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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: AHA's Cybersecurity Leader John Riggi on the Evolving Cyber Threats Facing Healthcare

August 17, 2018  |  Heather Landi, Associate Editor
article
A former FBI Cyber Division leader, John Riggi, now the AHA's senior advisor for cybersecurity and risk, discusses the evolving threats to healthcare.

Could Last Week’s Proposed-Rule Release Represent an Inflection Point for CMS and for Value-Based Federal Payment?

July 18, 2018  |  Mark Hagland
commentary
CMS’s release of a proposed rule that will impact a range of issues, from physician payment to quality measures, has unleashed a range of reactions from industry leaders—could this prove to be an inflection point?

National Coordinator Donald Rucker, M.D. Assesses Progress Towards Interoperability and the Development of Open APIs

May 21, 2018  |  Mark Hagland
article
Donald Rucker, M.D. spoke recently with Healthcare Informatics about the progress towards interoperability, a key objective of the current administration—and some of the challenges and opportunities for open-API development

At HLTH, a Candid Discussion of What the Federal Government Can and Should Do to Promote Healthcare Innovation

May 11, 2018  |  Mark Hagland
article
At the HLTH Conference this week, Rasu Shrestha, M.D. of UPMC sat down with HHS CTO Bruce Greenstein and former United States CTO Aneesh Chopra, to discuss the federal government’s role in facilitating technology innovation

GAO: Just 4 of 37 CMMI Payment Models Have Met Goals around Cost, Quality

May 11, 2018  |  Rajiv Leventhal
news
CMMI, created to test new and cost-effective approaches for delivering and paying for healthcare, has partially met its goals, while just four out of the innovation center’s 37 alternative payment models have actually achieved lower spending and higher quality.

Former HHS Secretary Price Emphasizes Consumer Options and Voluntary Payment Programs in World Health Care Congress Keynote

May 1, 2018  |  Rajiv Leventhal
article
During his keynote speech at the World Health Care Congress in Washington, D.C. this week, former HHS Secretary Tom Price, M.D., spoke about the need “to fix a broken healthcare system.”

Might CMS Move to Implicitly Mandate Health Data Exchange at Discharge, at the Federal Level?

April 26, 2018  |  Mark Hagland
commentary
Embedded in the release of a new proposed rule around what has been known as the meaningful use program, CMS officials have indicated the possibility that they might mandate electronic sharing of discharge data at the point of discharge

BREAKING: CMS to Rebrand Meaningful Use Program with New Emphasis on Interoperability, Burden Reduction

April 24, 2018  |  Rajiv Leventhal
article
In a rule released late in the afternoon on April 24, the Centers for Medicare & Medicaid Services (CMS) has made clear its intention to overhaul the meaningful use program.

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.

Mike Davis Looks at the Past, the Present, and the Future of EHR Adoption—and Customization

February 11, 2018  |  Mark Hagland
article
Mike Davis, perhaps best known as one as a co-creator of the EMRAM schematic, which measures EHR implementation advancement, in his work at KLAS Research, is working to advance EHR development globally

Randy McCleese on What it Means to Be CIO of the Year

February 8, 2018  |  Rajiv Leventhal
article
McCleese recently spoke with Healthcare Informatics about rural healthcare obstacles, what winning this award means to him, how he’s been able to have success in this role, and how he sees the policy landscape shaking out.

Andy Slavitt, Others Create “United States of Care” Health Reform Group

February 7, 2018  |  Rajiv Leventhal
news
Former CMS (Centers for Medicare & Medicaid Services) Administrator Andy Slavitt has announced that that he will be part of a new healthcare coalition that carries the goal of “putting healthcare over politics.”

Patient Access and Analytics: Perfect Together

February 7, 2018  |  Jason Williams, Vice President, Business Strategy & Analytics, Change Healthcare
article
Applying analytics to patient access can radically improve a health system’s ability to understand what’s influencing financial performance, and improve the metrics that matter.

Study: Payers, Providers, Patients Differ on Consumer Engagement Investments, Effectiveness

January 29, 2018  |  Change Healthcare
article
Value-based care is driving investments in consumer engagement strategies and technologies, but consumers are not seeing the difference.

What Might Alex Azar’s Tenure at HHS Bring to Health System Reform and Healthcare IT Policy?

