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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.

When It Comes to The Big Debate on ACOs, What Is “Big Enough” Savings?

December 12, 2018  |  Mark Hagland, Editor-in-Chief
commentary
The back-and-forth interaction between CMS Administrator Seema Verma and the ACO community is unfolding in a fascinating, if unpredictable way, at a key inflection point in the evolution of the MSSP program

Who Isn’t Using Patient Portals? New Study Sheds Light on Portal Use

December 12, 2018  |  Heather Landi, Associate Editor
news
About two-thirds of adult patients did not use an online patient portal in 2017, and research indicates vulnerable and disadvantaged patients are less likely to use these technology tools, according to a study published in the November issue of Health Affairs.

Becoming a Data-Driven Ecosystem: How San Diego County is Moving the Needle

December 11, 2018  |  Rajiv Leventhal, Managing Editor
article
San Diego County health officials detail the region’s care environment as it exists today, and how data sharing and collaboration will be critical elements in evolving toward a healthier future

Medicaid Transformation Project Expands to 24 Health Systems

December 6, 2018  |  Heather Landi, Associate Editor
news
Seven new health systems have joined the Medicaid Transformation Project, a national effort to transform healthcare and related social needs for the nearly 75 million Americans who rely on Medicaid.

Can Telehealth Slow the Traffic Between Nursing Homes, Emergency Departments?

December 6, 2018  |  David Raths
commentary
There are 1.3 million transfers from skilled nursing facilities to emergency rooms each year, and CMS estimates that two-thirds of those are avoidable. Could telehealth be part of the solution?

Intermountain CMIO Stan Huff on the Need for Greater Interoperability: “We’re Killing Too Many People”

December 6, 2018  |  Rajiv Leventhal, Managing Editor
article
Longtime Intermountain CMIO Stan Huff, M.D., recently chatted with Healthcare Informatics about all things interoperability, including the different types of data exchange that exist today, the greatest barriers, and pending regulations.

Telehealth, Interoperability Recommendations Outlined in Administration’s Health Reform Report

December 5, 2018  |  Rajiv Leventhal, Managing Editor
news
Various health IT recommendations related to telehealth and interoperability were made on the part of the Trump administration as part of its report on reforming the nation's healthcare delivery system.

EXCLUSIVE: NAACOS President Foresees “Shrinkage in Accountable Care Movement” Pending MSSP Final Rule

December 5, 2018  |  Rajiv Leventhal, Managing Editor
article
Clif Gaus, NAACOS president and CEO, speaks out on a few key problems that his organization, and others, have with CMS’ proposed changes to the MSSP.

HHS Issues Comprehensive Draft Report with Eyes on Reducing Health IT Burden

November 28, 2018  |  Rajiv Leventhal, Managing Editor
article
HHS has issued a federal draft strategy designed to help reduce administrative and regulatory burden on clinicians caused by technology such as electronic health records.

Meaningful Use of EHRs Leads to Earlier Patient Discharge, Study Finds

November 27, 2018  |  Rajiv Leventhal, Managing Editor
news
In patient care facilities that meet the highest federal standards for implementing EHRs (electronic health records), greater savings were achieved by reducing the average length of patient stays

Recent Humana Report Points to Encouraging Progress in the Shift to Value-Based Care

November 26, 2018  |  Heather Landi, Associate Editor
article
A recent study from Humana reports ongoing progress in improving health outcomes and lowering costs among patients treated by physicians in Humana Medicare Advantage value-based agreements.

At the D.C. Department of Health Care Finance, Digging into Data Issues to Collaborate Across Healthcare

November 22, 2018  |  Mark Hagland, Editor-in-Chief
article
Kerda DeHaan and her colleagues at the D.C. Department of Health Care Finance are tackling granular data management issues to expand their collaboration with health plans and providers

How Virtual Care is Improving Access and Affordability of Healthcare

November 20, 2018  |  Lee Horner, CEO of Synzi, Industry Voice
article
Recent CMS developments to expand virtual care access and reimbursement will help chronic care patients remain at home as they participate in the ongoing care needed to manage their conditions.

The 2019 Healthcare Informatics Innovator Awards Program is Open

November 15, 2018  |  the Editors of Healthcare Informatics
article
The 2019 Healthcare Informatics Innovator Awards Program is now open for submissions. As always, it’s a great privilege and pleasure for us to sponsor this program.

Olympic Marathons: Performance Improvement Initiatives Help to Power the Long Race

November 14, 2018  |  Mark Hagland, Editor-in-Chief
article
At a time when providers are being pushed to rework patient care delivery to deliver value, formal performance improvement initiatives are helping to achieve clinical and operational transformation.

