By Chris Rigsby, SVP Payer Solutions   For payers, 2024 was a challenging year. Sweeping policy changes squeezed reimbursement, and rising medical utilization sent costs soaring. Managed care stocks underperformed significantly, plummeting 13 percent and lagging far behind the S&P 500’s 23 percent growth, as investors reacted to worsening margin pressures and growing regulatory scrutiny. […]

By Anurag Mehta, CEO & Co-Founder The financial landscape for healthcare providers continues to evolve — and not necessarily in their favor.  Kaufmann Hall’s November 2024 Flash Report provides an at-glance positive outlook: Financial performance across 1,300 hospitals and health systems remained relatively consistent throughout the year. The data suggests that, following the historic lows […]

By Julius Raj Stephen, SVP Operations Proactive approaches can help address the source of nearly 50 percent of denials: front-end revenue cycle issues. Staff shortages, gaps in training, and technology non-adoption all contribute to the front-end errors and inefficiencies that lead to denials. In Part 1 of this series, we explored those challenges — and […]

By Julius Raj Stephen, SVP Operations The Cost of Denied Claims The impact of denied claims is evolving from cost concern to full-fledged financial crisis.  According to a recent survey from Premier, approximately 15 percent of all claims submitted to private payers are initially denied, including many that are pre-approved through prior authorization. Over 50 […]

By Jeff Studenka, SVP of Marketing & Mark Glickman, SVP, Growth & Strategy Over the past year, progress has been made on the road to post-pandemic financial recovery. According to a recent report from Kaufman Hall, key indicators — including improved outpatient revenue and shorter average length of stay — reveal that hospital finances overall […]

By Heather Grey, SVP/GM of RWD and Clinical Trials The need for diversity in clinical trials is well understood; it’s fundamental to supporting health equity and innovation across the healthcare continuum. But, improving clinical trial diversity in a sustainable, scalable way continues to be a challenge for drug developers, academic institutions, and clinical research overall.  […]

By Vijayashree Natarajan, SVP, Head of Technology The HLTH 2024 conference in Las Vegas (October 20-23) brought together healthcare leaders to explore a critical question: How can we give people more healthy years to spend doing what they love with the people they love? This overarching theme of ‘Increasing our Healthspan,’ coupled with a call […]

By Vijayashree Natarajan, SVP, Head of Technology AI in Healthcare: Where It Started & Where It’s Going Artificial Intelligence (AI) has dominated the headlines over the past few years, especially regarding its application in healthcare. While it may seem like a new technology, AI has existed in some form or fashion since the 1950s.  The […]

By Chris Rigsby, SVP Payer Solutions In an ideal world, risk adjustment begins with quality patient care. Patients actively participate in routine wellness visits and can easily access the healthcare services they need. Providers have plenty of time and energy for every patient they assess. Documentation is consistently captured during every visit, offering a complete […]

By Dave Friedenson, MD, FACEP, Chief Medical Officer Clinical documentation is undeniably the foundation of quality patient care and accurate reimbursement. It’s also a critical area of opportunity.  Introducing clinical documentation improvement (CDI) programs is a proven strategy for enhancing the accuracy and completeness of medical records, contributing to better clinical outcomes, more efficient resource […]

By Vijayashree Natarajan, SVP, Head of Technology, Omega Healthcare Artificial intelligence (AI) already is changing healthcare in significant ways, from improving scheduling to predicting cancer, but the field has only begun to feel the impact of this technology. As Generative AI and AI (collectively referred to as AI in this article) become more sophisticated and […]

Author: Heather Grey, SVP/GM of RWD and Clinical Trials, Omega Healthcare At two recent poster sessions co-presented with partners Memorial Sloan Kettering Cancer Center (MSK) and Dana-Farber Cancer Institute (DFCI) at the AACR Annual Meeting 2024 and the Cancer Center Informatics Society 2024 Summit & Clinical Trials Workshop, Omega Healthcare shared details of a unique […]