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October 28, 2021

Client Congress 2021: A Year to Review

As Client Congress 2021 comes to a close, we’re reminded how fortunate we are to continue to provide the valuable content the conference has always delivered while staying committed to the safety, health, and well-being of our attendees, speakers, and staff, by holding our ... Read ArticleRead Article

October 5, 2021

Experiences That Matter

Every year, our industry recognizes Customer Experience (CX) Day as a day to celebrate the many support individuals that focus on providing an exceptional experience for our customers. At Inovalon, we put a strong emphasis on the Total Customer Experience and we work to ensure ... Read ArticleRead Article

September 21, 2021

Strategies for Health Plans to Achieve Health Equity

The COVID-19 pandemic highlighted an ongoing issue in healthcare – health inequity. The differences in health outcomes between racial and ethnic groups can’t be denied, but health plans can take purposeful actions to alleviate health inequities among their member ... Read ArticleRead Article

September 10, 2021

Core Principles to Achieve Digital Transformation

Recently, I introduced the concept of digital transformation. I talked about how technology literally transforms you, the consumer, in various industries like retail, travel, and now healthcare. It is important to understand the core principles that make digital transformation ... Read ArticleRead Article

August 20, 2021

Digital Transformation of Healthcare

How many times have you heard the words “digital transformation of healthcare”? I know it seems cliched, overused, and kind of like a new buzzword that you are already tired of hearing. When I took on the role of managing Inovalon’s DataStream API Marketplace™ and ... Read ArticleRead Article

August 10, 2021

Vaccine Hesitancy Among Health Plan Member Populations Affects Quality Performance Ratings

Vaccine hesitancy has been center stage since the recent COVID-19 pandemic – this is also among health plan member populations. This hesitancy comes from a variety of factors, including poor public awareness, misinformation, costs, access, and other issues related to the ... Read ArticleRead Article

July 27, 2021

Vaccine Schedule Adherence Promotes Better Health Outcomes

Vaccines are one of the best tools to promote better health outcomes. Millions of lives are saved each year because of vaccine adherence,1 but unfortunately, at least one-third of all parents still do not adhere to the recommended vaccine schedule by the Advisory ... Read ArticleRead Article

June 15, 2021

Connected Digital Ecosystems Can Deliver Consumer-Centered Experiences That Drive Value

Imagine an integrated healthcare system where access to medical records in a secure environment is available in real-time for an accurate, consolidated view. Imagine providing consumers proactive tips based on their individual medical history and personal preferences to help ... Read ArticleRead Article

May 26, 2021

How Advanced Technology Is Driving More Value in Value-Based Care

The U.S. healthcare industry has evolved drastically to embrace value-based care models. As the journey continues, so too does payer and provider exploration of the most effective ways to manage value-based care contracts. The Affordable Care Act of 2010 triggered a massive ... Read ArticleRead Article

April 24, 2021

Level Up: Advancing Healthcare Analytics through Data Lakes

Across the healthcare ecosystem, payers, providers, pharmacy and life sciences organizations are leveraging data lakes, seeking to unite disparate structured and unstructured data from multiple sources such as claims data, clinical data, social determinants of health and quality ... Read ArticleRead Article

April 15, 2021

Why Is Provider Engagement So Important?

Enhancing provider engagement can have a dramatic impact on health plan performance. Recent studies show that health plans find that involving providers leads to improved clinical outcomes and quality ratings, member retention, and overall efficiency. Achieving meaningful ... Read ArticleRead Article

March 22, 2021

Inovalon’s Vaccine Adherence Program: Winning Strategies for Overcoming Barriers to Vaccination

Vaccination against preventable diseases is one of the most significant and successful public health strategies, improving health outcomes and saving the U.S. healthcare system billions of dollars annually. Studies show that vaccines help to prevent up to 3 million deaths each ... Read ArticleRead Article

March 9, 2021

How to Leverage Technology to Help Healthcare Facilities Manage COVID-19

COVID-19 brought many challenges to the world of healthcare. One challenge is protecting patients and residents in healthcare facilities. The federal government recognizes that protecting individuals during the pandemic will require funding. In a recently proposed pandemic ... Read ArticleRead Article

March 1, 2021

Virtual Health Visits Can Help Increase Access to Care

The COVID-19 pandemic accelerated adoption of telehealth and pushed us to collectively revisit its potential and effectiveness as a care modality integral to modern healthcare delivery. At a time when the US public health infrastructure (rightfully) urged social distancing, ... Read ArticleRead Article