At the Beverly Hills HIT Summit, APG’s Crane Offers a Vision of the Future of Medical Care

November 11, 2018  |  Mark Hagland, Editor-in-Chief
article
Don Crane, CEO of APG, a nationwide association of physician groups involved in risk-based contracting, offered HIT Summit attendees a vision of a coordinated care-based future

CMS: 93% of Clinicians Get Positive Payment Adjustments for MIPS Year 1

November 8, 2018  |  Rajiv Leventhal, Managing Editor
news
Ninety-three percent of MIPS-eligible clinicians received a positive payment adjustment for their performance in 2017, and 95 percent overall avoided a negative payment adjustment.

HHS Secretary Azar: HHS Is Planning New Mandatory Bundled Payment Models

November 8, 2018  |  Heather Landi, Associate Editor
news
CMS is revisiting mandatory bundled payment models, possibly for radiation oncology and cardiac care, according to Health and Human Services Secretary Alex Azar, which signals a strategic change in the Trump Administration’s policy about bundled payment...

The Key to Clinical and Financial Success? Atrius Health President Gives Out His Recipe

November 8, 2018  |  Rajiv Leventhal, Managing Editor
article
Atrius Health’s president and CEO, Steven Strongwater, M.D., discusses the organization’s population health initiatives that have led to strong clinical and financial performances.

Dr. Sanjay Gupta’s Heartening Speech at CHIME18 Should Inspire U.S. Healthcare Leaders

November 6, 2018  |  Rajiv Leventhal, Managing Editor
commentary
Perhaps we can use the story of the Tsimane tribe to push ourselves to develop a greater understanding of why we spend so much money on healthcare and don’t have the results to show for it.

Healthcare Leaders Praise Telehealth Advancements, Delayed E&M Coding Changes in Recent CMS Rule

November 5, 2018  |  Heather Landi, Associate Editor
article
Starting in 2019, for the first time, CMS will reimburse providers for virtual check-ins with patients, regardless of the patient’s location—a move that drew praise from many healthcare leaders.

BREAKING: CMS Publishes CY 2019 Physician Fee Schedule/QPP Final Rule

November 1, 2018  |  Heather Landi, Associate Editor
article
Late in the afternoon on Thursday, Nov. 1, CMS published the Physician Fee Schedule and Quality Payment Program final rule for 2019, which encapsulates the MIPS and Advanced Payment Models.

HIT Policy Winds Get Stronger as CMS, ONC Regulations Set to Drop Any Day

November 1, 2018  |  Rajiv Leventhal, Managing Editor
article
The calendar has now turned to November as health IT stakeholders continue to anxiously await regulations from federal health agencies, some of which are sure to come in the next 60 days.

Medi-Cal Telehealth Proposal Called ‘Remarkable Step Forward’

October 30, 2018  |  David Raths, Contributing Editor
news
The California Department of Health Care Services (DHCS) is proposing significant changes to its telehealth policy in the state’s Medicaid program known as Medi-Cal.

CMS Proposes to Expand Telehealth Benefits Under Medicare Advantage Plans

October 29, 2018  |  Rajiv Leventhal, Managing Editor
news
CMS is proposing to implement several sections of the Bipartisan Budget Act of 2018, including expanding telehealth benefits under Medicare Advantage plans.

Report: Complex and Rapidly Changing Payment Models Challenge Physician Practices

October 26, 2018  |  Heather Landi, Associate Editor
news
Physician payment models are becoming more complex and the pace of change is increasing, creating challenges for physician practices that might hamper their ability to improve the quality and efficiency of care despite their willingness to change, according to a...

Lawmakers Urge CMS to Modify Final Medicare ACO Regulation

October 24, 2018  |  Heather Landi, Associate Editor
news
bipartisan group of nine lawmakers today sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma asking for two key changes to the agency’s recently proposed rule that would reform the Medicare Shared Savings Program (MSSP...

Report: 34 Percent of Healthcare Payments in 2017 Tied to APMs

October 22, 2018  |  Heather Landi, Associate Editor
news
One-third (34 percent) of total U.S. health care payments were tied to alternative payment models (APMs), such as shared savings/risk arrangements, bundled payments, or population-based reimbursements, in 2017, up from 23 percent in 2015, according to a report...

Healthcare Groups to CMS: ACOs Need More Time in One-Sided Risk Models

October 17, 2018  |  Rajiv Leventhal, Managing Editor
article
Healthcare associations have written to CMS, urging the agency to reconsider its proposed regulation that would push ACOs more quickly into two-sided risk models.

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