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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.

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.

UC Davis Health’s Physician-Specific Approach to Addressing Burnout

October 16, 2018  |  Rajiv Leventhal, Managing Editor
article
In Sacramento, clinical and IT leaders at the University of California, Davis (UC Davis) Health have been eager to develop and roll-out a program to improve physician efficiency levels within the EHR.

Nemours Children’s Health’s New CEO: “The Most Exciting Time in Healthcare”

October 12, 2018  |  Mark Hagland
article
R. Lawrence Moss, M.D., who joined Nemours Children’s Health as CEO on Oct. 1, discusses the challenges and opportunities facing children’s hospitals and healthcare in the current environment

Heritage Medical Systems’ Voyage to Value—and How Physicians are Leading the Way

October 11, 2018  |  Rajiv Leventhal, Managing Editor
article
Mark Wagar, president of Heritage Physician Organizations, recently spoke with Healthcare Informatics about his organization’s value-based care journey, its ACO progress, and how physician culture can be changed.

Are Disruptive Forces in U.S. Healthcare Accelerating Now? Notes on the Now-Approved CVS-Aetna Deal

October 10, 2018  |  Mark Hagland
commentary
The Department of Justice’s approval Wednesday of the CVS-Aetna merger signals a new phase in the healthcare business world—and it’s time for patient care executives to rethink the meaning of competition—and of market disruption

DOJ Approves CVS-Aetna $69B Merger, On Condition Aetna Divest Part D Business

October 10, 2018  |  Heather Landi, Associate Editor
article
The Justice Department has approved a $69 billion merger between mega-pharmacy retailer CVS Health and health insurer Aetna, on condition that Aetna divest is Medicare Part D prescription drug plan business.

CMS Announces 1,300 Participants for New BPCI Advanced Initiative

October 10, 2018  |  Rajiv Leventhal, Managing Editor
article
CMS has announced that nearly 1,300 hospitals and physician group practices have signed agreements with the federal agency to participate in the Administration’s BPCI Advanced model.

MGMA Survey: Medical Group Practices Cite Increased Burden from Regulatory Demands, EHRs

October 4, 2018  |  Rajiv Leventhal, Managing Editor
news
Nearly nine in 10 medical group practice leaders have said that the overall regulatory burden on their organization has increased over the past year, according to a new survey from the MGMA.

Healthcare Executives Rank Data Analytics, Population Health as Top Challenges for 2019

October 3, 2018  |  Heather Landi, Associate Editor
news
Healthcare executive leaders identified leveraging data, particularly clinical data, to manage patients’ health, population health services and value-based payments as the top challenges they will face in the coming year, according to a survey by the Healthcare...

Managing the Consumer Data Deluge

October 2, 2018  |  Joe Marion, Industry Voice
commentary
In-home monitoring and diagnostic devices are likely to create substantial new diagnostic data to manage

On the Road to Risk, Summit Medical Group is Driving in the Fast Lane

October 2, 2018  |  Rajiv Leventhal, Managing Editor
article
In a recent interview with Healthcare Informatics, Jeffrey Le Benger, M.D., outlined the progress and evolution of his organization and how it’s continuing to plunge ahead into the world of risk and value-based care.

At the Raleigh HIT Summit, Mission Health’s CQO Shares About the Quality Journey

October 2, 2018  |  Mark Hagland
article
At the Health IT Summit in Raleigh, Mission Health CQO Chris DeRienzo, M.D. discussed the challenges—and the accomplishments—in his organization’s continuous performance improvement journey

Survey: EHRs, Value-Based Care Causing Docs to Sour on Profession

October 1, 2018  |  Rajiv Leventhal, Managing Editor
news
Seven out of 10 physicians are unwilling to recommend their chosen profession to their children or other family members, with frustrations over EHRs and value-based care ranking as key reasons why.

What to Expect Next from CMS Regarding the Proposed ACO Rule

October 1, 2018  |  Lynn Barr, Industry Voice, CEO and Founder, Caravan Health
article
In the accountable care community, we’re all anticipating the potential impacts of the recently proposed Medicare Shared Savings Program (MSSP) ACO (accountable care organization) rule.

