Actionable Content: A Framework For Better Decision Making

Actionable Content: A Framework for Better Decision Making

  • December 20, 2017

By Nilo Mehrabian and Steve Silverstein Driven by healthcare reform and other changing market dynamics, stakeholders are at last getting down to the business of effecting true transformation. Actionable content—usable information that is understood, adopted, and embedded into workflow—is a critical tool to enable that change. Clinical information or content brings consistency, collaboration, efficiency, and quality to both the delivery of healthcare services and the business of healthcare. In its fully realized form, content is truly intelligent or “actionable.” In other words, it recognizes the context in which it is invoked and automatically delivers specific and relevant guidance to the…

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The Risks Of Rising Self-Pay And 10 Ways To Keep Your Hospital Safe

The Risks of Rising Self-Pay and 10 Ways to Keep Your Hospital Safe

  • December 15, 2017

Patients are struggling to meet their financial responsibilities, and putting providers at risk, as employers increasingly move to consumer-directed health plans. But at HealthLeaders Media, Ken Carr, Change Healthcare VP of Revenue Cycle Management, provides practical ideas that can help providers boost self-pay collections. Read the article

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10 Ways To Offset The Self-Pay Cycle

10 Ways to Offset the Self-Pay Cycle

  • November 13, 2017

As more employers shift to consumer-directed health plans, many patients are challenged to meet their financial responsibilities. But in a feature on Healthcare Finance, Ken Carr, VP of Revenue Cycle Management at Change Healthcare, offers up suggestions on how to improve self-pay collection and communication. Read the article

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The Engagement Gap: Healthcare Consumer Engagement In 2017

The Engagement Gap: Healthcare Consumer Engagement in 2017

  • October 4, 2017

Investment in consumer engagement is a top priority for payers and providers, and value-based care is the main driver. But the majority of consumers say their experience with providers and health plans hasn’t improved--or has even gotten worse in the past 24 months. Plus, consumer engagement is hampered by a “millennial gap” that shows older patients aren’t getting the attention they need to benefit from consumerization strategies. These are just some of the findings from The Engagement Gap: Healthcare Consumer Engagement in 2017, a new study of the state of consumer engagement in healthcare conducted by ORC International and commissioned by…

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Reinventing Claims Payment For A Value-Based World

Reinventing Claims Payment for a Value-Based World

  • June 6, 2017

By Amy Larsson RN, BSN, MBA The U.S. healthcare industry’s claims-payment system is frustrating to providers, payers, and patients alike. Inefficiency and a systemwide tendency for error wastes precious resources, worsens miscommunication and mistrust among all stakeholders, and inhibits the ability to transition to value-based approaches that achieve better outcomes. We need to rethink our industry’s disjointed and siloed approach in order to solve a very integrated problem. Despite billions invested in achieving efficient claims payment, more than 7% of claims are not paid correctly the first time, the second time, and sometimes even the third time.¹ The remediation process…

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Reinventing Utilization Management To Bring Value To The Point Of Care

Reinventing Utilization Management to Bring Value to the Point of Care

  • June 6, 2017

How an automated exception-based approach can make UM more efficient and effective By Nilo Mehrabian How can health systems deliver the right care, at the right cost, in the right setting, without overwhelming delivery and reimbursement systems with administrative burden? The shift from volume to value-based care requires the deft combination of value-based delivery (enabled through actionable intelligence and new care delivery models) and value-based payment (enabled through select provider networks and new reimbursement models). Providers and payers must operate across a transparent, administratively simple, shared ecosystem. This giant leap from today’s world in which healthcare stakeholders currently operate might…

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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. 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 costs an average of…

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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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