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How Healthcare Can Prep for Artificial Intelligence, Machine Learning
HealthITAnalytics The term “artificial intelligence” often conjures up visions of apocalyptic landscapes decimated by hyper-intelligent machines with a penchant for destroying societies foolish enough to place their trust in autonomous robots and...
CMS Timelines for Stage 3 Meaningful Use, MACRA Implementation
RevCycleIntelligence For Medicare providers, CMS has set the pace for quality improvements and healthcare payment reform through Stage 3 Meaningful Use and the Quality Payment Program (under MACRA implementation). The programs are designed to put providers on...
How Medicare, Medicaid, and CHIP Guide the Health Payer Industry
HealthPayerIntelligence Medicare, Medicaid, and CHIP, the three major public insurance programs overseen by CMS, often set the tone for the large private health payer industry. CMS is using all three programs to actively encourage the movement towards...
HIPAA Data Breaches: What Covered Entities Must Know
HealthITSecurity As more healthcare organizations implement new technologies, connect to health information exchanges, and adopt electronic health record technology, they are potentially exposing themselves to more online threats and potential HIPAA data...
How Will MACRA Impact Patient Engagement, Care Coordination?
PatientEngagementHIT In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) with an overwhelming bipartisan majority. The complex piece of legislation has a number of provisions, each of which affects different areas of the...
How Health Insurance Mergers Could Change the Payer Industry
HealthPayerIntelligence During the summer of 2015, Aetna and Humana, as well as Anthem and Cigna, started a merger process that would reduce four of the nation’s largest insurers down to just two. If the mergers are successful, only three payers would...
How to Get Started with a Population Health Management Program
HealthITAnalytics Healthcare providers are well aware by now that there is no magic solution to the incredibly complex conundrum of systemic reform. Depending on who you ask, the answer to the puzzle of the Triple Aim is either more technology, less...
The Role of Risk Assessments in Healthcare
HealthITSecurity A risk assessment helps covered entities ensure they are compliant with the HIPAA requirements in terms of physical, technical, and administrative safeguards. It also assists in showing potential areas where an organization might be putting...
What Is the Role of Natural Language Processing in Healthcare?
HealthITAnalytics For many providers, the healthcare landscape is looking more and more like a shifting quagmire of regulatory pitfalls, financial quicksand, and unpredictable eruptions of acrimony from overwhelmed clinicians on the edge of revolt. The...
How Payers Could Succeed in ACA Health Insurance Exchanges
HealthPayerIntelligence State and federal health insurance exchanges stemming from the Patient Protection and Affordable Care Act (ACA) offer medical coverage for families and individuals that would have otherwise had little opportunity to obtain a health plan and...
How Patient Engagement Supports Chronic Disease Management
PatientEngagementHIT Patient engagement and chronic disease management are both key components in support of the healthcare industry’s shift toward value-based healthcare. Through robust patient support efforts inside and out of the doctor’s office,...
The Role of Healthcare Data Governance in Big Data Analytics
HealthITAnalytics Data has always been the lifeblood of the healthcare industry. From blood pressure readings and surgical records to insurance claims, immunization histories, patient demographics, and payment receipts, every action of every member of...
Preparing the Healthcare Revenue Cycle for Value-Based Care
RevCycleIntelligence Not only do value-based care models aim to make healthcare providers more accountable for the services they provide to patients, but they are also designed to shift financial accountability away from payers to healthcare organizations....
How Payers Should Prepare for Value-Based Reimbursement
HealthPayerIntelligence Value-based reimbursement is a new payment strategy between insurers and providers meant to foster higher quality care by incentivizing strong performance with shared savings, bonuses, or other financial rewards. This diverges from the more...
How the Affordable Care Act Impacts Patient Engagement
PatientEngagementHIT The 2010 passage of the Affordable Care Act began a thorough overhaul of the healthcare system. Some states expanded Medicaid, consumers began to buy health insurance on federal and state health insurance exchanges, and healthcare...
How to Choose the Right Healthcare Big Data Analytics Tools
HealthITAnalytics In just a few short years, the idea of “big data analytics” has transitioned from a mysterious new buzzword to an essential competency for healthcare organizations large and small. Analytics has moved from a lofty...
How to Overcome the Challenges of Bundled Payment Models
HealthPayerIntelligence Bundled payment models are a form of reimbursement between payers and providers that adheres to an episode of care instead of payment for a particular medical service. This reimbursement system was created to transition healthcare providers...
How the Affordable Care Act Changed the Face of Health Insurance
HealthPayerIntelligence The Patient Protection and Affordable Care Act (ACA) has revolutionized the health insurance industry in a number of ways. Its impacts have been vast and wide. One of the most significant impacts of the landmark legislation is the upward...
What Are the Benefits of Accountable Care Organizations?
HealthPayerIntelligence Accountable care organizations (ACOs) are provider and payer arrangements established to improve care coordination between primary care physicians, hospitals, specialists, and public or private health payers. The Centers for Medicare...
