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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

June 5, 2019

Artificial Intelligence and the Power of Deep Learning in Healthcare

In the past decade, no technology has generated more buzz than artificial intelligence. Speculation surrounding its ability to add value to the healthcare space has dominated conversations at every level, sparking debate over how—and at times even if—artificial intelligence ... Read ArticleRead Article

April 29, 2019

CMS 2020 Final Call Letter: What You Need to Know

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 flexibility to address social risk factors and attract new members. The updates for MA ... 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

January 4, 2019

Healthcare Industry Outlook: New Laws, Data Streams and Technology to Chart 2019 Course

From the launch of new initiatives aimed at increasing patient access to health data to the rising potential of artificial intelligence (AI) to meaningfully impact the outlook of healthcare delivery, 2018 was a year flush with change and new opportunities, with data and its role ... 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 13, 2017

Study on Healthcare’s Journey to Value-based Care Finds Costly Gaps Remain

According to the second annual study from Inovalon and Quest Diagnostics to gauge physician and health plan executive perspectives on the industry’s transition to value-based care, physicians still lack the tools needed to succeed in a value-based care system, with many ... 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

December 5, 2016

Point-of-Care Platforms Drive Better Diagnostics, Treatment and Quality Care

Increased value. Better health outcomes. Lower costs. The Institute for Healthcare Improvement’s triple aim approach to healthcare has resulted in meaningful changes in healthcare delivery. Paramount among the drivers of this change is the need for greater access to patient ... 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

March 30, 2015

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

February 26, 2015

Why Is Provider Engagement So Important?

Successfully engaging providers and their staff can have a dramatic impact on health plan performance. Health plans find that involved providers lead to improved clinical outcomes and quality ratings, member retention, and overall efficiency. Achieving meaningful provider ... 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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