article thumbnail

3 Ways Consumers are Putting the Pressure on Health Plans

Healthcare IT Today

Inflation will push Payers back into the Public Marketplace whether Statewide and Federal Health Exchanges, Medicaid and Medicare Before the pandemic, many payers left statewide health exchanges as they found more ways to become profitable outside of the public market. Overall, consumers are charting the way forward in healthcare.

article thumbnail

CMS Proposes”CMS-0057-P” to Streamline Prior Authorizations with Real-Time Approvals Using Interoperability in Healthcare

Telebehavioral Health Institute

Medicare and a supplemental plan) to receive care from multiple providers (e.g., In this article, the recent proposal identified as “CMS-0057-P” by the Centers for Medicare and Medicaid Services (CMS) for the concept of interoperability will be applied to the prior authorization process.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Weekly Roundup – March 9, 2024

Healthcare IT Today

John chatted with Dr. Don Rucker, now at 1upHealth, about why TEFCA isn’t ideal for real-time data access and how FHIR APIs will help do the job – and allow payers and even employers to access data, too. Read more… Home-Based Care a Powerful Example for Harnessing Technology Across the Care Continuum.

article thumbnail

Health/Care Everywhere – Re-Imagining Healthcare at ATA 2019

Health Populi

Cleveland Clinic is a prime example of a hospital system imagining and re-shaping what a hospital will be in the future. Cosgrove recently left his CEO post at Cleveland Clinic, where he pioneered telemedicine and virtual health in and beyond the Cleveland target market to the larger healthcare ecosystem.

article thumbnail

The healthcare executive’s guide to AI

Redox

For example, smartwatch software that uses ECG data to detect arrhythmias is now regulated as a medical device. AI reimbursement Medicare and Medicaid are beginning to reimburse for AI applications on a per-use basis, though adoption is still in its infancy. A FHIR store can also help providers capitalize on the cloud’s full potential.)

FHIR 69
article thumbnail

More Short Takes at #HIMSS18 – Harlow On Healthcare

Health Blawg

Aprima belongs to CommonWell, has done some FHIR development, and Michael would like to see Congress condition Medicare reimbursement on real interoperability. For example, Linguamatics can flag a report of a pulmonary nodule overnight and trigger needed follow-up the next day.

EHR 60
article thumbnail

More Short Takes at #HIMSS18 – Harlow On Healthcare

Health Blawg

Aprima belongs to CommonWell, has done some FHIR development, and Michael would like to see Congress condition Medicare reimbursement on real interoperability. For example, Linguamatics can flag a report of a pulmonary nodule overnight and trigger needed follow-up the next day.

EHR 60