MyHR Alert - The New Health Minister Has Drunk The MyHR Kool-Aid.
In comments made an hour or so ago he indicates that it is planned to update and improve the MyHR system to save and enhance the Medicare System.The details will be very interesting!You can read the full report here:Strengthening Medicare Taskforce Report (13 pages)https://www.health.gov.au/resour ces/publications/strengthening-medicare-taskforce-report?language=enHere is the key paragraph! (Source: Australian Health Information Technology)
Source: Australian Health Information Technology - February 3, 2023 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs
13 Year Old McAllen
BY IAN MORRISON
As a Scot, obviously I am a whisky fan, and although I prefer the smoky malts of Islay (where my grandfather was from and where I visit my friends there frequently), I am also a huge fan of McCallan 18-year-old whisky, the sticky toffee pudding of single malts.
But as all policy wonks know, McAllen Texas is not famous for whisky but for Atul Gawande’s “Cost Conundrum” article in the New Yorker, in 2009 which is still required reading in medical school and MPH classes and was arguably the cornerstone of Obama health policy and the ACO movement.
Dr. Atul Gawande described overutilization and hi...
Source: The Health Care Blog - February 2, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: The Business of Health Care Affordable Care Act Atul Gawande Ian Morrison McAllen Texas Source Type: blogs
The Power of a Quality Review: Your Best Defense Against OIG Audits
The following is a guest article by Rebecca Darnall, Risk Adjustment Leader at Episource.
You don’t have to be a fortune teller to see the future of auditing at the Office of Inspector General (or OIG). It has given every indication that it intends to investigate fraud, waste, and abuse more robustly in the foreseeable future. To that end, the agency doubled its budget for audits in 2022. The clear message is to expect — and prepare for — more audits.
These actions are more than just saber-rattling. The risk of audits is a legitimate threat to all payer organizations. As proof, several health plans have been making h...
Source: EMR and HIPAA - February 2, 2023 Category: Information Technology Authors: Guest Author Tags: Administration Healthcare IT Regulations Revenue Cycle Management Audits Centers for Medicare & Medicaid Services CMS Coding Errors Demographic Error Encounter Error Episource Health Plans Insurance Missed Condition Mock RADV A Source Type: blogs
Immigrants Use Less Welfare Than Native ‐Born Americans
ConclusionThe average immigrant consumed 27.3 percent less welfare than native-born Americans in 2020. Further reform should reduce that substantially by building a higher wall around the welfare state instead of around the country. Still better would be reducing or eliminating the welfare state for all but reducing or eliminating non-citizen access is a politically feasible first step. In the long-run, there are good reasons to think that immigrants won ’t increase the size of the welfare state and compelling evidence that they would reduce support for it. Still, the net-fiscal effects are most important – watch this ...
Source: Cato-at-liberty - February 1, 2023 Category: American Health Authors: Alex Nowrasteh Source Type: blogs
Data Quality Scrutiny, SDoH, Value-Based Care …What are the New Healthcare Truths of 2023?
Conclusion
These predictions highlight the need to address the issues of data quality, curation, and utility that are paramount for healthcare’s evolution in 2023. At Verinovum, we aim to remedy the pervasive problem of poor-quality clinical data with our Data Curation as a ServiceSM approach, so that clean, high-quality clinical data can inform reporting and actionable insights.
1HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
About Mike Noshay
As Chief Strategy & Marketing Officer at Verinovum, Mike is responsible for all prospective client interactions, including client ...
Source: EMR and HIPAA - January 23, 2023 Category: Information Technology Authors: Guest Author Tags: Analytics/Big Data Communication and Patient Experience Healthcare IT AI Artificial Intelligence Care Delivery Numbers CDI Clinical Data Integration Data Curation Data Quality Data Quality Scrutiny EHR Fast Healthcare Interoperabil Source Type: blogs
Medicare Advantage UpCoding Has Been Eliminated by CMS Effective 2022
By GEORGE HALVORSON
Medicare Advantage now enrolls almost exactly half the people enrolled in Medicare — and has both significant fans and hardline opponents in the health care policy circles who disagree about its performance.
The biggest attack point that comes from the critics deals with the issues of coding accuracy by the plans. The payment model for the program is capitation — and that capitation is based on the average cost of fee-for-service Medicare in every county. The people who designed the model believed that the country should use the average cost of fee-for-service Medicare in every county as the b...
Source: The Health Care Blog - January 23, 2023 Category: Consumer Health News Authors: matthew holt Tags: Health Policy CMS George Halvorson Medicare Advantage Source Type: blogs
End-of-life choices: Why Medicare needs to change [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! End-of-life care is a crucial and often overlooked aspect of health care. In this episode, we speak with Kevin Haselhorst, an emergency physician and author who shares his insights on the challenges and opportunities in this area. He discusses the limitations of the current
Read more…
End-of-life choices: Why Medicare needs to change [PODCAST] originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - January 22, 2023 Category: General Medicine Authors: The Podcast by KevinMD Tags: Podcast Medicare Palliative Care Source Type: blogs
Costco Wholesale: What Is Its Pharmacy Strategy? It's Complicated.
