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.
Ten eligible hospitals and 972 eligible professionals have attested to Stage 2 meaningful use as of July 1, according to the latest numbers from the government.
The Centers for Medicare and Medicaid Services has certified the Health Care Cost Institute as the first national "Qualified Entity" to have full access to national Medicare claims data for reporting on the costs and quality of healthcare services.
"Patient engagement" is a popular term currently, but the practice of providing consumers with relevant data about the clinical and financial aspects of their care is still in its infancy. Nevertheless, employers and health plans appear to be more than ready to provide such platforms to consumers.
Analyses of biomedical data from nearly 37,000 volunteer employees of a large company insured under Aetna shows a success rate of 80 percent to 88 percent in predicting risk of metabolic syndrome, which can cause chronic disease.
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.