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Halfway Through 2018 – Where Is Healthcare Headed?

With the continued frustration over rising healthcare costs, the White House has made prescription drug reform a top priority. Thomas Beaton of HealthPayerIntelligence recently published an article which shares that payers are eager to see this effort succeed as they also search for ways to best address the high prices of certain medications. In 2016,

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How Analytics Can Help Payers Monitor Specialty Drug Costs

With the continued frustration over rising healthcare costs, the White House has made prescription drug reform a top priority. Thomas Beaton of HealthPayerIntelligence recently published an article which shares that payers are eager to see this effort succeed as they also search for ways to best address the high prices of certain medications. In 2016,

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A Q&A with Neal Schwartz, MedeAnalytics COO

In March, we welcomed Neal Schwartz as our new chief operating officer (COO). Neal was brought on to oversee daily operations, define goals and metrics, and create a culture of customer success and satisfaction. Neal brings more than 25 years of consulting and executive leadership experience to the role. We caught up with Neal to

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Payer Innovation Exchange Lets Payers Influence Product Direction

As part of our continued commitment to improving the client experience, we recently launched the inaugural Payer Innovation Exchange, a community of health plan leaders who use data analytics to achieve their important objectives. This program enables members to preview new solutions from MedeAnalytics, offer insights and opinions on new capabilities, and influence product direction

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California mandate to lower C-sections will impact population health – how can analytics help?

Following a surge of cesarean section (C-section) operations for expecting mothers, doctors in California must now reduce the number of C-sections performed to 23.9 percent for low-risk births. The state’s health insurance marketplace under the Affordable Care Act, Covered California, wants to curb this rate to improve patient safety and quality. Any hospital that doesn’t

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How can Analytics Help Solve Healthcare’s Biggest RCM Issues?

Revenue cycle management (RCM) is a critical part of any healthcare operation and with rising healthcare costs it’s even more difficult to manage. However, to better handle costs and overall revenue, healthcare organizations need to prioritize and develop an RCM strategy. The strategy itself needs to address various revenue pain points, including: cash collections, bad

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Payer and Provider Collaboration Ensures the Industry is Tracking Towards Value

Collaboration between payers and providers is an important asset to improving quality of care across the healthcare ecosystem, while simultaneously keeping costs down. For example, payers have access to a significant number of claims data that creates a holistic view of patients’ information, while providers typically have discrete clinical data information. By working together to

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Managing high-cost members with analytics

As the health demands of patients expand, payers are increasingly focused on a small segment of their member population that is driving the largest share of healthcare spending: high-cost members. According to the American Health Policy Institute, these high-need, high-cost individuals can cost $100,000 every year, which accounts for one-third of total healthcare spending. As

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As costs go up, how can the industry adapt?

Healthcare costs continue to rise across the industry. According to a study published in the Journal of the American Medical Association, money spent on healthcare in the U.S. is nearly twice as high as 10 high-income countries. Not only does the U.S. have the highest percentage of obese adults but it also has the lowest

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Healthcare Data is Growing, But Are Health Plans Making the Most of It?

According to a report from Dell EMC, healthcare data is growing astronomically, at a rate of 48 percent per year. In today’s healthcare economy, payers are looking to leverage that data to provide better service, more customized plans, and improved care for their members. Data analytics enable payers to harness data insights to bring better

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