Client News Coverage

The uncertainty and risk created by pandemic-related disruptions in care have health plans in uncharted water when it comes to relying on claims data and utilization patterns to inform their risk models. But while these disruptions weakened the reliability of traditional risk models, they also created opportunities to deepen and enrich member data by leveraging consumer and other data related to social determinants of health (SDoH)that can deliver significant performance and accuracy benefits.

Expanding data sources and enhancing analytics capabilities allows health plans to develop the capacity for more precise, holistic member engagement while improving the most impactful health outcomes in individuals and populations. Doing so will help lift Star Ratings, improve care compliance, close gaps, enhance member satisfaction, reduce costs and drive profitability gains.

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At the intersection of health tech and diagnostics, hc1's CEO Brad Bostic talked about the company's origins and how it works with medical laboratories, hospitals and health plans.

The trade association for electronic health record (EHR) companies is asking the government to postpone civil monetary penalties for EHR developers and health information networks and exchanges that run afoul of new information-blocking regulations. The group contends that the industry needs to become familiar with the requirements and figure out how to comply with them.

Officials of the Electronic Health Record Association (EHRA) revealed the request during a press conference at the Health Information Management and Systems Society (HIMSS) convention in Las Vegas this week

The healthcare industry will be discussing COVID-19 lessons learned for the foreseeable future. Yet one take-away stands out as a glaring issue that demands immediate attention: keeping critical patient and public health data locked away in disconnected databases and multiple data siloes is not only unsustainable, but potentially deadly.

From the point when COVID-19 arrived in the U.S., public health officials lacked critical information and proactive real-time insights into the ebb and flow of the virus — denying them the ability to mobilize highly effective localized responses.

Typical attempts at defining, quantifying, and measuring social determinants of health (SDoH) are limited to geographic or population averages, which often mask individuals’ discrete and unique experiences. They can, therefore, lead organizations to implement costly and inefficient programs instead of addressing individuals’ actual barriers that represent the greatest potential for improving health outcomes and return on investment.

Recognizing this, the Colorado Hospital Association (CHA) sought to gain a better understanding of the unique fingerprint of risk within its members’ patient populations—knowledge that would lead to more effective strategies for its members to address emergency department (ED) super-utilization and readmission rates with interventions that would produce the greatest return on investment.

For healthcare organizations to succeed in an era where they are expected to deliver optimal patient results at the lowest cost, they need to abandon traditional low-value care models, which are characterized by patient care that does not lead to better outcomes. This inefficient practice can be detrimental to patients and costs the healthcare industry more than $340 billion per year.

Understanding how this process occurs — and how to eliminate it — is the first step toward implementing a high-value care strategy that works proactively toward lowering costs and improving results. And the best place to start is the lab, where blood and test utilization are responsible for most of the waste and inefficiencies that reside across the healthcare industry.

Minority communities are incredibly diverse, particularly when looking at population mix and rural vs. urban areas. From different household makeups and risk factors to varying engagement preferences, that diversity also impacts health outcomes—a reality laid bare by COVID-19.

An analysis by Carrot Health found that rural communities bear the highest burden of COVID-19, while Black and Hispanic populations are the most adversely impacted by the virus.

The pace of scientific advancement moves faster than ever, and today’s providers, by and large, are open to embracing new best practices and better approaches to medicine. When it comes to optimizing the bottom line, though, many physicians are hesitant to give up traditional manual approaches to revenue cycle management and embrace forward-thinking, data-driven revenue integrity models.

Yet, the stakes are higher than ever for taking a strategic approach to financial health. Today’s practices are facing some of the tightest operational margins in modern history, amid challenges brought on by COVID-19, a continuous decline in reimbursements, and the shift from traditional fee-for-service models to value-based care.

It’s safe to say the U.S. healthcare system’s inherent flaws and dysfunctions have been on full display over the past year. While healthcare stakeholders recognize the need for high-value care, the pandemic has underscored the urgency of investing in models that optimize coordinated, personalized approaches.

Healthcare’s outdated one-size-fits-all, trial-and-error model was performing unacceptably even before the pandemic, wasting up to $935 billion and racking up the highest rate of preventable deaths when compared to peer nations. Notably, research reveals that more than 128,000 people in the U.S. die each year from taking medications as prescribed—four times the number of people killed by prescription painkillers and heroin combined, as reported by the Centers for Disease Control and Prevention.

It has been more than a year since the start of COVID-19 pandemic. While it will be years before we truly know the effect it will have on our overall health, economy and society, there are a lot of things we do know about the impact on health systems.

Healthcare systems stepped up in a heroic way. They managed to test, treat and cure millions of patients. We went from having no standard test for COVID-19 to being able to test more than 2 million people in a single day. (Data from the Covid Tracking Project).

In today’s quality-driven, outcomes-focused landscape, it is important for healthcare organizations to strike the proper balance between driving better patient outcomes and enhancing efficiencies while still controlling overhead costs. A growing number of forward-thinking organizations are accomplishing this by implementing utilization programs that put operational processes under a microscope and turn lagging, outdated workflows into lean, money-saving activities.

It is a wise target, because unnecessary testing and blood waste put a huge financial strain on health systems. More than $340 billion is spent every year on excessive and inefficient care services, while nearly 50% of all blood transfusions and lab tests run across the continuum of care are unnecessary.

The fundamental problem with healthcare can be summed up in one sentence: We expect healthcare services that cater to our individual needs, yet the health care system operates under a one-size-fits-all, trial-and-error model. It is a model that results in missed diagnoses, protracted illnesses, and even premature death and wastes $935 billion annually.

The financial toll of this outmoded approach pales in comparison to the human toll. More than 128,000 people in the U.S. die each year from taking medications as prescribed—four times the number of people killed by prescription painkillers and heroin combined, as reported by the Centers for Disease Control and Prevention.

When it comes to healthcare in the U.S., we expect services that cater to our individual needs from a system that operates under a one-size-fits-all, trial-and-error model — one that results in missed diagnoses, protracted illnesses, and premature death while wasting up to $935 billion annually.

The financial toll of this outmoded approach pales in comparison to the human toll. More than 128,000 people in the U.S. die each year from taking medications as prescribed — four times the number of people killed by prescription painkillers and heroin combined, as reported by the Centers for Disease Control and Prevention.

2020 was an unprecedented year. Health care workers have gone above and beyond in their efforts to fight a global pandemic while continuing to provide care for non-Covid patients. Meanwhile, researchers, entrepreneurs and manufacturers specializing in the health care sector continue to develop new products and services to improve access and outcomes.

To honor their work, the Minneapolis/St. Paul Business Journal has launched our Health Care Heroes awards, recognizing individuals in the Twin Cities for putting innovation, care, dedication and compassion to work to improve the human condition. We received over 115 inspiring and impressive nominations for the inaugural year of this project, making the judging extremely difficult.

The secret to good health? Get enough sleep, eat well — and maybe vote regularly, according to Carrot Health, a Minneapolis firm that's working to better understand what are often called the social determinants of health and has collected data on millions of Americans.

The firm's approach is attracting attention: Carrot has already landed four of the country's top 10 health plans as its clients, CEO Kurt Waltenbaugh said.

The firm seeks to better understand the social factors that make people unhealthy and the barriers that prevent them from getting well. To do that, it needs a whole lot of data.