Eric Meyer

Interoperability standards continue to shape the #healthcare industry from #CMS regulations to #HEDIS reporting. To set themselves up for continued success, payers must anticipate the coming shifts, and stay ahead of the ever-evolving landscape. 💭 A recent byline in DOTmed.com, Inc from our client Cotiviti dives into the necessary steps payers must take to ensure these standards are met for seamless #dataexchange: https://lnkd.in/ghGB_txj #interoperability #datasharing #FHIR 

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Four things you'll learn in our August 14th, 12:00 PM live webinar with Intermountain Health's Mona Baset, MBA, MA, CHCIO, CDH-E & Endeavor Health's Jim Economou: 1. How Intermountain Health increased NPS by 130% YoY while cutting call abandonment rates by 85%. 2. Why Endeavor Health prioritizes average speed to answer. 3. Why digital healthcare experiences still lag behind other industries. 4. Newly released findings from a survey of 1,500 US patients. Don't miss out! Save your seat here https://bit.ly/3StXTFK #patientaccess #livewebinar #healthit

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📣📰🗣️Take a moment to read the latest on one of our WVU Innovation Corporation tenants, GATC Health and their great strides in AI drug discovery. #letsgooo #westvirginia #WVU #WVUMedicine.

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An Outpatient Clinical Documentation Improvement (CDI) program offers substantial advantages to healthcare organizations by elevating patient care and operational efficiency. By integrating risk stratification with chronic conditions, enhancing quality measures, addressing social determinants of health, and establishing a collaborative team empowered by technology, such strategic initiatives result in improved patient outcomes and streamlined operations.

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Healthcare has made improvements but there's still a long way to go to become truly digital-first. While we've seen advancements in telemedicine, electronic health records, and AI-driven diagnostics, the journey to fully integrate these technologies into everyday practice is far from complete. And the “door” to care – patient navigation – needs a lot of work. If we don't evolve, patient's will find others who do! https://lnkd.in/eSJKiHSR #patientcentricity #digitalfirst #digitaltransformation #patientnavigation

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Keep our rurals open but if you really want to help get the foreign equity owned GPO that sets the pricing for our hospitals BANNED from our state. Economies of scale are used by Vizient against Oklahoma rural hospitals. If you have 13 tiers, hidden tiers, and tier maxes…that’s not a contract, that a free for all nightmare of a scam we all fell for. Their awful written tiered agreements force our rurals to pay more for the exact same items that our large hospitals pay less for. Example box of gloves a large hospital system in the state will pay 6-8 bucks for a box of 250 exam gloves. That same box for a rural EMT? 24 bucks. There is no price transparency and you are forcing patients who live in rural areas to pay more because of the lack of infrastructure by the corporations serving them to effectively and economically get goods and services to these hospitals. And distributors who whine about the cost of delivering to rural hospitals all while posting BILLIONS in profit every quarter are the first on my 💩 list. Let’s keep our rurals open but let’s make them more profitable so that they can continue to add much needed services and gainfully employ more community members.

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“We envision a future where every child receives personalized, high-quality care. To make this vision a reality, we must overcome the challenges of #carecoordination,” said Dr. Amanda Furr, VP of #PopulationHealth at Pediatrics Associates Inc. “We understand the value of #dataanalytics, risk adjustment, quality gap closure and empowering #pediatric clinicians to improve outcomes. As our organization continues to grow, it’s imperative for us to scale our #PHM capabilities. The #Innovaccer platform enhances our understanding of patient populations and helps us make accurate diagnoses, establish and automate TCM protocols, and bridge care gaps. This holistic approach helps us to deliver a seamless, comprehensive #healthcare experience for our patients and families.” “We have an established relationship with the #PediatricsAssociates team, and we are excited to be working with them again as we are setting a new standard for #healthcare, where #technology and compassion converge to enrich the lives of children and their families,” said Abhinav Shashank, cofounder and CEO at Innovaccer. “Pediatric Associates has an impressive track record in managing over 1.5 million lives across Medicaid and commercial contracts. Innovaccer’s AI-powered, scalable PHM platform will help them effectively manage patient populations to meet their goal of managing over 1 million covered lives in the next two years. We look forward to supporting Pediatric Associates in its mission to launch a new era of pediatric care that is both proactive and profoundly impactful.” https://lnkd.in/gvUD-sm4

