Big Data Archives - Page 5 of 9 - BHM Healthcare Solutions - Experts in Healthcare Data Management.

Value-Based Contract Barriers for Innovative Medicines

2017-09-06T18:17:28-04:00By Eric Duchinsky|Big Data, Managed Care, Trends|

The shift under way in payment in US health care - from volume to value - has sparked interest in new contracting arrangements to pay for prescription drugs. The objective of these new arrangements is to reward successful outcomes of medication use in patients, rather than pay based on the volume of drugs sold. Unfortunately, value-based contract barriers stand in the way of one approach to managing drug costs and obtaining better value for money spent. However, achieving the full potential of these contracts will necessitate regulatory and other changes.

Drug-Related Risks and Outcomes: 1st Annual National Report

2017-09-05T18:03:16-04:00By Eric Duchinsky|Big Data, Managed Care, Population Health, Trends, Uncategorized|

The purpose of this first annual surveillance report is to summarize the latest information available on the national level for various drug-related risks and health outcomes, health behaviors, and prescribing patterns related to the drug problem in the United States. The most recent year of information available is different for different outcomes. The emphasis is on national information, but some state information is also presented. This document is intended to serve as a resource for payers, providers, and pharma companies charged with addressing this ongoing national problem. It will be updated annually.

Key Payer Competitive Differentiator: Analytics

2017-08-24T18:37:35-04:00By Eric Duchinsky|Big Data, Financial, Financial Analysis, Physician Advisor/Peer Review, Trends|

Many health plans are facing uncertainties: the changing health insurance landscape, the speed at which value–based care is approaching, and growing demands from customers, to name a few. But one investment may help executives meet each of these challenges—an investment in analytics. Health plans are data rich, yet those data are not always leveraged to understand what happened and why, or predict what is likely to happen. Health plans that don't take advantage of their data may risk being disrupted and left behind. Analytics can be a key payer competitive differentiator setting your organization ahead of the pack.

Margin Defense & Revenue Cycle Management: 8 Challenges

2017-07-04T19:58:23-04:00By Eric Duchinsky|Big Data, Financial Analysis, Health Insurance, Lean Management|

Payers and providers connect, both formally and informally, through the reimbursement process. In past times, the relationships were stormy. Today, market forces push the need for better understanding of margin defense and revenue cycle performance. Streamlining internal operations addresses many of these new market demands. For example, patients demand higher value for care pushing more review of claims which push greater need for consistent documentation.

13 Tips for HEDIS Success

2017-05-11T12:11:22-04:00By Eric Duchinsky|Big Data|

HEDIS is a tool used by 90% of America’s Health Plans to gauge performance on crucial aspects of care and service. By standardizing the way health plans collect, analyze, and report performance information and data, HEDIS creates an equal playing field for all health plans (who use HEDIS) to be compared. The tool is also used by health plans to learn which area they can improve in. On the other end, employers, consultants, and patients use HEDIS data to help them select the best health plan for their needs.

CMS Release Gold Mine of Data for Benchmarking Your Operations

2023-09-08T15:45:10-04:00By Eric Duchinsky|Big Data, Physician Advisor/Peer Review|

The Centers for Medicare & Medicaid Services (CMS) released Part 2 in a set of data that details information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program. The CMS believes that The Part D Prescriber PUF data will provide healthcare professionals with important information to drive change within the industry. “These data enable a wide range of analyses on the type of prescription drugs paid for under the Medicare Part D program, and on prescription drug utilization and spending generally.”

CMS Unlocks Claims Data. Now What?

2023-09-08T15:37:56-04:00By Eric Duchinsky|Big Data, Trends|

The Centers for Medicare & Medicaid Services (CMS) finalized a new rule that gives providers and employers better access to Medicare and private sector claims data. CMS hopes that the improved access will help organizations make more informed decisions about care delivery and quality improvement.

The Opioid Epidemic & the Importance of Data Management

2017-04-02T13:28:05-04:00By Eric Duchinsky|Behavioral Health Integration, Big Data|

In 2014 more than 14,000 people died from prescription opioid overdoses* and the numbers are not decreasing. Prescription Drug Monitoring Programs and the analysis of patient data, are two ways the healthcare industry is fighting the opioid epidemic.

CMS Updates Data Initiatives to Increase Access & Transparency

2023-09-08T14:50:16-04:00By Eric Duchinsky|Big Data|

The Centers for Medicare & Medicare Services (CMS) values data. And with the update of their data initiatives, it will now be more transparent and easier to access. Your organization will now be able to benchmark against some of the biggest health systems in the country. Data is crucial for measuring costs, services and trends, especially when it comes to organizational growth.

5 Important Questions On Data Security

2023-08-07T15:41:05-04:00By Eric Duchinsky|Big Data|

News of data breaches and cyberattacks have been ruling the headlines since early 2015. In fact, out of the 14 largest healthcare data breaches 5 occurred in 2015. As cyber attacks become more common it’s crucial for healthcare organizations to learn how to protect themselves, and their patient’s data, from breaches and attacks.

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