When utilization management works effectively in healthcare, everything runs better. That was the message delivered by Nilo Mehrabian, VP of Product Management at Change Healthcare, in the presentation she delivered at the AHIP Institute and Expo 2017, in Austin, Texas. Nilo discussed her session with Ian Gilbert, Senior Product Marketing Manager, Decision Management at Change Healthcare, in a live Twitter broadcast from the expo show floor. They discussed the importance of transforming UM, improving processes overall, and how to best utilize technology to help create trust between payers and providers. Get the synopsis of Nilo’s presentation, “Reinventing Utilization Management: Faster,…
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…
At the AHIP Institute & Expo in Austin, Texas, this week, Change Healthcare will throw the spotlight on a better healthcare system via two expert sessions and a number of innovative solutions, all designed to help payers and providers collaborate and thrive in a market rapidly moving to value-based payments. Read the news release
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
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…
Every provider would like prior auths to be faster and easier, so they can focus on delivering appropriate patient care instead of pushing paper. Now ZeOmega, developer of the Jiva population health management platform, has integrated InterQual Connect to help make automated authorizations a reality. In this new webinar, ZeOmega demonstrates how Jiva and InterQual Connect work together to streamline and automate auth requests, making exception-based UM a reality.
The prior-auth process has always been a challenge for providers: How to get approvals faster, so better care can go forward. Healthcare SaaS solutions innovator HealthTrio has integrated InterQual Connect into its Smart Connect portal to automate prior-authorization, resulting in faster auths and patient treatment. In this new webinar, see how nonprofit health plan CareOregon is using the solution to reduce manual work and speed appropriate patient care.
How did Palmetto manage to find $16 million a month in savings in its molecular diagnostics program? Learn their secret in this fascinating case study. Read the Case Study
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
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