New Version Of Clinical Decision Support Released

New Version of Clinical Decision Support Released

  • April 11, 2017

McKnight's covered the launch of InterQual 2017, the latest version of the evidence-based clinical decision support solution. McKnight's reports this new release includes more than 120 new criteria and enhancements that help enable faster, safer, and better clinical decisions at the point of care. Read the Article  

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How Hospitals Can Use Data Analytics To Improve RCM Performance: 4 Thoughts From Change Healthcare’s Marcy Tatsch

How Hospitals Can Use Data Analytics to Improve RCM Performance: 4 Thoughts from Change Healthcare’s Marcy Tatsch

  • April 4, 2017

Why is data analysis so important for hospitals? To thrive, hospitals need to accelerate reimbursement, remove obstacles to payment, and reduce bad debt -- all of which require harnessing their data for performance improvements. Change Healthcare's Marcy Tatsch explains why data analysis is becoming even more critical as hospitals move to complex value-based reimbursement models. Read the article

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Faster, Simpler, Smarter: InterQual 2017 Streamlines Clinical Care Decisions

Faster, Simpler, Smarter: InterQual 2017 Streamlines Clinical Care Decisions

  • April 3, 2017

Today, we unveiled InterQual 2017, a faster, more streamlined version of our flagship clinical decision support solution. InterQual 2017 introduces a new time-saving product, Medicare Procedures powered by InterQual,  which automates more than 400 Medicare National and Local Coverage Determinations. It also provides a more efficient set of level of care criteria, Initial Review, that supports faster, earlier decisions in the ER. Customers will benefit from a host of new updates, enhancements, and technological advancements, including more than 125 new content areas. Read the news release

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The Perfect Pairing: Patient Access And Analytics

The Perfect Pairing: Patient Access and Analytics

  • March 28, 2017

While more providers are taking advantage of technology to improve front-end revenue cycle processes, analytics lags behind. But when applied to patient access, analytics can help identify issues with registration and eligibility accuracy, and reduce downstream denials. A recent article in Multibriefs outlines the benefits of using analytics to improve patient-access processes in a value-based world. Read the Article

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Rethinking Denials Management

Rethinking Denials Management

  • March 16, 2017

Most organizations take an administrative approach to managing denials. Maybe that’s why they’re not collecting as much as they should. By Carmen Deguzman Sessoms The Denials Challenge Few hospitals would admit to not having a denials management program, and yet as many as one in five claims for services already rendered are denied or delayed.1 Denials erode the provider organization’s bottom line, resulting in the permanent loss of an estimated 3% of net revenue.2 However, it’s not just the cost of the denials themselves, or the revenue lost–3% of the bottom line is significant no matter how it is sliced–it…

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Reinventing Claims Management For The Value-Based Era

Reinventing Claims Management for the Value-Based Era

  • February 17, 2017

Provider claims management as we once knew it is not enough to thrive in a value-based era. Here’s what you need to know about taking claims management to a higher level. By Carmen Deguzman Sessoms Provider claims management can no longer exist as a silo. With the rapid transformation from fee-for-service to value-based models, denial rates remain high–nearly 1 in 5 claims–despite advances in technology and automation.1 The complexity of value-based payment models almost guarantees an increase in denials, simply because there’s so much to get wrong. For provider CFOs and their organizations to be effective–and thrive–in this environment, the…

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Patient Access And Revenue Cycle Analytics–Perfect Together, Yet Often Ignored

Patient Access and Revenue Cycle Analytics–Perfect Together, Yet Often Ignored

  • February 17, 2017

Why bringing analytics into patient access can radically improve a health system’s ability to get under the hood, understand what’s influencing financial performance, and improve the metrics that matter. By Jason Williams Some things go naturally together. Pen and paper. Thunder and lightning. Chocolate and peanut butter. And here’s a surprising one: patient access and revenue cycle analytics. You may have never thought of bringing the last two together, but no one thought of bringing chocolate and peanut butter together until it happened. Well, hospitals can make their revenue cycle much sweeter by applying revenue cycle analytics to improve patient…

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Four Steps To Develop, Implement, And Operationalize A Bundled Payment Strategy

Four Steps to Develop, Implement, and Operationalize a Bundled Payment Strategy

  • February 17, 2017

By Andrei Gonzales, M.D. In the continuing effort to increase quality and decrease costs, health plans and providers are shifting from volume-based care (fee for service) to a value-based reimbursement structure (fee for value). Value-based reimbursement promises benefits to patients, providers, and health plans, as it encourages delivery of high quality care at the lowest cost, largely by improving clinical and administrative efficiency.¹ This paradigm shift to value-based reimbursement creates increasingly complex reimbursement scenarios for health plans. According to a “Journey to Value” study Change Healthcare commissioned, an overwhelming 97% of health plans and 91% of hospitals are now deploying…

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Focus On Details Leads To 60% Fewer Readmissions

Focus on Details Leads to 60% Fewer Readmissions

  • January 24, 2017

By Jennifer VanWinkle, Clinical Product Manager, Change Healthcare As home health nurses, therapists and aides know all too well, caring for patients after they leave the hospital can be incredibly complex. But a program focused on relatively simple things like medication management, nutrition choices and transportation reduced readmissions in a Maryland community by 60%. After being assessed by a nurse practitioner at the University of Maryland St. Joseph Medical Center (UMSJMC), patients enrolled in the program were reassessed by a registered nurse at the home and assigned a community health worker (CHW). Supporting patients with complex conditions After 16 months,…

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Two New Federal Interoperability Rules: What You Need To Know

Two New Federal Interoperability Rules: What You Need to Know

  • January 12, 2017

By Lisa P. Conley, Esq. Payers and providers are increasingly vocal about their need for health information technology (HIT) systems to interoperate in a consistent and industry-wide manner. While the industry has made progress on this front, recent actions in Washington aim to accelerate the pace of progress while also demonstrating the government’s commitment to HIT interoperability. On October 14th, 2016, the federal government announced two final regulations that impact the ongoing transformation to “full interoperability” in healthcare. One regulation was the nearly 2,400-page final rule from the Centers for Medicare and Medicaid Services (CMS) on implementation of the Medicare…

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