February 10, 2021

How to Impact HEDIS® Measurement Year 2020 and Beyond

HEDIS® measurement year 2020 (MY2020) has just begun and there’s still plenty of time to positively impact this HEDIS® reporting season. Amid the past year’s unprecedented challenges primarily resulting from the COVID-19 pandemic, NCQA made significant changes to the ... Read ArticleRead Article

February 3, 2021

Value-based Care Improves Health Outcomes, Quality, and Experience

Value-based care aims to reward healthcare providers based on the quality of care and services delivered rather than on quantity, with the goal of improving health outcomes, quality, and experience. Health plans, with emphasis on the accurate capture and reflection of overall ... Read ArticleRead Article

January 11, 2021

Key Strategies for Successful Member Engagement

As the healthcare industry shifts from a consumption and value based model to one driven by quality, value and efficiency, consumers now have more choices than ever. As a result, health plans are increasingly focused on becoming more consumer-centric, implementing innovative ... Read ArticleRead Article

December 21, 2020

2022 Medicare Advantage Advance Notice: 5 Key Takeaways

The release of Part I and II of the 2022 Advance Notice came several months earlier than its typical release, along with the close of the comment period on November 30. Part I included proposed changes to the Medicare Advantage (MA) and Part D payment methodologies and Part II ... Read ArticleRead Article

December 10, 2020

Inovalon Consumer Health Gateway™: FHIR-Based Patient Access API Solution

Since 1996, with the introduction of HIPAA, interoperability has often taken center stage in the healthcare arena. Today, amid new federal regulatory requirements and an unprecedented global pandemic, the importance of – and need to accelerate – the industry’s journey to ... Read ArticleRead Article

November 18, 2020

Elevating Your Support Encounter – Evolving Client Support at Inovalon

Inovalon has experienced rapid growth over the years. As the Company has added clients and made strategic acquisitions, our portfolio has expanded, ushering in a broadened community of users with diverse needs and unique challenges. Our mission is to empower efficient and ... Read ArticleRead Article

November 13, 2020

Understanding the 2021 CMS Star Ratings for Medicare Advantage Plans

Lessons learned from the 2021 CMS Star Ratings to prepare us for the lasting effects of COVID-19 on quality improvement initiatives. An Unprecedented Year What a difference a year makes! This time last year, Medicare Advantage (MA) plans were reflecting on their 2020 Star ... Read ArticleRead Article

November 6, 2020

What Is Needed to Address Health Technology Systems That Are Limited in Their Capabilities, Effectiveness

This article originally appeared in Integrated Healthcare Executive on October 30, 2020. Eric Sullivan, Senior Vice President of Innovation & Data Strategies at Inovalon recently discussed the Company’s new API Marketplace, which brings the power of comprehensive ... Read ArticleRead Article

October 6, 2020

Celebrating Customer Experience Day 2020: Success Is More than Just Outcomes

Early in my career and long before I joined Inovalon, I learned a valuable lesson about what client success really means. One of my largest clients was in the middle of evaluating whether to stay with me, their incumbent solution vendor, or move in another direction with a ... Read ArticleRead Article

September 30, 2020

Client Congress 2020: Celebrating with Our Clients in Unusual Times

If there has been one constant in 2020, it’s that adapting to the unexpected is the new expectation. A year that started off with promise of innovation and development also brought us significant challenges – as an industry and as individuals. The way we work and the way we ... Read ArticleRead Article

September 18, 2020

To Design Equitable Value-Based Payment Systems, We Must Adjust for Social Risk

This article originally appeared in Health Affairs on September 17, 2020, and was co-authored by Philip M. Alberti, senior director, health equity research and policy at the Association of American Medical College, and David R. Nerenz, PhD, director emeritus of the Center for ... Read ArticleRead Article

August 21, 2020

Predicting Adverse Drug Events with Artificial Intelligence-Driven Analytics

Have you ever read the label on the back of a bottle of medication you received from the pharmacy or that you purchased over the counter at the grocery store? You’ll quickly see that medication labels are covered with sections titled “Warnings”, “Do not use” and ... Read ArticleRead Article

August 10, 2020

Connecting Healthcare: The Future of Clinical Interoperability

While the healthcare industry has made some significant strides toward the goal of achieving true interoperability among healthcare stakeholders, there is still a great deal of work to be done – especially under the current challenges all aspects of the healthcare ecosystem ... Read ArticleRead Article

