To overcome challenges and ensure that RPM reaches its full potential, both providers and payers need to implement several key strategies — and technology is a key component to making everything easier on all organizations.
As our industry continues its path toward value-based care, evolving payer models, and increasingly stringent regulations, revenue cycle processes will become even more complex. Providers can prepare by following these steps.
PurpleLab® stands out from others in this sector by providing its data analytics services to several different groups of users across healthcare and pharma companies.
Clearinghouses are just one great example of how the enhanced exchange of healthcare data can increase efficiency for healthcare providers and the greater healthcare community.
Payers and providers alike are struggling with data interoperability. It's clear that a more unified approach to data management is essential for payers to effectively navigate the complexities of value-based care.
Is it possible to be pro-human and pro-tech at the same time when it comes to our healthcare?
Many consumers leave their provider because of navigation problems, while many leave their insurer because of experience issues, a new Accenture report found.
Closing cancer health equity gaps require medical breakthroughs made possible by new funding approaches.
A new report from Ernst & Young revealed that healthcare organizations are seeing financial benefits and improved outcomes from their health equity strategies.
Providers must abandon paternalism and treat patients like partners in the decision-making process when drawing up care plans, according to Chris Waugh, Sutter Health's chief design and innovation officer. Instead of prescribing a major lifestyle overhaul without considering a patient's unique life circumstances, providers should "recognize that it's about the tiny things and the accumulation of marginal gains,” he said.
Carbon went out of Anthem Blue Cross’ network March 17 after not coming to an agreement on reimbursement. The company took the dispute public in an April 29 blog post declaring the rate Anthem pays its providers as not a livable wage. These kinds of disputes between payers and providers happen frequently, though they're usually not as public, one expert said.
CMS put out a request for information in October about a CMS-led national provider directory that would allow patients to find and compare providers based on preferences like language and location. Alexandra Mugge, director and deputy chief health informatics officer of the Health Informatics and Interoperability Group at CMS, said there is stakeholder support for the national directory — if it's executed correctly.
Hear executives from Quantum Health, Surescripts, EY, Clinical Architecture and Personify Health share their views on digital transformation in healthcare.
Nearly 40% of Americans struggle understanding their medical bills, a recent survey showed. But receiving more communication and support from providers and insurers would make bills less confusing, the respondents shared.
Leaders in healthcare draw attention to the myriad ways cloud computing technology is transforming healthcare.
Leaders in healthcare draw attention to the myriad ways cloud computing technology is transforming healthcare.
Of the billions of dollars provided by the government to support providers during the pandemic, $11.7 billion has been allocated but not spent, $7.1 billion has not been allocated and $8 billion has been returned for various reasons, including that the organization recovered faster than expected.
The bill, if enacted into law, will establish an electronic prior authorization process and require Medicare Advantage plans to report on their use of prior authorization and the rate of approvals or denials to CMS. It has 227 co-sponsors in the U.S. House, indicating strong support from both Republicans and Democrats.