Category: care management

  • Preparing for Omicron: streamlining care with digital scheduling tools

    The recent discovery of the Omicron variant has placed the world on high alert. As COVID-19 continues to transform and evolve, erupting as “new” pandemics within the existing pandemic,  it is becoming clear that digitally-enabled clinical care and access to that care are some of the world’s tools to mitigate its spread. Should infection rates […]

  • Expert Q&A: Streamlining prior authorizations for faster patient collections

    Healthcare providers could be losing up to $265 billion each year on avoidable administration costs. A recent investigation by the Washington Post and McKinsey & Company found expensive inefficiencies in several areas of healthcare expenditure, with financial transactions such as prior authorizations among the main culprits. How can healthcare organizations adjust to streamlining prior authorizations? […]

  • Alleviate the healthcare staffing crisis with automation

    After more than a year of stop-and-start elective services, providers are ready to cut through the backlog and help patients get their healthcare back on track. Unfortunately, growing staff shortages mean many providers are struggling to meet consumer demand. Unemployment may be falling overall, but the number of people employed in healthcare dropped by more […]

  • Expert Q+A: how top providers are using digital patient recruitment tools

    Mass relocations during the pandemic caused seismic shifts in healthcare markets. With millions of Americans moving and reshuffling to be closer to family or take advantage of remote working opportunities, healthcare providers have extra work on their hands to ensure their patient base holds steady. Some attrition is inevitable; however, as more patients relocate, providers […]

  • Getting a holistic picture of patients with social determinants of health

    This is the fifth in a series of blog posts that will highlight how the patient journey has evolved since the onset of COVID-19. This series will take you through the changes that impacted every step of the patient journey and provide strategic recommendations to move forward. In this post, explore the fifth step—treatment, and […]

  • The Post-COVID-19 Patient Journey: What’s next for healthcare?

    COVID-19 transformed the patient journey, and it’s clear when we evaluate every step. Data and technology gave patients the convenience, flexibility, and control to get care on their terms, and these changes will be here to stay. From marketing to scheduling to payments and more – providers and payers have ample opportunities to respond to […]

  • Lark Health Raises $100M for Digital Care Management & Prevention Platform

    What You Should Know:  – Lark Health, a healthcare technology company aimed at delivering infinitely scalable, virtual chronic and preventative healthcare through conversational AI announced it has raised $100M in Series D funding led by Deerfield Management Company. The funding round also includes crossover fund PFM Health Sciences, as well as returning investors Franklin Templeton, […]

  • Automated prior authorization: getting patients the approved care they need

    This is the fourth in a series of blog posts that will highlight how the patient journey has evolved since the onset of COVID-19. In this post, we address the fourth step – prior authorizations, and helping your patients get the approved care they need. This series will take you through the changes that impacted […]

  • 4 ways to strengthen digital patient access

    In November 2020, Experian Health conducted a survey to capture consumer and provider attitudes regarding patient access. At the height of the pandemic, patients welcomed telehealth services and maintained their distance from hospital waiting rooms. Providers scrambled to implement and provide digital services that would help them maintain quality care for their patients. In June […]

  • How COVID-19 changed the patient journey: A call for digital transformation

    COVID-19 changed every aspect of the patient journey – placing unprecedented demands on the healthcare system and accelerating the need for digital transformation industry-wide. Telehealth, touchless engagement, and self-service scheduling became the new normal; however, this created new stress on operations, administration, and finance. While this new normal comes with many challenges, data and digital […]

  • The State of Patient Access 2.0: 4 opportunities to strengthen the digital experience

    “93% of providers say creating a better patient experience remains a top priority, up 3% from last year.” – Experian Health’s State of Patient Access, June 2021 Download now In November 2020, we surveyed patients and providers for their sentiments on how patient access changed because of the pandemic. During this time, patients welcomed the […]

