FEATURED CONTENT

• ShiftWise Customer Case Study: Memorial Health System

  11/23/2009

  Memorial Health System is an award-winning provider of comprehensive health care services in southern Colorado. The 650-bed healthcare system is comprised of three hospitals, 12 ancillary facilities and 4,500 employees in the Colorado Springs region. By Shiftwise
• Pre-Pay, Post-Pay, And Blended Payment Integrity: Prevention Worth The Cure

  9/25/2019

  Today’s payers are increasingly focusing on optimizing claims management as part of a continuous effort to maximize operational cost savings. In fact, according to Black Book research, fraud management is projected to be one of fastest-growing payer services in the global healthcare BPO services market, with 92 percent of users citing it as a source of BPO value. Diligent attention to prevalent payment integrity issues is the fundamental requirement to combat the massive cost of recouping the overpaid amount. As a practice, payers deploy post-pay, pre-pay, or an amalgamated audit approach to detect, investigate, and recover overpaid claims or prevent overpayment.

• 5 Medical Procedures Revolutionized By MedTech

  8/26/2019

  Medical technology has undergone a dramatic transformation over the last century. Conditions that were once fatal are now simple to treat with antibiotics, surgery or similar solutions. With innovations in MedTech, the healthcare industry has changed for the better. With that in mind, here are five procedures and technologies that MedTech has revolutionized in recent years.

• Closing Gaps In Care With Digital Care Coordination

  1/4/2019

  The rates for closing gaps in care are some of the most widely used, quantitative metrics to measure quality, allocate incentives, and control costs. Both health plans and providers are each financially incentivized to close gaps in care. For health plans, programs through Medicaid (HEDIS) and Medicare (STARS) have meaningful incentives and/or penalties tied to a members’ ability to receive certain healthcare services. Similarly, valued-based providers can control costs by providing certain recurring services to their patients. Fee for service providers also benefit from the additional volume generated by closing gaps in care. Gap closure uniquely aligns quality and financial incentives across health plans and providers.

• Top Payer Priorities For 2020: Optimizing Operating Costs And Boosting Network Efficiency

  1/13/2020

  The health plan market is undergoing a drastic transformation. In the past, the competition had been lean with just a small number of payers. However, the market dynamics are changing. Since 2017, the number of MA plan choices per county has increased by 49 percent. The competition is said to grow even more in the coming years as more health plans are set to enter the market, owing to the fact that nearly 26 million baby boomers will age into Medicare through 2030.

• Achieving A Supply Chain That Can With Stand Any Disruption

  1/17/2018

  Nothing strikes fear and anxiety into the hearts and minds of supply chain departments across the country faster than the local news outlet predicting bad weather on the horizon. From an impending snow storm up north, to a catastrophic hurricane on the east coast, or a raging wild fire out west, the initial reaction within a healthcare supply chain department is panic. Do we have enough supplies? What will we need? Should we order more of everything?