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Great article by Priti Choksey Shah on the importance of integrating Clinical Documentation Integrity (CDI) and Utilization Management (UM) in hospitals. #HealthcareInnovation #RevenueManagement #AIinHealthcare #HospitalEfficiency #CDI #UM

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Is #ValueBasedCare reaching a tipping point? Early results from Blue Shield of California suggest we're on the verge of a health care transformation, with 56% of health care costs now in a VBC model. And the model is working! This year alone, Blue Shield of California’s Primary Care Reimagined strategy has produced “a 7.4% reduction in overall cost of health care,” says Krishna Ramachandran, senior vice president for health transformation and provider adoption. Read more at: https://bit.ly/3BIaCz9

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𝗧𝗿𝗮𝗻𝘀𝗳𝗼𝗿𝗺 𝗬𝗼𝘂𝗿 𝗣𝗿𝗮𝗰𝘁𝗶𝗰𝗲’𝘀 𝗥𝗲𝘃𝗲𝗻𝘂𝗲 𝗖𝘆𝗰𝗹𝗲 𝘄𝗶𝘁𝗵 𝗜𝗻𝗻𝗼𝘃𝗮𝘁𝗶𝘃𝗲 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗘𝗻𝗴𝗮𝗴𝗲𝗺𝗲𝗻𝘁 𝗦𝗼𝗹𝘂𝘁𝗶𝗼𝗻𝘀 At 𝗣𝗿𝗼𝗯𝗲 𝗣𝗦, we understand that effective patient engagement is key to driving revenue and improving health outcomes. Our advanced patient engagement technologies are designed to help independent practitioners connect with patients more creatively and meaningfully, improving both care delivery and revenue flow. 𝗢𝘂𝗿 𝗥𝗖𝗠 𝗦𝗲𝗿𝘃𝗶𝗰𝗲𝘀 𝗣𝗼𝘄𝗲𝗿 𝗬𝗼𝘂𝗿 𝗙𝗶𝗻𝗮𝗻𝗰𝗶𝗮𝗹 𝗦𝘂𝗰𝗰𝗲𝘀𝘀 We offer comprehensive Revenue Cycle Management (RCM) solutions that ensure seamless financial operations, including: • 𝗖𝗹𝗮𝗶𝗺 𝗦𝘂𝗯𝗺𝗶𝘀𝘀𝗶𝗼𝗻 & 𝗙𝗼𝗹𝗹𝗼𝘄-𝗨𝗽: Timely, accurate claims to minimize denials and speed up payments. • 𝗗𝗲𝗻𝗶𝗮𝗹 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁: Recover lost revenue with efficient denial resolution. • 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗕𝗶𝗹𝗹𝗶𝗻𝗴 & 𝗖𝗼𝗹𝗹𝗲𝗰𝘁𝗶𝗼𝗻𝘀: Streamlined billing processes for enhanced cash flow and collections. 𝗔𝘂𝘁𝗼𝗺𝗮𝘁𝗲𝗱 𝗜𝗻𝘀𝘂𝗿𝗮𝗻𝗰𝗲 𝗖𝗮𝗽𝘁𝘂𝗿𝗲 𝗳𝗼𝗿 𝗔𝗰𝗰𝘂𝗿𝗮𝗰𝘆 Our smart messaging system verifies insurance details and requests updated info via text, ensuring your practice captures accurate patient coverage without hassle. 𝗖𝗵𝗿𝗼𝗻𝗶𝗰 𝗖𝗮𝗿𝗲 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁 𝘄𝗶𝘁𝗵 𝗣𝗲𝗿𝘀𝗼𝗻𝗮𝗹𝗶𝘇𝗲𝗱 𝗔𝗹𝗲𝗿𝘁𝘀 We track chronic care needs and provide automated reminders for patients to stay on top of their treatment plans, enhancing compliance and health outcomes. 𝗪𝗲𝗹𝗹𝗻𝗲𝘀𝘀 𝗖𝗵𝗲𝗰𝗸𝘀 𝘄𝗶𝘁𝗵 𝗔𝘂𝘁𝗼𝗺𝗮𝘁𝗲𝗱 𝗦𝗰𝗵𝗲𝗱𝘂𝗹𝗶𝗻𝗴 Our system schedules wellness visits based on EMR data and sends personalized reminders to patients, ensuring regular care and improving preventive outcomes. 𝗥𝗲𝗳𝗲𝗿𝗿𝗮𝗹 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁 𝗠𝗮𝗱𝗲 𝗘𝗮𝘀𝘆 From eligibility verification to appointment scheduling and payment collection, we automate the entire referral process, reducing administrative burdens and improving patient satisfaction. By leveraging cutting-edge technology, we empower your practice to engage patients, boost health outcomes, and drive revenue growth. Ready to revolutionize your revenue cycle? Reach out to us at info@probeps.com #PatientEngagement #RevenueCycleManagement #IndependentPractices #RCM #ChronicCareManagement #WellnessChecks #ReferralManagement

