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Overcoming the Barriers of Value-Based Care Adoption

By |2023-02-06T16:38:06-05:00February 2nd, 2023|Tags: , , , , |

Over a decade of programs championed by the Center for Medicare and Medicaid Innovation, focusing on accountable care and bundled payments, have had some notable successes. Private value-based care arrangements, structured by health plans and state Medicaid departments have had some significant achievements.

Impact of a Divided Congress on Healthcare & Health Policy in 2023

By |2023-01-02T10:51:39-05:00December 21st, 2022|Tags: , , , , , , |

The midterm election cycle has come and gone. A divided government means that it is highly unlikely that Congress, and specifically the House, will pass any monumental policies that would face defeat in the senate or a veto from the Executive Branch. What does this mean for healthcare and health policy in 2023?

Using High-Quality Data to Demonstrate What Members Prize Most: Health Plan Value

By |2022-12-09T14:41:39-05:00December 8th, 2022|Tags: , , , , |

Competitive pressures and complex regulatory plan performance reporting requirements create an additional challenge – acquiring correct and accurate data to demonstrate the best possible value to potential members, governmental agencies, and employer purchasers.

Healthcare quality is rarely simple — but it can be simplified

By |2022-12-09T14:52:14-05:00November 17th, 2022|Tags: , , , , |

While a seismic shift in the administration, receipt, and payment for healthcare in the U.S. Quality has become a hot topic of discussion among stakeholders, change has been slow. The definitions of quality and value are rarely simple to quantify, and waste and error remain ubiquitous.

Better interoperability… Yet poor clinical data quality could cause a “mis-FHIR”

By |2022-12-09T15:08:13-05:00November 3rd, 2022|Tags: , , , |

The U.S. healthcare system’s information technology infrastructure is a house of cards when it comes to interoperability and clinical data usability. Efficiently sharing patient and member information among clinicians, practices, payers, and patients is an ongoing challenge and this house of cards often collapses due to complex interoperability and data quality issues.

NCQA Data Tips and Tricks: Q&A with Rick Moore

By |2022-12-09T15:26:46-05:00October 25th, 2022|Tags: , , , , |

In this Q&A interview, Verinovum’s Chief Strategy and Marketing Officer, Mike Noshay, sat down with former NCQA Chief Information Officer Rick Moore to discuss current challenges around collecting healthcare data and how payers can unlock the right data at the right time to improve performance measures.

High-quality clinical data enable effective interventions and cost reductions for chronic diseases

By |2022-10-20T16:27:24-04:00October 20th, 2022|Tags: , , , |

Payers typically have no shortage of clinical data at their disposal, with information from health screenings, health assessments, electronic health records (EHRs), clinician notes, test results, and more. But the quality of the data is suspect. In our experience, only about 40% of the clinical data our clients receive from providers or health information exchanges are usable, without need for curation and enrichment. The remaining 60% are inaccurate, incomplete, duplicative, or unstandardized. It requires various levels of curation and enrichment to make data standardized, accurate, and complete.