In the last few years, many payors have worked hard to implement a whole-person care approach or whole-person integrated care model. But what does that even mean? What is the definition of whole-person care? How is whole-person care delivered today? And what are the...
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How Rule-Driven Assessments Help Streamline Care Management
Assessments are a critical component of care and case management programs. Assessments help care and case managers quickly identify the health and social needs of members, flag at-risk individuals, and help teams prioritize and effectively handle their caseloads When...
Future of Care Chat – Episode 8: Talking Configuration Management in HELIOS
HELIOS is the most configurable platform for healthcare payors with 90% configurability right out of the box. You may have heard us say this before, but if not, "HELIOS is the most configurable and flexible solution for healthcare management." But what does that even...
What to Know About CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F): Quick Facts & Next Steps
For healthcare organizations, CMS-0057-F outlines the modern healthcare system and offers opportunities to improve care and utilization management In the last couple of years, the Centers for Medicare & Medicaid Services (CMS) have been making strides to increase...
How to Achieve Healthcare Data Interoperability Without Overtaxing IT Teams
For healthcare payors and organizations, the HL7® FHIR® (Fast Healthcare Interoperability Resources 1) standard is crucial to data interoperability efforts. This standard is designed to improve data interoperability by providing a standardized way to exchange and...
How to Establish a Connected Care Ecosystem: A Quick Guide for Healthcare Payors
The American Medical Association said it best: “In health care, teams that collaborate effectively can enhance the quality of care for individual patients. By being prudent stewards and delivering care efficiently, teams also have the potential to expand access to...
How a Collaborative Care Approach Can Enable Greater Value
Healthcare is now one of the highest costs of the U.S. economy. The country is expected to spend a projected $4.7 trillion (18 percent of the national economy) on healthcare alone in 2023. And according to a recent study by Accenture, health literacy may be playing a...
6 Healthcare Trends to Watch in 2024 and How They’ll Impact Care Management
As a new year approaches, the U.S. healthcare industry faces converging factors that signal some significant upcoming changes. An estimated 60% of adults have at least one chronic disease, and 40% suffer from two or more, straining healthcare resources. In 2023, life...
How Can Payers Achieve Cost-Savings Goals Faster?
CMS’ new care delivery model, Making Care Primary (MCP) focuses on a coordinated, collaborative approach at the primary care level, and the critical role it plays in an organization’s ability to deliver value-based care and improve health outcomes. As noted in our...
Interoperability in Value-Based Care: Leveraging FHIR-compatible Data for Seamless Care Coordination and Improved Population Health
New FHIR® data interoperability application helps payers quickly transform and manage critical data for organization-wide sharing, visibility, and care team us Data interoperability is a hot agenda item for many healthcare organizations. 1. Stakeholders across the...