Areas where technology helps providers cope with the new changes Identity Management EMPI solution to detect duplicate records Duplicate records…
Healthcare
Review Tools for QHP Application
The CMS provides issuers with a number of review tools to check their plans for errors in the QHP application…
Home Health Calendar Year 2019-20 Finalized Rules
CMS finalizes the calendar year 2019 and 2020 payment and policy changes for Home Health Agencies and Home Infusion Therapy…
QHP Certification Guidelines for Payers
The Patient Protection and Affordable Care Act (PPACA) and applicable regulations assert that health plans, including SADPs, must meet a…
An Introduction to Qualified Health Plan
The Affordable Care Act (ACA), defines QHP as an insurance plan certified by the Health Insurance Marketplace which provides Essential Health…
Current PHM solutions and associated challenges
In the previous section we discussed the technologies available to enhance a PHM solution, and how it helps the healthcare…
How Technology can enable PHM?
Healthcare organizations need to have technological capabilities within their care delivery processes to effectively use data to manage the cost…
Benefits of PHM / Value-Based Healthcare Delivery
Population Health Management is the systematic process of patient data gathering, analyzing and managing patient’s data in the health care…
Blue Button 2.0 and its impacts on different kinds of applications
The data being made available through Blue Button 2.0 initiative provides opportunities to leverage this data for meaningful purposes. Depending on the motivation of the user of these systems, the purpose and approach may differ.
BlueButton 2.0 Use Cases in Healthcare Ecosystem
Blue Button 2.0 is creating a data-centric ecosystem for Medicare beneficiaries. By facilitating access to patient health history, it has the potential to drive down Medicare spending and improve health outcomes.
Impacts of HHGM on Home Health Software
With the finalization of the Home Health Grouping Model, the CMS intends to shift from paying for volume to paying for value by eliminating therapy visits as a factor in payment determinations. The HHGM is expected to meet or exceed industry quality standards in healthcare by incentivizing home health providers. It also has the capability to remarkably influence the operations of home health agencies and healthcare industry as a whole.
Home Health Grouping Model
The current case-mix adjusted payments under the Home Health Prospective Payment System (HH PPS) are therapy driven, and beneficiaries with…