  • Automating authorizations as patients return to care

    “The entire healthcare industry was turned upside down by the pandemic. Procedures were pushed back, insurance companies gave policy holders a lot of mixed information. It has been a mess.” This is what one healthcare executive told us when we surveyed patients and providers on the state of patient access, in June 2021. Changing prior […]

  • Rescheduling COVID-deferred screening appointments with automated patient outreach

    More than 40% of patients surveyed skipped medical care in the early months of the pandemic, according to a recent study by researchers at the Johns Hopkins Bloomberg School of Public Health. Of those who needed care, 58% missed scheduled preventive care. Similar trends are observed in cancer screening, with appointments for breast, colorectal, and […]

  • Elevate Health Taps Innovaccer to Redefine Its Care Management Model – PHM

    What You Should Know: – Elevate Health, a Washington-based nonprofit Accountable Community for Health (ACH) organization, has partnered with us to leverage the Innovaccer Health Cloud to strengthen care management and improve patient outcomes. It was challenged to integrate data from disparate sources and close gaps for hundreds of patient records. – With the Innovaccer Health Cloud, Elevate Health saved $6M […]

  • Enriching patient identity management with social determinants of health

    Download the Guide: The Backbone of Healthcare’s Digital Transformation Knowing that clinical care accounts for only a portion of health outcomes, understanding how patients are affected by social determinants of health (SDOH) continues to gain attention as a critical factor in care delivery. COVID-19 has thrust the issue even further into the spotlight, with socially […]

  • Cohere Health Raises $36M to Automate Prior Authorization Between Payers & Providers

    What You Should Know: – Boston-based health IT company Cohere Health has closed a $36 million Series B funding round led by Polaris Partners, with additional participation from new investors Longitude Capital and Deerfield Management, as well as existing investors Flare Capital Partners and Define Ventures. The round comes less than a year after the company launched, and only 3 months after […]

  • Time and Goals Should Drive Your Post-COVID-19 Care Management Strategy

    Jessica Scruton, BSN, RN, CCM, VP of Clinical Transformation for Lightbeam Health Solutions COVID-19 forced many health systems to reassess and reconfigure their care management processes and staffing models so that clinicians could better manage more of their acute, complex, and otherwise healthy patients remotely to limit in-person care.  During this time, health systems likely […]

  • Driving member engagement with health plan data analytics

    As Spotify and Amazon can attest, digital technology plus personalization is a winning formula. Consumers want anytime-anywhere access to the services and products they enjoy, without having to sift through irrelevant information. They want tailored recommendations that will make their life easier. More than eight in ten consumers say they’re more likely to choose businesses […]

  • Q&A: Optimize reimbursements by submitting cleaner claims

    Many thought the end of COVID-19 was in sight with the availability of a vaccine, and while that is somewhat true, an entirely new set of issues has arrived: how to properly administer and manage the vaccine. Now that a COVID-19 vaccine is approved and underway, providers need to execute a medical billing and coding […]

  • Apriss Health Acquires Care Coordination Platform PatientPing

    What You Should Know: PatientPing, a comprehensive care collaboration platform, today announced that it has entered into a definitive agreement to acquire Appriss Health, a cloud-based care coordination software and analytics solutions focused on behavioral health and substance use disorder. – Together, PatientPing and Appriss, backed by Clearlake Capital Group, L.P. and Insight Partners, will represent the largest and most diverse care […]

  • Providence-Backed Tegria Acquires Healthcare IT Consulting Firm Cumberland

    What You Should Know: – Tegria today announced the acquisition of Cumberland, a leading healthcare IT consulting and services firm for payers and providers. Financial details of the acquisition were not disclosed. – The acquisition accelerates the growth of Tegria, launched by Providence in October 2020 to provide next-generation technologies and services to the healthcare […]

