MRO Compliance

JUNE 15, 2023

So Many Records, So Little Time: How to Manage Burgeoning Health Plan Requests June 15, 2023 Healthcare IT Today Providers are witnessing an explosion in health plan requests for medical records. Reasons for the spike include upticks in claims denials, more risk adjustment reviews, and increases in mandatory HEDIS reporting.

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MRO Compliance

JUNE 15, 2023

So Many Records, So Little Time: How to Manage Burgeoning Health Plan Requests June 15, 2023 Healthcare IT Today Providers are witnessing an explosion in health plan requests for medical records. Reasons for the spike include upticks in claims denials, more risk adjustment reviews, and increases in mandatory HEDIS reporting.

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Bill of Health

JULY 26, 2023

For example, Bangladesh’s National Disaster Management Plan 2021-2025 recognizes that persons with disabilities “are often overlooked and remain unrecognized, and current national [disaster management] systems and mechanisms require more emphasis on managing risks in an inclusive manner.”

Governance 246

Governance World Health Public Health 246

Compliancy Group

JANUARY 19, 2024

This post explores how an OSHA risk management plan and OSHA risk management training are intended to serve as more than tasks on a compliance checkbox. What Is OSHA Risk Management in Healthcare? There is abundant risk in any hospital setting, making OSHA a necessary risk management strategy.

Compliance 52

Compliance Regulatory Compliance Hospitals 52

Healthcare It News

MAY 17, 2023

Haas is a technology management consulting manager in RSM US’s healthcare industry practice. According to Medical Economics , physicians spend more than three hours a day on documentation and inbox management. What is an organization’s risk plan to make sure a patient receives the correct care?

Hospitals 281

Hospitals 281

HIT Consultant

JANUARY 4, 2024

Of the four key types of data analytics – descriptive, diagnostic, predictive, and prescriptive – only the first two are effectively used in managing healthcare costs and member healthcare delivery. Traditionally, these models have relied on descriptive data and statistical analysis to identify health risks and historical trends.

Health Outcomes 115

Health Outcomes Public Health Hospitals 115

Healthcare It News

DECEMBER 7, 2023

On an ongoing basis, AI is also being used to better customize care plans and support resources for each patient’s unique and constantly evolving health needs. You suggest that to help improve the patient experience, physicians can use AI to translate complex jargon and concepts into a message that's easy to understand.

Patient Satisfaction 256

Patient Satisfaction Hospitals Health Outcomes Medicare 256

Compliancy Group

DECEMBER 27, 2023

The risks involved in providing quality care range from complex medical procedures to rapidly evolving technology. This is where risk management in healthcare plays a vital role, ensuring the safety and security of patients while enabling healthcare professionals to deliver effective treatment.

Compliance 52

Compliance Malpractice Health Insurance HIPAA 52

HIT Consultant

MARCH 8, 2024

(NYSE: TDOC) , the global leader in whole-person virtual care, today announced expanded capabilities designed to help employers and health plans manage rising demand for anti-obesity medication such as glucagon-like peptide 1 (GLP-1) agonists and support safe, sustainable weight loss and cardiometabolic health improvement for members.

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Healthcare It News

MAY 8, 2023

The New York City-based Urban Health Plan used artificial intelligence to improve operational efficiency and patient care and got a handle on its annually high patient no-show rates with cost-effective patient interventions. The designated associates documented call outcomes. "It wasn't a huge lift."

Doctors 286

Doctors Telemedicine Health Outcomes 286

Healthcare IT News - Telehealth

JANUARY 30, 2023

FINDINGS Based on the state audit , the department fell short in governance, risk management, and evaluation of the telehealth expansion. " The audit found that it did not require key implementation decisions and plans to be documented.

COVID-19 135

COVID-19 Governance Medicare Medicare 135

Total Medical ComplianceHIPAA

APRIL 12, 2024

Let’s explore the benefits of cyber insurance, the risks faced by those without it, and the effects it has on those handling a cyber incident. Cyber insurance providers offer invaluable assistance in risk management, helping healthcare organizations proactively identify and address security gaps.

