Posts

Electronic Health Record (EHR) is a word that has been perplexing caregivers, physicians and hospitals for more than a decade. Simply put, an Electronic Health Record is a summation of medical records and history of a patient in electronic form, with information technology bolstering it from the core. However, this simple definition does not justify the mammoth task this technological transfer entails. In practice, creation of an electronic health record requires accessing every known medical detail of a patient and processing, collating and presenting it in a usable form. The emphasis is on usable data, data that can be analyzed, adjusted and utilized for providing better care.

The sheer magnitude of the task and its inherent importance has coaxed the government into taking active steps toward motivating the stakeholders to move to EHR and shun paper records. Incentives, through Health Information Technology for Economic and Clinical Health (HITECH) Act, are working as an impetus for doctors and hospitals to adopt the EHR for data storage. Even with this in place, there are certain areas where EHR still needs to catch up.

Read more

There have been a lot of opinions expressed about how the payer’s margin will be squeezed in the reformed health insurance market. This discussion focuses its attention on dealing with the situation, i.e. preparing a business strategy for survival in the new Exchange market.

1. Get Smart About It: There is Life for Plans off the Exchange
Restrictions imposed by the ACA are here to stay but a smart payer can still dig out profits by reading between the lines. For instance, the Healthcare Law stipulates that health insurance products sold on and off the federal/state health care exchanges should put forth the same range of premiums, out-of-pocket expenses, etc. However, the ACA doesn’t stipulate that standalone products sold on the exchange need to be retailed in the same format in the non-exchange market.

Read more

This is the second part of a discussion about how healthcare leaders should perceive the emerging Exchange marketplace and get ready to ensure survival and profitability in this fast changing domain.

Healthcare leaders shouldn’t think they need to drastically reform their business model to survive in the reformed market. The better approach is to perceive the situation as rebooting their operations, armed with better technologies and greater business intelligence. To ensure that their business is positioned for success, senior decision-makers across healthcare organizations need emphasize upon:

Read more

This is the second part in our discussion about the increasing role of Analytics in the Healthcare industry. Here, we explore how Analytics offer irrefutable benefits to the insurers and try to derive a conclusion. (Please to view the first part of this discussion).

For Payers: Analytics Eases Adaptation to Healthcare Reforms
Payers can benefit from Healthcare Analytics where everything from Electronic Health Records to ICD-10 and Health Information Exchange updates can impact their expenses, profitability and marketing penetration. Typical areas where analytics are immediately useful include categorization of population health indexes, evaluating success of marketing strategies and assessing new provider networks. In addition, analytics invariably yield a more granular form of data which is better suited for disease management programs.

Read more

This is the first of a 2-part discussion that explores the role Healthcare Analytics can play in the era of Health Reforms.  Here, we discuss the contemporary realm of Analytics and the challenges to its usage.

Pharmaceutical companies are perhaps the most seasoned users of Analytics in the healthcare market since detailed analysis is central to their efforts in drug research and clinical trials. Other healthcare entities like payers, provider organizations and government agencies haven’t adopted Analytics as enthusiastically. However, this scenario might change rather soon. With State Exchanges set to redefine the health insurance marketplace, most healthcare organizations have understood that they can either adapt to the reforms or perish. As 2013 progresses, healthcare businesses are realizing that they need to squeeze more out of every dollar spent, limit wastage of resources and eliminate fraudulent practices to achieve profitability-cum-compliance. This translates into many operational and administrative changes. Healthcare Analytics can make this transformation less challenging.

Read more

The creation of Electronic Health Records (EHR) was established by President George W. Bush in 2004. He created the Office of the National Coordinator (ONC) for Health Information Technology to support the adoption. The ONC created standards for medical records but adoption was slow. In 2009, President Barack Obama picked up the torch stating EHR was a priority.

Other countries have picked up the adoption of EHR as well. In the UK, where it is referred to as EPRs (Electronic Patient Records), representatives from NHS (National Health Service) have touted EPRs vital for streamlining and safeguarding patient information, improving health informatics and fueling data-driven patient services.

Read more

The year 2012 proved to be an eventful period for the U.S. health insurance industry. The Affordable Care Act (ACA) continued to charge ahead amid widespread controversies—including a ruling by the Supreme Court—and became infused with a fresh lease of life when President Obama won a second term in office. With last year witnessing the rise of private health exchanges, payer-provider mergers, Accountable Care Organizations, 2013 is now poised to see some important developments and new trends in the U.S. healthcare sector. Some of the landmark changes that are sure to gain prominence in 2013 include:

Read more