  • Glooko Raises $30M to Expand Digital Diabetes Management Platform

    What You Should Know: – Glooko, a Palo Alto, CA-based provider of remote patient monitoring and chronic care management solutions including diabetes and obesity, today announced that they have raised a $30 million Series D round of funding. The funding was led by Health Catalyst Capital along with participation from existing investors Canaan Partners, Georgian, […]

  • Why A Smart Command Center Requires A Health Cloud Platform

    Dr. David Nace, Chief Medical Officer at Innovaccer Aviation, military, NASA, or even utilities like the New York Power Authority—almost all high-consequence, complex organizations have one thing in common: a command center. The concept of a command center or a ‘war room,’ or ‘air traffic control’ has been around for a while. Command centers help […]

  • Q&A: Segmenting your patient population for the COVID-19 vaccine

    While the various waves of vaccine priority may be largely defined, the ability for many providers to segment their patient populations based on those designations isn’t always simple. Without accurate data, there’s a risk that some vulnerable patients will be missed out. We interviewed Mindy Pankoke, senior product manager at Experian Health, about the challenges […]

  • Supercharge your COVID-19 vaccine management plan with digital solutions

    If President Biden’s two trillion-dollar stimulus package is approved by Congress, support will include funding for a national vaccination program. While the arrival of the vaccine is an immense relief, the logistics for rolling it out across the country present a major challenge. Even at a rate of one million shots administered per day, it […]

  • Casana Raises $14M to Expand IoT Heart Health Toilet Seat

    What You Should Know: – Casana raises $14M in Series A funding to pursue FDA clearance for its an IoT heart health toilet seat that captures clinically relevant measurements, including heart rate, blood pressure, blood oxygenation, and cardiac output. Casana, previously known as Heart Health Intelligence, Inc., a healthcare technology firm that is re-inventing in-home […]

  • Epic, Galen Healthcare, Chartis Group Named 2020 Overall Best in KLAS Awards

    What You Should Know: – Epic was named the top Overall Software Suite for the eleventh consecutive year in the Best in KLAS 2021 Software & Services report, released today, which reports on the top vendors for 2020. Epic was also named the top Overall Physician Practice Vendor. Galen Healthcare Solutions was named the top Overall IT Services Firm. […]

  • It’s that time of year – payer Groundhog’s Day

    At this time every year payers employ teams of people whose full-time job is calling a doctor’s office, requesting information, and waiting weeks for the data to be mailed in hard copy or being required to physically drive to the provider location to pick up records. How will it get better?

  • Why CMS Will Lead the 2021 Kidney Care Revolution

    Chris Riopelle, CEO of Strive Health After an unprecedented year, kidney care providers, including nephrologists, dialysis facilities, and care extenders are expecting 2021 to follow suit. We will see an overhaul in reimbursement and major industry shifts, partly led by CMS, that will require providers to advance their capabilities in a way that will usher […]

  • How a unique patient identifier gets health plans closer to interoperability

    Health plans have been fighting against inaccurate member data, incomplete member profiles and duplicate records for years. Without a watertight way to keep track of patient identities so health data is reliably linked and accessible across multiple services, payers can’t always be confident that the record in front of them matches the member they have […]

  • Philips Acquires Medical Device Integration Platform Capsule for $635M

    What You Should Know: – Philips announces the acquisition of Capsule, a leading vendor-neutral Medical Device Integration Platform with a software-as-a-service business model – The Capsule acquisition is a strong fit with Philips’ strategy to transform the delivery of healthcare along the health continuum with integrated solutions. Philips, today announced that it has signed an […]

  • Shields Health Solutions, ExceleraRx Announce Specialty Pharmacy Merger – M&A

    What You Should Know: – Shields Health Solutions and Excelera announce a major specialty pharmacy merger that will form a combined company that consults with 700+ hospitals in 43 states, including Mass General Brigham, Yale New Haven, Intermountain Healthcare and Henry Ford. – The network of hospitals is designed to improve patient care through an […]

