McKesson’s InterQual Now Available On The Cloud

McKesson’s InterQual Now Available on the Cloud

  • January 17, 2017

McKesson announced that InterQual Criteria can now be accessed via cloud implementations of InterQual Online, InterQual Anonymous Review, and InterQual Transparency. What began over 40 years ago as thick printed books that users had to page through is now accessible on a variety of applications and platforms, from PCs to mobile devices to connected automated services and now, the cloud.

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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

Federal agencies finalized two new rulings aimed at accelerating the pace of interoperability in health IT.  The ONC just released its 2017 Interoperability Standards Advisory and final rulings were made on MACRA. In the first of a series of white papers on interop policy, we review what these regulations mean for the industry. Taken together, the rulings demonstrate the government’s commitment to pushing the industry towards a fully open and connected health information infrastructure. Read now or download and read later  

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The State Of Value-Based Reimbursement And The Transition From Volume To Value In 2014

The State of Value-Based Reimbursement and the Transition from Volume to Value in 2014

  • January 1, 2017

How fast are payers and providers adopting new value-based payment models? According to the first industry study of its kind, more than two-thirds of payments are expected to be based on value measurements by 2020. Remarkably, 90% of payers and 81% of providers are already using some mix of value-based reimbursement and fee-for-service, according to the new report, The State of Value-Based Reimbursement and the Transition from Volume to Value in 2014. Read now or download and read later  

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How We Can Make Healthcare Payment And Delivery Reform Work

How We Can Make Healthcare Payment and Delivery Reform Work

  • January 1, 2017

As we move from fee-for-service to value-based care, payers and providers struggle to contend with the many reform models being tested and implemented. To successfully make the transition, stakeholders need to address these five critical pieces: • Shared risk for all stakeholders • A robust primary care foundation • The alignment of payment models and incentives • Information technology that supports such alignment • Strong regional collaboration Experts from McKesson Health Solution describe how to get it done in How We Can Make Healthcare Payment and Delivery Reform Work. Read now or download and read later  

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From Silos To Services For Value-Based Care

From Silos to Services for Value-Based Care

  • January 1, 2017

Even though healthcare has spent decades automating processes and digitizing information, both remain remain largely locked in IT silos. There are impenetrable system boundaries between payers, providers, and vendors that reduce efficiency, increase costs, and resist automation. In other words, true interoperability is sorely lacking. From Silos to Services for Value-Based Care reviews the history of interoperability in healthcare and makes a case for how we can unlock the silos, bring information together, and align processes to improve clinical and financial outcomes. Read now or download and read later

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Five Ways To Improve Medi-Cal Claims Processing

Five Ways to Improve Medi-Cal Claims Processing

  • January 1, 2017

About 12 million Californians are enrolled in Medi-Cal, the state’s Medicaid program. But many providers find that Medi-Cal claims are challenging to manage, leading to claim denials and lost or delayed revenue. The good news: RelayHealth Financial’s research revealed five actions hospitals can take to improve Medi-Cal claim processing, speed reimbursement, and reduce denial rates. Learn more about these five actions and how to implement them. Read now or download and read later

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Ten Steps To Reduce Denials, Win More  Appeals, And Improve Hospital Performance

Ten Steps to Reduce Denials, Win More Appeals, and Improve Hospital Performance

  • January 1, 2017

Providers face tremendous pressure to reduce denials. Although many issues can lead to denials, there’s one area that denial management programs can easily overlook: issues related to medical necessity. This white paper focuses on 10 gaps that can cause medical necessity denials and how to address them, from beefing up emergency department case management to improving level of care management. Read now or download and read later

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The Top 10 Things Payers And Providers Can Do Today To Start Aligning With VBR Tomorrow

The Top 10 Things Payers and Providers Can Do Today to Start Aligning with VBR Tomorrow

  • January 1, 2017

CMS set a goal of having value-based payments account for 50% of Medicare reimbursement by 2018. It's equally ambitious and daunting for many payers. But in this new white paper, The Top 10 Things Payers and Providers Can Do Today to Start Aligning with VBR Tomorrow, McKesson offers a proven 10-step plan that can help payers and providers work together to accelerate their journey to value and improve their odds of achieving these regulatory goals. Read now or download and read letter

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Journey To Value: The State Of Value-Based Reimbursement In 2016

Journey to Value: The State of Value-Based Reimbursement in 2016

  • January 1, 2017

There's no turning back from value-based care and value-based reimbursement. Payers are 58% along the continuum to VBR, up from 48% in 2014. And Providers are now 50% down the road to value. That's according to a national study of 465 payers and hospitals conducted by ORC International and commissioned by McKesson. Yet despite tremendous growth in capitation/global payments, pay for performance, and episode of care/bundled payments, many payers and providers still face obstacles in the transition to value-based care. See where healthcare stands in its journey to value and what it means for the industry in Journey to Value: The State…

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The Interoperability Imperative

The Interoperability Imperative

  • January 1, 2017

Interoperability in healthcare is not just about moving financial and clinical data between payer or provider or moving clinical data from one application to another. True interoperability allows enterprise applications to "talk" and collaborate in a smart, open, and agile manner. The Interoperability Imperative explains what this means; how and why interoperability is necessary to scale complex value-based reimbursement models; and how payers, providers, and vendors can get started. Read now or download and read later

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