Mark Head’s Post

Where is your company regarding sharing client information? CMS Interoperability and Patient Access Rule, CMS-9115, was released on May 1, 2020. This rule impacts Medicare Advantage, Medicaid, CHIP, and ACA payers. Drawing inspiration from the 21st Century Cures Act and ONC's Cures Rule, this marks a pivotal moment for the agency as it takes on new roles in driving health plan modernization, advocating for payer-centric API technologies, and implementing significant insurer infrastructure updates. If you are a payer or provider of services Fivebase can help in your journey against information blocking. Please take a look at this great review by Brendan Keeler.

Interested in a RPM program for 2025? Here’s 10 questions you can ask during exploration based on key takeaways from the latest OIG report. 1. Retention Strategies: What specific strategies does your solution implement to ensure patients remain engaged for 5+ months on average? 2. Tracking Engagement: How does your system measure and report patient retention over time? 3. Comprehensive Coverage: How do you ensure enrollees fully utilize all three RPM components: Setup & Educate, Transmission of Data, and Interpretation & Management? 4. Service Coverage: How does your RPM solution utilize the CPT code set to ensure maximum reimbursement opportunities? 5. Compliance Tracking: Can your system track and report on the usage of all three RPM components? 6. Provider Assignment: How does your solution track and record the ordering provider to ensure compliance with Medicare’s data transparency needs? 7. Order Verification: What processes are in place to verify that RPM services are appropriately ordered by qualified healthcare providers? 8. Provider Education: Do you offer training or resources to help our staff understand RPM billing codes and compliance requirements? 9. Documentation Support: How does your solution support accurate documentation for appropriate billing practices? 10. Audit Preparedness: What tools or resources do you provide to help us remain compliant and prepared for potential CMS audits? When it comes to evaluating RPM, use reports like these to help you know if the solution addresses the needs and compliance requirements of your orthopedic practice effectively.

As we navigate the ever-changing landscape of healthcare, one thing remains constant: the importance of leveraging data to inform decision-making. From optimizing workflows to improving patient experiences, healthcare analytics empowers us to create a brighter, healthier future for all. Excited to be part of this transformative journey! #HealthcareAnalytics #DataDrivenDecisions https://lnkd.in/e48XdHNw

🌟 Why CAHPS Scores Matter for MA Plans 🌟 At Get Well, we recognize the importance of CAHPS scores in shaping the landscape of Medicare Advantage. These scores not only reflect patient experiences but also directly influence reimbursement and plan performance. Our latest article explores: ▶ The correlation between CAHPS scores and patient satisfaction ▶ Strategies to leverage these insights for quality improvement ▶ The implications for MA plans striving to enhance their service delivery Discover how optimizing CAHPS can lead to better outcomes and stronger patient relationships. Read the full article here: https://lnkd.in/exgKvWwU #GetWell #CAHPS #MedicareAdvantage #HealthcareInnovation

The American Joint Replacement Registry Quality Improvement Scorecard is now live in RegistryInsights®! This powerful new tool allows participants to view and analyze performance on five key metrics: 1️⃣ Unplanned 90-day readmission/admission rate 2️⃣ 90-day composite complication rate 3️⃣ Preoperative PROMs completion rate (90-0 days pre-op) 4️⃣ Postoperative 1-year PROMs completion rate (300-425 days post-op) 5️⃣ Pre AND postoperative 1-year PROMs completion rate (300-425 days post-op) (This metric aligns with the Centers for Medicare & Medicaid Services and The Joint Commission 1-year PROMs requirements.) ⭐ Action Needed: To ensure all your site’s users receive the scorecard this fall, please confirm your users are current in the “Role Management” section under “Administration” on RegistryInsights: https://bit.ly/3WD8uPQ Stay ahead of the curve with these valuable insights and improve patient outcomes!

During National Patient Experience Week, HealthTrackRx proudly reaffirms our strong dedication to revolutionizing healthcare with patient-centered PCR testing solutions! Below are a few ways we put patient experience at the forefront of our business. Fast Diagnostics: We understand the importance of timely care. That's why our PCR tests deliver next-morning outcomes, enabling clinicians to swiftly make informed treatment decisions, ensuring the best possible care for every patient. Leading-edge Solutions: We are committed to staying at the forefront of healthcare innovation, and that includes simplicity. Our ONE Universal collection device can test for a wide range of infections. Simple Billing: Laboratory testing is covered by most insurance companies, including Medicare and Medicaid! Join us in honoring National Patient Experience Week as we celebrate 21st century patient-centric care. Discover how HealthTrackRx’s PCR testing solutions can truly enhance patient experiences and elevate healthcare practices! Learn more: https://bit.ly/3SGOz0n #PatientExperience #HealthcareInnovation #NationalPatientExperienceWeek

I know I have some connections in the Pharmacy space. I thought you so might be interested. Feel free to share! Explore new insights on improving Pharmacy Benefit Manager oversight in Medicaid Managed Care. It's essential for ensuring transparency and accountability. Check out our latest article for strategic approaches that can lead to better outcomes. Read it here: https://okt.to/C4sR6x #HealthcareTransparency #MedicaidManagedCare #MedicaidOversight #MyersAndStauffer #PBMOversight

CMS estimates that the new TEAM will save Medicare $481 million over 5 years! 💸 The TEAM model sets the stage for managing care episodes as a standard practice. Curious about the difference between TEAM and previous models like BPCI? We’ve got you covered in our latest blog. 💻 Read more about how this will impact hospitals starting in 2026. https://loom.ly/pEZ0AoQ #ValueBasedCare #HealthcareInnovation #CMSUpdates #HealthcareStrategy #HealthPolicy #RiskSharing #HospitalLeadership #AlternativePaymentModels

Join HNI and a panel of BPCI Advanced participants for a discussion on tactics for sharing data with Post-Acute Care organizations and primary care providers, how to manage data across other models and programs, and aggregate data from multiple sources. Hosted by the Center for Medicare and Medicaid Innovation. Tuesday, April 2, 2024, at 2 PM ET Register here: https://hubs.ly/Q02rl5k80 HNI leaders Merced Gonzales (CTO) and Tom Hashman (SVP, Clinical Performance) will share key insights and demonstrate how HNI technology & clinical capabilities support outstanding performance in BPCIA. There will be time for Participants to ask questions, discuss specific concerns, develop solutions and network with their peers. #BPCIAdvanced #HealthcareInnovation #Interoperability #PatientCare #Networking

CMS Rule Connects Patients, Providers, & Data Like Never Before! Explore the recent Coronis Health blog post to unravel the details of improved interoperability and streamlined prior authorization.