More Features
Key Steps for Payer Success in Accountable Care Organizations
HealthPayerIntelligence In recent years, healthcare reforms have set out to reduce constantly rising medical costs, improve coverage for the many Americans who lacked primary care access, and advance population health outcomes. Over the past few years, the...
Top Revenue Cycle Management Vendors and How to Select One
RevCycleIntelligence As value-based reimbursement models, such as the upcoming Quality Payment Program, break down the walls between care quality and healthcare payments, more providers have set their sights on implementing vendor-sponsored revenue cycle...
What Providers Should Know to Improve Patient Access to Healthcare
PatientEngagementHIT Patient engagement, consumer satisfaction, and patient access to healthcare are three of the most critical pieces of the value-based care puzzle. As outcomes, satisfaction, and patient loyalty become more important to financial security for...
Understanding HIPAA-Compliant Cloud Options for Health IT
HITInfrastructure Healthcare providers looking for HIPAA-compliant applications, storage, and networking options are increasingly turning to the cloud, which has quickly become a low-cost way to develop the complex infrastructure required to support a...
What a Trump Presidency Means for Value-Based Care and the ACA
RevCycleIntelligence Love it or loathe it, the United States is headed for four years of drastic policy changes under a Donald Trump administration, giving lawmakers another good chance to repeal, replace, or revise the Affordable Care Act. The landmark...
The Progress and Challenges of the Affordable Care Act
HealthPayerIntelligence Before the Patient Protection and Affordable Care Act (ACA) became law on March 23, 2010, the healthcare industry faced a number of obstacles particularly in terms of providing medical care and health insurance to many low-income families...
How to Maximize Revenue with Improved Claims Denials Management
RevCycleIntelligence Claims denials may be a part of life for healthcare revenue cycle managers, but a prevention-focused denials management strategy may be able to significantly reduce the number of times billing staff are faced with unpaid claims. Recent...
CMS Timelines for Stage 3 Meaningful Use, MACRA Implementation
RevCycleIntelligence For Medicare providers, CMS has set the pace for quality improvements and healthcare payment reform through Stage 3 Meaningful Use and the Quality Payment Program (under MACRA implementation). The programs are designed to put providers on...
How Medicare, Medicaid, and CHIP Guide the Health Payer Industry
HealthPayerIntelligence Medicare, Medicaid, and CHIP, the three major public insurance programs overseen by CMS, often set the tone for the large private health payer industry. CMS is using all three programs to actively encourage the movement towards...
HIPAA Data Breaches: What Covered Entities Must Know
HealthITSecurity As more healthcare organizations implement new technologies, connect to health information exchanges, and adopt electronic health record technology, they are potentially exposing themselves to more online threats and potential HIPAA data...
How Will MACRA Impact Patient Engagement, Care Coordination?
PatientEngagementHIT In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) with an overwhelming bipartisan majority. The complex piece of legislation has a number of provisions, each of which affects different areas of the...
How Health Insurance Mergers Could Change the Payer Industry
HealthPayerIntelligence During the summer of 2015, Aetna and Humana, as well as Anthem and Cigna, started a merger process that would reduce four of the nation’s largest insurers down to just two. If the mergers are successful, only three payers would...
The Role of Risk Assessments in Healthcare
HealthITSecurity A risk assessment helps covered entities ensure they are compliant with the HIPAA requirements in terms of physical, technical, and administrative safeguards. It also assists in showing potential areas where an organization might be putting...
How Payers Could Succeed in ACA Health Insurance Exchanges
HealthPayerIntelligence State and federal health insurance exchanges stemming from the Patient Protection and Affordable Care Act (ACA) offer medical coverage for families and individuals that would have otherwise had little opportunity to obtain a health plan and...
How Patient Engagement Supports Chronic Disease Management
PatientEngagementHIT Patient engagement and chronic disease management are both key components in support of the healthcare industry’s shift toward value-based healthcare. Through robust patient support efforts inside and out of the doctor’s office,...
Preparing the Healthcare Revenue Cycle for Value-Based Care
RevCycleIntelligence Not only do value-based care models aim to make healthcare providers more accountable for the services they provide to patients, but they are also designed to shift financial accountability away from payers to healthcare organizations....
How Payers Should Prepare for Value-Based Reimbursement
HealthPayerIntelligence Value-based reimbursement is a new payment strategy between insurers and providers meant to foster higher quality care by incentivizing strong performance with shared savings, bonuses, or other financial rewards. This diverges from the more...
How the Affordable Care Act Impacts Patient Engagement
PatientEngagementHIT The 2010 passage of the Affordable Care Act began a thorough overhaul of the healthcare system. Some states expanded Medicaid, consumers began to buy health insurance on federal and state health insurance exchanges, and healthcare...
How to Overcome the Challenges of Bundled Payment Models
HealthPayerIntelligence Bundled payment models are a form of reimbursement between payers and providers that adheres to an episode of care instead of payment for a particular medical service. This reimbursement system was created to transition healthcare providers...
