Client News Coverage

In Context of COVID-19, Jefferson Health CEO Klasko Talks Importance of Precision Health, SDOH

Posted in Client News Coverage on Monday, November 09, 2020.

As the healthcare delivery system continues on its journey from a fee-for-service to value-based care reimbursement model, the realization of moving from a traditional “sick care” system that has driven the healthcare industry to date to one that provides more affordable, personalized and preventive care, will be critical to achieving success in this movement.

Many industry leaders believe that the tools needed to reimagine and change how to treat illness, and to establish healthy behaviors in patients by focusing on personal details—such as their unique biology, traits, and environmental factors—are already in place, and the next steps needed to shift the paradigm will be around culture, mindset and operational transformation.

hea!thcare innovation»

Revenue Integrity in the Era of Heightened Regulatory Scrutiny

Posted in Client News Coverage on Saturday, October 31, 2020.

The healthcare industry continues to see an uptick in oversight of federal healthcare payments. In late 2019, HHS’s Office of the Inspector General (OIG) reported that Medicare made $54.4 million in improper payments to acute care hospitals due to incorrectly coded claims. It also recommended that CMS direct its contractors to recover the lost money.

Enter 2020 and the introduction of COVID-19 incentive payments, and today’s C-Suite can expect a continuation of this trajectory in terms of increased scrutiny. In fact, the OIG recently announced its audit plans related to hospital payments covering COVID-19 discharges under the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Healthcare Business Today»

Readers Write: Who Remembers the Opioid Crisis?

Posted in Client News Coverage on Friday, October 02, 2020.

The last few years have ushered in significant progress on the opioid crisis containment front. Acknowledging decades-long misinformation shortfalls, negligence, and improper prescribing patterns, the healthcare industry took important steps on national and state levels to get out in front of devastating statistics.

A March 2020 report suggested the needle was finally pointing in the right direction. The Centers for Disease Control and Prevention (CDC) reported a 13.5% decrease in opioid overdose deaths from 2017 to 2018.

Unfortunately, that report was quickly overshadowed by the global pandemic that brought the nation to its knees. Opioid misuse, like many other critical healthcare priorities, took a back seat to COVID-19. The fallout is notable. A recent analysis points to a spike in opioid overdose cases by 18% since the start of the pandemic.

HISTalk»

Taking Hold of the AI Opportunity in Revenue Integrity

Posted in Client News Coverage on Friday, September 25, 2020.

Health care is realizing the promise of artificial intelligence (AI) across a broad and seemingly endless range of use cases. The opportunities for using advanced technologies to accelerate labor-intensive processes touch everything from research and operations to supply chain and point-of-care decision making.

Data-hungry revenue integrity and billing compliance functions are no exception. AI tools such as machine learning, natural language search, and anomaly detection are fueling new and expanded insights into revenue integrity, billing compliance, and quality assurance to advance process improvement initiatives. And not surprisingly, the value proposition of these tools is growing rapidly amid COVID-19 as health care organizations try to maximize reimbursements against notable challenges such as revenue shortfalls and rapidly changing regulations.

ForTheRecord»

Hayes Launches Revenue Optimizer To Help Hospitals and Healthcare Organizations Reverse Revenue Declines, Reduce Claim Denials

Posted in Client News Coverage on Tuesday, September 08, 2020.

Finding new revenue opportunities and avoiding claims denials has taken on greater urgency as hospitals and other healthcare organizations face growing reimbursement shortfalls in the wake of the COVID-19 pandemic.

It is why Hayes, makers of the industry’s leading integrated compliance and revenue integrity platform for the nation’s premier healthcare organizations, has launched Revenue Optimizer to equip healthcare organizations with actionable insights that help eliminate barriers to revenue integrity and manage overall financial performance.

Electronic Health Reporter»

What Epidemiology Is and Reasons to Study It

Posted in Client News Coverage on Thursday, August 20, 2020.

THE CORONAVIRUS pandemic has underscored that the field of epidemiology, which focuses on discovering the causes of disease outbreaks and tracing the spread of illness, is an academic discipline with real-world relevance. When policymakers propose solutions to the COVID-19 outbreak, they often base their recommendations on advice from epidemiologist.

Epidemiologists, sometimes referred to as "disease detectives," are trained to recognize, control and mitigate the proliferation of disease within a population and often work in academia, government or the nonprofit sector. They also sometimes work for corporations that require guidance on occupational and environmental health and safety measures. 

U.S. News and World Reports»

Inching Closer to a National Patient Identifier – House Passes Removal of Ban on National Patient ID

Posted in Client News Coverage on Tuesday, August 04, 2020.

Little by little, we’re working towards a National Patient Identifier.  For those not familiar with the topic, the US government in a section of the federal budget has banned HHS from even working with the private sector to develop a national patient identifier.  However, the House of Representatives thanks to leadership from Representative Bill Foster (D-IL) and Representative Mike Kelly (R-PA) have passed a bill to remove this ban.

On behalf of our patients and caregivers, Intermountain Healthcare applauds House passage of the Foster-Kelly Amendment and looks forward to a future in which patients can accurately, safely, and consistently be matched to their health data across the care continuum,” said Ryan Smith, Vice President and Chief Information Officer at Intermountain Healthcare.

Healthcare IT Today»

Healthcare’s Evolving Reimbursement Imperative

Posted in Client News Coverage on Friday, July 31, 2020.

Embracing the shift from revenue cycle to revenue integrity

Reimbursement is becoming increasingly complex for today’s providers. And while it is fair to say that a certain amount of missed revenue has always been part of the bottom-line equation, healthcare organizations simply cannot afford to leave money on the table in the current market climate.

