NEWDIGS Initiative at Tufts Medical Center’s Post

For healthcare providers, getting claims accepted the first time is more than just a process—it’s essential for financial health. A recent Inovalon survey of over 400 healthcare organizations revealed that front-end RCM tasks, such as eligibility checks, pre-certification, and data verification, are top contributors to claims denials across hospitals, physician practices, and home health settings. The takeaway? Prevention is paramount. Front-end RCM teams need data-driven tools that simplify and streamline processes. By automating eligibility verification, updating patient demographics in real-time, and identifying coverage gaps early on, healthcare teams can focus on what matters most: patient care and timely, accurate reimbursements. Learn more in our latest blog. https://lnkd.in/eWnUNDVM

"About 800,000 Americans are misdiagnosed each year. Large swaths of the country don’t have access to high quality specialists. We believe that programs like the Second Opinion program by Cleveland Clinic help fill an important gap that not only saves money, but also makes a fundamental impact on the quality of people’s lives." Our CEO Frank McGillin recently sat down with HIStalk to share insights on the importance of getting a second opinion for consequential health decisions, how The Clinic by Cleveland Clinic's Virtual Second Opinion program works, and the impact that access to specialty care has for patients, payers, and employers. Read the interview here: https://lnkd.in/ewh2Zzqi #virtualsecondopinion #virtualcare #digitalhealth

🚨 The Silent Patient Exodus: The Hidden Challenge Healthcare Can’t Ignore 🚨 In healthcare, the patients who don’t speak up often leave behind the biggest clues about what’s wrong. Silent defections—patients who just… leave—can be harder to spot but they’re a sign of deeper issues. 🛑 Why Are Patients Leaving Without a Word? - Feeling Ignored? A staggering 71% of patients leave because they feel unheard. - Frustration with Inconvenience:62% say long wait times, poor communication, and lack of accessibility push them elsewhere. - Experience Matters: 68% of patients prioritize the overall care experience (empathy, communication) over just clinical treatment. 🔍The Opportunity for Improvement - Patient Retention = Growth: A 5% increase in patient retention can skyrocket profits by 25-95%! - Spotting Silent Defections Monitoring no-shows and follow-up rates can help identify those quietly slipping away. - Leverage Predictive Analytics: Predictive tools can reduce silent defections by 20% by catching early signs of dissatisfaction. 💬 The Secret? Proactive Engagement! - Follow-Up = Insights: Post-discharge surveys have a 40% response rate, revealing hidden issues. - Personalized Care: Customizing patient interactions can boost retention by up to 10%. 🔄 Turning Silent Defections Into Opportunities It’s not just about losing patients—it’s a chance to improve. By embracing feedback, using data, and focusing on the whole patient experience, healthcare providers can reduce silent exits and build stronger loyalty. Don't let silence speak louder than action. 👂 #Healthcare #PatientExperience #PatientRetention #DataAnalytics #ContinuousImprovement #HealthcareInnovation #ProactiveCare #SilentDefections #PatientLoyalty

Since the pandemic, the movement of care from high-cost, post-acute sites to lower-cost, freestanding and non-acute sites has accelerated. In the International Journal of Science and Research (IJSR), MMIT’s Dinesh Kabaleeswaran and Julia Scanlan discuss the impact of payer site-of-care preferences across payers, oncologists and physicians. Click to read the research: https://ow.ly/5i5350SaVQ3. #ManagedCare #PatientAccess #HealthcareAccess #Healthcare #SiteOfCare

🚨 Poor medication adherence is a silent crisis – leading to 125,000 American deaths and costing the healthcare system hundreds of billions of dollars every year. How can health plans tackle this issue and improve outcomes? At PurpleLab, we believe that leveraging real-world evidence (RWE) can give health plans the tools they need to identify patterns in medication adherence, predict noncompliance and implement effective interventions. With pharmacy and medical claims data, health plans can build a more comprehensive understanding of their members and spot key issues in adherence before they escalate. But there's a catch: Traditional closed claims data only gives a limited view of a patient’s journey. Adding robust open claims data fills in the gaps, providing a longer timeframe and broader perspective across healthcare settings. The result? Improved medication adherence and reduced healthcare costs. Want to explore how to fill the gaps in your claims data and build a stronger foundation for better health outcomes? Discover how PurpleLab can help 👉 https://lnkd.in/dnt3gjpn #RealWorldEvidence #MedicationAdherence #HealthcareOutcomes #RWE #HealthPlans #DataDrivenHealthcare #PurpleLab #ClaimsData

According to several research when patients have access to their records, they tend to become more involved in and knowledgeable about their health. There are also occasions when they found errors and reported to their providers. Another research found that 21% of patients who accessed their records found errors, and 42% of those errors were described as serious. MyDigiRecords enables patients to have access to their records and helps in patient empowerment. #digitalhealth #patientcare #patientempowerment #QualityOfLife

David Grigsby opens our #webinar discussing how the population is set to grow by 4% over the next 15 years and how a #PopulationHealth approach is key to drive improved outcomes and deliver greater efficiency across the healthcare system. #PHITA #TransformingCare

Roughly 11,000 individuals become eligible for Medicare each day, and by 2030, more than half of the elderly population in the country will be enrolled in #medicare Advantage. The focus of payers has long been on expanding access to these potential members, recognizing that influence in this sector can lead to advantageous terms in provider contracts. But gone are the days when a payer could capture market share with low / no cost access to primary care, lower cost sharing for tier one drugs, or lowered premiums. These items are table stakes, and the market demands are more nuanced today. The current healthcare ecosystem is driven by those who can utilize #data and #ai to provide better whole health products and services to improve member experience. Our seniors definitely have a seat at the table during this #digital revolution. As the number of Medicare-enrolled Americans grows, the payer community will need to embrace the proliferation of data and artificial intelligence to expand (hopefully easier!) digital access for seniors more quickly.

We're excited to share the results of a recent case study we published with The Villages Health System, LLC. The health system, which serves primarily Medicare patients, used NeuroFlow to amplify the impact of integrated care. Prior to leveraging NeuroFlow's technology, The Villages integrated care program improved BH access and lowered total cost of care by 39%. With NeuroFlow, the Villages increased access to behavioral health resources and patient screening. The health system identified that 24% of a patient cohort not enrolled in integrated care would benefit from the program. Check out some of the highlights: https://lnkd.in/gg4FSuTD #behavioralhealth #integratedcare #Medicare

Since the pandemic, the movement of care from high-cost, post-acute sites to lower-cost, freestanding and non-acute sites has accelerated. In the International Journal of Science and Research (IJSR), MMIT’s Dinesh Kannan Kabaleeswaran and Julia Scanlan discuss the impact of payer site-of-care preferences across payers, oncologists and physicians. Click to read the research: https://ow.ly/pY9c50SaVaB. #ManagedCare #PatientAccess #HealthcareAccess #Healthcare #SiteOfCare