August 5, 2020

Artificial Intelligence and the Power of Deep Learning in Healthcare

In the past 6 months, it feels like the whole world has gone virtual. With office building and schools closed, in-person meetings and concerences moved to digital, online platforms, and leaders across all industries adjusting to a new “normal” for business operations, ... Read ArticleRead Article

July 16, 2020

How Member Engagement & Supplemental Benefits Reduce Care Disparities

The understanding that social determinants of health (SDOH) play a pivotal role in health outcomes has been a game changer in the way healthcare organizations across the country approach member engagement and supplemental benefit programs. Eliminating health disparities has been ... Read ArticleRead Article

June 30, 2020

How to Realize Accurate HCC Documentation Amid the COVID-19 Pandemic

According to CMS’ Office of the Actuary, healthcare spending is predicted to increase at an average annual rate of 5.5%, reaching $6 trillion by 2027. This projected growth doesn’t account for patient care implications or the economic impact stemming from the ongoing ... Read ArticleRead Article

June 24, 2020

5 Healthcare Technology Trends to Watch in 2020

This past decade experienced a tremendous digital transformation, with one of the most significant healthcare technology trends centered on data and its increasingly vital role in everything from informing diagnoses and improving the patient experience, to driving greater ... Read ArticleRead Article

June 18, 2020

What Health Plans Need to Know to Comply with the FHIR-Based Patient Access API Mandate

“Patients must have complete transparency into the cost and outcomes of their care.” -The Office of the National Coordinator for Health Information Technology (ONC), U.S. Department of Health and Human Services 21st Century Cures Act: Data Transparency & Access ... Read ArticleRead Article

June 11, 2020

How Data Is Being Used to Respond to COVID-19

Already flush with data, the healthcare industry is now facing a new data challenge – how to leverage the tsunami of data created by the COVID-19 pandemic to make decisions that will keep patients and the public safe and healthy. COVID-19 has placed extreme strain on ... Read ArticleRead Article

May 13, 2020

Healthcare Data Analytics: How It’s Improving Healthcare Delivery

In just a short time, the world’s attention has coalesced on a single issue: the exponential spread of the novel coronavirus, COVID-19. As healthcare organizations around the globe navigate through the challenges of COVID-19, the vital role of healthcare data analytics has ... Read ArticleRead Article

May 8, 2020

3 Ways Telehealth Improves Health Plan Performance

Telehealth is the topic on the minds of so many in healthcare today. Also referred to as virtual health, telehealth seems to be having its moment in the sun. Although the concept of telehealth services has been around for decades, and telehealth services have been offered in ... Read ArticleRead Article

April 21, 2020

How Artificial Intelligence Is Helping Fight COVID-19

In response to the COVID-19 global pandemic, healthcare and technology innovators from across the world are stepping up their game to stem the effect of the disease – from rapidly implementing telehealth services to seeking ways to greatly increase testing to developing ... Read ArticleRead Article

April 10, 2020

3 Ways to Improve Your Risk Adjustment Data Submissions

With up to half of a health plan’s revenue determined by the health status of its membership, accurate data submissions play a key role in both regulatory compliance and financial performance. A misstep in your documentation can make or break you, especially as it pertains to ... Read ArticleRead Article

April 9, 2020

Expansion of Telehealth Services in Response to Coronavirus

The ongoing response to the COVID-19 crisis has the healthcare industry scrambling as hospitals, urgent care centers, and emergency departments quickly become overwhelmed with symptomatic patients. As people all across the globe are being encouraged to practice social distancing ... Read ArticleRead Article

March 20, 2020

Medicare Telehealth Expansion Amid Coronavirus May Have Long-Term Access Implications

Summary New flexibilities for telehealth services in fee-for-service (FFS) Medicare are designed to support ongoing COVID-19 response efforts. Ongoing COVID-19 response efforts have increasingly focused on the role that telehealth services can play in augmenting ... Read ArticleRead Article

March 13, 2020

Coronavirus: How Inovalon is Responding to the Global Pandemic

As COVID-19, the disease caused by the coronavirus, continues to proliferate around the world, Inovalon has been following the situation closely. We understand that it is affecting our communities in a variety of ways, and our leaders are working round the clock to ensure the ... Read ArticleRead Article

March 13, 2020

Challenges of Artificial Intelligence in Healthcare

Artificial intelligence has become an intricate part of our everyday lives. We encounter it consciously and subconsciously — at the grocery store, when we call customer service, and even in our homes and cars. With an increasing reliance on a technology designed to constantly ... Read ArticleRead Article

March 4, 2020

Interoperability in Healthcare: Are We There Yet?

