Boe Hartman

On multiple occasions during the past several years, #CMS has solicited input on how it might reimburse for digital health products that present an awkward fit within the Medicare system. Now, developers say it’s time to act. Ultimately, many stakeholders agree that the #Medicare system wasn’t crafted to address software used as a primary healthcare tool. Thus, long-term solutions will almost certainly require legislation. That is not going to happen right now, though, and industry stakeholders say CMS’ annual rules offer at least some potential opportunities to push the system forward: https://bit.ly/4d3KZq3

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Some impactful changes ahead for hospitals for the conditions below, that will make strong home health & post acute collaboration even more essential. --3. Hospitals will be responsible for managing the Full 30-Day costs of these 5 surgical procedures. Considering that anywhere from 22% (CABG) to 63% (SHFFT) of total episode costs occur after the patient is released from the hospital, that means that participating hospitals (TEAM "Participants") will be incredibly dependent on building and working with high-performing post-acute networks (TEAM "Collaborators") in their markets. In total- these 5 conditions represent roughly $44 Billion in total Medicare 30-day spending, of which about $18B is post-discharge spending inclusive of readmissions.--

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Looking to maximize the efficiency of your citizen developer projects? Look no further! Join us in watching a compelling video featuring Major Sandin, SVP of Risk Strategy at U.S. Bank, as he shares invaluable insights on the pivotal role of IT collaboration in project success. 🚀 Don't miss out on Major Sandin's expert advice! Watch the video now:  https://lnkd.in/eg6iFiA3 #CitizenDevelopers #ITCollaboration #Innovation #AI #ArtificialIntelligence #MachineLearning #DigitalTransformation

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Provider billing trends can impact prospective payment integrity programs and provider network management. But data that is limited to one organization may not yield sufficient insight to reveal claim payment trends and their full impact on payment policy. Join our upcoming webinar this Thursday at 2:00 PM ET to explore notable trends in provider billing, benchmark billing accuracy, and identify payment policy opportunities. Register today. https://bit.ly/3KFRiUy #payments #HealthPlans

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#HomeCarePodcast #HCAF Home Care 2.0: Unlock the Power of Value-Based Payments! Join Fady Sahhar, President of XtraGlobex, Inc., as we explore how value-based payments help improve quality in home care. Listen now and empower yourself for the future of home care! #Caresmartz360 #care #homecare #podcast #quality #caring #speakers #podcasters #payments

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Just months after completing one of the biggest deals of her career, Stephanie Ferris, the CEO of Fidelity National Information Services, has a message for everyone: FIS isn’t done. Ferris and the company she leads is looking to get to back to buying. In February, FIS closed the sale of a majority stake in WorldPay to GTCR, a Chicago buyout shop. The transaction helped FIS cut its total debt, which had ballooned to about $19.1 billion at the end of 2023, to about $10 billion once the sale was completed. As of March 31, FIS debt stood at $11.2 billion while its leverage ratio was about 2.7 times, a spokesman said.  The deleveraging means FIS is reinstating its M&A agenda, Ferris said. The Jacksonville company provides fintech software to merchants, banks, and capital markets firms. FIS is allocating about $1 billion a year to deals and will be targeting small, synergistic products that the company currently doesn’t have or doesn’t have enough time to build organically, she said. Its purchase last year of Bond Financial Technologies, a banking-as-a-service startup, was an acquihire—something FIS is not seeking to replicate this time around. “We’re really looking for products or businesses that have revenues and EBITDA and a proven business model,” Ferris said. Read more: https://lnkd.in/eeuDust6

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Check out the Synergy Billing Insights where we supply several articles on all things FQHCs.📢 Hey FQHC community! 🌟 Ready to dive deep into crucial insights shaping our world? Check out our Insights Page! 📚 From dissecting Inflation's Impact on FQHCs to navigating the maze of Medicaid Trends and managing grant dependencies, we've got you covered. Stay informed, stay empowered! 💡 Explore now: https://hubs.li/Q02t4g9b0 #FQHC #HealthcareInsights #MedicaidTrends #ValueBasedCare 🚀

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Not all bundled payments are created equal in VBC. Retrospective bundles – which make up the bulk of today’s bundled payment arrangements – lack key factors that lead to behavior change.  Prospective bundles require everyone to take on risk, and efficiently manage care based on a set price. They are one of the most effective alternative payment models to reduce costs and improve care quality in specialty care.     Only Cedar Gate has the back-end analytics and claims engine to make it possible, and over 30 years of experience administering prospective bundles.      https://lnkd.in/e92r6S_F    #healthcare #healthcareIT #valuebasedcare #vbc #prospectivebundles #bundledpayments #collaboration 

