The Genetic Testing Conundrum

The Genetic Testing Conundrum

  • July 28, 2017

By Lynanne B. Morganstern, MD, MBA Medical Director, InterQual Care Planning Genetic tests are revolutionizing more than medicine. They’re revolutionizing the doctor-patient experience as they increasingly become a consumer-driven service. And that’s raising questions for providers and challenges for payers. The direct-to-consumer 23andMe DNA test kit was FDA-approved in early April. For $200, anyone can order a test that reports on genetic markers for certain health conditions, and genetic variants for certain health conditions’ carrier status. For just $50 more, consumers can order the Color test panel which looks at 30 genes to provide a risk assessment for common hereditary…

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Predictive Analytics: A Prescription For A Better Patient Experience

Predictive Analytics: A Prescription for a Better Patient Experience

  • June 30, 2017

Consumer expectations about their “healthcare experience” continue to rise, and providers must raise their game as well if they hope to successfully compete. As Keith Roberts and Lucas Lukasiak of the Change Healthcare Engagement Solutions team note, advanced predictive analytics techniques and artificial intelligence infrastructures are giving savvy industry stakeholders the edge they need to better target patient engagement. Read the article

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Reinventing Utilization Management To Bring Value To The Point Of Care

Reinventing Utilization Management to Bring Value to the Point of Care

  • June 6, 2017

How an automated exception-based approach can make UM more efficient and effective By Nilo Mehrabian How can health systems deliver the right care, at the right cost, in the right setting, without overwhelming delivery and reimbursement systems with administrative burden? The shift from volume to value-based care requires the deft combination of value-based delivery (enabled through actionable intelligence and new care delivery models) and value-based payment (enabled through select provider networks and new reimbursement models). Providers and payers must operate across a transparent, administratively simple, shared ecosystem. This giant leap from today’s world in which healthcare stakeholders currently operate might…

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McKesson Entity Now Change Healthcare

McKesson Entity Now Change Healthcare

  • May 6, 2017

McKesson Technology Solutions and Change Healthcare have merged to create a new healthcare information technology company. The new Change Healthcare includes all of Change Healthcare's businesses and the majority of McKesson Technology Solutions, and will employ about 15,000 people. Read the article

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Consistent Review Outcomes Are Quality Outcomes

Consistent Review Outcomes are Quality Outcomes

  • May 2, 2017

By Steven Silverstein, MD Recent articles in the Journal of the American Medical Association (here1 and here2) reported on the use and misuse of clinical practice guidelines, and the need to avoid hedging and equivocation when writing them. These articles also discussed the differences inherent in targeting individual physician decision support versus more general purposes, as well as issues related to lack of adherence to guideline development standards published by the Institute of Medicine3. A related issue is that it is not uncommon for guidelines developed by different specialty societies to advocate different approaches to a given clinical situation. This…

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Change Healthcare’s InterQual Expert To Share Blueprint For Case Management Optimization At ACMA 2017

Change Healthcare’s InterQual Expert to Share Blueprint for Case Management Optimization at ACMA 2017

  • April 17, 2017

The American Case Management Association's annual conference, ACMA 2017, gets underway in Washington this week, and attendees looking to gear their case management programs for the industry shift to value should be sure to attend the “Blueprint for Case Management Optimization” presentation. That's where Change Healthcare’s Carol Everhart will share nine best practices to help assess the health of a case management program. Read the News Release

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New Version Of Clinical Decision Support Released

New Version of Clinical Decision Support Released

  • April 11, 2017

McKnight's covered the launch of InterQual 2017, the latest version of the evidence-based clinical decision support solution. McKnight's reports this new release includes more than 120 new criteria and enhancements that help enable faster, safer, and better clinical decisions at the point of care. Read the Article  

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Faster, Simpler, Smarter: InterQual 2017 Streamlines Clinical Care Decisions

Faster, Simpler, Smarter: InterQual 2017 Streamlines Clinical Care Decisions

  • April 3, 2017

Today, we unveiled InterQual 2017, a faster, more streamlined version of our flagship clinical decision support solution. InterQual 2017 introduces a new time-saving product, Medicare Procedures powered by InterQual,  which automates more than 400 Medicare National and Local Coverage Determinations. It also provides a more efficient set of level of care criteria, Initial Review, that supports faster, earlier decisions in the ER. Customers will benefit from a host of new updates, enhancements, and technological advancements, including more than 125 new content areas. Read the news release

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Two New Federal Interoperability Rules: What You Need To Know

Two New Federal Interoperability Rules: What You Need to Know

  • January 12, 2017

By Lisa Conley Payers and providers are increasingly vocal about their need for health information technology (HIT) systems to interoperate in a consistent and industry-wide manner. While the industry has made progress on this front, recent actions in Washington aim to accelerate the pace of progress while also demonstrating the government’s commitment to HIT interoperability. On October 14th, 2016, the federal government announced two final regulations that impact the ongoing transformation to “full interoperability” in healthcare. One regulation was the nearly 2,400-page final rule from the Centers for Medicare and Medicaid Services (CMS) on implementation of the Medicare and CHIP…

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