As the quest for health equity gains momentum, the nation’s oldest and largest healthcare evaluation and accreditation body has announced new standards…
Value-based care is the future of healthcare in the U.S. These four core competencies can help guide your organization toward a model…
Meaningful Measures 2.0 goals are designed to facilitate the ongoing move toward value-based care, which targets issues including person-centered care, safety, chronic…
These four states are taking a boots-on-the-ground approach to addressing social determinants of health. Subscribe to our blog Don’t forget to share…
When you can align activities such as prior authorizations, utilization management and operational workflows with regulatory mandates for quality, timeliness, interoperability and…
The latest episode of Liberation Lab focuses on CMS changes to Star Ratings and what the shift in weights of different measures…
Nancy Green, senior vice president at Aveus, sat down with Julie Barnes, founder of Maverick Health Policy, and Debbie Hill, vice president…
The U.S. Department of Health and Human Services has prioritized efforts to contain the COVID-19 pandemic over enforcing HIPAA rules. Subscribe…
A game-changing revision to CMS rules for Star ratings puts Medicare Advantage plans under extra pressure to deliver an excellent customer experience….
The latest episode of Liberation Lab focuses on the prior authorization rule affecting utilization management. Julie Barnes, JD, Founder and Principal of…
What does the new interoperability and prior authorization rule mean for the patient experience? Julie Barnes, founder and principal of Maverick Health…
The healthcare appeals process can be difficult to navigate. How can we ensure that patients easily understand the process and their healthcare…
The COVID-19 pandemic has resulted in more people on Medicaid. It’s more important than ever before for the healthcare industry to do…
New rules will ease administrative burden, speed up reimbursement and remove fears of accidental violations. Subscribe to our blog Don’t forget to…
Liberation Lab turns its sights to the potential implications of the November 2020 election on US healthcare policy. Our expert guests include…
Moving forward, Fast Healthcare Interoperability Resources (FHIR) will be used for the digitalization of HEDIS quality measures. Subscribe to our blog Don’t…
In January 2019, Medecision launched a yearlong process to achieve MARS-E compliance. Here’s how we did it. Subscribe to our blog Don’t…
In October 2019, CMS proposed changes to the Stark Law, which was enacted in 1988 to prevent physicians from prioritizing financial concerns…
CMS and ONC delays to enforcement give the industry a few additional months to prepare for major overhauls to ensure the appropriate…
Medical loss ratio (MLR) rebates hit a record $1.3 billion in 2019 because health plans spent too little on medical claims and…
More state Medicaid programs are now addressing SDOH through managed care plans and Section 1115 demonstration waivers. However, while these Medicaid programs…
In his “Automating Compliance in the Cloud” session during the CTO Roundtable at Liberation 2019, Gerry Miller, the founder and CEO of…
In February 2019, the Centers for Medicare and Medicaid Services (CMS) issued new requirements for Medicaid, the Children’s Health Insurance Program, Medicare…
Healthcare organizations’ success under risk sharing and value-based care relies on a well-oiled UM program. Subscribe to our blog Don’t forget to…
Research shows that social determinants of health (SDoH)—such as housing, transportation, access to healthy food and more—are linked to patient outcomes. Managed…
Until recently, Utilization Management was all about how health plans determine preauthorization. But that definition is fast becoming outdated. Subscribe to our…
What does Utilization Management have to do with Population Health? The answer: everything. Subscribe to our blog Don’t forget to share this…
SaaS application connects provider contract and member enrollment details for real-time authorizations and referrals, eliminates costs and delays tied to manual utilization…