Despite vastly improved technology, interoperability in the healthcare industry remains a challenge. The electronic exchange of health data has faced hurdles since the introduction of electronic health records (EHR) decades ago. A data brief from the Office of the National ... Read ArticleRead Article

February 17, 2020

Improving Outcomes with Population Health Analytics: Q&A with the Population Health Analytics Team at Johns Hopkins Medicine

Population health management is a hot topic in 2020, but what does it mean and why does it matter? Defining population health management is challenging—there is no clear or standard definition of population health within the healthcare industry. If you ask 10 different people ... Read ArticleRead Article

February 10, 2020

Artificial Intelligence Adoption in Healthcare: Perspectives from Dr. Gordon Gao

Artificial intelligence (AI) – long an impactful technology in other industries – is in the midst of rapid adoption across the healthcare industry. What was once seen as having great potential is now making its way to real-world implementation, driving improvements in care ... Read ArticleRead Article

February 3, 2020

How Artificial Intelligence Solutions are Disrupting the Healthcare Market

Health data is most often associated with vital signs: height, weight, blood pressure, and heart rate immediately come to mind. But in recent years, the reality of what health data encompasses has become so much broader. Today, a multitude of data is being collected on patients. ... Read ArticleRead Article

January 28, 2020

Leveraging ICD-10 Codes for Social Determinants of Health Data | How Can We up the Ante?

There is growing consensus that social determinants of health (SDOH) are powerful influencers of healthcare outcomes, utilization and cost. According to a report issued in December 2019 by the nonprofit Center for Open Data Enterprise, healthcare organizations are increasingly ... Read ArticleRead Article

January 6, 2020

HCC Coding: How to Improve Risk Adjustment Coding Accuracy & Efficiency

As Medicare Advantage (MA) member populations continue to grow in today’s extremely competitive, quality-focused and highly regulated market, risk management efforts are becoming more challenging. The growth of MA plans is just one of several business challenges health plans ... Read ArticleRead Article

November 25, 2019

Natural Language Processing in Healthcare: Turning Promise into Change

If you’re still waiting for natural language processing to make an impact in the healthcare industry, a quick look around should tell you that artificial intelligence in healthcare — inclusive of natural language processing — is doing more than just promising change – ... Read ArticleRead Article

October 25, 2019

Client Congress 2019: Celebrating our Clients, Patient Advocates and Busting Silos

It’s far too easy to get caught up in the day-to-day work we do. It’s important work, vital work, but it’s important to take a step back and give space to appreciate and celebrate the clients and partners that are also doing the important work of improving the patient ... Read ArticleRead Article

October 1, 2019

Customer Experience Day Is Every Day at Inovalon

Today is CX Day (customer experience)—a day that celebrates the professionals and companies that make great customer experience happen. In a business like ours—one where the work we do every day directly impacts not only our clients but also the healthcare of millions of ... Read ArticleRead Article

September 23, 2019

Data-Driven Consumer Experience: Leveraging Artificial Intelligence to Improve Patient Outcomes

The past decade has been one of significant evolution for the healthcare industry, shifting from a disparate and transactional environment to a more value-based model where patients are at the center. With untold amounts of health and medical information at their fingertips, ... Read ArticleRead Article

July 25, 2019

Preparing for an Artificial Intelligence-Driven Future

This article originally appeared in Inside Digital Health on July 17, 2019. Artificial intelligence has found application in almost every industry today, but the stakes are arguably highest in healthcare because mistakes can affect patient care. The tsunami of health data being ... Read ArticleRead Article

April 29, 2019

CMS 2020 Final Call Letter: What You Need to Know

Read our blog post from earlier this year for information on the 2021 Advance Notice. Medicare Advantage (MA) enrollment is at an all-time high. As competition among health plans in the MA space increases, a growing list of nontraditional benefit options is giving MA plans the ... Read ArticleRead Article

March 28, 2019

The Promise and Pitfalls of Medicare Advantage Encounter Data, Part 3

A version of this blog post was originally published by Health Affairs on February 25, 2019. Stakeholders hope to analyze encounter data to gain insight into a wide variety of trends in MA. However, the limitations of the data set, combined with the difficulties that ... Read ArticleRead Article