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The most recently released Medicaid Managed Care final rule gives states enhanced flexibility to implement value-based payment arrangements under MCO contracts. Is your ACO ready to succeed in Medicaid value-based payments? #HopkinsACG can help. Our patient #segmentation methodology, combined with cutting-edge pharmacy and health outcomes features, drive long-term success in #Medicaid populations. https://lnkd.in/etUp5kiq

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With the push to do more with less, it's too easy to inadvertently add complexity to #paymentintegrity operations. But there is a way out. Innovative program leaders from health plans across the country recently came together to share their vision for the future of the industry. Here are their top 6 recommendations: 1️⃣ Embrace A.I. for efficiency: A.I. isn't a panacea, but as part of a larger, focused strategy, it can help make the most of limited resources. By using A.I., you can streamline operations, detect anomalies, and enhance payment accuracy. 2️⃣ Shift to prepay cost avoidance: Preventing payment errors before they happen is the ultimate goal, saving time and resources in the long term. 3️⃣ Build relationships with data transparency: Openly sharing data with partners - across and outside of the #healthplan - strengthens trust and collaboration, leading to better decision-making and mutual success. 4️⃣ Optimize with right-sourcing: Cut costs and boost efficiency by outsourcing non-core functions to specialized vendors. Focus on core tasks while benefiting from external expertise. 5️⃣ Drive success through collaboration: Work with internal teams, external partners, and industry experts to overcome challenges and achieve remarkable results. Ready to unlock the full potential of technology in payment integrity? Learn more at https://hubs.ly/Q02CS4Jd0 #ComplexitytoClarity #EnterpriseTechnology

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Transitioning from fee-for-service to APMs is daunting, especially as more advanced levels of interoperability and operational efficiency are required to scale and succeed across multiple contracts and payment models. In this video, David Wolf, MBA and Lynn Carroll share tips for ramping up value-based care efforts and reducing friction in the change management process. #HIMSS24 Watch: https://lnkd.in/g79VmSZr

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A transition from fee-for-service to value-based payment models could help #palliativecare providers boost recruitment and retention. https://bit.ly/4dVeQ53

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The U.S. Center for Medicare and Medicaid Innovation is launching a new Quality Pathway to elevate patient-centered quality goals in the design and evaluation of alternative payment models. The Quality Pathway will align model design around quality goals; elevate outcomes and experience measures, particularly patient-reported outcomes; and ensure that evaluations have the ability to assess the impact of models on primary quality goals. These determinations will help the Innovation Center make critical decisions about which models to scale or expand in the pursuit of improving the quality of care for people with Medicare and Medicaid: https://nej.md/3xoXUmU

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When it comes to open banking, do you know the facts? Read this article from Shanda Purcell, senior director of open banking at CSI, to explore three common misconceptions that community banks should avoid as they explore how to deploy open APIs within their tech strategies: https://bit.ly/3UjiRHH

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How does a bank blend tradition with a tech-savvy approach? 🤔 "Data is both the disease and the cure." - Anthony Peculic, Head of BaaS and Cards, Cross River Bank Join Tedd Huff and Nate Bray as they chat with Anthony Peculic about the changing landscape of banking. They discuss how Cross River Bank combines the stability of traditional banking with the creativity of a tech company. From dealing with regulations to adapting to new market conditions, this episode is packed with insights! 💡 1️⃣ The impact of macroeconomic changes on products 2️⃣ The shift from banks being just vendors 3️⃣ The role of data in financial solutions Learn how Cross River Bank is investing heavily in technology to enhance their services and stay ahead of the curve. Accrued, a Fintech Confidential series presented by LoanPro #CrossRiverBank #TraditionalBanking #TechCompany #AnthonyPeculic #BaaS #BankingAsAService #MacroeconomicSituations #FinTech #BusinessPerspective #BankingVendors #DataInBanking #TechnologyInBanking #EmbeddedFinance #CardPrograms #BankingRegulation #EntrepreneurialBanking #InnovativeBanking #FinancialTechnology #BankTechnologyInvestments #BankingEngagement #CardSponsorship #BankingTech #BankingProducts #BankRegulation #BankingInnovation #TechDrivenBanking Tedd Huff DD3 Media Fintech Confidential

