Tag Archives: Big Data

Expanding the scope of healthcare data

With data and analytics accepted as valuable tools in population health management, questions are now focused on what kinds of data to include and how to best use it. Health care leaders quickly learned that the most accessible data – claims data – is important but not enough. It’s not particularly timely and it’s often […]
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Linking quality data to risk-based contracting success

What you don’t know might hurt you. That seems to be the fear plaguing health care executives eyeing a transition to contracts that put providers on the hook for financial risk. Healthcare Informatics (HCI) reported on a survey from trade association American Medical Group Association (AMGA). It asked health care executives about the biggest barriers […]
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Rethinking department cooperation to build IT, HIE systems

To really manage clinical and financial risks, healthcare providers may need to do more with their data. To enable that goal, they may need to rethink how tasks are divided between departments. Health Data Management reported on an issue paper from the Workgroup for Electronic Data Interchange. WEDI found a strong health IT infrastructure and […]
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Learn about business pros who can make risk less risky

When the Centers for Medicare and Medicaid Services (CMS) called on health plans to apply for a value-based insurance test project, it stipulated that interested organizations must include financial projections and that those projections must be “actuarially certified.” While that term wouldn’t stump health plans and traditional payers – for whom the use of actuaries […]
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New technologies are breaking down data silos

The highest quality data does no one any good if the information is locked up in silos, unable to be shared. Now the tools of health care are changing in a way that will allow data to be accessed and analyzed. Electronic Medical Records (EMRs) and Health Information Exchanges (HIE) represent two of the top […]
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Is your data organized to allow for utilization?

Even early-adopter health systems – leaders in the transition to population health management who have relied on data for some time – find it valuable to review their analytics platforms and ask, ‘what can you do for me now?’ One such system is Mercy health system – a Pioneer ACO and participant in the Physicians Group Practice demonstration […]
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3 analytics deliverables credited with ACO progress

What does it take to create an accountable care organization that meets benchmarks in care delivery and proves to be profitable? Jeff James, Chief Executive Officer at North Carolina-based Wilmington Health, says metrics and analytics allow for his group’s ACO to exist. The ACO was formed as a partnership with Blue Cross Blue Shield of […]
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Documenting diagnoses makes a difference in care quality.

An often-repeated statistic warns that 8 million Americans have diabetes and don’t know it. There are similar claims about other chronic illnesses, like hypertension and chronic heart failure. If a patient doesn’t know they are missing a diagnosis, their health care provider may not either. The white paper Accurate coding: The foundation of accountable care explains that […]
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Lessons learned from payers aid in shift to value-based care.

As fee-for-value payment models replace fee-for-volume models, providers are more often managing medical costs and risk. These are roles once dominated by payers. As providers find themselves needing to analyze risk, they can learn from health plans, employers and other payers — and adopt some of the same tools they use. One tactic providers can […]
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Data can help shape patient interventions.

The future success of fee-for-value payment models depends partially on the ability of provider organizations to help patients manage their own health. The idea is that proactive interventions will keep patients healthier and avoid the high costs that arise when a condition worsens to the point of requiring acute care. Analytics can help providers create […]
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