March 22, 2019

The Promise and Pitfalls of Medicare Advantage Encounter Data, Part 2

A version of this blog post was originally published by Health Affairs on February 25, 2019. As CMS and other stakeholders continue to take steps to improve the quality of encounter data, it can be a tool for researchers aiming to understand use trends in Medicare Advantage ... Read ArticleRead Article

March 15, 2019

The Promise and Pitfalls of Medicare Advantage Encounter Data, Part 1

A version of this blog post was originally published by Health Affairs on February 25, 2019. Earlier this year, CMS released preliminary Medicare Advantage (MA) encounter data from calendar year 2015, providing researchers with potential new insights into patient-provider ... Read ArticleRead Article

March 12, 2019

As Healthcare Costs Increase, Cost-of-Care Discussions Can be Make or Break for Patients

Healthcare spending has reached astronomical figures, exceeding $3 trillion a year and straining the budgets of patients, according to CMS. Over the past decade, the percentage of patients who spend $1,000 or more out of pocket for healthcare each year has increased from 17 to ... Read ArticleRead Article

January 14, 2019

Webinar: Avalere Healthcare Industry Outlook 2019: View All Angles

Avalere’s annual Healthcare Industry Outlook webinar was held on January 10, 2019. Avalere experts explored the main industry trends from each stakeholder’s point of view, and discussed changes that will shape the industry in 2019 and why they matter. Key topics include: ... Read ArticleRead Article

October 9, 2018

Data-Driven Healthcare Takes Center Stage at Client Congress 2018

Industry executives from across the healthcare ecosystem, including health plans, providers life sciences and pharmacy professionals, gathered in Washington, D.C., for the 10th annual Inovalon Client Congress, September 30 – October 2. The nation’s most influential leaders ... Read ArticleRead Article

September 10, 2018

How Health Plans Can Ensure a Successful Quality Season in 2019

Nearly 75% of Medicare Advantage (MA) enrollees were enrolled in plans rated at 4-Stars or higher in 2018, but the percentage of health plans that received a quality bonus for reaching four or five stars dropped from 49% to 44% — a decrease that may be cause for concern in ... Read ArticleRead Article

July 6, 2018

How Healthcare Organizations Leverage Data-Driven Insights to Succeed

Data – how you capture it, how you analyze it and how you leverage the insights gleaned from it – is one of the most valuable tools healthcare organizations have in their arsenal to meaningfully improve the patient experience and overall health outcomes while ... Read ArticleRead Article

May 7, 2018

Will New CMS Initiatives Advance the Journey toward Patient-Centered Care?

To truly achieve value-based care, patients must be placed at the center of the healthcare system. This sentiment is front and center in CMS’ Data Driven Patient Care Strategy, an offshoot of the agency’s MyHealthEData initiative. Recognizing that data – quality data, ... Read ArticleRead Article

March 8, 2018

How Data-Driven Insights are Powering Patient-Centric Healthcare

A version of this article was originally published by Becker’s Health IT & CEO Review on March 2, 2018. In response to patients’ increasing demand for more information about their health, Apple has launched Health Records, a personal health record (PHR) feature that ... Read ArticleRead Article

January 10, 2018

Healthcare Industry Outlook for 2018: New Year, New Opportunities

Healthcare organizations spent much of the past year wondering what healthcare reform might look like under a new Administration. Although uncertainty remains, one thing is clear: healthcare is increasingly becoming data-driven in its nature, transactional in its design, ... Read ArticleRead Article

December 8, 2017

MACRA’s First Year, Part 3 of 3: Data-Driven Analytics Support QPP Reporting Requirements

The fact that the Medicare Access and CHIP Reauthorization Act’s (MACRA) Quality Payment Program (QPP) and the two pathways within—the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs)—are complex comes as no surprise. The ... Read ArticleRead Article

December 8, 2017

MACRA’s First Year, Part 2 of 3: What’s Next?

