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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.

CMS’ MSSP Proposed Changes Slammed by Leading ACO Organization

August 10, 2018  |  Rajiv Leventhal
article
The National Association of ACOs called CMS’ proposals to redo the MSSP “misguided,” noting that the changes, if finalized, “will upend the ACO movement by creating havoc with a significant overhaul introducing many untested and troubling policies.”

BREAKING: CMS Proposes Sweeping Changes to MSSP ACO Program

August 9, 2018  |  Rajiv Leventhal and Heather Landi
article
The Centers for Medicare & Medicaid Services (CMS) is proposing a new direction for ACOs (accountable care organizations) in the Medicare Shared Savings Program (MSSP), with the goal to push these organizations into two-sided risk models.

A Pioneering M.D. Leader Shares Insights on Successfully Navigating the Massachusetts Healthcare Market

August 9, 2018  |  Rajiv Leventhal
article
At the Boston Health IT Summit, the veteran healthcare expert dropped in to give attendees an inside look at how her organization has achieved value-based care success

BREAKING: CMS Finalizes “Promoting Interoperability” Rule

August 2, 2018  |  Rajiv Leventhal
article
Just three months after issuing a proposal, the Centers for Medicare & Medicaid Services (CMS) has finalized a rule late this afternoon that will overhaul the meaningful use program with a core emphasis on advancing health data exchange among providers.

Virginia Launches Program to Connect All EDs Across the State

August 1, 2018  |  Heather Landi
news
The state of Virginia launched the Virginia Emergency Department Care Coordination (EDCC) Program, a single, statewide technology solution connecting all hospital emergency departments in the Commonwealth.

At BIDCO, a “Pharmacy First” Approach to Population Health is Driving Promising Results

July 31, 2018  |  Heather Landi
article
Leaders at Beth Israel Deaconess Care Organization deployed a unique “pharmacy first” approach specifically to its Rising Risk Management program with the aim of achieving improved health outcomes in months, not years.

In Virginia, Centra Health Surges Ahead in its IT-Based Push to Value

July 25, 2018  |  Rajiv Leventhal
article
Two of the health system’s executive leaders recently spoke with Healthcare Informatics about Centra Health’s value-based care journey and how IT is playing a key role.

HSX, Food Alliance Partnership Extends Data-Sharing to Food, Nutrition

July 24, 2018  |  Heather Landi
news
The Philadelphia-based Metropolitan Area Neighborhood Nutrition Alliance (MANNA) has become a participating member of HealthShare Exchange (HSX), which enables the food alliance to receive important medical updates from HSX on its clients.

Adam Boehler Tapped by Azar to Serve as Senior Value-Based Care Advisor

July 19, 2018  |  Rajiv Leventhal
news
Adam Boehler, currently director of CMMI, has also been named the senior advisor for value-based transformation and innovation, HHS Secretary Alex Azar announced.

Has the Value-Based Care Train Stalled?

July 19, 2018  |  Rajiv Leventhal
commentary
When pondering the question of if the value-based care train has stalled, the answer will depend on which side of the healthcare stakeholder table you are asking—payers or providers.

In Holston Medical Group’s March to Value, an HIE Proves Mission Critical

July 18, 2018  |  Rajiv Leventhal
article
HIEs have been brought into the healthcare ecosystem to connect providers, improve workflow and coordinate care with others, in real-time. But HIEs are also serving as a critical component in the industry’s value-based care shift.

Healthcare Leaders React to CMS’ 2019 QPP Proposed Rule and E&M Coding Changes

July 18, 2018  |  Heather Landi
article
Some health IT industry groups have voiced concerns that the CMS proposals, specifically in its proposed rule for the third year of the Quality Payment Program, will undermine efforts to move Medicare provider payment to value.

Value-Based Care Shift Has Halted, Study Finds

July 17, 2018  |  Rajiv Leventhal
news
A new study of 451 physicians and health plan executives suggests that progress toward value-based care has stalled. In fact, it may have even taken a step backward over the past year, the research revealed.

Telehealth Advocates Respond to CMS ‘Virtual Visit’ Proposal

July 16, 2018  |  David Raths
article
Telehealth advocates applaud a CMS proposal to pay for brief e-visits, but they ask whether providers are going to determine it is worth it to invest in telehealth systems.