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In my weekly piece, I discuss AI-based services in healthcare. The integration of AI-delivered healthcare services is poised to revolutionize patient care, but a significant question remains: will payers equitably reimburse these services compared to care provided by human practitioners? my piece delves into the financial implications and policies surrounding AI in healthcare, highlighting the necessity for fair compensation frameworks. It emphasizes the potential benefits of AI for enhancing healthcare quality and accessibility while advocating for equitable reimbursement structures. Follow https://lnkd.in/ewwss6wy

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Linus Health Chief Product Officer John Showalter, MD, challenged Jessica Hagen of MobiHealthNews to imagine a world without early detection of chronic diseases like hypertension and cancer. While we have come a long way in detecting many chronic diseases such as these earlier, we still have work to do when it comes to routine screenings for mild cognitive impairment. However, evidence-based digital screenings are helping healthcare providers efficiently drive the early detection of mild cognitive impairment–and care pathways focused on lifestyle are making a difference for the better. https://lnkd.in/gqmP3N4D I #AlzheimersDisease #BrainHealth #MCI #AlzheimersAwareness #PreventativeCare #PrimaryCare #HIMSS24

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The 'payvider' becoming a healthcare delivery niche player. It appears all outpatient...infusion, pharma, home health, urgent care, etc. Seeing more signs of consumers being directed by payers. No real, big box hospital purchases. Are beds being isolated and commoditized? #hospitals #healthcare #business #payers

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I'm excited to share what one of my clients (UCI Health) is doing to enhance patient experience by boosting communication between doctors and nurses. NRC Health's new article covers their journey and key takeaways. Plus, catch the full webcast on-demand for more details. Read and watch at the link below! #HumanUnderstading #PatientExperience

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As our population ages, the strain on our healthcare system will continue to face unprecedented challenges, especially in caring for individuals with complex care needs. Coupled with this crisis, is an opportunity, to leverage new technology and innovation that can reimagine care delivery and the care experience. Questions we ideate on at AlayaCare include: How might we imagine, enable and empower physicians, nurses, therapists, and personal care aids to use technology to improve their practices and scale working in integrated care teams to keep people in their homes, where they want to be. One of the ways that we are answering these questions is by introducing the first-ever Large Language Model (LLM)-based smart AI assistant for home-based care. This new AI assistant will aid home care providers by providing real-time clinical decision support, reducing administrative burdens, and enabling more focused patient-centred care. Our goal is to mitigate risks of adverse clinical events, and hospital or institutional readmissions, but going further, perhaps one day even preventing them altogether. We want to optimize care schedules to make care providers' days just that much easier so that they can care for more individuals. Our true north is to find efficiencies and improve the quality of care that is being provided so that more of our loved ones can receive care in the place they call home. Thank you to the invaluable partnership of DIGITAL, Canada’s Global Innovation Cluster for this investment, trust and partnership as we continue to work to transform home-based care. https://lnkd.in/gN5Debhs

