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.
Physicians, frequently perceived as a roadblock to a high-quality/low-cost paradigm, often spearhead IT advances central to the effort.
Nearly all inconsistencies for those who enrolled for healthcare through the Affordable Care Acts federal exchanges were unable to be resolved due to Centers for Medicare and Medicaid Services systems not being fully operational.
The Office of the National Coordinator for Health IT this fall will launch a national campaign to boost consumer use of Blue Button technology to securely access their health records electronically.
Data analytics vendors were out in force on the exhibit floor of the Healthcare Financial Management Association annual conference last week in Las Vegas.
Traffic was strong in the exhibit hall during the Healthcare Financial Management Associations recent Annual National Institute in Las Vegas and included several vendor announcements.
The Centers for Medicare and Medicaid Services plans on releasing an ICD-10 national timeline to assist stakeholders in preparing for the expected new October 1, 2015 implementation deadline.
Healthcare payers were "uniformly ready or on track to be ready" for the October 1, 2014 ICD-10 deadline, according to performance management consultant Enkata.
As provider organizations enter into accountable care organizations, bundled payment agreements and other value-based reimbursement contracts with health insurers, they are finding some unanticipated pitfalls.
Forrest General Hospital in Hattiesburg, Miss., has a program to determine if uninsured patients may be eligible for healthcare coverage which has helped several thousand get insurance since 2008.
Clinical and healthcare financial professionals dont talk to each other and need to, according to Atul Gawande, M.D., a surgeon at Brigham and Womens Hospital, physician IT champion and best-selling author who delivered a June 23 keynote address at the HFMA Annual National Institute in Las Vegas.
A pilot program for the Food and Drug Administrations Sentinel active surveillance system, dubbed Mini-Sentinel, is leveraging electronic healthcare data--principally claims data but also including data from EHRs--to monitor the safety of FDA-regulated medical products.
According to a survey conducted by consulting firm KPMG LLP, healthcare industry managers and executives are expecting profits to be hurt from the introduction of value-based contracting.
Health systems and public sector officials who hope to successfully deploy Medicaid accountable care organizations will have to draw lessons from the Medicare ACO programs underway, yet be flexible in creating the new delivery systems, according to staff analysts from the Center for Strategic Health Studies.
Some health plans and claims clearinghouses are charging excessive fees for paying providers via the HIPAA-mandated electronic funds transfer transaction, or are using virtual credit cards to reimburse for care, according to the Medical Group Management Association.
The California HealthCare Foundation has launched ACA 411, an interactive data tool that supplies policymakers, providers, and other healthcare delivery stakeholders in the state an at-a-glance resource to gauge progress of the Affordable Care Act.