Reinventing Claims Payment For A Value-Based World

Reinventing Claims Payment for a Value-Based World

  • June 6, 2017

Payers need to choose between automated payment and accurate automated payment By Amy Larsson RN, BSN, MBA The U.S. healthcare industry’s claims-payment system is frustrating to providers, payers, and patients alike. Inefficiency and a systemwide tendency for error wastes precious resources, worsens miscommunication and mistrust among all stakeholders, and inhibits the ability to transition to value-based approaches that achieve better outcomes. We need to rethink our industry’s disjointed and siloed approach in order to solve a very integrated problem. Despite billions invested in achieving efficient claims payment, more than 7% of claims are not paid correctly the first time, the…

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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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From Silos To Services For Value-Based Care

From Silos to Services for Value-Based Care

  • March 31, 2017

Morning Consult covered the evolution of HIT interoperability and how, despite industry advances, most systems aren't working together. The article reports on how interoperability facilitates value-based care and reimbursement, and why that's crucial to the future of HIT. Read the Article

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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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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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How We Can Make Healthcare Payment And Delivery Reform Work

How We Can Make Healthcare Payment and Delivery Reform Work

  • January 9, 2015

By David Nace, MD, Vice President and Medical Director, Change Healthcare The goal of payment reform is to align providers and patients in coordinated and collaborative care models that reduce costs while improving quality. But the current array of reforms hasn’t produced a single reimbursement model that can replace our reliance on a fee-for-service (FFS) foundation, nor has it accounted for the seismic shift in care delivery that providers must make. Powerful incentives and inertia remain intact, limiting stakeholders’ willingness to experiment with the range of innovative reimbursement models that promise to make the effort and cost of reform worthwhile.…

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