Author: eric

Emergency Coverage Top Healthcare Consumer Demand For Payers

When talking about access to care, healthcare consumers were highly in favor of transparency and want payers to cover emergency services.
A new poll from the American College Of Emergency Physicians (ACEP) and Morning Consult found that 95 percent of healthcare consumers say payers should cover emergency services. Out of the 1,791 healthcare consumers surveyed, about 31 percent had visited an emergency department with 35 percent saying they went to the emergency department because they were unable to get a physician appointment.  Read the full article.
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The importance of securing patient identity as health IT goes virtual

Normal healthcare concerns become even more pressing with the growing prevalence of virtual care.
Health IT solutions must address patient ID challenges along the care continuum. As virtual care grows to engage a wider breadth of patients, the industry needs to look at innovative ways to ensure ID security.  Read the full article.
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7.1M Patients Use Remote Monitoring, Connected Medical Devices

More patients than ever are using connected medical devices to engage in remote monitoring and virtual healthcare.
More than seven million patients now benefit from remote monitoring and the use of connected medical devices as an integral part of their care routines, says a new estimate from Berg Insights.  Remote monitoring use grew by 44 percent in 2016 as providers and patients rapidly embraced the convenience of mHealth tools. Read the full article.
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Cloud healthcare: The connection economy’s next frontier

Welcome to the connection economy: a commercial world based on relationships in which who and what you know beats out tangible assets as the fundamental cornerstone of doing business.
The connection economy effectively promises to upend the traditional healthcare industry. However, it will also create many new opportunities and ways for entrenched market players to rethink the way they do business.  Read the full article.
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How Payers Could Assist Primary Care Docs with Value-Based Care

By sharing timely data, healthcare payers could help primary care practices succeed in value-based care.
“One of the things I hear from the primary care providers is that there are oftentimes competing or discrepant pay for performance programs between the health plans and they may use different codes to track a visit,” Matovsky said. “They may use different standards in terms of performance and achieving different metrics. The more complicated those programs are and the discrepant they are from health plan to health plan, it makes the whole system less effective because it is a lot of variables to juggle.”  Read the full article.
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Key Challenges and Solutions of Healthcare Payment Reform

Payers will need to support their provider networks when advancing healthcare payment reform.
Healthcare payment reform is becoming more common across payers and providers with many stakeholders transitioning from the traditional fee-for-service reimbursement system to value-based care payments. Representatives from the National Academy of Medicine published an editorial in the Journal of the American Medical Association (JAMA) outlining how healthcare payment reform could lead to better quality of care and patient engagement.  Read the full article.
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5 Solutions for Conquering Challenges of Bundled Payment Models

Healthcare information technology in 2017
Payers and providers face various challenges when implementing bundled payment models including mistrust on both sides, low case volumes, difficulties of defining a bundle, and inadequate infrastructure.  Read the full article.
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How Payers, Providers Could Streamline Medical Claims Management

Payers and providers may need to boost training and medical documentation processes while reducing denial rates to streamline medical claims management.
Successful medical claims management and processing is not always easy to garner for health insurance companies due to a lack of training among insurance agents, missing or inaccurate documentation, and the general time-consuming aspect of resolving claim denials between payers and providers. Read the full article.
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Health Information Technology Allows Payers to Share Data

CMS partnered with private payers to improve primary care delivery using health information technology and data exchange.
The Centers for Medicare & Medicaid Services (CMS) strive to create programs meant to bring “better care, smarter spending, and healthier people”. CMS partnered with healthcare payers across seven regions to improve primary care through the Comprehensive Primary Care initiative (CPC), according to The CMS Blog. Through the use of health information technology and multi-insurer payment reform, the program was created to support primary care practices in advancing the quality of care.  Read the full article.
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6 major mistakes of patient engagement

Is your healthcare facility making patient engagement mistakes?
The first step to solving any problem is realizing there is one. Patient engagement has for many health organizations, become a catchy buzzword to satisfy meaningful use. However, the following seven major mistakes are ones, which when realized and rectified, can create powerful results to support your organization’s mission. Read the full article.
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