The final rule for the second year of the Medicare Access and CHIP Reauthorization Act (MACRA)’s Quality Payment Program (QPP) takes important steps toward acknowledging the challenges and concerns voiced by stakeholders regarding the ability of some clinicians to meet QPP ... Read ArticleRead Article

November 30, 2017

MACRA’s First Year, Part 1 of 3: CMS, QPP Rule Address Challenges, Maintain Flexibilities

On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) released its 2018 final rule, reflecting updates and changes to the Medicare Access and CHIP Reauthorization Act’s (MACRA) Quality Payment Program (QPP). The 2018 rule, which implements changes to the ... Read ArticleRead Article

November 6, 2017

Health Plans See Opportunity in Outcomes-Based Contracts

A version of this article was originally published by Health IT Outcomes on October 19. Escalating drug costs are compelling many states to develop and implement policy solutions to stem its rise. In fact, earlier this year, New York became the first state to place a cap on drug ... Read ArticleRead Article

September 6, 2017

A 360-degree Patient View Powers Data-driven Care

A version of this article was originally published by Health IT Outcomes on August 17, 2017. Many of us make important healthcare decisions with a surprising lack of rigor. Instead of conducting in-depth research one would expect with a potentially life-and-death decision, ... Read ArticleRead Article

August 4, 2017

Social Determinants of Health and the Importance of Patient-level Insights

To deliver patient-centered care and improve long-term health outcomes, healthcare organizations are increasingly investing in efforts to address patients’ social needs, such as housing, employment, education, transportation and family support, in addition to their clinical ... Read ArticleRead Article

June 9, 2017

The Impacts of AI in Healthcare in the Decade Ahead, Part 2 of 2

A version of this article was originally published by Becker’s Hospital Review on April 25, 2017. The U.S. healthcare system has been plagued by rising costs and inefficiencies attributed to the fragmented nature of care delivery and communication. As frameworks for ... Read ArticleRead Article

June 9, 2017

The Impacts of AI in Healthcare in the Decade Ahead, Part 1 of 2

A version of this article was originally published by Becker’s Hospital Review on April 25, 2017. As the healthcare ecosystem continues to transition to value-based care models, we will see significant investments and related advancements in applications of machine learning ... Read ArticleRead Article

January 9, 2017

21st Century Cures Act: Big Win for EHR Interoperability

In what can be seen as a huge win for all segments of the healthcare ecosystem, which was two years in the making, overwhelmingly passed in both the House of Representatives and the Senate, and President Obama signed the legislation on December 13, 2016. The Cures Act includes ... Read ArticleRead Article

September 12, 2016

Tips for Your Next HEDIS Season

Another HEDIS® season has been completed. With 65% of the nation’s clinical and quality outcomes measurement analytics using Inovalon’s platforms, we have analyzed our clients’ results to share some of the best practices and key lessons learned this season to help you ... Read ArticleRead Article

January 4, 2016

The Power of Real-Time Analytics at the Point of Care

There has been a lot of talk about transforming healthcare into an industry that leverages real-time analytics. Sadly, while the cost of a cup of coffee at Starbucks appears on your iPhone in seconds and your 401k reflects every change in holding and values at any given moment, ... Read ArticleRead Article

September 23, 2015

Motivating Members for Health Assessment Programs

Have you ever wondered how you can better engage your members? How do you get them to participate in preventive health measures? The easiest way to get answers to these questions is simply by asking the members themselves. In a recent Inovalon study, we went straight to the ... Read ArticleRead Article

June 26, 2015

What Data-Driven Tools Do Physicians Really Need to Improve Quality of Care?

Ask providers what keeps them up at night, and many will say it’s a patient needing care and not getting it. But ensuring that every patient who needs care receives it— regardless of how busy the provider is and how difficult the patient is to reach—is no easy feat. ... Read ArticleRead Article

April 29, 2015

Inovalon Study Demonstrates Need for Star Rating Adjustments

The bars in the graph represent the percentage difference in rates between dual eligible and non-dual eligible members. A bar below 0% indicates dual eligible members perform worse than non-dual eligible members, while a bar above 0% indicates dual eligible members perform ... Read ArticleRead Article

December 16, 2014

Exploring the Many Facets of Member Engagement

The introduction of the Affordable Care Act’s Health Insurance Marketplace has created a rapidly growing, competitive landscape with diverse audience segments. Member engagement has become a key focus for health plans to increase member interaction, preventive health ... Read ArticleRead Article

August 20, 2014

Taking the Medical Record Review Process to the Next Frontier

It seems counterintuitive, but in healthcare, it’s often the things you can’t see that are most important. Providers and payers need to see the patient and the patient’s medical records, of course, but finding where care is missing is perhaps the most critical and ... Read ArticleRead Article

May 22, 2014

Meeting the Retail Clinic Technology Challenge

For much of the 20th century, the pharmacy was a community gathering place, dispensing medicine, advice, and even ice cream. Over time, pharmacies have evolved into mini department stores, and today they are expanding to offer patient care with in-store clinics. It’s clear ... Read ArticleRead Article

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