  • How to Capitalize on Digital Health Momentum in 2021

    Adam Sabloff, Founder and CEO of VirtualHealth As we re-examine the healthcare system in the wake of the pandemic, we are continually identifying opportunities to rebuild parts of the system to new and improved specifications. One critical facet is digital health, where we continue to struggle with what should really be table stakes: the ability […]

  • M&A: Philips Acquires Remote Cardiac Monitoring BioTelemetry for $2.8B

    What You Should Know: – Philips acquires BioTelemetry, a U.S. provider of remote cardiac diagnostics and monitoring for $72.00 per share for an implied enterprise value of $2.8 billion (approx. EUR 2.3 billion). – With $439M in revenue in 2019, BioTelemetry annually monitors over 1 million cardiac patients remotely; its portfolio includes wearable heart monitors, […]

  • How to close gaps in care with automated patient outreach

    Scheduling an appointment shouldn’t be complicated. Yet too often, patients are left to figure out their next move alone, with just a single phone number to call. Frustrated and confused, patients may drop out of the scheduling process entirely or miss the appointments they’ve already booked. Missed appointments can lead to critical gaps in care, […]

  • Healthcare M&A: DAS Health Acquires Randall Technology Services

    What You Should Know: – DAS Health Ventures acquires healthcare and managed IT company Randall Technology Services (RandallTech). – This acquisition adds Allscripts® PM and EHR solutions to the DAS portfolio of supported products, and DAS Health has now added additional staff in Texas that will create opportunities for greater regional support of its entire […]

  • How Care Coordination Technology Addresses Social Isolation in Seniors

    Jenifer Leaf Jaeger, MD, MPH, Senior Medical Director, HealthEC Senior isolation is a health risk that affects at least a quarter of seniors over 65. It has become recognized over the past decade as a risk factor for poor aging outcomes including cognitive decline, depression, anxiety, Alzheimer’s disease, obesity, hypertension, heart disease, impaired immune function, […]

  • How RPA Can Help Get COVID-19 Vaccines to High-Risk Patients First

    Ram Sathia, VP of Intelligent Automation at PK While most of the public’s attention is focused on the horse race for an approved COVID-19 vaccine, another major hurdle lies just around the corner: the distribution of hundreds of millions of vaccine doses. In today’s highly complex and disconnected health data landscape, technologies like AI, Machine […]

  • How health plans can reduce ED visits and readmissions post-pandemic

    Visits to emergency departments (ED) dropped by 42% in the early months of COVID-19, according to the CDC. In pre-pandemic times, this might have been a positive sign. Two-thirds of ED visits are thought to be avoidable, with emergency care used as a safety net in the absence of access to more appropriate services. Excessive […]

  • Rural Hospital Execs Can Beat COVID-19 By Shifting From Reactive to Proactive Care

    Eric Tran, Tulane School of Medicine Donald Voltz, MD, Aultman Hospital The COVID-19 virus is ravaging the planet at a scale not seen since the infamous Spanish Flu of the early 1900s, inflicting immense devastation as the U.S. loses more than 200,000 lives and counting. According to CDC statistics, 94% of patient mortalities associated with […]

  • Healthify Integrates with Altruista Health to Help Payors Address SDoH

    What You Should Know: – Healthify’s social determinants of health (SDoH) infrastructure will be integrated into Altruista’s GuidingCare® platform to support health plans in addressing the social needs of members. – SDoH such as poverty, housing instability, and food insecurity can significantly impact health outcomes, so it is imperative that they are not overlooked. Healthify, a […]

  • Innovaccer Unveils Risk Adjustment Solution For Improved Coding Accuracy

    What You Should Know: – Innovaccer unveils new risk adjustment solution to help providers better segment their population to refine the risk scoring process and improve coding accuracy and efficiency, thereby improving performance on risk-based contracts. – The solution utilizes Artificial Intelligence (AI) and Natural Language Processing (NLP) to make risk predictions. Innovaccer, Inc., a […]

  • Is Your Community Ready for Connected Community of Care Model?

