 2009, she helped found Health Intelligence Partners, a global healthcare consultancy. Below,…
How has caregiving in America changed? For starters, more caregivers are adopting technology to help them address the complex and challenging workflow. Unfortunately, more caregivers are reporting that their own…
CMS and ONC delays to enforcement give the industry a few additional months to prepare for major overhauls to ensure the appropriate sharing of patient health information. Yet the need…
Chris LaVictoire Mahai, president of Aveus, a division of Medecision, shares six essential practices for improving the patient experience emerging from our shared COVID-19 lessons learned. Don’t forget to share…
People are craving a return to “normal,” but no one quite knows what “normal” is anymore. Dr. Richard Popiel, Medecision Advisory Board chair and a senior adviser with McKinsey &…
Healthcare providers across the nation have shifted gears and switched to telehealth—and so have care and case managers. Aerial helps care and case managers virtually connect with members to manage…
How will the COVID-19 pandemic affect healthcare’s shift to value-based care payment models? Tamara Cull, DHA, Senior Vice President of Portfolio Management, shares her thoughts. Don’t forget to share this…
As chief executive officer for Rackspace, Kevin Jones is responsible for the company’s global strategy and operations—spanning the U.S. and three other continents where Rackspace maintains offices and data centers.…
Healthcare heroes across the country are teaming up and going beyond the call of duty to provide empathetic, high-quality care during a time of great need. Don’t forget to share…
This is the fifth in a five-part series about demonstrating BOLD leadership during a pandemic transformation from our colleagues at Aveus. Each entry in the series focuses on the characteristics of…
This is the fourth in a five-part series about demonstrating BOLD leadership during a pandemic transformation from our colleagues at Aveus. Each entry in the series focuses on the characteristics of…
Dr. Terry McInnis, a board-certified physician in preventive medicine and president of Blue Thorn Inc., shares what the healthcare industry knows and is continuing to learn about the novel coronavirus,…
This is the third in a five-part series about demonstrating BOLD leadership during a pandemic transformation from our colleagues at Aveus. Each entry in the series focuses on the characteristics of…
The coronavirus has affected more than just our physical well-being—it’s also affecting mental health, as many people grapple with the unknowns surrounding the virus. Don’t forget to share this post!
This is the second in a five-part series about demonstrating BOLD leadership during a pandemic transformation from our colleagues at Aveus. Each entry in the series focuses on the characteristics of…
Gyms and community rec centers are closed, but that doesn’t mean you have to let exercise and physical activity fall by the wayside. You can still stay active at home.…
How can leaders show up BOLD-ly during a pandemic? Our colleagues with Aveus explore how leaders can navigate effectively during these uncertain times. Don’t forget to share this post!
Long after we flatten the curve, Americans will still be dealing with lingering mental health issues. Don’t forget to share this post!
Terri Kline, MPH, former president and chief executive officer of Health Alliance Plan, former executive vice president of Henry Ford Health System and current Medecision Advisory Board member, shares her…
Aerial™ has integrated COVID-19-specific enhancements to support clients and their employees on the front lines of managing care during this pandemic. Don’t forget to share this post!
The coronavirus has a lot of us on edge, but our smartphones can help us breathe deep, meditate, change mental habits, get a good night’s sleep and more. Don’t forget…
For many employed Americans, the coronavirus pandemic has brought about a new reality. Here’s some advice for doing your job without driving yourself—or your family—crazy. Don’t forget to share this…
As the world struggles with the coronavirus, our healthcare heroes are going above and beyond, working selflessly for the greater good. Don’t forget to share this post!
Social distancing doesn’t have to mean isolation. Thankfully, we live in the digital era and there are apps to help friends and family stay connected. Don’t forget to share this…
No one is immune from the coronavirus, but low-income and other marginalized groups of people face a higher risk of impact. Don’t forget to share this post!
We’re doing our part to flatten the curve and put an end to the coronavirus. Playing our small role—staying home—can have a big impact on lessening the burden on the…
A reflection on the Coronavirus Disease 2019 (COVID-19) pandemic from our partners at the American College of Medical Quality. Don’t forget to share this post!
During this challenging and evolving time, we are providing the following update for our clients on our business operations and how we are engaging to support our clients’ organizations. Don’t…
As the Coronavirus Disease 2019 (COVID-19) situation continues to evolve, we are sharing information about the steps we’ve taken in response to the crisis. Don’t forget to share this post!