Compliance 75

Compliance Ransomware HIPAA Governance 75

HIT Consultant

MARCH 7, 2024

(NYSE: TDOC) , the global leader in whole-person virtual care, today announced expanded capabilities designed to help employers and health plans manage rising demand for anti-obesity medication such as glucagon-like peptide 1 (GLP-1) agonists and support safe, sustainable weight loss and cardiometabolic health improvement for members.

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Innovaare Compliance

APRIL 7, 2024

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% First and foremost is for Case Managers to know the demographics and needs of their enrollees beyond physical health needs. generics) beginning in 2025 [1]. billion [4].

Medicare 59

Medicare Medicare COVID-19 Hospitals 59

HIT Consultant

FEBRUARY 7, 2024

Chartis repeats its success as the Overall Healthcare Management Consulting Firm for the fourth year in a row. Evergreen Healthcare Partners is named the Overall Implementation Services Firm, marking a first-time win for the company.

Nurses 102

Nurses Governance Compliance Hospitals 102

Healthcare IT Today

MARCH 11, 2024

As the industry navigates this perilous digital terrain, understanding, managing, and effectively integrating cyber insurance into its risk management strategies has never been more critical. This heightened risk landscape emphasizes the need for robust cybersecurity measures. Let’s dive in.

Ransomware 107

Ransomware Hospitals 107

Compliancy Group

APRIL 8, 2024

Patient safety and regulatory compliance are paramount, and healthcare organizations face numerous challenges in effectively managing their operations. The complex nature of the healthcare industry calls for a robust framework to ensure governance, mitigate risks, and maintain compliance with various regulations.

Governance 52

Governance Compliance Regulatory Compliance Fraud 52

Compliancy Group

APRIL 2, 2024

Healthcare organizations are complex systems, fraught with a dynamic range of risks. Risk is a given in a complex system or program. Managing risk and ensuring various types of compliance are paramount to the organization’s health and longevity. This all applies to risk management software.

Compliance 52

Compliance Regulatory Compliance Telemedicine 52

HIT Consultant

FEBRUARY 14, 2024

. – The technique, identified by the Division of Artificial Intelligence in Medicine and the Biomedical Imaging Research Institute at Cedars-Sinai, can help physicians better understand and manage heart disease risk in patients. – Early risk prediction: Helps identify patients at higher risk for heart disease early on.

Doctors 91

Doctors 91

Compliancy Group

APRIL 22, 2024

Regulations abound in the modern healthcare ecosystem, a reliable compliance project manager is more than a necessity—it’s a strategic advantage. ” Businesses struggling to stay afloat in the complex waters of regulatory compliance in healthcare can benefit from investing in an effective compliance project manager. .”

Compliance 59

Compliance Regulatory Compliance Hospitals HIPAA 59

Innovaare Compliance

APRIL 7, 2024

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% First and foremost is for Case Managers to know the demographics and needs of their enrollees beyond physical health needs. generics) beginning in 2025 [1]. billion [4].

Medicare 52

Medicare Medicare COVID-19 Hospitals 52

AIHC

APRIL 10, 2024

HIPAA and HITECH is for all health care organizations falling under the definition as a Covered Entity, from solo practices to larger clinics and hospital medical networks to health plans and clearinghouses. As you will find out, we do have a lot of information, so much when you are writing your own HITECH plan you don’t know where to start.

Compliance 99

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

HIT Consultant

APRIL 5, 2024

This data-driven approach ensures that StrokeCP offers effective tools and interventions proven to support post-stroke care management. CMS now mandates screening for five key SDOH risk factors, which disproportionately impact underserved communities.

Electronic Medical Records 92

Electronic Medical Records 92

HealthIT Answers

OCTOBER 31, 2023

By Anup Panthaloor - As states disenroll millions of individuals from their Medicaid rolls, small and medium sized health plans with managed Medicaid plans face multiple risks. The post How Small and Medium Sized Managed Medicaid Plans Can Survive Redetermination appeared first on Health IT Answers.

Medicaid 69

Medicaid Medicaid 69

HIPAA Journal

JANUARY 13, 2023

A recent survey conducted for the Healthcare and Public Health Sector Coordinating Councils (HSCC) found that healthcare organizations of all sizes are struggling to manage third-party risks, especially small- and medium-sized healthcare organizations, which typically have limited budgets and resources to devote to third-party risk management.

