Trends in Healthcare

Clinical Peer Review’s Role in Modern Performance Management

2024-02-07T07:50:18-04:00By |Clinical Analysis, Clinical Operations Improvement, Staff, Trends|

Clinical peer review in modern performance management requires a secure, easy-to-use software system. Peer reviews are a form of performance evaluation that involve feedback from colleagues within the same profession or industry. In the healthcare industry, peer reviews are commonly used to evaluate the performance of clinical staff, including physicians, nurses, and other healthcare professionals.

Prior Authorization Process Improvements

2024-02-07T07:48:44-04:00By |Payer Trends, Trends, Utilization Management|

Prior authorization is a utilization management process used by some health insurance companies for determining if the patient’s health policy covers a prescribed services, like procedures, tests, or medications, before services are rendered. While intended to control healthcare costs, prior authorizations can be a significant burden on healthcare providers and can delay patient care.

Top At-Risk Conditions and Utilization Spikes

2023-01-12T11:12:16-04:00By |Behavioral Health Integration, Mental Health, Payer Trends, Quality Improvement Programs, Revenue Cycle Improvement, Trends, Utilization Management|

Top At-Risk Conditions and utilization spikes that healthcare leaders and stakeholders across the industry must prepare to proactively address in the upcoming year highlight the recently released, 2023 State of Health – In The Aftermath Report. The report also presents predictive findings and explores the top contributing factors of many utilization increases.

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