January 25, 2018  |  Mark Hagland
commentary
As he takes the helm at HHS, Alex Azar is faced with a raft of choices around how to steer federal healthcare policy forward—both on the internal healthcare system reform front, and on the healthcare IT policy front

Ohio HIE Has Sent 8.1 Million Results

January 22, 2018  |  David Raths
news
CliniSync, the nonprofit statewide health information exchange for Ohio, offered a year-end 2017 report, noting that almost all of its 157 hospitals are in production or live, sending results and reports to practices.

Healthcare IT: Where Did it Come From and Where is it Going?

January 11, 2018  |  Joe Marion
commentary
Dan Brown's book, Origin, offers some interesting insight on where cognitive computing is taking healthcare IT

A Framework for the Future: 3 Steps to Building an Enterprise Architecture

December 18, 2017  |  Bob Hoover, VP of Consulting Services at Change Healthcare
article
Successfully delivering value from healthcare IT investments is difficult. That’s a refrain I’ve heard again and again from healthcare leaders, whether in the boardroom, the executive suite, or the data center.

Study Identifies Seven Barriers to Research on Impact of HIEs

December 14, 2017  |  David Raths
commentary
Despite the public and private investments made in health information exchanges, there have been relatively few empirical research studies on their impact. Why is that?

Community Data Sharing: Eight Recommendations From San Diego

December 12, 2017  |  David Raths
news
A learning guide focuses on San Diego’s experience in building a community health information exchange and the realities of embarking on a broad community collaboration to achieve better data sharing.

Ten Steps to Reduce Denials, Win More Appeals, and Improve Hospital Performance

December 8, 2017  |  Carol Everhart, RN, MS, IQCI, Senior Clinical Consultant, Decision Support Change Healthcare
article
Hospitals everywhere are striving to answer this question: How can we better manage denials? Denials related to medical necessity account for about 5% of denials nationally. But by closing common gaps that lead to medical necessity denials, your...

Lawsuit: 62 Indiana Hospitals Made Fraudulent Claims to Get Federal MU Dollars

November 28, 2017  |  Rajiv Leventhal
news
Two lawyers in South Bend, Indiana are claiming that 62 Indiana hospitals made false claims to receive federal grant dollars and participated in kickback schemes by overbilling for the release of electronic medical records.

Research Finds States Remain Committed to Value-Based Payment Models

November 16, 2017  |  Carolyn Wukitch, Senior Vice President & General Manager, Network & Financial Management, Change Healthcare
article
Alternative payment programs are now firmly rooted in state-level healthcare policy, as discussions regarding health reform continue in Washington. That’s according to a new national study commissioned by Change Healthcare which finds over 40 states pursuing...

The MACRA QPP 2018 Final Rule: Is It a Glass Half-Empty or a Glass Half-Full?

November 7, 2017  |  Mark Hagland
commentary
What one thinks of the QPP CY 2018 final rule could depend at least partly on a number of factors, including where one “sits” in the healthcare stakeholder constellation—and what one might have to do to respond to it, as a result

Unnecessary Care: It’s Not Necessary

November 2, 2017  |  Suresh Yarlagadda, Medical Director, Clinical Strategy, Change Healthcare
article
Unnecessary care is unnecessarily in the news these days. We say “unnecessarily” because such care—as well as the associated costs it incurs and risks it poses for patients—can be mitigated. Kaiser Health News just published a report, “So Much Care It Hurts...

SHIN-NY 2020 Roadmap Seeks to Address ‘Perfect Storm of Reduced Support’

October 10, 2017  |  David Raths
commentary
A New York statewide health information exchange roadmap addresses funding challenges, value-based care, and provider interest in the types of data currently not available through the network.

During Health IT Week, Industry Leaders Discuss HIT Initiatives and Driving Policy Change

October 6, 2017  |  Heather Landi
commentary
At the tail end of National Health IT Week, a webinar focused on the industry leaders who are driving change, both by championing health IT initiatives or by advocating at the policy level, offered interesting insights on leadership and policy development.

The Dawn of Consumerism: Key trends and strategies for healthcare consumerism

October 6, 2017  |  David V. Gallegos, SVP, Consulting Services, Change Healthcare Consulting
article
Reducing costs and improving quality are the two prevailing objectives behind most healthcare initiatives. However, one leg of the proverbial stool that doesn’t get much attention are the efforts to improve the patient experience. Healthcare in the United...

Is Our Health System Limping Along or in the ICU?

September 29, 2017  |  David Raths
commentary
Debate premise: Is the U.S. healthcare system like a patient in the intensive care unit battling sepsis? Or is it more like someone in a skilled nursing facility recovering from a stroke?

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