Payers are stretched to the breaking point trying to manage the onslaught of substance use disorder cases. It’s more important than ever to acquire accurate data to help payers and policy makers establish effective and long-lasting opioid crisis measures.
The shift to accountable care and value based payment models is coming. Accountable Care Organizations (ACOs) are just one of the value-based models making waves throughout the healthcare industry. Based on current growth trends it is predicted by 2020 approximately 70 million people will be covered by ACOs. Focusing on shared accountability and quality improvement, ACOs have become champions of the healthcare triple aim. Not to mention a major player in CMS’ plan to tie a large percentage of payments to value by 2017. As ACOs soar in popularity now is the time to weigh your options. Are you are thinking or making the transition to an ACO? What are the benefits
Managed Care Organizations (MCOs) utilize an array of important techniques to decrease the cost of care. Transitioning to an MCO, the case study outlined here makes significant...
Utilization management (UM) is crucial facet of the healthcare ecosystem. It ensures that healthcare systems are running efficiently and providing a standard level of care. Overall, utilization management is critical for ensuring that an organization is not only reducing denied claims, but catering to patients’ preferences and providing proper care.
The healthcare industry is rapidly growing: With innovations in medical tools and new successful procedures performed annually, there is no shortage of change. Just as vital to the industry are solutions that help manage the information of the millions of patients who visit each year. To keep up with the demand and to facilitate the process, adjusting healthcare information management practices is a necessity. Here are three trends that are being implemented.
BHM's webclinic “Components of a Great Peer Review Program” goes live Wednesday, November 18th from 12:00pm to 1:00pm EST. You don't want to miss this great opportunity to receive expert advice related to Peer Review Services. Don't worry you still have time to sign up!
Revenue cycle management (RCM) is incredibly important to a practice’s profitability. Without the ability to streamline the billing and collections processes, a medical enterprise will find it challenging to stay afloat. Managing your practice’s revenue cycle requires you and your staff to take an honest look at your current workflow to determine what’s working and what isn’t. Here are some things to focus on:
The NCQA's Patient Centered Medical Home program has been running since 2008 but over the past few years it has gone through some substantial revisions. Now the NCQA is asking for people in field, both who are providing care and receiving care, to help make the PCMH program the best it can be. Here are the basics you need to know:
Specialty pharmacy is a growing industry and with many pharmacies moving toward accreditation, the process can get overwhelming. The following infographic will review some basics of the new CPPA Specialty Pharmacy Accreditation.