News

A healthy, stable revenue cycle is crucial to every healthcare organization’s success. However, managing the revenue cycle takes experienced coders, complete documentation, and timely resolution of denials.

Administrative processes account for about 30% of U.S. healthcare costs, which means that all areas of a patient encounter, from check-in to billing and claims, are potential targets to obtain greater efficiency.

In its comments to the ONC on the draft QHIN, Participant and Subparticipant Additional Requirements SOP, the EHR Association recommends workforce authentication requirements be applied only to the Qualified Health Information Network workforce, with specific consideration given to participants and sub-participants who are not HIPAA-covered entities.

WHY IT MATTERS

The Office of the National Coordinator for Health Information Technology (ONC) is accepting comments on proposed requirements for QHINs, participants and sub-participants under its Trusted Exchange Framework and Common Agreement developed by the enlisted Sequoia project.

Industry groups and watchers have wide respect for the accomplishments over the past two decades of the Office of the National Coordinator for Health Information Technology.

Despite concerns about achieving interoperability across the industry and sometimes overly optimistic expectations about the industry’s ability to manage change, there’s widespread appreciation for the amount of change accomplished by the federal office.

The Office of the National Coordinator for Health Information Technology (ONC) has grown in its understanding, over time, about the breadth of technical capabilities and maturity of organizations that must implement regulations and technical requirements to achieve national goals.

This is not an easy process and ONC has shown a willingness to be open and learn about infrastructure capabilities across the healthcare ecosystem. This is particularly true in the pursuit of national interoperability, where a variety of health information technology (HIT) will be involved in the management and dissemination of all electronic health information.

Data governance was one of the major trends that shaped analytics in 2022.

Data governance isn't glamorous like augmented intelligence, machine learning or natural language processing. It's the grunt work of analytics.

But after many organizations suddenly realized the importance of data-informed decision-making at the start of the COVID-19 pandemic -- and have continued to recognize its value as world events like the war in Ukraine and repeated supply chain disruptions have resulted in ongoing economic uncertainty -- data governance is starting to be a critical need.

Leaders from EHR vendors such as Oracle Cerner and Meditech were named to the Electronic Health Record Association's executive committee for 2023.

Becker's Health IT»

Congress was full of good intentions when it directed the Department of Health and Human Services to make sure patients get their test results as soon as they’re available.

But the implementation of that directive has set off a battle between doctors on one side and HHS and patient advocates on the other, and raised a fundamental question: How should patients get bad news? The debate underscores how medicine’s digital transformation is changing the doctor-patient relationship and upending ingrained practices.

As 2022 draws to a close, many healthcare organizations are dealing with a unique double whammy – both on supply and demand. That’s according to our 2022 MDaudit Annual Benchmark Report, which found that as consumers cut discretionary healthcare spending and postpone medical visits, patient volumes began falling dramatically in physician office visits and hospitals. The 3rd quarter of 2022 saw declines as steep as 33% relative to the first two quarters.

Healthcare organizations are also under tremendous pressure to reduce compliance risk and optimize revenue flow, a feat that will require flawless optimization for billing compliance, coding, revenue cycle, and revenue integrity capabilities. Amidst the challenges, however, our analysis also revealed many opportunities for health systems to accelerate digital initiatives and drive sustainable value with analytics, automation, collaboration, and upskilling people.

This month’s roundup of surveys and reports from around the industry includes the 2022 National Healthcare Quality and Disparities Report, the No Surprises Act prevents more than 9 million surprise bills since January 2022, caregivers in financial precarity, uncertainty of healthcare costs deters 35% of American from seeking care for themselves, and more!

Health IT Answers»

In today's digital age, technology leaders possess a unique opportunity to drive growth and innovation by adopting certain traits and transformation strategies – ways of working and leading that provide real value and make a direct impact on outcomes for the team and organization.

Most importantly, success at driving innovation (IT or otherwise) hinges on whether leaders possess several skills, some of which might be surprising to see. Based on my experience, two are most critical. The first skill of effective IT leaders is working toward becoming a bilingual strategist with well-rounded business and technology acumen.

Every organization, regardless of its level of success, must continuously evolve and transform. It is a necessity for any organization that seeks to grow, but when the focus is on transformation through IT innovation, the results are particularly powerful.

Leaders driving the digital agenda require a holistic mindset of understanding the market and industry needs and executing digital initiatives that are oriented towards both the growth and value agendas that drives business outcomes. No longer is it enough for the CIOs and CTOs to define technology stacks, manage costs and select software vendors and tools. They must now also possess a strategic mindset to collaborate with business leaders as they reimagine their business models and execute digital transformations.

MINNEAPOLIS, MN. – December 21, 2022 – Engage Venture Partners, a venture capital (VC) firm committed to building a funding community for early-stage medical technology companies and their investors, announces its investment in VOCxi Health. This marks the third investment for Engage since the firm’s launch earlier this year and the first time it has led a funding round.

Engage was founded in July 2022 to provide clients access to extensively vetted investment opportunities in the medical device, digital health, and healthcare software sectors. The firm’s Special Purpose Vehicles (SPVs) allow investors to choose the startups they wish to fund. This flexible, investor-friendly model also has lower fees than traditionally structured venture capital funds

Healthcare organizations are always looking for ways to save money — so what if they could retain 15%-25% of overall revenue? It’s possible, using workflows designed to resolve issues in billing and coding before claims are submitted.

According to MDaudit research, claim denials increased across the board in 2022, both in terms of number of denials and the average amount of each denial. More than half of denied claims are never reworked – translating into $3.5 billion left on providers’ tables – and the price tag is hefty for those that are. The average cost to rework a claim is $25-$31. Consider the number of denied claims in a month and multiply that number by $25 to get a rough estimate of the additional funds your organization is spending to rework claims.

MINNEAPOLIS – July 14, 2022 – Engage Venture Partners, a new venture capital (VC) firm focused on medical technology companies, announces its launch and inaugural company investment. Backed by deep technical expertise, extensive due diligence capabilities, and specialized industry knowledge, Engage was established to address the need for a more accessible, lower-friction funding community for seed- and early-growth stage medtech companies and their investors.

Engage also announced its first investment with Minnesota-based medical device manufacturer Melodi Health. Melodi offers surgical solutions to women undergoing breast surgery by developing a novel absorbable scaffold intended to support soft tissue and improve patient outcomes.

ICD-10-CM coding guidelines state that all documented conditions coexisting at the time of an encounter that require or affect patient care treatment or management must be coded as a diagnosis. As such, physicians must clearly and precisely document each diagnosis based on clinical medical record documentation from a face-to-face encounter, which means that diagnoses cannot be completely determined from test results and a patient’s past medical history.

For example, well-documented progress notes include the history of present illness, review of systems, and physical exam. They also detail the medical decision-making process. Each diagnosis must be documented in an assessment and care plan. To ensure this is the case, many organizations use the “MEAT” criteria—monitoring, evaluation, assessment, treatment—for their documentation practices, along with hierarchical condition category (HCC) assignments and ICD-10-CM diagnosis coding.