Readmissions Management Experts

Wearable Technology

2024-11-21T12:20:44-04:00By |Operational Analysis, Readmissions|

The integration of wearable technology in the healthcare sector has transformed the way health insurance payers assess risk, engage customers, and manage costs. Devices like fitness trackers, smartwatches, and biosensors provide real-time data that helps payers make informed decisions while enhancing customer engagement. Today, we’re exploring the impact of wearable technology on health insurance payers, supported by statistical data, case studies, and comparative analysis of predicted and actual developments.

Reducing Hospital Readmission Rates

2024-11-14T12:56:51-04:00By |Operational Analysis, Readmissions|

An exploration of evidence based strategies and policy implications that may reduce hospital readmission rates. Readmission rates, defined by the frequency with which patients return to the hospital within 30 days of discharge, are influenced by multiple factors ranging from socio-demographic attributes to the quality of post-discharge care.

Strengthening Care Through Physician Peer-to-Peer Reviews

2023-09-28T15:47:51-04:00By |Physician Advisor/Peer Review, Readmissions, Revenue Cycle Improvement, Staff, Utilization Management|

The healthcare industry has embraced a collaborative approach that is gaining significant traction—physician peer-to-peer reviews. In this comprehensive exploration, we will delve into the significance of physician peer-to-peer reviews, their role in enhancing healthcare, and how they strengthen the bonds within the medical community.

Physician Advisor Reviews Improve Patient Outcomes

2023-10-31T14:19:34-04:00By |Physician Advisor/Peer Review, Readmissions, Revenue Cycle Improvement|

Physician advisor (PA) reviews play a crucial role in improving patient outcomes by facilitating various processes within healthcare organizations. PAs act as liaisons between hospital administration, clinical staff, and support personnel to ensure compliance with regulatory issues, advise physicians on medical necessity, and help achieve overall organizational goals related to the efficient utilization of healthcare services. Physician advisors contribute to better patient outcomes through several key activities.

CMS Star Ratings Major Setback for 2 Insurers

2022-11-10T19:16:20-04:00By |Readmissions, Utilization Management|

The federal government hit CVS Health and Centene with lower quality scores for the health-insurance plans they sell to seniors. Star Rating scores are a big deal for health insurers, because plans that score 4 stars or higher receive bonus payments from the federal government that they can use to edge out competition by funding new health-plan benefits to attract more customers.

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