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…
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.…
Health economist and trend weaver Jane Sarasohn-Kahn shares insights on how COVID-19 (coronavirus) is impacting Americans’ behavior and spending – and the implications for health systems and plans. Don’t forget…
Participants from the Liberation 2019 Clinical Executive Summit share their insights from the conversation. Don’t forget to share this post!
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…
Health economist Jane Sarasohn-Kahn shares her takeaways from CES 2020—and explains how digital health technology is blurring into healthcare. Don’t forget to share this post!
Dr. Donald Casey, president, American College of Medical Quality, highlights the most thought-provoking insights from the Clinical Executive Summit at Liberation 2019. Don’t forget to share this post!
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…
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…
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…
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…
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…
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…
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…
A conference about dying brings to light important lessons about living. Don’t forget to share this post!
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…
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…
Health Evolution CEO Julie Murchinson challenged Liberation attendees to gather with their personal tribes to drive change in the healthcare industry. Don’t forget to share this post!
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…
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…
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…
The following blog post is courtesy of Jane Sarasohn-Kahn of healthpopuli.com, one of the featured speakers at the Liberation 2019 event. Don’t forget to share this post!
Digital health technologies may one day potentially solve some of healthcare’s biggest problems. But big problems require big solutions in order to demonstrate significant Impact on Quality (IoQ). Don’t forget…
Healthcare organizations’ success under risk sharing and value-based care relies on a well-oiled UM program. Don’t forget to share this post!
Quality requires assessment tools that operate in an objective manner. That’s where healthcare performance measurement programs come in. Don’t forget to share this post!
Managing mental health is critical for achieving desired physical health outcomes. That’s why some companies are partnering with health organizations to make mental health a priority. Don’t forget to share…
Medecision’s new Aerial Experience helps care teams engage consumers, improve patient health and drive collaboration. Don’t forget to share this post!
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…
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…
Technology can help scale social determinants of health. But to be effective, we must first understand the people with whom we wish to engage. Don’t forget to share this post!
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…
Healthcare organizations need consumers actively involved in their own care in order to dramatically improve outcomes. As such, healthcare organizations, including health plans, need to forge partnerships with consumers. Don’t…
The concierge care model looks to provide personalized service to health plan members. Don’t forget to share this post!
Reports of the industry’s data breaches have been grabbing headlines for several years now. The challenge for healthcare organizations is to go beyond acknowledging vulnerabilities and to do something about…
To effectively manage care, care team members need to have access to the right information at the right time. Without access to relevant data at the point of decision, however,…
When it comes to pricing transparency, the healthcare industry should be in a copasetic state. That’s far from the reality. Don’t forget to share this post!
When patients don’t follow doctors’ orders, the consequences are dire. Health plans can help by understanding the specific challenges that members are facing – and then intervening to enable them…
Until recently, Utilization Management was all about how health plans determine preauthorization. But that definition is fast becoming outdated. Don’t forget to share this post!
What does Utilization Management have to do with Population Health? The answer: everything. Don’t forget to share this post!
Access to healthcare in rural settings is a true challenge. Americans living in rural areas are more likely to die from five leading causes than their urban counterparts. How should…
In addition to leveraging claims and clinical data, insurers are now relying on social determinants of health data to paint a better picture of their member populations, create meaningful interventions…
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…
One-to-one transactions do not really constitute holistic engagement. Payers should take a fresh look at what it really means to engage consumers by providing solutions that empower their consumers to…
Health plan leaders are recognizing that they need new ways to address a member’s health sooner to prevent them from escalating into poor outcomes that drive great financial risk for…
In this last installment of our three-part blog series on healthcare data security, we’ll describe the benefits of choosing technology vendors that are HITRUST Common Security Framework (CSF) certified. Don’t…
HIT companies have to remember that at the end of a digital transaction, there’s a person. Don’t forget to share this post!
In this second installment of our three-part blog series on healthcare data security, we’ll cover ways to Prepare for, Respond to, and Recover from security breaches. Don’t forget to share…
Think for a moment about the vast amount of clinical, financial and other personal data collected within healthcare information systems today. It’s not only sensitive information about individuals’ health conditions,…