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Many healthcare payers are still struggling with coordinated care. Data from Beckers Healthcare earlier this year found that disconnections with providers, interoperability challenges, and a lack of communication and visibility are contributing factors. “It’s not surprising to see such a high prevalence of payers struggling to successfully execute coordinated care,” said Sue Powers, Chief Growth Officer at VirtualHealth. “This is often one of the concerns payers come to us with when evaluating care management platforms, and we usually see several barriers that are preventing true care collaboration. The most common barriers we see to coordinated care include 1️⃣ communication barriers between payers and providers; 2️⃣ disparate systems and data formats that create silos of information; 3️⃣ lack of active patient engagement; 4️⃣ gaps in the proactive whole-person care approach — specifically those related to social determinants of health; and 5️⃣ poorly constructed workflows. And what makes coordinated care more challenging is that all these are connected. You can’t create better communications across the care continuum or properly identify health-related social issues if data isn’t transparently centralized and shared. And you cannot engage members in their health without them in a timely fashion, which is created by leveraging intelligent streamlined workflows.”

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Key Strategic Insights = A Successful OP CDI Program The challenge of value-based care starts with a collaborative approach, when launching an Outpatient Clinical Documentation Integrity (OP CDI) program. Here are some key strategic insights to success: 1. Engage with Population Health Understand Pain Points: Begin by understanding the specific challenges faced. This fosters collaboration. Tailored Questions: Use customized questions to facilitate productive discussions and ensure alignment with needs. 2. Effective Software Implementation Manage Patient (Pt.) Volumes: Implement software solutions to efficiently handle pt. volumes. OP CDI Calculator: Utilize a calculator to determine Full-Time Equivalent (FTE) needs. Data Analytics and Reporting: Emphasize the importance of continuous improvement via data analytics. 3. Workflow Creation Establish Robust Workflows: Create strong workflows before integrating reviewers. 4. Collaboration & Communication Promote Strong Collaboration: Encourage robust communication between key stakeholders. Leverage Software: Use technology to reduce physician burnout & streamline communication. 5. Patient-Centered Approach Address social determinants of health (SDOH) & ensure accurate documentation of conditions and care plans. Patient Outcomes: Keep patient care at the center of all doc. & workflow processes. 6. Regulatory Compliance Adhere to Guidelines: Follow regulatory requirements such as CMS guidelines on Hierarchical Condition Categories (HCC) coding to avoid penalties and enhance credibility. 7. Measurable Outcomes Set Clear Goals: Aim for measurable outcomes like improved HCC recapture rates, enhanced RAF scores, better HEDIS measures, and addressing SDOH needs. 8. Stakeholder Engagement Involve All Stakeholders: Ensure that executives, clinicians, and other relevant parties are involved in planning and implementation process. Success Stories Recently, I helped several CDI directors validate their cases for OP CDI programs within Accountable Care Organizations (ACOs). By engaging with population health leadership, we identified key issues such as RAF gaps and HEDIS measures, and tailored processes to address them. For instance, a CDI director I guided successfully identified HCC and HEDIS recapture as their biggest pain points. With strategic solutions in place, they are now ready to implement the project for the 2025 budget yr., aiming to improve their HCC recapture rate by 20%, leveraging data analytics for outcomes and improvement needs. Benefits of Implementing These Strategies Align Risk Stratification: Properly align risk stratification with chronic conditions and healthcare needs. Quality Measures: Improve quality measures and address SDOH. Collaborative Team: Ensure success with a collaborative team supported by technology. Overall, these strategic actions will enhance patient care and operational efficiency. #Healthcare #Leadership #CDI #PatientCare #ValueBasedCare #HealthcareInnovation

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