Blog 2017-04-02T13:27:54+00:00

Challenges of Developing Workers Compensation Treatment Guidelines

By | May 23rd, 2017|Categories: Care Coordination, Trends, Utilization Management|Tags: , , , , |

Workers compensation treatment guidelines can help prevent unnecessary medical procedures and the prescribing of potentially harmful medications. However, they are not all the same, nor are they without challenges. Understanding a jurisdiction's strengths/weaknesses, taking a strategic approach to developing guidelines, and using common sense can lead to better outcomes for injured workers—and, ultimately, lower costs for payers.

Not Waiting For Capitol Hill: Health System Leaders Move Ahead

By | May 23rd, 2017|Categories: Clinical Operations Improvement, Compliance, Financial, Financial Analysis, Governments, Health Care Reform|Tags: , , , , |

Despite industry uncertainty about the fate of healthcare under the new administration and Republican Congress, health system leaders move ahead and are preparing for the future. A recent Premier Inc. survey show the target areas for improvements within their systems. The results signal growth concerns and why the leaders will not wait for Capitol Hill results.

Update: Payer Efforts Against Opioid Epidemic

By | May 23rd, 2017|Categories: Care Coordination, Clinical Analysis, Clinical Operations Improvement|Tags: , , , |

According to the CDC, drug overdoses are the leading cause of accidental death in the United States. Of the overdose deaths that occurred in 2015, 63 percent involved an opioid. Payer options for managing efforts against opioid overuse range from monitoring population data to working with provider networks.

Removing Value-Based Care Barriers

By | May 22nd, 2017|Categories: Financial, Physician Advisor/Peer Review, Services|Tags: , , , |

The promises of value-based payment models came to life within the last 12+ months with results of real world tests. They quickly move to the implementation of useful models and processes. With ramped-up implementations overcoming value-based care barriers step out as real things.

Fight The Health Plan Disconnect To Members

By | May 22nd, 2017|Categories: Healthcare IT, Services|Tags: , , , |

Fighting the health plan disconnect to members and provider networks takes diligence and the basic understanding of customer needs. The technology tools integrated into consumers' everyday lives set a very high expectation for services from their health plans and service providers.

Cyber-attacks Vulnerable Healthcare Industries

By | May 17th, 2017|Categories: Healthcare IT, Services|Tags: , , , |

WannaCry ransomware attack jumped cyber threat levels to new heights. Particularly hard hit were healthcare facilities in the UK. Three news articles summarize the attack and address healthcare industry's vulnerability. The US missed the brunt of the lockdown because of an accident in the form of an entrepreneurial coder inadvertently tripping the "kill switch". Cyber-attacks vulnerable healthcare industries missed the 10 years of preparation.

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