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Reinventing Utilization Management to Bring Value to the Point of Care

February 21, 2018  |  Nilo Mehrabian Vice President, Product Management, Decision Support, Change Healthcare
article
How an automated exception-based approach can make UM more efficient and effective.

PODCAST: AMIA’s Jeff Smith on MACRA/MIPS in this Current Moment and What’s Next in HIT Policy

April 19, 2018  |  Rajiv Leventhal
article
On the latest Healthcare Informatics podcast, AMIA’s Jeff Smith gives his thoughts on where things stand with MACRA/MIPS right now, the future of MU, 21st Century Cures tidbits and more.

ACP Study: Only 37 Percent of MIPS Measures Are Valid

April 19, 2018  |  David Raths
news
A new study from the American College of Physicians Performance Measurement Committee rated as valid only 37 percent of the 86 Quality Payment Program measures for 2017 deemed relevant to ambulatory general internal medicine.

AMA-Led Alternative Payment Model Aims to Improve Opioid Use Disorder

April 17, 2018  |  Rajiv Leventhal
news
The American Society of Addiction Medicine (ASAM) and the American Medical Association (AMA) have jointly announced the release of a concept paper detailing an alternative payment model (APM) that will aim to improve how patients with opioid use disorder are...

Community Health Leaders Share Their Progress on Integrating SDoH Data into Healthcare

April 10, 2018  |  Heather Landi
article
Many community-based organizations are advancing forward in their efforts to use health IT to collect, standardize and integrate social and behavioral health data, as detailed during a panel discussion at the 2018 State Healthcare IT Connect Summit last week.

Survey: Healthcare Providers Report Slow Progress on Population Health Goals

April 10, 2018  |  Heather Landi
news
While most healthcare executives agree that population health is the future, most organizations have failed to keep pace with anticipated progress, indicating a growing gap between intentions and progress for provider adoption of value-based practices, according...

Adam Boehler Officially Named CMMI Director

April 9, 2018  |  Rajiv Leventhal
news
The Center for Medicare and Medicaid Innovation (CMMI) officially has a new director—Adam Boehler, the former CEO of home-based care startup Landmark Health.

Analysis: MSSP ACOs Have Performed Below CBO Estimates

April 3, 2018  |  Rajiv Leventhal
news
According to a new analysis from Avalere, MSSP ACOs have performed considerably below the financial estimates from the Congressional Budget Office made in 2010 when the MSSP was enacted as part of the ACA.

A Final Rule Around Medicare Advantage Plans Hints at Potential Future Changes to MIPS Data Reporting

April 2, 2018  |  Mark Hagland
article
Amid the announcement of a final rule around changes to the Medicare Advantage program, CMS Administrator Seema Verma hinted at data measurement changes that could touch on provider measures as well

With the Walmart-Humana Revelation, a Cresting Wave of Disruptive Developments in U.S. Healthcare?

April 1, 2018  |  Mark Hagland
commentary
The media reports about a potential Walmart purchase of Humana, coming on top of the CVS-Aetna merger announcement and the Amazon/Berkshire Hathaway/JP Morgan Chase announcement, should put provider leaders on alert

At the HIT Summit in Cleveland, MetroHealth Executives Share their Journey into Value

March 30, 2018  |  Mark Hagland
article
Drs. Nabil Chehade and David Kaelber of Cleveland’s MetroHealth System shared with HIT Summit-Cleveland attendees insights on their organization’s journey into value-based care delivery, including on the vital role of HIT

A Clinically Integrated Network Forges Success in Southeastern New Jersey

March 25, 2018  |  Mark Hagland
article
In New Jersey, Shore Quality Partners is succeeding as a clinically integrated network, through clear strategy and excellent execution—and successful leveraging of data and IT to support clinical transformation

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