HELIOS is the most configurable platform for healthcare payors with 90% configurability right out of the box. You may have heard us say this before, but if not, “HELIOS is the most configurable and flexible solution for healthcare management.” But what does that even mean? HELIOS comes 90% configurable out-of-the-box, and that means clients on HELIOS can tweak it to meet their specific program needs. This makes it easier to drive efficiencies and productivity gains for care management, disease management, population health, utilization management, and more. In HELIOS clients can configure many things including workflows, assessments, task assignment, rules, access...
6 Healthcare Trends to Watch in 2024 and How They’ll Impact Care Management
As a new year approaches, the U.S. healthcare industry faces converging factors that signal some significant upcoming changes. An estimated 60% of adults have at least one chronic disease, and 40% suffer from two or more, straining healthcare resources. In 2023, life expectancy declined to 76.4 years, due in part to social inequities and to a healthcare system that has long prioritized cure over prevention. Many providers are still generally operating under a fee-for-service model where compensation is based on service volume instead of the value and quality of the provided care Evolutions in technology for healthcare services have increased...
Interoperability in Value-Based Care: Leveraging FHIR-compatible Data for Seamless Care Coordination and Improved Population Health
New FHIR® data interoperability application helps payers quickly transform and manage critical data for organization-wide sharing, visibility, and care team us Data interoperability is a hot agenda item for many healthcare organizations. 1. Stakeholders across the board – providers, payers, patients, and regulatory bodies – are recognizing the need for a frictionless data ecosystem that allows quick, accurate exchange of patient information at the point of care. Improving care coordination and outcomes and reducing overutilization depends on it. 2. Data silos are becoming even more problematic. Currently, critical patient data is often stored in multiple systems and formats, each with...
Track 3 of the Making Care Primary Model: Enable and Optimize Continuous Care Coordination
Track 3: Using Quality Improvement Frameworks to Optimize Care Delivery and Gain Financial Benefits In our last few blogs, we’ve been looking at CMS’ new Making Care Primary (MCP) model, which aims to have Medicaid advance value-based care at the primary care level through better coordination of care. Participating in MCP is voluntary, but the implication is clear: CMS isn’t deviating from a path toward value-based care anytime soon, and aligning primary care delivery with the model’s objectives can only help payers prepare for a future of healthcare that prioritizes member outcomes, quality of service, and caring for the whole...
The Positive Impact of Employing Value-based Care for Treating Depression
While the fear, uncertainty, and isolation of the COVID-19 pandemic have practically disappeared, the mental health crisis sparked by these issues have not been so easily erased. Moreover, the number of people who need mental and behavioral health services continues to surge.
Moving to Value-based Care in a Post-Pandemic World
“We shall have no better conditions in the future if we are satisfied with all those which we have at present.” ― Thomas A. Edison
HealthEC Achieves Fourth Recertification for Accreditation from EHNAC for Privacy and Security Compliance
OSAP accreditation ensures adherence to health data processing standards and compliance with security infrastructure and integrity requirements.
Combining Behavioral Health and Value-based Care: How One IPA Succeeded Using HealthEC’s PHM Solution
A clinically integrated behavioral health network was created to improve the integration of behavioral and physical healthcare by serving Medicaid beneficiaries in collaboration with payers. The evolution and transition to behavioral health value-based contracting was an initiative that proved rewarding for the independent practice association (IPA) providers and patients.
Downside Risk Pays Off: Four Best Practices for High ACO Performance
The Medicare Shared Savings Program (MSSP), the accountable care organization (ACO) model that served 10.6 million seniors in 2020, collectively saved Medicare $4.1 billion last year, and $1.9 billion after accounting for shared savings payments, according to the National Association of ACOs (NAACOs) and as recently published in Healthcare Finance. 513 ACOs participated in the Shared Savings Program in 2020, down from the 541 MSSP ACOs in 2019.
Patient Centeredness Transfers to Data, Too
We know data from population health technology can assist the provider organizations to make management strategy decisions that make a significant impact in disease management, for instance, with diabetic populations thanks to sophisticated technology and tracking tools that add real-time data from remote monitoring devices to influence the drug regime changes for optimizing patient outcomes, however, how about pattern recognition when race and racial information is added to the clinical data that highlights disparities that have been documented across the healthcare industry including COVID-19 morbidity and mortality rates? How can data-driven technology help physicians and care teams improve care quality...