Industry News
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Read ArticleAvoiding Common Pitfalls of Performance Guarantee Surveys
Many health plans and pharmacy benefit managers (PBMs) have contractual commitments with their large clients to meet certain performance guarantees (“PGs”), including meeting minimum levels of...
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Read ArticleAddressing America's Looming Healthcare Gap Crisis During COVID-19
While putting off care during the initial onset of the coronavirus made sense, continuing to do so will affect long-term outcomes. Here’s how providers can get patients back on track.
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Read ArticleMedicare Advantage Star Ratings: The New Patient Experience Imperative for Health Plans
CMS is putting more weight on patient experience measures in its Medicare Advantage and Part D Star ratings. What health plans can do now to improve their ratings.
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Read ArticleThree ways payers and providers are improving collaboration during the COVID-19 pandemic
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Read ArticleMaximizing Revenue and Optimizing Performance With Quality Measures
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Read ArticleThe Future of Personalized Patient Engagement: Driving Optimal Population Health Outcomes
While technology certainly hasn’t solved all our problems, one thing technology has provided healthcare is the opportunity to really personalize patient engagement at scale.
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Read ArticleHow Proactive Patient Engagement Can Influence Patient Health During COVID-19
More than half of approximately 600 consumers (52%) surveyed in mid-March—the time when major metropolitan areas began issuing “shelter-in-place” orders and encouraging “social distancing”...
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Read ArticleGauging Patients’ Healthcare Needs During a Crisis: Lessons from Successful Consumer Brands
What are patients’ most pressing healthcare needs during a crisis? If you ask healthcare plans and physicians, they’ll likely say “communication” and “care.”
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Read ArticleMedicare Advantage Star Rating Calculations Change; Act Now to Change 2023 Perceptions
Experience, access, and complaints will matter more in future scores; current studies indicate plans currently are not communicating well with members.
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Read ArticleCase Study - JCMC: Technology and Workflow Improvements Lower Overall Costs and Increase Revenue While Improving Patient Service
JCMC’s journey to becoming a model physician group began with a familiar challenge: In today’s fast changing regulatory and payment environment, mid-sized and many large independent physician groups..
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Read ArticleAmerican Family Care’s CMO Shares Learnings from Data-Driven Performance Improvement in the Urgent-Care Setting
Benjamin Barlow, M.D., the CMO of American Family Care, the nation’s largest system of urgent care clinics, explains how AFC has become successful in using data to further performance improvement
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Read ArticleCMS Interoperability and Patient Access Fact Sheet
The Interoperability and Patient Access final rule (CMS-9115-F) delivers on the Administration’s promise to put patients first, giving them access to their health information when they need it most an
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Read ArticleONC’s Cures Act Final Rule
The rule is designed to give patients and their healthcare providers secure access to health information. It also aims to increase innovation and competition by fostering new applications.
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Read ArticleHow Payers and Providers Can Align and Collaborate, with or without Vertical Integration
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Read ArticleWhy payer-provider partnerships need more collaboration
The number of accountable care organizations (ACOs) reached an all-time high in 2018, notes an article in the journal Health Affairs.
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Read ArticleInside CMS’ 2020 Proposed Changes to QPP
What’s at Stake for Medical Practices in 2020 and Beyond? CMS’ 2020 Proposed Rule for the Medicare Physician Fee Schedule calls for a number of changes.
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Read ArticleLeveraging The Right Ruler For Measuring Clinical Outcomes
Knowing how to properly measure outcomes is as important as having the right clinical resources in place If you’re not measuring your efforts against industry benchmarks, how do you know you’re making
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Read Article88 ASCs awarded for excellence in patient satisfaction — 3 details
Eighty-eight ASCs were named recipients of the SPH Analytics National Apex Quality Award, a distinction recognizing providers who demonstrate excellence in patient satisfaction.
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Read Article5 ways to create and implement better MIPS quality improvement strategies
The Centers for Medicare & Medicaid Services (CMS) recently announced that 98.4 percent of eligible clinicians participated in the second year (2018) of Merit-based Incentive Payment System (MIPS).
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Read ArticlePhysicians are facing more demands on their time than ever. What can payers do to help?
Increased prevalence of complex, chronic conditions. Numerous documentation requirements. Digital transformation and disruption. The shift to value-based care models. With all of the change happening
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