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Don’t Negotiate Your Next Payer Contract Without These Three Phrases

Chris Arthur

Tech Optimization Services, Director

Reimbursements are a significant source of revenue for health systems. Yet, many organizations don’t receive the full reimbursement for a service rendered, even when the payer and provider have agreed on a rate. Unfortunately, keeping up with payer policy changes is difficult and most healthcare organizations don’t have a payer expert who regularly analyzes payer contracts. To protect themselves from surprise policy changes that lead to lost revenue, organizations should include three key phrases in their current and existing payer contracts:1. “We’re not bound by payer policies unless agreed to in writing by both parties.”2. “Once authorization is approved for a service, it cannot be subsequently denied.”3. “Any code not in this contract will be reimbursed at a percent of charge.”

How to Accelerate Clinical Improvement Using Four Domains of Clinical Analytics

As health systems increase their focus on improving clinical performance, they rely on clinical analytics from different sources to identify opportunities for improvement. Although the process of aggregating, organizing, and deriving analytic insight from data is complex, Holly Rimmasch, Chief Clinical Officer, SVP, and General Manager of Clinical Quality Analytics at Health Catalyst, explains why it’s critical for health systems’ survival. She also takes a deep dive into the following four domains of clinical analytics, showing how healthcare organizations can take their data farther and scale long-lasting clinical improvements:1. Data acquisition.2. Clinical analytics usage.3. Unrealized opportunities of clinical analytics.4. Patient engagement.

Your Guide to Augmented Intelligence in Healthcare: Three Hows for AI Success

Healthcare experts estimate that augmented intelligence (AI) in healthcare will increase 40 percent by 2028. With AI growing at such a rapid rate, it is critical that health systems avoid the common AI pitfalls that impede success. By addressing the three “Hows” that set the foundation for meaningful AI in healthcare, organizations can benefit from AI in minutes instead of months. In his second podcast, Dr. Jason Jones, our Chief Analytics and Data Science Officer, explains how AI intersects with other digital healthcare trends, how organizations can effectively integrate AI into existing workflows, and lastly, how health entities can create easy-to-use AI for team members across all domains.

Three Crucial Mindset Shifts to Reach Peak Financial Healthcare Management

Each health system takes a unique approach to financial management. No matter the organization, Dan Unger, SVP and General Manager of Financial Transformation at Health Catalyst, says that effective financial management should promote better financial decision making across the system. And even though optimal financial management is critical to healthcare operations, organizations struggle to deal with its complexities. With challenges ranging from government-set funding to newly emerging competitors in the market, health systems need to optimize their approach to financial management. Unger suggests healthcare organizations adopt three mental shifts that lead to better financial management:  1. Identify a forward-thinking financial leader. 2. Collaborate with clinical and operational domains. 3. Implement activity-based costing. 

The Four Pillars of Successful Self-Service Analytics in Healthcare

Travis Touroo

Sr. Product Manager, DOS

To prepare for successful self-service analytics, healthcare organizations must lay a strong foundation to ensure team members feel comfortable and confident with data. Many health systems are so eager to reap the benefits of self-service analytics that they rush its implementation before their team members are ready. These hurried approaches often lead to unsuccessful self-service analytics implementation that lacks the agility to support systems in a rapidly changing industry. To ensure self-service analytics success and avoid common pitfalls, healthcare organizations can focus on four pillars that build a strong self-service analytics foundation:1. Develop a data-centric culture.2. Promote data literacy.3. Garner leadership support and ensure governance.4. Define a business goal.

Accelerate Data-Driven Healthcare Improvement: 5 Tenets

Growing amounts of data can be overwhelming for healthcare entities to organize, manage, and distribute effectively, sometimes making data more of a burden than a benefit. However, if organizations adopt the right data mentality, they can gain insight into performance, track an intervention’s success, and improve outcomes. According to data experts, Bryan Hinton, our Chief Technology officer, and TJ Elbert, our SVP and General Manager of Data, organizations can apply five mindset changes to avoid data overload and achieve data-driven improvement:1. Focus on data orchestration, not data computing.2. Leverage real-time data, especially in a pandemic.3. Prioritize data democratization over data control.4. Use AI, if you’re not already.5. Change current care models to fit the data.

Deliver Better Population Health by Avoiding Three Mistakes

Jonas Varnum

Population Health Strategic Services, VP 

Despite the widespread use of population health as a solution to control rising costs and poor outcomes, healthcare organizations struggle to effectively achieve population health success. A common barrier to success is lack of access to data about a system’s most impactable patients, their interventions, and how said interventions impact a patient’s health. However, health systems can overcome the following all-too-common population health mistakes by leveraging detailed data about their most impactable patients and interventions:1. Lacking an effective solution for data-driven strategy.2. Using delayed analytic insight to understand performance and opportunities.3. Not tracking member-level data to measure intervention effectiveness.

The Healthcare Research Network: 5 Modernizing Features

In an era of technological innovation and extraordinary connectivity, why does clinical research follow a decades-old model? Clinical trials remain concentrated among leading urban medical centers with narrow patient populations, but today’s data and collaborative capabilities can support a broader, more robust reach. To that end, the new Health Catalyst Research Offering accelerates and optimizes clinical research in five groundbreaking ways:1. Connects key players in clinical research.2. Provides a network of healthcare provider systems, biopharmaceutical companies, and clinical research organizations.3. Gives access to research-oriented Health Catalyst products and services.4. Supports clinical study from planning through the active trial.5. Maintains a national repository of clinical data.

Close Gaps in Patient Care with the Health Catalyst Embedded Care Gaps™ Application

Tarah Neujahr Bryan

Chief Marketing Officer

With the pandemic fueling increasing financial and clinical demands, health systems need automated tools and processes to deliver cost-effective care without compromising quality. Traditional data infrastructure that delivers delayed insights to clinicians creates additional barriers to better care. Yet, many organizations still use these fragmented systems. Now, with the Health Catalyst Embedded Care Gaps™ application, organizations can deliver relevant insight to decision makers at the point of care. With accurate, actionable insight embedded directly into the EHR, Embedded Care Gaps empowers clinicians to close gaps in patient care, maximize every patient visit, and operate at the top of their licenses. Furthermore, patients reap the benefits of closing gaps by receiving more complete care through an efficient, well-planned visit.

HAS 21 Virtual in Review: Soaring Satisfaction Rates, Attendee Profiles, and More

Even virtually, transporting 3,000-plus healthcare leaders and activists across three international destinations is no small feat. Add world-class data and analytics insight and inspiration from healthcare and beyond to the voyage and you have a three-day journey of a lifetime—otherwise known as the Healthcare Analytics Summit™ (HAS) 21 Virtual. The 2021 edition of healthcare’s premier analytics summit once again gathered innovators and heroes from around the globe to explore multi-domain analytics as the framework for a winning team approach to healthcare transformation.

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