- Center on Health Equity and Access
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Addressing Social Determinants of Health to Drive Member Retention, OutcomesWith considerable evidence that interventions aimed at social determinants of health can positively influence health outcomes and costs, the discourse is changing among providers and policy influencers to look beyond disease and clinical conditions.
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Workplace Wellness Can Be Hazardous to Your HealthThe health hazards of workplace wellness programs fall within 6 categories.
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Contributor: MA Plans Can Leverage Advanced Technology to Shore Up Risk Adjustment PracticesFaced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care for members.
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Towards Healthcare Interoperability: What Must Be Done?Interoperability is becoming the most sought-after in healthcare, but needs further standardization.
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The MACRA Landscape: Risk and Reward? Part IIRead on for a breakdown of what to expect from the near-final MACRA rule announced by CMS on October 14, 2016.
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Where's the Evidence? Barriers to Analyzing Digital Health's ImpactWhile digital health companies strive to address important healthcare issues by developing products and service offerings in various categories such as genome sequencing, analytics, telemedicine, mobile apps, and population health management tools, little evidence is available in the digital space when it comes to peer-reviewed publications, measurement of potential impact, and effect on patients with the greatest burden of disease, says Meridith Peratikos, Director of Enterprise Research, axialHealthcare.
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Federal Health IT Plan Recognizes Shortfalls of the Past“The course of history shows that as government grows, liberty decreases.” --Thomas Jefferson
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Trust—Doctor, You Have ItThe fact that trust cannot be purchased highlights an important truth: trust needs to be earned. And healthcare professionals have earned it.
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Drivers of Patient Experience in Medicaid Managed CareThough they may not directly provide patient care for their members, managed care organizations (MCOs) play a substantial role in the patient experience of millions of Medicaid enrollees.
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CAQH Index: Cost of Doing Business Falls as Complexity, Volume RiseThe CAQH Index, an annual study of progress to simplify healthcare administrative functions, found signs that the US healthcare system has become more efficient and the cost of doing business may be declining.
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Make Accreditation Part of Your IT Risk Management StrategyAs healthcare continues to see high-profile data breaches, underwriters are looking for third-party accreditation before issuing cyber-security policies.
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Managed Care in 2020 and Beyond: The Decade for Integrated, Individualized CareCardinal Innovations Healthcare is the largest specialty health plan in the country, insuring more than 850,000 North Carolinians with complex needs. Using a community-based model of care management, Cardinal Innovations has led the way in developing services, processes and solutions that improve the lives of our members and their families. Recognized for operational excellence, innovative solutions and superior outcomes for members, accuracy and speed of payments to providers, and cost-effective funds management, Cardinal Innovations is a leading healthcare company in the United States.
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Four Ways to Protect Yourself From Ransomware AttacksRemoving outdated systems and using offsite backup strategies are keys to protecting a health system from ransomware attacks, which are on the rise.
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No Time to Wait: How to Flatten the COVID-19 Curve FasterTriage via text messaging can help providers reach patients in a shorter amount of time, the author says.
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Virtual Health Coach Finds Chain Restaurant Salads Can Top Burgers in CaloriesIf you choose salads because they're healthy, check those calories. The virtual health coach Noom Coach reports that toppings like fried chicken and fatty dressings can push calorie counts of some popular salads past those of signature burgers.
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When Employee Healthcare Costs Move StocksHealthcare costs in America are seeping into nonhealthcare companies’ earnings announcements. None of those companies discussed healthcare this time last year.
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Waking Up to the Opportunity of Self-Funded Employee Health BenefitsSelf-funded employee health benefits are becoming increasingly prevalent as employers seek ways to reduce healthcare expenses, increase plan flexibility, manage risk, and tailor plans to what their workers really want and need.
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Diabetes Shouldn't Cost Patients Their LegsHeart disease and kidney disease are widely known comorbidities of diabetes, but a lesser-known complication that dramatically effects between 10 million and 20 million American adults is peripheral arterial disease (PAD). In its most extreme form, PAD can lead to limb loss.
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Proposed Rule for Medicare ACOs Includes Notable Changes for Rural ProvidersCMS’ proposed rule described strong financial results from low-revenue ACOs, as well as ACOs in risk-bearing tracks, but it mostly ignored the success of small, rural providers in ACOs.
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Medical Technology Use Spurs New C-Suite Titles, Which Bring Opportunity and RiskThe C-suite of the healthcare industry has grown dramatically over the last several years, and has been spurred by legislation that ties reimbursement rates under Medicare and Medicaid to the use of technology in medicine.
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Humana CEO Says Health Care Will Never Be the Same, Here's Why He's RightRita E. Numerof, PhD, is the president of Numerof & Associates, a firm that helps businesses across the healthcare sector define and implement strategies for winning in dynamic markets. For more than 25 years, she has helped executives understand the implications of an evolving healthcare market. Working with leaders in the healthcare space, she has consulted with everyone from top academic and community hospital systems, payers, and Fortune 500 pharmaceutical, device, and diagnostics companies. She is the coauthor of several books, most recently, "Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model" (2016).
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How Does a PCI-Validated P2PE Solution Benefit Providers and Payers?Last month, the healthcare payment network InstaMed announced that it was the first in the industry to achieve point-to-point encryption (P2PE) v2.0 validation. How important is this level of encryption for healthcare? What will this mean for those who seek better protection of their payment card data?
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Strong Referral Network Integrity Requires Continuum-Wide Communication and Data SharingMissed referrals and other appointments, often due to a lack of coordination and follow-up, have far-reaching impacts beyond lost revenue. Avoiding such consequences requires a strong referral network management plan.
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Effective Management of COPD in Primary Care: Challenges and OpportunitiesBy meeting challenges in caring for patients with chronic obstructive pulmonary dieases head-on, primary care doctors have an opportunity to reduce the potential for unnecessary or sub-optimal care while improving patient outcomes.
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How Effective Hospital Pharmacy Operations Can Diminish Surprise Billing for PatientsNearly 28.5 million Americans are uninsured or underinsured, leaving them at risk for medical costs they may not be able to afford. Surprise billing is particularly problematic for acute, or emergency cases.
