Category Archives: Payer

Unlocking insights and value within health care data through NLP

I recently called natural language processing (NLP) artificial intelligence (AI) with an ROI — and yes, it’s a catchy phrase, but it’s also true. NLP is an essential asset in today’s health care landscape. Let me tell you a story. Bill and Ted work at the same company – Excellent Adventures, Ltd. – but they […]
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Osler Health’s journey to greater analytic sophistication

With health care providers treating hundreds of thousands of people each year, the amount of data generated by those interactions is complex and overwhelming. Yet it is this very data that answers the questions central to health care management and achieving the Triple Aim. The challenge for health care providers is to develop strategies that […]
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HfS Winner’s Circle Recognition for Optum Health Care Business Operations Services

An interview with Brian Murray, Senior Vice President, Optum HfS Research is a global research and advisory firm. They recently published their Healthcare Business Operations Services Blueprint. It provides an analysis of the business process services and outsourcing market for health care business operations. HfS placed Optum in the HfS Winner’s Circle for its data- […]
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Data can turn frustrated consumers into loyal ones

As health care becomes more complex, the consumer experience is getting more fragmented, which makes it all too easy for people to feel overwhelmed and frustrated. This is not good. For one thing the industry is trying to improve health, not make it worse by leaving a trail of exasperated consumers. What’s more, health care […]
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Artificial intelligence unlocks buried data

Did you know that more than half of the information contained in electronic medical records is unusable to health care organizations? Mark Morsch, Optum360 Vice President of Technology, says studies show 60 to 80 percent of EMR content is unstructured. That means some data that could potentially be used to create a more complete picture […]
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Learn to speak the same health care language

Take a trip around the world and you’ll hear a lot of different languages, including some you probably won’t understand without a translator. Data is the language of today’s health care system. But a patient’s journey through that system collects data from a variety of sources in many different formats. It’s hard for anyone to […]
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The 10 most significant HEDIS challenges

Improving quality measures and HealthCare Effectiveness Data and Information Set (HEDIS®) scores is becoming increasingly important to improving Star ratings and bottom-line performance. But to boost HEDIS scores and gain competitive advantage, health plans must be aware of the challenges and the strategies necessary to meet them. The 10 most significant HEDIS challenges and strategies: […]
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AHIP Institute & Expo focuses on complex priorities for payers

What are the biggest disruptors to our health system, and what is their potential impact on your future business strategies? How can improved infrastructure and technology benefit clinical care, increase efficiencies and reduce costs? How do we build long-term relationships with consumers? These questions and more will be addressed during the AHIP Institute & Expo, […]
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CMS Advance Notice and 2017 Draft Call Letter: Implications for MA and PDP plans

The Centers for Medicare & Medicaid Services (CMS) released its 2017 Advance Notice and Draft Call Letter in February, proposing numerous changes for Medicare Advantage (MA) and Part D plan sponsors. The notice contains both opportunities and challenges that you will need to assess in order to determine how your organization will react. It’s important […]
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Oncology issues and solutions: Establishing a comprehensive care strategy

While cancer continues to be one of the most common causes of death in the United States — exceeded only by heart disease — there is some good news. Prevention and early detection/treatment are improving five-year survival rates, with clinical care and treatment options advancing as more is understood about the disease. Complex care, complex […]
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