By Scott Hampel – I think a lot–and I’m not the only one–about how we can improve the ways we pull information from data. Data on its own is inert: just waiting to be understood and then used. And that’s a major challenge for many organizations. Data is often trapped in different applications with no easy or convenient way to extract it.

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Many challenges face healthcare’s underserved. There are issues with food, housing, reliable transportation, steady employment and more. Each contributes to and is one element of social determinants of health (SDH). In communities around the world, public and private organizations are taking steps to address SDH-related issues and challenges that negatively impact healthcare.

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Every patient has a plethora of data associated with their health record, which can include decades of enrollments, claims, accounts and charges. Much of this data is not housed within the same institutional, facility or provider database…

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Value-based care remains top of mind for payers and providers alike. However, continued misalignment between payers and providers can hinder their ability to achieve cost and quality goals. A recent Quest Diagnostics study shows that 62 percent of health plan executives feel that payers have made progress in aligning with providers, while only 41 percent of physicians agree with this notion. What’s more, according to an HFMA survey commissioned by MedeAnalytics, an overwhelming 88% of providers say they are not ready for value-based care.

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Frequent utilization of the emergency department for non-emergent care remains a chronic challenge for health plans looking to improve costs and quality. Studies show that as much as 5% of the overall patient population seen in the ED accounts for as much as 18% of all annual emergency department visits. In addition, nearly 20% of ED complaints stem from mood disorders, and another 10% relate to alcohol use.

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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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