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How does a bank blend tradition with a tech-savvy approach? 🤔 "Data is both the disease and the cure." - Anthony Peculic, Head of BaaS and Cards, Cross River Bank Join Tedd Huff and Nate Bray as they chat with Anthony Peculic about the changing landscape of banking. They discuss how Cross River Bank combines the stability of traditional banking with the creativity of a tech company. From dealing with regulations to adapting to new market conditions, this episode is packed with insights! 💡 1️⃣ The impact of macroeconomic changes on products 2️⃣ The shift from banks being just vendors 3️⃣ The role of data in financial solutions Learn how Cross River Bank is investing heavily in technology to enhance their services and stay ahead of the curve. Accrued, a Fintech Confidential series presented by LoanPro #CrossRiverBank #TraditionalBanking #TechCompany #AnthonyPeculic #BaaS #BankingAsAService #MacroeconomicSituations #FinTech #BusinessPerspective #BankingVendors #DataInBanking #TechnologyInBanking #EmbeddedFinance #CardPrograms #BankingRegulation #EntrepreneurialBanking #InnovativeBanking #FinancialTechnology #BankTechnologyInvestments #BankingEngagement #CardSponsorship #BankingTech #BankingProducts #BankRegulation #BankingInnovation #TechDrivenBanking Tedd Huff DD3 Media Fintech Confidential

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How does a bank blend tradition with a tech-savvy approach? 🤔 "Data is both the disease and the cure." - Anthony Peculic, Head of BaaS and Cards, Cross River Bank Join Tedd Huff and Nate Bray as they chat with Anthony Peculic about the changing landscape of banking. They discuss how Cross River Bank combines the stability of traditional banking with the creativity of a tech company. From dealing with regulations to adapting to new market conditions, this episode is packed with insights! 💡 1️⃣ The impact of macroeconomic changes on products 2️⃣ The shift from banks being just vendors 3️⃣ The role of data in financial solutions Learn how Cross River Bank is investing heavily in technology to enhance their services and stay ahead of the curve. Accrued, a Fintech Confidential series presented by LoanPro #CrossRiverBank #TraditionalBanking #TechCompany #AnthonyPeculic #BaaS #BankingAsAService #MacroeconomicSituations #FinTech #BusinessPerspective #BankingVendors #DataInBanking #TechnologyInBanking #EmbeddedFinance #CardPrograms #BankingRegulation #EntrepreneurialBanking #InnovativeBanking #FinancialTechnology #BankTechnologyInvestments #BankingEngagement #CardSponsorship #BankingTech #BankingProducts #BankRegulation #BankingInnovation #TechDrivenBanking Tedd Huff DD3 Media Fintech Confidential

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How does a bank blend tradition with a tech-savvy approach? 🤔 "Data is both the disease and the cure." - Anthony Peculic, Head of BaaS and Cards, Cross River Bank Join Tedd Huff and Nate Bray as they chat with Anthony Peculic about the changing landscape of banking. They discuss how Cross River Bank combines the stability of traditional banking with the creativity of a tech company. From dealing with regulations to adapting to new market conditions, this episode is packed with insights! 💡 1️⃣ The impact of macroeconomic changes on products 2️⃣ The shift from banks being just vendors 3️⃣ The role of data in financial solutions Learn how Cross River Bank is investing heavily in technology to enhance their services and stay ahead of the curve. Accrued, a Fintech Confidential series presented by LoanPro #CrossRiverBank #TraditionalBanking #TechCompany #AnthonyPeculic #BaaS #BankingAsAService #MacroeconomicSituations #FinTech #BusinessPerspective #BankingVendors #DataInBanking #TechnologyInBanking #EmbeddedFinance #CardPrograms #BankingRegulation #EntrepreneurialBanking #InnovativeBanking #FinancialTechnology #BankTechnologyInvestments #BankingEngagement #CardSponsorship #BankingTech #BankingProducts #BankRegulation #BankingInnovation #TechDrivenBanking Tedd Huff DD3 Media Fintech Confidential

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When it comes to patient payments, March is consistently the highest-paying month. But what happens after? In our latest blog post, Senior Director of Value Engineering Allison Eschbach dives into patient payment seasonality trends, including what to expect in Q2: https://lnkd.in/eF_jEFes

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