Jill Dillingham

Register to close care gaps using CDI: https://lnkd.in/gXRqb3Be Healthcare disparities plague the industry, leading to worse health outcomes for specific member groups. Traditional administrative claims data often lacks the clinical granularity needed to expose the full picture. This webinar tackles the power of Clinical Data Integration (CDI) in identifying these hidden disparities. Leverage the expertise of Health Chain as we delve into how CDI programs can analyze clinical data to reveal: 🎯 Disparities in Dx/Px Rates: Unearth discrepancies in diagnosis (Dx) and procedure (Px) rates across different member segments. This unveils potential under-treatment or missed opportunities for early intervention in high-risk populations. 🎯 Preventive Care Gaps: Uncover potential differences in preventive care utilization across different member segments. Racial and ethnic minorities often experience lower rates of preventive screenings compared to white populations. 🎯 Leverage CDI to identify these disparities and develop strategies to close the gap and improve overall population health. 🎯 Social Determinants of Health (SDOH) Impact: Social factors like income, education, and access to healthy food significantly influence health outcomes. 🎯 Leverage CDI to identify SDOH impacting specific communities within your member base. Here from Nikita Ravindran and Vinay S. how Health Chain’s robust CDI solutions can be used to identify these disparities within your member population. Tune in at 1pm CST | 11am PST on 27th September 2024 to learn practical strategies to leverage rich clinical data captured through CDI for developing targeted interventions and improving health equity for all members. Bonus for attendees 📣 Get a free copy of Gartner’s report on “How Clinical Data Integration Improves U.S. Healthcare Payer Interoperability” #CDI #Caregaps #populationanalytics #healthcaredata #FHIR #payers #HCwebinars #Gartner Sudheen (Sudheendra) Kumar Mason Burr

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👩‍⚕️ Enhancing Provider Engagement: 9 Best Practices for Optimizing In-Office Assessments for Risk Adjustment 📅 As Q4 approaches, managed care organizations should focus on optimizing their risk adjustment in-office assessment processes to ensure accurate patient assessments, which are crucial for appropriate revenue realization and quality care management. ▶ ▶ The following comprehensive action plan by Jonathan Rogers outlines 9 best practices that will enhance provider group performance, tailor engagement methods, and achieve coding accuracy. 1️⃣ Review Performance-to-date by Provider Group 2️⃣ Review Performance-to date By Individual Provider 3️⃣ Stratify Providers and Groups 4️⃣ Perform Individual Provider Analysis 5️⃣ Review Coding Accuracy 6️⃣ Reconcile Claims and Medical Records  7️⃣ Explore Pros & Cons of IOA Communication Methods 8️⃣ Implement Individualized Scorecards 9️⃣ Take the Next Steps ATTAC Consulting Group’s team of risk adjustment experts is dedicated to helping MCOs implement best practices, overcome challenges, and achieve outstanding outcomes for members. Reach out to ATTAC today to discover how we can assist in developing a compliant, high-performing provider engagement program. https://rb.gy/ubz602

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Consolidation in health care can be good for certain segments of the industry, but in many cases, consolidation increases costs for self-insured plan sponsors and their partners. The Coalition Against Surprise Medical Billing (CASMB) – of which SIIA is a member – recently responded to a Request for Information (RFI) noting that consolidation of certain medical providers has allowed these providers to balance bill patients and abuse the Federal Independent Dispute Resolution (IDR) process.     For more information on this, and other issues impacting the self-insurance marketplace, check out our latest Government Relations Newsletter.   Link to Newsletter | https://lnkd.in/exi788Mg   Support SIIA's efforts as the self-insurance marketplace's most vocal advocate on Capital Hill by becoming a SIIA member | https://lnkd.in/e3hF2jnX THIS is where the business of self-insurance gets done.

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Great News: UnitedHealthcare (UHC) Extends Z-Code Requirement Deadline to June 1! Great news for labs and healthcare providers! UnitedHealthcare (UHC) has once again extended the deadline for implementing Z-codes for certain molecular test claims to June 1. This extension provides an additional two months for integration and preparation, easing the transition for providers. This marks the third delay in the Z-code requirement's effective date, originally slated for August 1, 2023. Despite these delays, UHC remains committed to the implementation of Z-codes for commercial claims, with no indications of abandonment. Effective June 1, UHC will require Z-codes for specific CPT codes and proprietary lab analysis codes, impacting high-volume procedures such as CPT 81479 and CPT 81279. Providers must ensure tests have received a Z-code and passed technical assessment from Palmetto GBA’s MolDX program to avoid payment denials. It's important to note that UHC's commitment to Z-code implementation remains firm, as indicated by their existing Smart Edits system. Providers should continue their preparations to seamlessly integrate Z-codes into their claims processes. Let's make the most of this extension by ensuring smooth integration and compliance with UHC's Z-code requirement. Stay tuned for further updates and guidance as we navigate this transition together! #Healthcare #UnitedHealthcare #ZCodeRequirement #MolecularTesting #Compliance #HealthcareProviders #MedicalBilling

