For all the progress made in shifting the U.S. healthcare system toward value-based care, one of the most powerful levers for improving outcomes and reducing costs remains underused: medications. Medications influence every dimension of health outcomes. They prevent disease progression, reduce hospitalizations, and determine whether chronic conditions stay controlled or spiral into costly complications. Yet,…
The transition to value-based care may seem daunting for many healthcare leaders, especially those who operate independently and have less margin for error when it comes to implementing new systems and initiatives. Flagler Health is a technology company offering AI tools and other advanced technologies to streamline many aspects of patient care for medical practices….
Download Slides Are you prepared for heightened scrutiny from the Centers for Medicare & Medicaid Services (CMS)? CMS is dramatically amplifying its audit efforts, with a renewed focus on Medicare Advantage plans and Risk Adjustment Data Validation (RADV) audits. This is not just another day at the office—CMS is expanding its audit workforce, increasing…
Electronic Clinical Quality Measures (eCQMs) are revolutionizing the way healthcare organizations evaluate care quality, track patient outcomes, and meet regulatory requirements. By embracing digital solutions, providers can not only streamline reporting processes but also deliver higher-quality care tailored to individual needs. This blog combines practical steps for eCQM implementation with the latest trends shaping their…
As the healthcare industry continues its shift toward value-based payment models, ASCs could be poised to be major beneficiaries of this transformation. Many industry leaders believe ASCs’ cost efficiency, streamlined operations and focus on quality outcomes make them ideal candidates for success in a value-driven healthcare landscape. According to FTI Consulting’s “Hospital Operations Outlook Survey,”…
In the complex world of healthcare, the importance of accurate coding and billing cannot be overstated. For healthcare providers participating in Medicare Risk Adjustment (MRA) programs, coding compliance is crucial in ensuring that patients receive the right care and that healthcare organizations meet legal and financial obligations. Non-compliance can lead to significant financial risks, regulatory…
Presidential transitions are always a time of great change, but few leaders have ushered in a shift as sweeping as the rewiring of one-seventh of the U.S. economy. President Trump has the opportunity to do just that by doubling down on the health transformation achievements of his first term. A key to success is continuing the…
Few buzzwords are as popular in healthcare as “value-based care.” But understanding of the term is often superficial, according to Alex Ding, MD, enterprise deputy chief medical officer at Humana. The company published its annual value-based care report in February. The annual report provides data on savings and outcomes achieved through value-based care — but…
Medical coding plays a vital role in healthcare, converting patient encounters into standardized codes used for billing, insurance claims, and performance tracking. Despite its behind-the-scenes nature, coding significantly impacts revenue cycles and regulatory compliance in healthcare organizations. With increased scrutiny from payers and government agencies, ensuring that medical coding practices align with current regulations has…
Clinical Documentation Improvement (CDI) programs play a vital role in Accountable Care Organizations (ACOs), ensuring accurate and comprehensive documentation that supports proper reimbursement, compliance, and quality patient care. With healthcare reimbursement models becoming increasingly complex, ACOs must implement strategies that streamline documentation, reduce errors, and align with Medicare’s risk adjustment models like Hierarchical Condition Category…