Payers

Thursday, June 20, 2013

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.

CMS Wants New Measures for PQRS

Joseph Goedert | Jun 04

The Centers for Medicare and Medicaid Services is seeking new suggestions for quality measures that could be included in the Physician Quality Reporting System program in coming years.

Group Practices

Policy & Regulation

Revenue Cycle Management

Practice Management

Revenue Cycle & Payments

EHR

States May Lose $8.4 Billion in U.S. Funds by Rejecting Medicaid

Alex Wayne of Bloomberg | Jun 04

Texas, Louisiana and 12 other U.S. states that are declining to expand Medicaid under President Barack Obama’s health overhaul will lose at least $8.4 billion in federal funding in 2016 alone, a study found.

Consumer Health

Group Practices

Hospitals

Policy & Regulation

More Product Entries in the Stage 2-Certified List

Joseph Goedert | Jun 04

Two more health information technology vendors recently received Modular EHR certification for meeting some of the requirements of revised Stage 1 and Stage 2 electronic health records meaningful use criteria, called the 2014 Edition.

EHR

Group Practices

Policy & Regulation

Hospitals

Stimulus

Uninsured are Uncertain, Uninformed About Health Coverage

Joseph Goedert | Jun 03

Many consumers without health insurance don’t have immediate plans to buy it when federally subsidized plans become available this fall via health insurance exchanges, according to a new survey.

Consumer Health

Group Practices

Hospitals

Policy & Regulation

HHS Makes More Health Data Available

Joseph Goedert | Jun 03

The Department of Health and Human Services unveiled a number of new initiatives on June 3 during the Health Datapolooza IV conference in Washington:

Consumer Health

Group Practices

Hospitals

Policy & Regulation

Chronic Care

Coding

Prediction: Modest Medicaid Boost Under Reform, Big Fall in Number of Uninsured

Joseph Goedert | Jun 03

A new study from data analysis vendor Truven Health Analytics predicts a modest increase in Medicaid enrollment in the early years of health care reform as tens of millions of consumers enroll in health insurance exchanges to compare and select a benefit plan.

Consumer Health

Group Practices

Hospitals

Policy & Regulation

Revenue Cycle & Payments

Guidance Walks through New EFT/ERA Transactions

Joseph Goedert | Jun 03

A new report from the Workgroup for Electronic Data Interchange covers the new electronic fund transfer and electronic remittance advice HIPAA transactions that were mandated in January 2014.

Coding

Electronic Data Interchange

Group Practices

Hospitals

Policy & Regulation

Practice Management

Revenue Cycle Management

Revenue Cycle & Payments

Assessing the Future of Real-Time Claims Adjudication

Gary Baldwin | Jun 03

When the topic turns to real-time claims adjudication, Bryan Braswell gets to the point-as fast as the technology itself. He's not interested.

Electronic Data Interchange

Group Practices

Hospitals

Revenue Cycle & Payments

Practice Management

Revenue Cycle Management

Coding

Getting 'Real' About Claims Processing

Gary Baldwin | Jun 01

Real-time adjudication largely remains a claims transaction fantasy, but snarled operations and new reimbursement models cry out for it.

Group Practices

Hospitals

Revenue Cycle Management

Practice Management

Revenue Cycle & Payments

Electronic Data Interchange

ACOs Are Coming, Will HIEs Be There?

Joseph Goedert | Jun 01

There are well over 400 accountable care organizations in the nation now and about two dozen self-sustaining health information exchanges.

Health Info Exchange

Group Practices

Hospitals

Policy & Regulation

Revenue Cycle & Payments

Sky's the Limit on Complexity

Greg Gillespie | Jun 01

This month's features are about a variety of topics-HIEs/ACOs, claims adjudication, radiology analytics, EHRs-that share one common denominator: they're all about technologies, processes and transactions that are immensely complex.

Hospitals

Group Practices

Electronic Data Interchange

EHR

Health Info Exchange

Medical Imaging

Are HIEs Ready for Accountable Care?

Joseph Goedert | May 31

The Obama Administration shepherded through the HITECH Act in 2009 to accelerate adoption of information technology to support the health care reform initiative, which heavily relies on I.T. and health information exchange to manage a new health system centered on the patient, value and outcomes.

EHR

Group Practices

Health Info Exchange

Hospitals

Policy & Regulation

Revenue Cycle & Payments

How Can Clearinghouses Help with ICD-10?

Joseph Goedert | May 31

The Centers for Medicare and Medicaid Services has issued guidance on the role of claims clearinghouses in the transition to ICD-10 code sets:

Coding

Decision Support

Electronic Data Interchange

Group Practices

Hospitals

Revenue Cycle & Payments

Practice Management

Revenue Cycle Management

Policy & Regulation

EHNAC Accreditation Firm Updates Criteria

Joseph Goedert | May 30

The Electronic Healthcare Network Accreditation Commission has released for comment updated versions of criteria for 12 existing programs and three new programs covering use of the Direct Project secure messaging protocols.

Electronic Data Interchange

Revenue Cycle & Payments

Vendor News

Group Practices

Health Info Exchange

Hospitals

Policy & Regulation

Tablets to Outsell Portable PCs in 2013

Bob Violino of Information Management | May 30

Shipments of tablet devices are expected to grow 59 percent year-over-year in 2013, reaching 229.3 million units, up from 144.5 million units in 2012, according to a new forecast from IDC’s Worldwide Quarterly Tablet Tracker.

Group Practices

Hospitals

Mobile Technology

Hardware

Most Emailed

Slide Shows

2013 Best in KLAS/Medical Equipment

Twitter

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Current Issue

ACOs Are Coming, Will HIEs Be There?

There are well over 400 accountable care organizations in the nation now and about two dozen self-sustaining health information exchanges.

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Health I.T. Keeps NY Islanders On the Ice

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