Medicare Risk Contracts

Medicare Risk Contracts

In 2008, Congress passed the Medicare Improvements for Patients and Providers Act (MIPPA). This legislation started the trend for value-based care programs (also known as value-based contracts or risk contracts). The industry then began the transition...
What is Healthcare Tech?

What is Healthcare Tech?

Healthcare tech refers to technology-enabled products and services in healthcare. Distinct from medical devices and diagnostics, healthcare tech focuses on facilitating and enabling healthcare functions. Healthcare tech is a vast, hyper-fragmented field. Individual...
CMS Updates Medicare COVID-19 Data Information

CMS Updates Medicare COVID-19 Data Information

The Centers for Medicare & Medicaid Services (CMS) released an updated data snapshot detailing the impact of COVID-19 on Medicare beneficiaries, particularly among underserved beneficiaries including racial and ethnic minorities, adults 85 years old and older, and...
Medicare and Data Analytics

Medicare and Data Analytics

The Centers for Medicare & Medicaid Services (CMS) reported that the use of data analytics in the Medicare program has resulted in millions of dollars in cost avoidance savings and recoveries. Combining relevant data with the right analytical and interpretive...
What is the Primary Care First Model?

What is the Primary Care First Model?

Primary Care First is a set of voluntary alternative five-year payment options that reward value and quality by offering an innovative payment structure to support the delivery of advanced primary care. In response to input from primary care clinician stakeholders,...
Fraud is mounting in Medicare Advantage

Fraud is mounting in Medicare Advantage

Can a patient have and not have diabetes at the same time? According to private insurers participating in the Medicare Advantage program, the answer is yes. The data architecture of Medicare Advantage is vulnerable to fraud perpetrated by the Medicare Advantage...
Population Health Management and Medicare Advantage

Population Health Management and Medicare Advantage

In the past decade the Medicare fee for service have seeing several changes, leading by programs that seek to create higher quality and more affordable care for Medicare beneficiaries. A common feature across these programs is the increasing emphasis on Population...
What is Population Health Management?

What is Population Health Management?

Population health management is the collection of patient data across various health information technology resources, and the interpretation of that data into an actionable patient record. Population health management seeks to improve the care and health results of a...