From Silos To Services For Value-Based Care

From Silos to Services for Value-Based Care

  • September 19, 2016

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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The Interoperability Imperative

The Interoperability Imperative

  • September 19, 2016

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

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

  • June 24, 2016

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

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

  • June 13, 2016

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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McKesson Extends Contract With EQHealth

McKesson extends contract with eQHealth

  • December 7, 2015

Radiology and diagnostic imaging news site AuntMinnie.com covered our recent customer news. We announced that eQHealth will use InterQual evidence-based clinical criteria for its state Medicaid contracts in Florida, Illinois, Mississippi, and Colorado, in addition to its other commercial lines. Read the full story

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Five Ways To Improve Medi-Cal Claims Processing

Five Ways to Improve Medi-Cal Claims Processing

  • September 23, 2015

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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Decision Support At Work

Decision Support at Work

  • June 24, 2015

In its July issue, Health Management Technology magazine asked several industry experts, including our own Nilo Meharabian, about the role and impact of decision support technology in healthcare. Read the web version of the magazine article here.

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