Already operating within razor-thin margins, today’s hospitals and health systems must now address current and future reimbursement and revenue risks introduced by the COVID-19 pandemic. In a recent study, Strata Decision Technology estimated that 97% of health systems will lose an average of $1,200 per coronavirus case, or as high as $8,000 in some instances—even with the 2% Medicare payment increase.

HealthIT Answers»

Kurt Waltenbaugh, Founder & Chief Executive Officer, Carrot Health

Posted in Client News Coverage on Tuesday, July 21, 2020.

Carrot believes in enabling a future where each of us has no barriers to leading our healthiest lives. Unfortunately, health in this country is distributed very inequitably. In the Twin Cities we have communities with a 30-year gap in mortality: Medina at ~90 years, Frogtown in St. Paul at ~60 years.

That distribution is often based on lines drawn by racism. Take food insecurity. Those who struggle to get enough to eat report the highest levels of poor health – exacerbating nearly every medical condition.

In Minnesota, the ‘average’ person has much better access to food than the national average – only 75% of the national risk. Until we look at the data by race – in North Minneapolis, a family has 1.6x the likelihood of food insecurity, compared to the nation as a whole.

Medical Alley»

 

Overcoming Telehealth Reimbursement Risks

Posted in Client News Coverage on Monday, June 15, 2020.

Saying that telehealth has moved front and center amid the COVID-19 pandemic is an understatement. With the Centers for Medicare and Medicaid Services (CMS) now reimbursing for remote care models, adoption of telehealth is rapidly advancing as physicians strive to overcome barriers to continuity of care and maintain operations amid stay-at-home orders.

Notably, one analysis found that from March 14 to April 1, daily telehealth claims for upper respiratory infections using ICD-10 diagnosis codes from private insurance increased nearly 12 times from the daily average over the previous month. In this case, upper respiratory infections were chosen to reflect COVID-19-related illnesses prior to the introduction of a diagnosis code for COVID-19.

Physicians Practice»

 

Elevating Billing Compliance and Revenue Integrity amid the Pandemic

Posted in Client News Coverage on Friday, June 12, 2020.

While the introduction of new COVID-19 reimbursement rules and regulations have brought on their share of confusion, there is one certainty healthcare organizations can bank on: oversight of incentive dollars will be a regulatory priority. In fact, federal watchdogs are not wasting any time, as reports suggest monitoring of billing and claims data is already underway to ensure that hospitals are not upcoding to take advantage of higher COVID-19 reimbursement rates.

RACmonitor»

Impact of Post-Pandemic World on Health Insurance Choice for Seniors

Posted in Client News Coverage on Tuesday, June 09, 2020.

The last 15 years have seen steady, continual growth in both Medicare Advantage (MA) enrollment and the number of payers offering MA health plans. Yet much of that growth has gone to handful of large, national vendors—UnitedHealthcare, Humana, the Blues, CVS-Aetna—that control nearly 70% of the market Carrot Health has been analyzing its robust database of consumer information to explore how behavior is changing in light of the pandemic and—dare we imagine—the post-pandemic world.

InsureTech360»

How a big company pivots like a lean start up w/ Sheila Loy

Posted in Client News Coverage on Friday, April 24, 2020.

Listen to the entire podcast here»

When you’re an established, comprehensive company bringing products to market in a vertical industry such as healthcare, there’s a certain amount of expectation that runs alongside your everyday processes. That is, of course, until a pandemic comes knocking on your door.

So what happens when an industry hemmed in by HIPAA guidelines and government regulations is given the proverbial green-light to act quickly? They pivot — and they pivot with lightning speed.

In this episode, Sheila Loy discusses how HID Global took a proven, tested product and reworked parts of the platform to meet the need for infectious disease tracking that’s necessary not only in today’s COVID-19 economy, but for future disease-specific crises as well. Sheila gives us insights into:

  • The importance of having a strong understanding of your market and how that can help uncover an unmet need
  • Staying on track with expectations in a fast moving pivot when your company has historically long go-to-market procedures
  • How to know when you have a product that is relevant in the current market — and when you need to add to, or scale back, that product to give clients the most useful end-product for their needs
  • Timing and relevance and how they represent half the battle when bringing a product to market
  • Why communication and internal education is key to a successful pivot — when everyone is on the same page, it’s easier to make the necessary adjustments and keep your company’s momentum moving forward

 

Guest Bio

Sheila Loy is the Director of Vertical Segmentation of Strategy at HID Global, a worldwide leader in providing trusted security solutions in the identity and access management space. Sheila manages the framework strategies and how HID goes to market as a comprehensive company in a vertical industry such as healthcare.

You can reach Sheila at  This e-mail address is being protected from spambots. You need JavaScript enabled to view it . You can also visit HID Global’s website to learn about their contact tracing and surge response solutions.

Who Are You? The Quest for a Unique Patient Identifier

Posted in Client News Coverage on Monday, March 23, 2020.

Patient identification and matching (PIM) errors carry consequences that range anywhere from frustration due to relatively minor mistakes to outcomes that can only be described as devastating.

At one end of the spectrum is a scenario in which two siblings were patients at the same physician practice. When a medical assistant didn’t check multiple identifiers for one of the siblings, they accidentally documented in the wrong file, leading the physician to write a note in the incorrect sibling’s chart. This mistake, fortunately, was caught early.

Journal of AHIMA»

ONC’s Adoption of USCDI A “Significant Step” Toward Minimizing MPI Errors

Posted in Client News Coverage on Monday, March 23, 2020.

On Mar. 9, 2020, the U.S. Department of Health and Human Services (HHS) finalized “two transformative rules that will give patients unprecedented safe, secure access to their health data.” Issued by the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS), the Final Rules implement interoperability and patient access provisions of the 21st Century Cures Act and support President Trump’s MyHealthEData initiative.

Electronic Health Reporter»