Month: September 2017
Healthcare executives on overcoming the barriers to payer-provider data exchange
FierceHealthcare Exclusive
“The holy grail of data-sharing is integrated clinical and claims data. But there are plenty of barriers, from cost to interoperability challenges to lingering distrust between payers and providers. But when we gathered a group of more than 20 executives to discuss payer-provider collaboration, they all agreed that health information technology and data play an integral role.â€Â Read the full article.
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Internet unleashes .health domain names
Healthcare Industry News
“The health care industry now has its own domain name on the internet, just like universities have .edu and not-for-profits have .org. Several companies and organizations went live with the .health extension through DotHealth, the official registry.” Read the full article.
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CMS releases proposed rules on Outpatient and Physician Fee Schedule
HIMSS News
“Last month, the Center for Medicare and Medicaid Services (CMS) released two new Notice for Proposed Rulemaking (NPRM).” Read the full article.
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Partnership-Driven Cost Savings in Healthcare
Core Admin Processing Systems: Our Hidden Engine
A frequently overlooked driver of cost savings is streamlined back-office operations. At HealthAxis, our Core Admin Processing Systems power this efficiency in several ways:
1. Automated Claims & Authorization Workflows
By automating routine claims adjudication and prior authorization, we reduce:
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Manual labor
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Processing errors and resubmissions
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Administrative burden for both providers and payers
This enables faster payments, fewer disputes, and lower overhead.
2. Shared Data Repositories
Our systems centralize member and patient data, serving all parties. This eliminates duplication, speeds decision-making, and enhances care coordination—cutting down on unnecessary procedures.
3. Analytics & Reporting
Through integrated dashboards, partners gain real-time insights into utilization patterns, care gaps, and cost drivers. This enables:
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Quick detection of inefficiencies
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Data‑driven interventions (e.g. targeted care management)
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Transparent tracking of cost savings
4. Scalable Integration
Our platforms are built to support expanding partnerships—whether with CBOs, ACOs, or payers—without scaling administrative complexity. Shared platforms mean shared savings.
The HealthAxis Advantage
By combining:
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Proven partnership models (rooted in social determinants and clinical coordination),
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Relationship infrastructure that funds and sustains collaborative efforts,
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And, vitally, Core Admin Processing Systems that operationalize savings—
HealthAxis delivers a comprehensive, lasting solution for lowering cost while improving care. Our clients consistently experience measurable reductions in avoidable utilization and administrative overhead, confirming that investments in both partnerships and infrastructure deliver genuine value.
Source:
65% of healthcare partnerships lead to cost savings, study shows, Healthcare Dive
Member Engagement for Payers Should Focus on Simplicity
Claims Management News from HealthPayer Intelligence
“Effective member engagement strategies for payers should focus on locating member pain points and simplicity of communication for plan†Read the full article.
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OIG plans to investigate $15 billion in meaningful use payments
Healthcare IT News on Meaningful Use Payments
“The Department of Health and Human Services Office of Inspector General will review the accuracy of $14.6 billion in meaningful use payments made to hospitals by Medicare between 2011 and 2016. Earlier this year, the OIG estimated physicians were wrongfully paid $729 million under meaningful use.” Read the full article.
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Guides Help Employers Decide on Accountable Care Organization Use
Value-Based Care News
“ACOs have the potential to deliver lower-cost, higher-quality and more consumer-focused health care. However, with over 900 ACOs in the marketplace, and most varying in size, provider-mix, leadership structure, quality measures, performance and other characteristics, employers have many questions about how ACOs deliver value better than the network models they offer today. That’s one of the main reasons we developed these resources.” Read the full article.
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