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    NCQA Population Health Management Accreditation

    Change Healthcare
    11/9/2020
    National Committee for Quality Assurance (NCQA) has set the gold standard for quality and accreditation for various types of health care organizations. According to the PHM resource guide these standards provide guide to a model of care that addresses individuals’ health needs at all points along the continuum of care, including in the community setting. Read more to learn more about the four areas of focus within the PHM standards.

    Cotiviti CEO Emad Rizk, M.D. on the importance of interoperability

    Cotiviti
    11/4/2020
    Cotiviti’s CEO writes for the Journal of AHIMA on why analytics-driven interoperability is vital in 2020 and beyond.

    Enterprise Risk Management, HITRUST, SOC 2, and You

    Change Healthcare
    11/2/2020
    Information is flowing between multiple on-premise and cloud data centers; among vendors, software services, and APIs; and often across the public Internet. This cybersecurity month, listen in to hear Bob Hoover, VP of Change Healthcare Consulting and others from Change Healthcare Consulting discuss the state of IT security and where HITRUST, SOC 2, and enterprise risk management fit.

    It’s not too late to meet your plan’s 2020 performance goals

    NovuHealth
    10/29/2020
    It’s no secret that the COVID-19 pandemic has upended the world of healthcare. If you’re concerned about hitting performance targets for 2020, you’re not alone; we’ve heard concerns from plans across the country. But there’s no reason to fear. With a little last minute focus and these actionable steps, there’s still plenty of opportunity to get back on track.

    A Rapid Response: From Digital Adherence Programs to COVID-19 Monitoring

    emocha Health
    10/8/2020
    emocha has been clinically validated to help payers and providers improve clinical outcomes by removing traditional geographical, time, and resource barriers. In response to COVID-19, emocha has leveraged its extensive public health experience to rapidly support healthcare workers, municipalities, and employers with remote symptoms and temperature monitoring.

    Case Study: Health Plan Engages Bill Review to Realize Millions in Claim Savings

    Summit Re
    9/28/2020
    The traditional claims process--receive a claim, verify the member’s eligibility, review for medical necessity, pay the claim-focuses more on the viability of the treatment than the billing of it. The billing process must also be taken into account in order to ensure the health plan is providing the most appropriate, cost-effective coverage. Summit Re, together with Zelis, helps companies do just that. Webinar event: October 29 - 11:00 AM (CDT)

    Exploring Short-Term and Long-Term Impacts of the Pandemic on Healthcare

    Change Healthcare
    9/28/2020
    To better understand the issues raised by COVID-19 for the healthcare industry, Change Healthcare and the HealthCare Executive Group conducted a follow-up survey to append the results of the 10th Annual Industry Pulse Study, released in February 2020. The results reveal the current challenges and priorities of payers and providers across the nation. Read more to hear how COVID-19 impacted healthcare’s priorities.

    Help for Those Being Laid Off

    Gibson Consulting
    9/23/2020
    Today’s health plan job market is a mixed bag. Some plans are hiring, while others are laying off. It sometimes varies even more from function to function. If you have to lay someone off, or if a friend or colleague has been let go, you may want to share these job-hunting tips. Some are obvious, others less so, but they are all time-tested and true.

    Health Plan Executive Brief: How to Evolve to the Next Generation of Behavioral Health Solutions

    HealthScape Advisors
    9/23/2020
    The demand for services to address behavioral health conditions—inclusive of mental health and substance use disorders—has never been greater given changes in cultural acceptance, evolving regulation, increasing attention to integrated care, and most recently, the acute impact of the COVID-19 pandemic. Check out HealthScape Advisors latest brief to learn the drivers of this growing demand and the challenges health plans face.

    Executive Brief: Learn Why HMOs May Be Increasing In Demand

    Change Healthcare
    9/23/2020
    In HealthScape Advisors latest Executive Brief, they discuss how the economic environment may accelerate the trend towards increased demand for Health Maintenance Organization (HMO) products in commercial insurance markets over the next 1 – 2 business cycles. For a thorough analysis of the emerging HMO lifecycle and HealthScape's perspective on this potential shift, check out their latest Executive Briefing, “HMOs: An Emerging Competitive Front in a Post-COVID World.”

    Executive Brief: Learn How to Build a Virtual Health Engagement Platform of the Future

    Change Healthcare
    9/22/2020
    Given the rapidly changing landscape (e.g., interim shifts in regulations, security, and financial assistance) and increased consumer and provider willingness to utilize virtual health solutions, HealthScape Advisors has broken down the opportunities health plans now have to lean in and build on during this developing momentum.

    The Path to Prioritizing Cybersecurity in Healthcare

    Change Healthcare
    9/15/2020
    Listen in to hear Phil Alexander join Change Healthcare Consulting’s John Zuziak on today’s show to dig into common gaps in security awareness and their implications. Phil and John examine the elements of a successful security awareness program, including how to gain buy-in; setting goals; identifying wins; communicating progress and successes; and ultimately making security awareness a part of the organization’s culture.

    Welltok Adds Two COVID-19 Testing and Screening Companies to Connect Partner Ecosystem

    Welltok
    9/12/2020 12:00:00 PM
    Companies nationwide are challenged with ensuring safe and healthy work environments for their people as the pandemic persists. To help employers respond, Welltok has partnered with Safe Health Systems, Inc. and Prevenna to make it easier for employers to provide on-site and at-home screening and testing options for COVID-19.

    Avalon Healthcare Solutions Ranks No. 4 on the 2020 Inc. 500 List of America’s Fastest-Growing Private Companies

    Avalon Healthcare Solutions
    9/7/2020 12:00:00 PM
    Avalon Healthcare Solutions is pleased to announce it has achieved the No. 4 ranking on Inc.’s annual Inc. 500 list, the most prestigious ranking of the nation’s fastest-growing private companies. The list represents a unique look at the most successful companies within the American economy’s most dynamic segment—its independent small businesses.

    Understanding the types of D-SNP Infographic

    Change Healthcare
    8/19/2020
    While some states require D-SNP participants to be fully eligible for Medicaid, others require only partial Medicaid eligibility. In 2021, all D-SNPs must meet new integration requirements to be designated as one of three types of D-SNP plans. Read more to understand the different types of D-SNP plans.