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🏛 Julia Kelly outlines key pillars of strategic provider attribution in healthcare: - Assignment of responsibility  - Accountability for care quality  - Performance measures  - Payment models See how these core components are essential for healthcare organizations that aim to excel in population health management ➡️ https://lnkd.in/eHFZF6rW #valuebasedcare #populationhealth #datamanagement 

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Here are our EVP of Health & Business Development's final thoughts on the Sage Growth Partners survey of more than 100 C-Suite executives about "Health System Leader Perceptions and Priorities." #health #healthcare #digitalhealth #virtualcare #patientcare #telehealth #telemedicine

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In the News: Automatic downgrades and denials from some Medicare Advantage plans are increasing patient costs and disrupting senior care—despite CMS requirements, according to a Healthcare Financial Management Association (HFMA) article. Learn more about the two-midnight rule compliance challenges and access HFMA's comprehensive guidance here: https://hubs.li/Q02YdxD50 #hfma #revenuecyclemanagement #RCM #twomidnightrule #medicareadvantage #hospitalfinance #medicare #cms #healthcarecosts #coverage #hospitalrevenuecycle #hospitalrevenue #hospitalmargins

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📢 Attention Healthcare Providers: Are You Ready for MIPS 2024 Final Rule Compliance? With the 2024 MIPS Final Rule introducing new performance thresholds, updated measures, and reporting changes, it's essential to stay ahead and ensure compliance. At ReportingMD, we specialize in simplifying the MIPS reporting process to help you meet CMS requirements while maximizing your performance scores. Here's how we can help: ✅ MIPS Reporting & Submission: Our easy-to-use platform ensures accurate data capture and submission. ✅ Expert Guidance: Our team of Dedicated Advisors provides personalized support to help you navigate the latest MIPS Final Rule changes. ✅ Performance Analytics: Get actionable insights to improve performance and maximize your incentives. ✅ Compliance Assurance: We minimize your risk of penalties with comprehensive compliance support. Whether you’re new to MIPS or looking to optimize your strategy, ReportingMD is here to support you every step of the way. 💡 📅 Let's talk! Contact us to schedule a consultation or learn more about how we can help you stay compliant and succeed with MIPS in 2024.

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📏 What gets measured gets managed. The best patient financial experiences start with understanding what ‘great’ looks like. But in the absence of industry benchmarks, providers have no choice but to rely on feature utilization or outdated revenue cycle KPIs—falling short of what a great patient financial experience demands. In conversation with RevCycleIntelligence, VP of Commercial Strategy Ryan McPherson dives into Cedar's new PFX Benchmarks, offering objective insight into both the financial and human impact of patient financial experience: https://lnkd.in/e5YSPSWw

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Is operational efficiency in healthcare solely about speed and cost-cutting? With insights from a decade of operational leadership, our COO, Marin Rothenberg, sheds light on why the notion of efficiency as merely speed and cost-cutting is a common misconception and explores how job satisfaction could truly be the unsung hero driving productivity and results. We'll dive deeper into discovering practical strategies you can employ for nurturing a supportive environment and maximizing productivity! It's time to start recognizing that happy employees can be the cornerstone of success in healthcare! Read more below on our blog, The Salve! #OperationalEfficiency #EmployeeSatisfaction #HealthcareInnovation"

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The growth of the health insurance marketplace is picking up steam, fuelled by Medicaid disenrollment. https://ow.ly/N1vW50Tafsq MMIT’s Erin Trompeter explains what these large-scale changes mean for providers, manufacturers, payers and health IT vendors. Get the insights by clicking the link in this post. #HealthInsuranceMarketplace #HealthInsurance #Medicaid

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🌟 A successful CCM program meets CMS criteria, enhances patient outcomes, and reduces healthcare costs. 👉 Our latest blog post https://rb.gy/yhl16e discusses best practices for implementation and management and strategies for better patient engagement. #ChronicCareManagement #CCM #caremanagement #chroniccare #GenByGenHealth #virtualcaremanagement #remotepatientmonitoring #rpm #valuebasedcare

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