Preparing for 2027: Driving health equity with inclusive member education
Sponsored by
Wolters Kluwer
November 7, 2024
For payers and care management teams looking to gain or maintain STARS ratings or HEDIS scores, focusing on the upcoming changes from the Centers for Medicare and Medicaid Services (CMS) Health Equity Index is of vital importance.
Ensuring members receive quality care and service experiences that consider health equity factors can not only improve member outcomes and help maintain or increase Stars ratings, but can also create more effective programs with the opportunity to expand Medicare Advantage (MA) programs. Partnering with members will be key to understanding their needs, both individually and as a population, and to meet these expectations.
Navigating the RCM Challenge: How Physician Practices Can Thrive in a Complex Financial Landscape
Sponsored by
Coronis Health
November 6, 2024
In today’s challenging healthcare environment, physician practices face increasingly complex revenue cycle management (RCM) demands. “Navigating the RCM Challenge,” by Patrick D. Free of Coronis Health, outlines how specialized RCM partnerships can help practices streamline operations, optimize revenue, and enhance patient experiences. This article is essential for practices aiming to thrive financially while delivering high-quality patient care.
Key Takeaways:
Specialty-Specific Coding Precision: Partnering with RCM experts helps minimize costly errors, recover lost revenue, and maintain compliance.
Streamlined Operations and Technology Use: Efficient RCM processes lead to faster claims, reduced denials, and better cash flow.
Transparency for Patient Trust: Clear billing fosters patient loyalty and reduces billing disputes, enhancing the patient experience.
Download the article to explore practical strategies for navigating RCM complexities and achieving sustainable growth.
Benefits of Better BP Measurement: Steps to Help Ensure Consistent and Accurate BP Readings
Sponsored by
Midmark
November 6, 2024
Value for Patients, Providers and Healthcare Systems
Blood pressure (BP) measurement has perhaps the most clinically significant connection to point-of-care diagnosis, patient risk stratification, and proper medication dosing. These important factors of care management are essential to proper diagnostic and therapeutic decision-making tied to better outcomes.
This white paper identifies some of the steps providers and healthcare systems can take to help ensure consistent and accurate BP readings and some of the more important benefits providers and patients may realize.
Boosting Diagnostic Accuracy and Operational Efficiency with Butterfly Network’s Enterprise Ultrasound Solution
Sponsored by
Butterfly
October 30, 2024
The clinical and economic value of point-of-care ultrasound (POCUS) is well-documented, with numerous studies showcasing its impact on improving clinical outcomes, enhancing efficiency, and driving cost savings. The benefit of POCUS to modern medicine is no longer a hypothesis—care improves when POCUS is used.
Across the nation, medical schools and residency programs have acknowledged the importance of POCUS, embedding it as a vital element in their training curricula. This movement reflects the strong consensus and extensive evidence that POCUS is now a fundamental tool in modern medical practice, making clinician training and adoption essential. However, challenges such as cost, limited device availability, integration infrastructure, and governance have impeded broader adoption.
In early 2021, the University of Rochester Medical Center partnered with Butterfly Network to deploy a system-wide ultrasound program aimed at improving patients’ access to imaging, streamlining physician workflows, and optimizing revenue capture. This case study describes the implemntation and demonstrates that deploying affordable, portable POCUS devices like Butterfly, combined with integrated, device-agnostic software, is both practical and cost-effective. At a time when healthcare margins are thin and efficient care models are essential, URMC has harnessed the power of POCUS to effectively meet these challenges. Read more on their approach, which serves as a compelling blueprint for other institutions to follow, ushering in a new era where the promise of POCUS is fully realized across all specialties and care settings.
The APIs Are the Easy Part: Maximizing Your ROI while Meeting CMS Interoperability and Prior Authorization Requirementsy
Sponsored by
InterSystems
October 15, 2024
Health plans should be able to harness the investment in IT infrastructure mandated by the latest CMS rule on interoperability and prior authorization to create the data liquidity needed drive top strategic goals, such as reducing provider abrasion, improving member experience, increasing productivity, and supporting value-based care. The scope of CMS-0057-F, however, is wide ranging.
This white paper:
Summarizes new requirements for the four types of information sharing addressed, namely payer-to-payer, payer-to-provider, payer-to-member, and prior authorization submission and determination.
Analyzes processes and workflows impacted by the regulation and resulting opportunities for performance improvement.
Provides key “Questions to Consider” that should inform plan investment decisions.
Designed to be shared with IT, clinical, and operational leaders, the paper will help your leadership team achieve larger strategic returns on mandated plan investment while meeting regulatory requirements.
The latest report from Vizient on "Overcoming Capacity Constraints: Top Healthcare Leaders Share Their Strategies" explores the critical challenges healthcare systems face due to capacity constraints. These challenges are driven by factors such as tight financial margins, an aging population, a shrinking healthcare workforce and the closure of hospitals, which collectively increase the burden on emergency departments and inpatient care facilities.
You'll get expert advice from leaders at five well-known healthcare companies: Froedtert ThedaCare Health, Memorial Hermann Health System, NYU Langone, Sanford Health and UC San Diego Health. These leaders share their strategies for addressing these constraints, which include the adoption of advanced data analytics to enhance care delivery, strategic workforce management and the redesign of care delivery models to better meet patient needs.
For example, UC San Diego Health has introduced a geriatric-specific emergency department to cater to the unique needs of older patients. Similarly, Sanford Health has expanded its use of virtual care technologies to serve patients in rural areas more effectively. Another significant strategy discussed is the use of predictive analytics by Memorial Hermann Health System to identify high-risk areas for patient readmissions and to deploy targeted interventions to mitigate these risks.
This report also highlights the importance of addressing social determinants of health (SDOH) to tackle capacity issues more comprehensively. By focusing on these broader social factors, healthcare providers can implement more targeted and effective strategies to improve patient outcomes and manage capacity more efficiently.
This report underscores the need for proactive and data-driven approaches by healthcare leaders to navigate the complexities of capacity constraints and maintain high standards of patient care in a competitive healthcare environment.