In 2020, the Department of Justice estimated that fraudulent, wasteful, and abusive (FWA) billing practices account for more than $100 billion of the nation’s healthcare expenditures.1 Today, the National Healthcare Anti-Fraud Association (NHCAA) conservatively estimates that healthcare FWA costs the nation about $68 billion annually, representing 3% of the nation's $2.26 trillion in healthcare spending.2 FWA estimates from commercial health plans range as high as $230 billion annually, or
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CMS| News, Analysis, Insights - HIT Consultant
Get Well to Roll Out New Social Determinants of Health Screening Solution Nationwide
What You Should Know: Get Well, a global leader in digital patient engagement, today announced it has expanded its industry-leading digital patient engagement portfolio to include new social determinants of health (SDOH) screening solutions.The new solution will be available to more than 200 enterprise healthcare organizations nationwide that are using GetWell Inpatient, an interactive patient care and hospital experience management product, at no additional cost. Enabling Enterprise
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Expectations For The Connected Care Business In The Years Ahead
Though we seldom see their use in our modern world and, even then, only in fiction, there was a time when it was common for people to actually use things like crystal balls and divining rods to try to uncover unknown yet valuable information. As unbelievable as it may seem, soothsayers peered into crystal balls aiming to help seekers look into the future for guidance, while prospectors would rely earnestly on divining rods as they attempted to locate underground riches of water or oil. While
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6 Ways Health Payors Can Leverage Intelligent Document Processing for Cost Savings
The prevailing global economic conditions are negatively impacting the healthcare industry. Continuing staff shortages, endemic COVID-19, high inflation rates, and supply chain disruptions continue to drive medical costs higher, worsening what is already a persistent challenge for health insurers. To offset rising healthcare costs, health insurance payors are challenged to find ways to contain their own costs by streamlining their processes and tightening their belts, which invariably
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Glytec Unveils Real-Time Analytics to Help Hospitals Prepare for New CMS Measures
What You Should Know: Glytec, the only provider of cloud-based insulin management software across the continuum of care, today announced the next evolution of GlucoMetricsⓇ to provide new analytics, dashboards and data visualizations that give hospitals and health systems new insight into glycemic outcomes. The enhanced visibility this provides is essential as hospitals prepare for new measures from the Centers for Medicare and Medicaid Services (CMS) on severe hypoglycemia and hyperglycemia
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1upHealth Raises $40M for FHR Data Platform
What You Should Know: 1upHealth, a modern data platform that’s cloud-based, API-enabled, and FHIR-native today announced the close of a $40M Series C investment led by Sixth Street Growth with participation from existing investors F-Prime Capital, Jackson Square Ventures, and Eniac Ventures. Founded in 2017, 1upHealth’s FHIR®-native platform designed for interoperability and modern computing is used by over 75 enterprise organizations including leading national and
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Q1 2023 Digital Health Funding Reaches $3.4B Across 132 Deals
What You Should Know: 2023 started off with the hallmarks of a rebound year. While Q4 2022 signaled the tail end of the digital health funding cycle, January and February funding numbers began to suggest that sector investment was slowly but surely inching back upwards. Inflation was easing ever so slightly. Investors were rediscovering their confidence and launching new projects, signaling optimism in the sector, according to a new Rock Health report. However, recent news—the collapse of
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Value-Based Administration Enables All VBC Network Stakeholders to Benefit
Despite holding the promise of delivering superior patient outcomes while lowering healthcare costs, many providers remain reluctant to embrace value-based care (VBC) reimbursement models. Progress toward VBC adoption hasn’t achieved its potential yet, hovering around 60% of all payment models from 2018 to 2021, with the remaining 40% comprised of traditional fee for service (FFS). Though some providers simply are hesitant to abandon the FFS model that has served them well, others are leery
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How The Healthcare Industry Can & Should Be Supporting Unpaid Caregivers
Unpaid caregivers are the backbone of society, providing an essential service, yet often feel invisible and without support. In recent years, that backbone is starting to break with research showing that 70% of caregivers, including parents and caregivers of adults, have at least one significant mental health impact. Even more worrisome, the same study indicated that more than half (52%) of those considered part of the sandwich generation - caring for an aging parent and a child at the same time
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Accenture Report Reveals Staggering Health Inequities and the Role of US Healthcare Ecosystem in Addressing Them
What You Should Know: - Health equity – or the lack thereof – is one of the biggest challenges facing US healthcare organizations today. - A new report from Accenture, US health inequity: beyond the statistics, analyzes the role US healthcare ecosystem participants can play in addressing health inequities due to race and ethnicity. The statistics are staggering. Analysing Key Trends Concerning Health Inequities To understand the human and economic
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