    Dr. Keith Kosel is a Vice President at Parkland Center for Clinical Innovation (PCCI) This question initially brings to mind many possibilities such as connection to the latest 5G cellular service, a new super-fast internet provider, or maybe one of the many new energy suppliers jockeying for market share from traditional utility companies. While all […]

  • Getting Beyond the Telehealth ‘Stop-Gap’ Mentality

    Roland Therriault, President, InSync Healthcare Solutions Since COVID-19 emerged as a major health threat, virtual care has taken off. As many as 46% of patients reported in late April that they had used telehealth to replace a canceled healthcare visit in 2020, while 48% of physicians said they had started using telehealth to treat patients.   […]

  • Accounting for the Social Determinants of Health During the COVID-19 Pandemic

    Andy Aroditis, CEO, NextGate The COVID-19 pandemic is not just a medical crisis.  Since the highly contagious disease hit American shores in early 2020, the virus has dramatically changed all sectors of society, negatively impacting everything from food supply chains and sporting events to the nation’s mental and behavioral health. For some people, work-from-home plans […]

  • Finding unidentified coverage without a Social Security Number (SSN)

    Finding previously unidentified insurance coverage can feel a little like a game of hide and seek. Patients may not always be aware of their insurance or eligibility for Medicare and Medicaid, and, in an effort to both improve the patient financial experience and simultaneously improve collections, providers are often tasked with finding this information on […]

  • How health plans can close more gaps in care with digital scheduling

    Four in ten Americans live with multiple chronic conditions. For these individuals, life is punctuated with physician appointments, visits to the pharmacy and referrals to different specialists. Their care should be coordinated with orchestral precision, but the reality is somewhat less harmonious. Snail-paced scheduling systems, poor communication and mismatched patient records can lead to a […]

  • Improving patient intake during COVID-19 starts with patient experience upgrades

    Despite the majority of elective procedures being up and running again, patients are still keeping their distance. Nearly half of Americans say they or a family member have delayed care since the beginning of the pandemic, while visits to the emergency room and calls to 911 have dropped significantly. Patients are avoiding care, but it’s […]

  • Fast track the path to closing gaps in care

    The rates for closing gaps in care are some of the most widely used, quantitative metrics to measure quality, allocate incentives, and control costs. Unfortunately, health plans face numerous obstacles closing gaps in care, from social determinants of health to inconsistent coordination of care, and don’t always have a care gap closure program in place. […]

  • Verily Forms New Subsidiary Focused on Employer Stop-Loss Through Precision Risk

    What You Should Know: – Alphabet’s Verily has established a new subsidiary, Coefficient, with a mission to create value by combining innovative health technology solutions with new insurance and payment models. Verily is the majority shareholder and Swiss Re Corporate Solutions, an established player in the employer stop-loss market, has a minority stake in the […]

  • Dignity Health Management Services to Leverage Innovaccer’s FHIR-enabled Data Activation Platform

    What You Should Know: – Dignity Health Management Services (DHMSO), the largest health system in the state of California to transform their network health data into actionable insights. – With this partnership, the organization will leverage Innovaccer’s FHIR-enabled Data Activation Platform to better manage healthcare services for its attributed patients. Dignity Health Management Services (DHMSO), […]

  • Innovaccer Launches Perioperative Optimization Platform for Surgeons

    What You Should Know: – Innovaccer launches a perioperative optimization solution for surgeons to realize clinical and financial goals with patient-risk analysis. – The solution redefines surgical planning and post-surgical recovery with machine learning-based patient stratification for optimized surgery experience and personalized patient care management. Innovaccer, Inc., a San Francisco, CA-based healthcare technology company, recently […]

