Payers

Health insurance plans serve as the financial backbone of health care, functioning as the crucial link between employers and providers in the $2.5 trillion industry. Topics include: claims management systems, quality improvement programs and claims processing standards.

First Vendors Get Accredited for Direct Messaging Services

Joseph Goedert | May 22

The Electronic Healthcare Network Accreditation Commission has accredited the first four vendors to meet newly developed best practices for providing secure messaging services using the Direct Project protocols.

Health Info Exchange

Group Practices

Hospitals

EHR

Policy & Regulation

Systems Integration

New WEDI Program Facilitates State ICD-10 Cooperation

Joseph Goedert | May 22

The Workgroup for Electronic Data Interchange has launched a new program for states to collaborate on reaching compliance with the ICD-10 code sets.

Coding

Electronic Data Interchange

EHR

Group Practices

Hospitals

Policy & Regulation

Revenue Cycle & Payments

Consumer Groups, EHR Vendors Talk Back to GOP Senators

Joseph Goedert | May 21

Fourteen consumer organizations in a joint letter advise six Republican members of the U.S. Senate to not seek to pause or delay the electronic health records meaningful use program.

EHR

Consumer Health

Health Info Exchange

Group Practices

Hospitals

Policy & Regulation

Stimulus

Vendor News

AHA to Senators: EHR Concerns Understandable, but Don’t Pause Meaningful Use

Joseph Goedert | May 20

The American Hospital Association concurs with many concerns from six Republican members of the U.S. Senate who recently called for a pause to the EHR meaningful use program and re-examination of its strategies.

EHR

Group Practices

Hospitals

Stimulus

Policy & Regulation

Coalition to Senate: Time to ‘Re-do’ Meaningful Use

Joseph Goedert | May 20

The electronic health records meaningful use programs has not improved the quality and efficiency of care and needs to be redone, a small coalition of industry leaders say in a letter to six Republican members of the Senate.

EHR

Group Practices

Hospitals

Policy & Regulation

Revenue Cycle & Payments

Medical Loss Ratio Rules Finalized for Medicare Advantage & Drug Programs

Joseph Goedert | May 20

The Centers for Medicare and Medicaid Services has issued a final rule to implement medical loss ratio requirements for the Medicare Advantage Program (Part C) and the Medicare Prescription Drug Benefit Program (Part D).

Revenue Cycle & Payments

Policy & Regulation

Consumer Health

Rule Sets Pre-existing Coverage Rates

Joseph Goedert | May 20

The Centers for Medicare and Medicaid Services has issued an interim final rule setting payment rates for treatment of patients enrolled in the federal government’s Pre-Existing Condition Insurance Plan authorized under the Affordable Care Act.

Chronic Care

Consumer Health

Group Practices

Hospitals

Revenue Cycle & Payments

Policy & Regulation

Beyond the HIT Boom

Steven Heck | May 20

The thriving health care information technology industry is no longer news. But, much like the real estate market, there’s a crash coming, and soon.

Group Practices

Hospitals

Policy & Regulation

Vendor News

5 Principles to Simplify Lean BI

May 18

These five considerations can get you started on the path toward more efficient and pointed business intelligence.

Decision Support

Group Practices

Hospitals

KLAS Ranks I.T. Outsource Companies

Joseph Goedert | May 17

A new report from vendor research firm KLAS Enterprises ranks customer satisfaction levels for eight companies offering outsourced health information technology services.

Group Practices

Hospitals

Vendor News

California Developing Guidance for Patient Consent of HIE

Joseph Goedert | May 17

The California Health and Human Services Agency has released a guidance tool on requirements for obtaining patient authorization and consent for providers to electronically exchange information for treatment purposes.

Data Security

Consumer Health

EHR

Health Info Exchange

Hospitals

Group Practices

Policy & Regulation

Tableau Sold as “DATA” in Stock Market Debut

Justin Kern of Information Management magazine | May 17

Analytics and visualization vendor Tableau Software introduced itself to Wall Street on May 17 by ringing the opening bell and starting sales of 8.2 million shares of common stock at $31.

Group Practices

Hospitals

Vendor News

AMA Board to Members: Skipping ICD-10 for ICD-11 Not Recommended

Joseph Goedert | May 16

A new report from the American Medical Association Board of Trustees concludes that the advantages of skipping implementation of the ICD-10 code sets and waiting until ICD-11 are outweighed by the disadvantages.

Coding

Electronic Data Interchange

Group Practices

Hospitals

Policy & Regulation

Revenue Cycle Management

Revenue Cycle & Payments

WEDI Picks Leaders for New Report on Next Generation HIE

Joseph Goedert | May 16

The Workgroup for Electronic Data Interchange has announced co-chairs of four workgroups that will work on the 2013 WEDI Report, envisioned as a definitive roadmap for the next generation of health information exchange technologies.

Health Info Exchange

Group Practices

Hospitals

Policy & Regulation

OCR Seminars to Walk through Omnibus HIPAA Rule

Joseph Goedert | May 16

The HHS Office for Civil Rights has scheduled four Web seminars to explain the omnibus final HIPAA rule to modify the privacy, security, breach notification and enforcement rules.

Consumer Health

Data Security

Health Info Exchange

EHR

Group Practices

Hospitals

Stimulus

Policy & Regulation