The Genetic Testing Conundrum

The Genetic Testing Conundrum

  • July 28, 2017

By Lynanne B. Morganstern, MD, MBA Medical Director, InterQual Care Planning Genetic tests are revolutionizing more than medicine. They’re revolutionizing the doctor-patient experience as they increasingly become a consumer-driven service. And that’s raising questions for providers and challenges for payers. The direct-to-consumer 23andMe DNA test kit was FDA-approved in early April. For $200, anyone can order a test that reports on genetic markers for certain health conditions, and genetic variants for certain health conditions’ carrier status. For just $50 more, consumers can order the Color test panel which looks at 30 genes to provide a risk assessment for common hereditary…

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More Than Price Transparency: Patients Need Information Transparency

More Than Price Transparency: Patients Need Information Transparency

  • July 25, 2017

Most patients find it difficult to locate timely, accurate, and complete health data, but that data is precisely what they need now to make health decisions they’ve never had to make before. In his column on Health IT Outcomes, Tate McDaniel, Senior VP of Engagement Solutions at Change Healthcare, makes the case for the rising importance of information transparency. Read now or download and read later

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Simple Tips To Rein In Rising Consumer Collection Costs

Simple tips to rein in rising consumer collection costs

  • July 25, 2017

As rising patient collections efforts place greater demands on existing revenue cycle resources, physicians need to rethink their collections processes. One area worth focusing on is ensuring strategies are in place to capture payments more efficiently. In a new piece on ModernMedicine.com, Stuart Hanson, Senior VP and GM of Consumer Payment Solutions at Change Healthcare, shares thoughts on adopting a communication strategy tailored to patients’ needs. Read the article

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Predictive Analytics: A Prescription For A Better Patient Experience

Predictive Analytics: A Prescription for a Better Patient Experience

  • June 30, 2017

Consumer expectations about their “healthcare experience” continue to rise, and providers must raise their game as well if they hope to successfully compete. As Keith Roberts and Lucas Lukasiak of the Change Healthcare Engagement Solutions team note, advanced predictive analytics techniques and artificial intelligence infrastructures are giving savvy industry stakeholders the edge they need to better target patient engagement. Read the article

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New Study Reveals Impact Of Claim Denials On Providers

New Study Reveals Impact of Claim Denials on Providers

  • June 26, 2017

Medical claim denials--they erode providers’ bottom lines, impede timely reimbursement, and sap time and money to appeal. But how much hospital revenue is put at risk by denials annually? How much does it really cost to re-work a claim? What are provider organizations spending on appeals? How do denial rates compared across the country? These are some of the questions that Change Healthcare analytics experts looked to answer. And using our revenue cycle analytics tools—the same tools we provide to customers—we revealed the state of denials nationally. The answers, available in a new e-book, may surprise you. Download the e-book

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Reinventing Claims Payment For A Value-Based World

Reinventing Claims Payment for a Value-Based World

  • June 8, 2017

The health care industry’s claims payment system is frustrating, inefficient, and prone to errors, according to a new Op-Ed in Morning Consult. But Amy Larsson says one way to overcome these challenges is to start automating disparate payment systems to reduce manual interventions and thus the errors they might introduce. Read the article

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Reinventing Claims Payment For A Value-Based World

Reinventing Claims Payment for a Value-Based World

  • June 6, 2017

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 second time, and sometimes even the third time¹. The remediation process…

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Reinventing Utilization Management To Bring Value To The Point Of Care

Reinventing Utilization Management to Bring Value to the Point of Care

  • June 6, 2017

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…

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Consistent Review Outcomes Are Quality Outcomes

Consistent Review Outcomes are Quality Outcomes

  • May 2, 2017

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…

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The Perfect Pairing: Patient Access And Analytics

The perfect pairing: Patient access and analytics

  • March 28, 2017

While more providers are taking advantage of technology to improve front-end revenue cycle processes, analytics lags behind. But when applied to patient access, analytics can help identify issues with registration and eligibility accuracy, and reduce downstream denials. A recent article in Multibriefs outlines the benefits of using analytics to improve patient-access processes in a value-based world. Read the Article

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