PODCAST: Policy Experts Dissect CMS’ “Modernizing Medicare” Proposed Rule

July 16, 2018  |  Rajiv Leventhal
article
Jeff Smith, vice president of public policy at AMIA, and Tom Lee, Ph.D., CEO and founder of Chicago based SA Ignite, a company that helps healthcare organizations with value-based reporting, weigh in on the different components of CMS' proposed rule

BREAKING: CMS Proposes Dramatic Changes with Aim to “Modernize Medicare and Restore Doctor-Patient Relationships”

July 12, 2018  |  Rajiv Leventhal
article
CMS today proposed changes that the agency believes will “fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to use their EHRs to document clinically meaningful information.”

Analysis: Many States Continue to Have Restrictive Telemedicine Policies

July 11, 2018  |  Heather Landi
news
State Medicaid programs are evolving to accelerate the adoption of telemedicine models, this evolution is occurring more quickly in some states than others, according to a recent analysis by Manatt Health.

New Research Reveals MIPS Confusion Among Physicians

July 10, 2018  |  Rajiv Leventhal
article
A survey of internal medicine physicians has revealed low levels of familiarity with the Merit-based Incentive Payment System (MIPS), with some respondents also believing that MIPS requirements could lead to unintended consequences.

CMS Approves California’s $40M Health IT Plan for EMS

July 9, 2018  |  Heather Landi
news
The Centers for Medicare & Medicaid Services (CMS) has signed off on California’s Health Information Technology (HIT) for Emergency Medical Services (EMS) proposal for $40 million through September 30, 2021, according to the California Emergency Medical...

Making Inroads into Telehealth: How One “Sub-Sector” of Healthcare Continues to Evolve (Part 2)

July 9, 2018  |  Rajiv Leventhal
article
A longtime healthcare executive touches on how recent legislations could impact the telehealth sector, how providers and payers are feeling about telehealth today, all while offering predictions for the future.

NCQA Updates HEDIS Quality Measures, New Measure Addresses Opioid Use

July 3, 2018  |  Heather Landi
news
The National Committee for Quality Assurance (NCQA) released new technical specifications for the Healthcare Effectiveness Data and Information Set (HEDIS), for 2019, including four new measures.

How Academic Researchers Are Helping North Carolina Create an Opioid Analytics Roadmap

July 3, 2018  |  David Raths
article
Chief Data Officer Aaron McKethan describes how the State of North Carolina enlisted the support of 70 experts, including researchers from Duke, the University of North Carolina, SAS and research firm RTI to identify questions that need to be answered.

CMS Offers Demonstration to Waive MIPS Requirements for Some Clinicians

July 2, 2018  |  Rajiv Leventhal
news
CMS is advancing the Medicare Advantage Qualifying Payment Arrangement Incentive Demonstration, which, when approved and adopted, would waive Merit-Based Incentive Payment System (MIPS) requirements for some clinicians.

Geisinger Becomes the Latest to Join AVIA Innovator Network

June 29, 2018  |  Rajiv Leventhal
news
Geisinger, the Danville, Pa.-based health system, has become the latest member of the AVIA Innovator Network, a network of health systems working together to innovate and transform.

National Governors Association Sponsors State Health Data Initiatives

June 29, 2018  |  David Raths
news
With funding assistance from the Robert Wood Johnson Foundation, the National Governors Association recently announced three new health policy initiatives today to assist states in modernizing state data systems, improving the health of children and families and...

Rule Roundup: Health IT Groups Respond to CMS’ Promoting Interoperability Proposal

June 27, 2018  |  Rajiv Leventhal
article
Health IT associations have sent in their public comments on CMS' meaningful use rebranding proposed rule, with a key focus of the remarks centering around the government’s proposal to consider interoperability as a condition of Medicare participation.

Analysis: Early Years of VBP Models Show Limited Impact on Reducing Cost of Care

June 25, 2018  |  Heather Landi
news
The penetration of population-based value-based payment models is not yet having an impact on curbing growth in total cost of care, according to a new analysis by the Healthcare Financial Management Association (HFMA), Leavitt Partners and McManis Consulting.

CMS to Host Blue Button 2.0 Developer Conference

June 22, 2018  |  David Raths
news
The Centers for Medicare & Medicaid Services will host the first Blue Button 2.0 Developer Conference at the General Services Administration national headquarters in Washington, D.C., on Monday, Aug. 13, 2018.

In Arizona, the Ambition of “True Care Coordination” is Being Realized

June 20, 2018  |  Rajiv Leventhal
article
Phoenix-based Equality Health was formed with the goal to look at addressing healthcare outcomes disparities through the lens of culture. A population health management platform is helping to accomplish that.

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