What will you do differently this HEDIS® season?

Speaking from experience With limited resources during the short HEDIS season, health plans must make quick decisions to prioritize the number of medical records to retrieve, abstract and over read to meet their goals. One year when I was at a health plan, we were at the end of the HEDIS season. We were two […]
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The people side of “analytics”

For HHS agencies, the focus is on improving lives To slightly misquote Benjamin Disraeli, there are lies, damn lies, and analytics. Okay, let me say it another way.  It’s not that “analytics” are actually lies, but – like “statistics” in Disraeli’s time – they can be misleading and, if not used and interpreted properly, can […]
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After nearly 50 years, it’s time to retire traditional MMIS procurements

There are only 51 of them in the entire country, but their reach affects millions and their impact is profound. Cumulatively through the years, these systems have cost states billions of dollars and consumed thousands of hours of productivity. They’ve caused headaches, heartburn and sleepless nights for agency IT experts, financial executives and policy analysts […]
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A SMART approach to your employees’ New Year’s resolutions — or any time

It’s that time of year again. With the holidays close by, it’s natural for your employees to start thinking about New Year’s resolutions. Keeping a promise to oneself is more easily said than done, though. Year after year, people enter January with ambitious goals: losing weight, exercising more, signing up for a race. Sound familiar? […]
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Population health management requires care coordination and patient engagement

Healthcare is experiencing unprecedented change at the moment; some would say this is long overdue. Between regulatory and reimbursement reforms, emerging technologies, and the pursuit of the Triple Aim, managing population health has become a fundamental requirement for most health systems. While the benefits of value-based care are many, the transformation to a more patient-centric […]
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What can you achieve by improving the employee experience?

Savvy employers know that creating a great employee experience matters — and are constantly looking for ways to improve it. A new webinar from Optum showcases research that reveals a strong correlation — specifically between eNPS and the availability of well-being programs offered to employees, and high participation rates in those programs. Watch the webinar […]
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AI for health care: Supporting providers in delivering better care

Artificial intelligence (AI) has enormous potential to transform health care over the next decade. There is anticipation building that the financial impact could be remarkable, with one study estimating $52 billion in savings across health care by 2021. The impact on areas of disease diagnosis, patient treatment and health care operations is equally promising. Capitalizing […]
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Helping employees achieve resiliency

When I was a high school teacher, I used to compare the end of the school year to going over a waterfall. You’re floating down the river with your gear neatly organized in your boat. Then, all of a sudden, you’re falling. Everything you’ve so neatly put together is flying through the air around you. […]
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Best practices to decrease growing emergency department costs

The costs of services provided by hospital emergency departments have become a source of major concern for payers. When a member receives care at an emergency department (ED), the facility and physicians separately submit evaluation and management (E/M) codes on the claim for services performed. E/M codes are based on services performed while caring for […]
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Not science fiction: AI is creating value in surprising places

You might think of artificial intelligence (AI) in health care as science fiction — something that’s a future possibility. But the truth is, the future is here now. AI is a collection of methods and technologies for performing tasks we often associate with the human mind, such as learning and reasoning. AI approaches already have […]
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