Mandatory Bundled Payment Models Are Coming: What You Need to Know

LISTEN NOW Representatives from CMS just announced a policy shift regarding mandated alternative payment models. HHS Secretary Alex Azar said the administration would “revisit” mandatory models that it had previously abandoned in cardiac care, noting the time had come for “exploring new and improved episode-based models in other areas, including radiation oncology.” To understand the impact this policy shift might have on payers and providers, Patrick McGuigan, Producer of Episode Intelligence, connected with Dr. Andrei Gonzales, who leads the product development efforts for Change Healthcare’s value-based payment solutions. In this interview, they discuss: What CMS is introducing and why it’s

Change Healthcare and Health Fidelity Partner to Increase Quality and Accuracy of Risk Adjustment Coding

Change Healthcare announced a collaboration with Health Fidelity, Inc. to embed natural language processing (NLP) and machine learning technology into its risk adjustment coding offering to help Medicare Advantage, ACA commercial, and Medicaid payers increase claim accuracy and better address compliance obligations. Read the news release

Change Healthcare Acquires PokitDok Assets

Change Healthcare announced that it has acquired intellectual property (IP) and other key assets from PokitDok, Inc., a platform-as-a-service company for healthcare. With this advanced software, IP, and the PokitDok team, Change Healthcare further extends the capabilities and technology leadership of the Change Healthcare Intelligent Healthcare Network™ for payers, providers, and independent software vendors (ISVs). The integration of key PokitDok APIs into the network will add new capabilities for digital health, telemedicine, and other new, disruptive care models that support value-based, patient-centric healthcare. Read the news release

Change Healthcare Acquires PokitDok Assets

Artificial Intelligence in Radiology

Current AI can answer specific questions, but it is still a far cry from human-like intelligence. In most cases, questions evolve around predictions. In the diagnostic world of enterprise imaging, radiologists have been extensively trained to identify disease and are skilled at making efficient predictions—thus limiting the value of AI. In specific cases, algorithms could overcome the intrinsic limitations of human perception—such as skin cancer detection, diabetic retinopathy, or difficult-to-discern diseases on chest X-rays. Beyond these instances, the immediate future of AI lies more in aiding medically underserved areas. However, AI is already far more valuable when its predictions are

AI in Radiology

The Value of Artificial Intelligence in Radiology Today and Tomorrow

Current AI can answer specific questions, but it is still a far cry from human intelligence. In most cases, questions evolve around predictions. In the diagnostic world of enterprise imaging, radiologists have been extensively trained to identify disease and are skilled at making efficient predictions, thus limiting the value of AI. In specific cases, algorithms could overcome the intrinsic limitations of human perception, such as skin cancer detection, diabetic retinopathy, or difficult-to-discern diseases on chest X-rays. Beyond these instances, the immediate future of AI lies more in aiding medically underserved areas. However, AI is already far more valuable when its

Artificial Intelligence in Radiology

Experian Health and Change Healthcare Partner to Deliver Identity Management

Change Healthcare and Experian Health announced a partnership to solve one of the most common challenges in healthcare today: accurate identification of patients across care settings. The two companies plan to provide an identity management solution to solve patient identification and duplication challenges. Read the news release

Three Simple Ways to Leverage Technology to Reduce Denied Claims and Improve Practice Efficiencies

Most physician practices would agree that denied claims are a drain on resources and have a negative impact on cash flow and revenue. What practices may not realize is just how significant that impact can be. Nearly 90% of denied claims are avoidable and 50% to 65% are never reworked, which leaves a lot of money left on the table—money that could be used to bring on new staff, replace outdated technology, or make improvements to the office.1,2, When you factor in the cost to rework a denial—$25 not including time and overhead—the impact is even greater.3 While the causes

Beyond the Exam Room: The Increasing Role of the Patient Financial Experience in Access to Timely Care

Few physician practices or specialty providers have escaped the impact of high-deductible health plans (HDHPs), which now account for nearly 43% of all private health plans.¹ Out-of-pocket maximum patient responsibility increased nearly 30% between 2015 and 2017, now averaging $4,400, putting greater financial strain on patients and providers alike.² The process of seeing a patient, submitting the claim, receiving reimbursement from the payer, and balance-billing the patient for the remainder is an outdated, ineffective business model. It is also a business model that can be harmful to patient care. According to an article published by Patient Engagement HIT, 64% of

How Payers Can Increase Provider Adoption of Electronic Payments

Despite the obvious time and cost-saving benefits of using electronic transactions, providers continue to resist electronic payment, and payers continue to struggle to get providers to sign on. But there are several new techniques that are more appealing, to help decrease paper-based transactions and reduce costs overall. Read the white paper now or download and read later

Removing the Hurdle of Provider Enrollment

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