HIPAA 97

HIPAA Public Health 97

HIT Consultant

APRIL 17, 2024

– The AI-enabled tool leverages artificial intelligence (AI) to streamline the risk adjustment audit process, potentially saving MAOs millions of dollars. The Challenge: A Complex and Costly Regulatory Landscape Health plans, particularly MAOs, face a growing burden from complex regulations and stringent audits.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Compliancy Group

FEBRUARY 6, 2024

million and submit to a corrective action plan. Now more than ever, the risks to patient protected health information cannot be overlooked and must be addressed swiftly and diligently,” said. On February 6, 2024, Montefiore Medical Center reached a settlement with the HHS over potential HIPAA Security Rule violations.

HIPAA 64

HIPAA Compliance 64

HIT Consultant

FEBRUARY 20, 2024

. – This significant investment, led by AlleyCorp, Arkin Digital Health, Tau Ventures, and The Charlotte Fund, underscores the growing demand for Siftwell’s innovative approach to population health management. Siftwell goes beyond simply identifying high-risk individuals.

Health Outcomes 95

Health Outcomes 95

HIT Consultant

OCTOBER 31, 2023

– Health Action Plan is a helpful first step when it comes to prevention and early risk detection. . – Health Action Plan is a helpful first step when it comes to prevention and early risk detection. It offers customers specific actions and next steps on their health journey.

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HIT Consultant

MARCH 19, 2024

The cloud-native SaaS platform combines Ribbon’s high-quality provider data directory with advanced data management capabilities – a powerful, first-of-its-kind combination for the industry that allows healthcare enterprises to easily configure custom data workflows to drive operational efficiency and value.

Health Insurance 95

Health Insurance Governance Compliance 95

Healthcare IT Today

JANUARY 26, 2024

This starts with continuous learning, fostering a culture of cybersecurity, risk and security assessment, incident response plan, and implementing a defense-in-depth strategy. Regular risk assessments should be performed to identify vulnerabilities, and corrective actions should be prioritized.

Compliance 92

Compliance Ransomware 92

Healthcare IT Today

FEBRUARY 22, 2024

The following is a guest article by Kevin Riley , CEO and President at Zyter|TruCare In an era dominated by the complex challenges of chronic diseases, which account for approximately 90% of healthcare costs , a strategic approach to chronic care management (CCM) is essential. affecting about 6 in 10 adults.

Hospitals 105

Hospitals Health Insurance Public Health Governance 105

Healthcare IT Today

FEBRUARY 5, 2024

In the same way, investing in cybersecurity early on makes digitized healthcare manageable — preventing the dreaded cyber-attack before it ever infiltrates the hospital ecosystem. CMO Meet CISO, CISO Meet CMO It’s the Chief Medical Officer (CMO) who oversees this level of secure hospital management. Train staff in cybersecurity risks.

Hospitals 89

Hospitals Health Insurance HIPAA Doctors 89

American Medical Compliance

APRIL 23, 2024

The following Managing Heart Failure Training educates healthcare providers (HCP) on the underlying mechanisms that lead to heart failure. Risk Factors and Prevention Unfortunately, many things can raise a person’s risk of heart failure. The overall risk of heart failure goes up if you have more than one of the following.

Compliance 52

Compliance 52

Healthcare IT Today

DECEMBER 21, 2022

As the industry grows, more service and operational needs arise, resulting in increased outsourcing, and additional vendor risk. Protecting Your Organization Through Third-Party Risk Management (TPRM) Actions. Identify various scenarios and plan your course of action accordingly. Plan your communication strategy.

HIPAA 85

HIPAA Governance Compliance Hospitals 85

MedTrainer

APRIL 18, 2024

When reporting these events, an incident response plan is crucial, as it outlines the next steps for individuals to take and how to respond. Creating a healthcare incident response plan is one way to combat underreporting incidents in healthcare and maintain compliance.

Compliance 52

Compliance HIPAA Compliance Officers 52

Healthcare IT Today

FEBRUARY 14, 2024

AI-powered security solutions can automate the process of mapping out networks, identifying risk points, and detecting anomalous behavior that could indicate a cyber attack. These capabilities allow security teams to continuously monitor third-party cyber risk and make sure external partners are upholding their security assurances.

US Department of Health and Human Services 102

US Department of Health and Human Services Compliance Hospitals 102