Conclusion: Costco Pharmacy Manages Hybrid Cash/Insurance Payments for Rx Drugs Better Than Most Other Big Pharmacy Chains. Still, Costco Won ' tALWAYS Be the Low-Price Leader Because of How the U.S. Prescription Drug Market Functions.Costco Pharmacy ' s cash prices for many prescriptions may be low enough for people to simply bypass their insurance and pay out-of-pocket, which Costco welcomes, similar to how Mark Cuban Cost Plus Drug Co. or a number of other rapidly-growing, cash-only pharmacies which are popping up nationwide operate because their cash prices may be potentially even cheaper than by using insurance. Howev...
Source: Scott's Web Log - January 21, 2023 Category: Endocrinology Tags: 2023 Big pharma bypass insurance cash pharmacy cash-only pharmacy Costco Costco Wholesale Corp. PBM ' Source Type: blogs
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CMS has outlined its approach to implementing the first year of the Medicare drug negotiation process, including how it will engage with the public.
(Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - January 20, 2023 Category: International Medicine & Public Health Authors: Lovisa Gustafsson, Rachel Nuzum Source Type: blogs
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Medicare beneficiaries of color used more home health care services than white beneficiaries overall and were more likely to rely on unpaid informal caregivers.
(Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - January 19, 2023 Category: International Medicine & Public Health Authors: Loren Saulsberry Source Type: blogs
Monogram Health Closes $375M Growth Capital Raise to Support Continued Expansion of Innovative In-Home Kidney and Polychronic Care Model
Milestone funding from leading strategic and financial investors will help accelerate company’s mission to measurably improve outcomes for patients living with polychronic conditions, including chronic kidney and end-stage renal disease
Monogram Health, a value-based specialty provider of in-home evidence-based care and benefit management services for patients living with polychronic conditions, including chronic kidney and end-stage renal disease, today announced it has closed on $375 million of new funding. This milestone growth funding round included investments from leading strategic investors CVS Health, Cigna Ventu...
Source: EMR and HIPAA - January 18, 2023 Category: Information Technology Authors: Healthcare IT News Tags: Communication and Patient Experience Health IT Company Healthcare IT Telemedicine and Remote Monitoring Affordability BofA Securities Chronic Kidney Disease Cigna Ventures Cravath CVS Health Disease Management Frist Cressey Ventures Source Type: blogs
Congressional Pay for Performance: No Budget, No Pay
Romina BocciaImagine you are an executive at a major corporation. One of the core responsibilities of your job is to collaborate with the other executives to adopt budget and organizational policies for your corporation each year. Instead of meeting your responsibilities, most years the corporation is forced to operate without a budget as outdated policies continue and the firm bleeds red ink. Such a dysfunctional corporation likely wouldn ’t last very long. You and the other executives would also likely face pay cuts, before eventually getting fired.Now, imagine this same scenario, but you ’re a me...
Source: Cato-at-liberty - January 17, 2023 Category: American Health Authors: Romina Boccia Source Type: blogs
Activating Transparency in Health Care Pricing
The Centers for Medicare & Medicaid Services (CMS) have taken up the campaign for price transparency over the past few years. The need for this is obvious and pressing. Unlike any other industry, health care institutions have historically been totally free to charge what they want and not even tell you in advance. Most of us have had lived the horror movie that follows a hospital stay, receiving a bill in the mail…and then another bill…and another…
Hospitals have trouble predicting how much a procedure will cost for many reasons. They have a welter of agreements with different insurance companies and ...
Source: EMR and HIPAA - January 13, 2023 Category: Information Technology Authors: Andy Oram Tags: Administration Analytics/Big Data Health IT Company Healthcare IT Revenue Cycle Management CMS Costs Healthcare Cost Transparency Healthcare Price Transparency Healthcare Prices Healthcare Pricing Marcus Dorstel Turquoise Health Source Type: blogs
Healthcare Consumerism – 2023 Health IT Predictions
As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. We asked the Healthcare IT Today community to submit their predictions and we received a wide ranging set of responses that we grouped into a number of themes. Check out our communities predictions below and be sure to add your own thoughts and/or places you disagree with these predictions in the comments and on social media.
All of this year’s 2023 health IT predictions:
Healthcare Security and Risk
Healthcare AI
Business of Healthcare and Value Based Care
Healthcare Workforce
Telehealth and RPM
Pharma
Health E...
Source: EMR and HIPAA - January 12, 2023 Category: Information Technology Authors: John Lynn Tags: Communication and Patient Experience Health IT Company Healthcare IT 2023 Health IT Predictions Adrienne Boissy Brad Kittredge Brightside Health Cedar Cleveland Clinic Craig Worland Dave Bennett Derek Streat DexCare Diana Zuskov Source Type: blogs
Pharma – 2023 Health IT Predictions
As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. We asked the Healthcare IT Today community to submit their predictions and we received a wide ranging set of responses that we grouped into a number of themes. Check out our communities predictions below and be sure to add your own thoughts and/or places you disagree with these predictions in the comments and on social media.
Check out our community’s pharma predictions.
Jesse Cugliotta, Global Industry GTM Lead, Healthcare & Life Sciences at Snowflake
Industry investments in data platforms to enable decentra...
Source: EMR and HIPAA - January 9, 2023 Category: Information Technology Authors: John Lynn Tags: Health IT Company Healthcare IT 2023 Health IT Predictions Abrpo BrainCheck Doceree Harshit Jain Ian Chen Jesse Cugliotta Kimberly Powell Lance Hill Lauren Ohlsson Mike Montalto NVIDIA Ofer Sharon OncoHost PathAI Pharma Source Type: blogs
