David Crocker

Big things are in store for Medicare Advantage in 2024 and beyond! CMS enacted several new rules impacting health plans, from electronic prior authorization to Star Ratings revisions. Here's a quick glimpse at some key changes: ** Electronic Prior Authorization:** Plans must adopt electronic systems for prior authorization by 2026, streamlining the process for both providers and patients. ** Star Ratings Updates:** CMS is addressing concerns about certain measures and introducing a Health Equity Index in 2027. ** Utilization Management:** Plans must adhere to Medicare coverage rules, post internal criteria, and establish a review committee for utilization management policies. ** Marketing Makeover:** New rules restrict sales calls, mandate plan explanations, and prohibit misleading marketing tactics. ** Medicare Prescription Payment Plan:** Patients with high drug costs can spread them out across the year starting in 2025. This is great news for beneficiaries, but plan sponsors face operational challenges. ** Behavioral Health Access:** Improved network adequacy standards for behavioral health services are coming; CMS aims to ensure better access to psychiatry, psychology, and social work for Medicare Advantage enrollees. ** Agent and Broker Compensation:** CMS aims to reduce potential bias and enhance market transparency. ** Health Equity:** CMS proposes including a health equity expert in Utilization Management Committees and analyzing prior authorization requests through an equity lens. Want to dive deeper? Here's a link to more information: https://hubs.ly/Q02dNPTQ0

Big things are in store for Medicare Advantage in 2024 and beyond! CMS enacted several new rules impacting health plans, from electronic prior authorization to Star Ratings revisions. Here's a quick glimpse at some key changes: ** Electronic Prior Authorization:** Plans must adopt electronic systems for prior authorization by 2026, streamlining the process for both providers and patients. ** Star Ratings Updates:** CMS is addressing concerns about certain measures and introducing a Health Equity Index in 2027. ** Utilization Management:** Plans must adhere to Medicare coverage rules, post internal criteria, and establish a review committee for utilization management policies. ** Marketing Makeover:** New rules restrict sales calls, mandate plan explanations, and prohibit misleading marketing tactics. ** Medicare Prescription Payment Plan:** Patients with high drug costs can spread them out across the year starting in 2025. This is great news for beneficiaries, but plan sponsors face operational challenges. ** Behavioral Health Access:** Improved network adequacy standards for behavioral health services are coming; CMS aims to ensure better access to psychiatry, psychology, and social work for Medicare Advantage enrollees. ** Agent and Broker Compensation:** CMS aims to reduce potential bias and enhance market transparency. ** Health Equity:** CMS proposes including a health equity expert in Utilization Management Committees and analyzing prior authorization requests through an equity lens. Want to dive deeper? Here's a link to more information: https://hubs.ly/Q02dNz5P0

The #VA plans to continue its #EHR implementation by the end of FY 2025. #Oracle should have time to improve significant prior #patientsafety concerns with scheduling and #prescriptiondrug issues with #pharmacies. #healthcare #medicine #business #education

Top Four Reasons You Need Accurate Data Mapping: 1. Enhance Quality of Care. 2. Improve Patient Outcomes. 3. Make Effective Data-Driven Decisions. 4. Keep Providers Happy. Learn more about Aesto's data mapping services: https://zurl.co/8JFe

Top Four Reasons You Need Accurate Data Mapping: 1. Enhance Quality of Care. 2. Improve Patient Outcomes. 3. Make Effective Data-Driven Decisions. 4. Keep Providers Happy. Learn more about why you need accurate data mapping: https://zurl.co/fdNk

The Transparency in Coverage Rule made the contracted rates between Payers and Providers an open book. Access to this publicly available data is essential for many healthcare stakeholders, particularly independent provider groups. Ever wonder what that provider group across the street is getting reimbursed for the same procedures you provide from UnitedHealthcare?? If your group doesn't know this currently, today's Transparency Tuesday is for you! Please contact Pete Titas for a demo!! Deerhold Ltd. The Transparency in Coverage Rule made the contracted rates between Payers and Providers an open book. Access to this publicly available data is essential for many healthcare stakeholders, particularly independent provider groups. Ever wonder what that provider group across the street is getting reimbursed for the same procedures you provide from UnitedHealthcare?? If your group doesn't know this currently, today's Transparency Tuesday is for you! https://lnkd.in/e6xxn_6d

The bottom line is you have financial responsibility for a provider group? Your competitors have the ability to know your contracted rates for everything you do. That's the bad news. The good news is that you can know theirs to help you in your next negotiation. Deerhold Ltd. The Transparency in Coverage Rule made the contracted rates between Payers and Providers an open book. Access to this publicly available data is essential for many healthcare stakeholders, particularly independent provider groups. Ever wonder what that provider group across the street is getting reimbursed for the same procedures you provide from UnitedHealthcare?? If your group doesn't know this currently, today's Transparency Tuesday is for you! https://lnkd.in/e6xxn_6d

Epic’s EHR market share gains continue, KLAS report shows - Healthcare IT news Summary: According to a recent KLAS report, Epic's EHR market share continues to grow steadily. The report highlights Epic's dominance in the healthcare IT industry, showcasing its widespread adoption and user satisfaction. Key findings from the report include Epic's strong performance in areas such as interoperability, usability, and overall customer experience. The data indicates that Epic remains a top choice for healthcare organizations looking to implement a comprehensive EHR solution. This report underscores Epic's ongoing success and solidifies its position as a leading player in the EHR market. #Epic #EHR #MarketShare #KLASReport #HealthcareIT Headings: 1. Epic's EHR Market Share Growth (#EpicMarketShare) 2. Dominance in Healthcare ai.mediformatica.com #health #hospital #hospitals #epic #klas #report #healthsystems #healthcare #market #news #acutecare #healthcareit #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/3UGXgcg)

AdvancedMD Summer Release Streamlines Revenue Cycle, Enhances EHR and Patient Engagement - HIT Consultant AdvancedMD's summer release brings significant improvements to revenue cycle management, EHR functionality, and patient engagement. #AdvancedMDRelease Enhanced Revenue Cycle Management features include improved billing workflows, automated claim status checks, and streamlined payment posting processes. #RCMEnhancements The updated EHR system offers new customization options, improved interoperability with third-party systems, and enhanced clinical decision support tools. #EHRUpdates Patient engagement tools have been upgraded to include secure messaging, online appointment scheduling, and virtual visit capabilities, improving communication and access to care for patients. #PatientEngagement Overall, AdvancedMD's summer release aims to optimize practice efficiency, improve financial performance, and enhance the patient experience. #HealthITImprovements ai.mediformatica.com #advancedmd #management #payments #revenue #revenuecycle #engagement #medical #patientengagement #platform #revenuecyclemanagement #this #benefits #digitalhealth #healthit #healthtech #healthcaretechnology @MediFormatica (https://buff.ly/3RUfSFb)