CMS ICD-10 ‘Acknowledgement’ Test Done, Now Comes The Hard Part

CMS ICD-10 ‘Acknowledgement’ Test Done, Now Comes the Hard Part

  • March 7, 2014

In a first step towards the ICD-10 transition, CMS Acknowledgement testing was successful, according to an article in HealthData Management. But Josh Berman, Director of ICD-10 at RelayHealth, said that while the results were reassuring, more needs to be done. The real concern,  said Berman, remains whether insurers will be able to process the claims. Berman urged payers to begin conducting end-to-end testing.  "While most providers were not ready for end-to-end testing three or four months ago, large numbers are quickly getting there and Berman expects end-to-end test requests to ramp up in April and May," the article stated. Read the full article

Read More
Eight Questions Health-Care CEOs Must Ask IT Leaders Before Deploying Systems In The Cloud

Eight Questions Health-Care CEOs Must Ask IT Leaders Before Deploying Systems in the Cloud

  • March 4, 2014

Healthcare CEOs know how important the cloud is to the future of health care, but they don't necessarily know how to get there, writes Bob Franceschini in the Wall Street Journal. In the article, Franceschini, Vice President of Enterprise Architecture & Technology at McKesson, shares eight crucial questions CEOs need to think about and discuss with their CIOs before making a move to the cloud. Read the full article  

Read More
ICD-10 And Revenue Cycle Readiness: Six Key Steps

ICD-10 and Revenue Cycle Readiness: Six Key Steps

  • March 3, 2014

The ICD-10 deadline is looming, and payers and providers need to focus on testing, education, and process improvement.  Healthcare Finance News asked Josh Berman, Director of ICD-10 at RelayHealth, what providers can do to weather the transition. Berman shares his advice on the importance of end-to-end testing, training, knowing your KPIs, and being prepared to send both ICD-9 and ICD-10 codes. Read all six readiness steps here

Read More
How We Can Make Healthcare Payment And Delivery Reform Work

How We Can Make Healthcare Payment and Delivery Reform Work

  • February 27, 2014

DOWNLOAD and share the WHITE PAPER now The current array of healthcare 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. We need a definitive transition from the current FFS system to one that will drive value through mixed reimbursement schemes, which themselves support multiple forms of payment bundling in conjunction with limited FFS. In this new white paper, How We Can Make Payment and Delivery Reform Work, Dr. David Nace, VP and medical director at McKesson Health Solutions, defines the five critical elements of successful care delivery reform that payers and…

Read More
Revitalizing Primary Care Said Key To Success Of Health Reform

Revitalizing Primary Care Said Key to Success of Health Reform

  • February 26, 2014

Psychiatric News featured comments from McKesson medical director David Nace, MD, in a recent article covering the Patient-Centered Primary Care Collaborative (PCPCC), a coalition of advocacy groups dedicated to advancing an effective health system built on a foundation of primary care and the patient-centered medical home (PCMH). Read the article

Read More
Why A Universal Catalog For Molecular Testing Is Critical

Why a Universal Catalog for Molecular Testing is Critical

  • February 26, 2014

In earlier posts on the new frontier of Molecular Diagnostic testing, I’ve discussed the need for identifying and classifying tests as well as the opportunity and challenges this new technology brings to payers, providers and lab stakeholders. Building a knowledge base of basic principles is the next step. In this post, I explore the merits of a single national catalog for Molecular Diagnostics testing. Test information is complex and always changing Marketing 101, Theorem 1: Buyers must first understand what products, devices, or services are available before they can choose what to buy – or how much to pay. Let’s…

Read More
The Future Of Claims Processing Is Bundled

The Future of Claims Processing is Bundled

  • February 25, 2014

"Changing the future of claims processing." That's how ACO News reported McKesson Episode Management's™ recent release of 22 new episodes based on the PROMETHEUS Payment® Evidence Informed Case Rate (ECR) definitions. The bundled payment solution is the first milestone in our agreement with the Health Care Incentives Improvement Institute (HCI3) to advance adoption of healthcare payment reform. With the initial 22 episodes, McKesson is addressing 35 percent of commercial payers’ spend. And these episodes are just the first in a planned series of PROMETHEUS ECRs intended to cover up to 80 percent of U.S. medical spend. Read the full story and the press release

Read More
Palmetto GBA Cut Its MDx Spending In Half With Innovative Approach

Palmetto GBA cut its MDx spending in half with innovative approach

  • February 21, 2014

A dramatic rise in spending on molecular diagnostic (MDx) tests, coupled with an inability to identify specific MDx tests submitted on claims, led Palmetto GBA, to initiate the Palmetto MolDX program. The Medicare Administrative Contractor (MAC) for the Centers for Medicare & Medicaid Services (CMS) wanted a way to uniquely identify and improve coverage and reimbursement for molecular diagnostic tests. The Palmetto MolDx program helped Palmetto meet accurately process claims by identifying specific MDx tests and applying Medicare coverage policies. The return on investment for the program was immediate, according to Palmetto and resulted in a cost avoidance of about…

Read More