Climbing Up the Risk Ladder: How National ACO Has Built a Winning Value-Based Care Infrastructure

September 27, 2018  |  Rajiv Leventhal, Managing Editor
article
National ACO—headquartered in Beverly Hills, Calif., but with providers in multiple states—has progressed through the federal ACO ranks in a way that could set the path for others

Premier Inc. Executives: Time to Unpack Some of the Challenges and Opportunities Inherent in the Path Into Risk

September 24, 2018  |  Mark Hagland
article
Shawn Griffin, M.D. and Steve Valentine of Premier Inc. discuss the challenges involved in the path into risk-based contracting, and the potential upending of the landscape by new disruptors

Is the Discourse Over the MSSP Program Teetering Towards Potential Conflict?

September 21, 2018  |  Mark Hagland, Editor-in-Chief
commentary
The joint statement by nine associations challenging CMS Administrator Seema Verma around her plans to insert more rigor into the MSSP program, feels like a teeter-totter moment for CMS

NAACOS, AMA, Others Urge CMS to Reconsider MSSP Proposed Changes

September 21, 2018  |  Rajiv Leventhal, Managing Editor
news
NAACOS and eight other healthcare stakeholder groups have sent a letter to CMS, expressing concerns about the federal agency’s proposed changes to the Medicare Shared Savings Program.

Town Hall Ventures Close First Fund at $115 Million

September 20, 2018  |  David Raths, Contributing Editor
news
Town Hall Ventures, an investment firm built to address the healthcare challenges of the most vulnerable Americans, has closed its first fund at $115 million.

Survey: Physicians Sour on Value-Based Care Metrics, EHRs

September 19, 2018  |  Rajiv Leventhal, Managing Editor
news
More than 50 percent of U.S. physicians who receive value-based care compensation said they do not believe that the metrics the reimbursement is tied to improve the quality of care or reduce costs, according to a new survey.

The CEO of a Nationwide Association of MD Groups Sees the Future—and It’s Not in Fee-For-Service

September 18, 2018  |  Mark Hagland
article
Don Crane, CEO of APG, a nationwide association of medical groups working in risk-based contracting, shares his perspectives on the future of medical groups in a shifting landscape

On Staten Island, a Highly Innovative Program That's Redefining What’s Possible Under Medicaid

September 17, 2018  |  Mark Hagland, Editor-in-Chief
article
Healthcare leaders on New York City's Staten Island have been achieving exciting success in population health management in their community’s Medicaid and uninsured populations

On Capitol Hill, Healthcare Leaders Raise Concerns with CMS’ Proposed ACO Rule

September 17, 2018  |  Heather Landi, Associate Editor
article
During a House subcommittee hearing, healthcare leaders voiced concerns that CMS' proposed changes to the MSSP ACO program will impede progress in the transition to value-based care.

Humana’s CMO Speaks of the “Bold Goal” Embedded in the Company's Population Health Work

September 14, 2018  |  Heather Landi, Associate Editor
article
Roy Beveridge, M.D., Humana’s chief medical officer, shares his perspectives on the drive to value-based care, population health and addressing social determinants of health.

The Shock of the New: The Paris Art World of 1916—and the U.S. Healthcare Landscape of 2018

September 13, 2018  |  Mark Hagland, Editor-in-Chief
commentary
What does a revolution in art from a century ago say about the present moment in U.S. healthcare?

Check and Checkmate: Is the Debate Around the MSSP ACO Program About to Get Super-Heated?

September 12, 2018  |  Mark Hagland
commentary
The publication this week in Health Affairs of a study sponsored by NAACOS that implicitly denounces CMS’s method for calculating the success of MSSP ACOs, is a fascinating move in a chess game playing out on multiple policy levels

New Healthcare Alliance Launches APM for Addiction Recovery

September 12, 2018  |  Rajiv Leventhal, Managing Editor
news
A national multi-sector alliance of healthcare stakeholders has announced the creation of the Addiction Recovery Medical Home (ARMH) model.

The Ongoing Exploration for Artificial Intelligence’s Best Use in Healthcare: One Expert’s Viewpoint

September 12, 2018  |  Rajiv Leventhal, Managing Editor
article
One of the biggest “buzz terms” in healthcare and health IT is undoubtedly artificial intelligence, or AI, but there are still plenty of questions and debate on how AI can best be leveraged to lower costs.

In South Los Angeles, a High-Tech Hospital Delivers Healthcare to an Underserved Community

September 11, 2018  |  Heather Landi, Associate Editor
article
Executive leaders at Martin Luther King, Jr. Community Hospital discuss the organization's journey to achieve HIMSS Analytics Stage 7 and meeting the healthcare needs of an underserved community.

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