  • New Tech Solution Lets People Securely Share COVID-19 Testing Results

    What You Should Know: – TransUnion, in partnership with CLX Health, a joint venture from UST Global and SiriusIQ, announced the launch of HealthyAmerica, a technology solution that will give individuals the power to securely share their COVID-19 testing results while maintaining their individual privacy – helping businesses and schools across the country to minimize risk and […]

  • Innovaccer, CareSignal Partner to Enable Deviceless Remote Patient Monitoring

    What You Should Know: – Innovaccer has recently partnered with CareSignal to address healthcare’s urgent need amidst the COVID-19 pandemic: to create and maintain solid, clinically actionable relationships with patients in a new set of predominantly virtual care. – CareSignal offers evidence-based end-to-end support services for chronic medical conditions such as asthma, CHF, COPD, diabetes, […]

  • DAS Health Acquires Managed IT Services and CyberSecurity Company Technology Seed

    – Both companies’ clients will gain an increased depth of IT and security support, and Technology Seed’s healthcare clients will now have a substantially improved value proposition DAS Health Ventures, Inc., a provider of health IT and management, announced today it completed the acquisition of Technology Seed, LLC, a managed IT and cybersecurity services company based in Salem, NH. […]

  • Five Ways to Improve Health Plan Member Engagement

    The focus on improving health plan member engagement and overall experience has been steadily growing over the years, much of it being driven by the push towards a more consumer-friendly healthcare experience. James Beem, Managing Director, Global Healthcare Intelligence at J.D. Power, states, “health plans are doing a good job managing the operational aspects of […]

  • How ADT-Based E-Notifications Can Enable Better Safety for COVID-19 Patients

    Jay Desai, CEO & Co-Founder, PatientPing As COVID-19 continues to impact the country, providers across the continuum face new challenges delivering care and ensuring safety for their patients and themselves.  During this period, sharing real-time information about patients’ care encounters across provider types and care settings matter more than ever. In particular, hospitals sharing admission, […]

  • Current Health, Dexcom Partner to Deliver Continuous, Remote Glucose Monitoring

    What You Should Know: – Current Health has partnered with Dexcom to add continuous glucose monitoring (CGM) capabilities to its remote patient monitoring (RPM) platform – enhancing care and improving outcomes for diabetics. – Dexcom CGM data will transmit directly into the Current Health wearable and platform for review by the care management and clinical […]

  • Virtually or In-Person, Automation Improves The Healthcare Experience

    Muthu Alagappan, MD, Medical Director at Notable Health The COVID-19 pandemic has caused an unprecedented shift in the way consumers view and access a variety of goods and services—and healthcare is no exception. Recent studies show that many patients, including vulnerable populations like those living with cancer, are delaying recommended care and procedures—and will continue to do so for at least several […]

  • Emtiro Health Taps Innovaccer to Leverage the FHIR-Enabled Data Activation Platform

    What You Should Know: – Emtiro Health, an innovative population health company in North Carolina has selected Innovaccer to deliver data-powered solutions to enhance the efficiency and effectiveness of care delivery.  – Powered by Innovaccer’s FHIR-enabled Data Activation Platform, Emtiro Health will create unified patient records that drive comprehensive, whole-person care management, no matter where […]

  • Health Catalyst Acquires Clinical Workflow Optimization Solution healthfinch

    What You Should Know: – Health Catalyst announces an agreement to acquire clinical workflow optimization solution healthfinch using a mix of stock and cash. – As part of the acquisition, healthfinch will be a new application suite category called EMR Embedded Insights and its refills, care gaps closure, and visit planning applications will continue to […]

  • Philips and BioIntelliSense Integrate to Enhance Remote Patient Monitoring

    What You Should Know: – Philips integrates the BioIntelliSense FDA-cleared BioSticker™ sensor as part of its remote patient monitoring solutions for patients outside the hospital. – Multi-parameter sensors aid monitoring across multiple chronic conditions with medical-grade vital signs for physicians to remotely track core symptoms, including COVID-19. – Healthcare Highways is the first to leverage […]