by Di Simplot | Nov 8, 2024 | news
CMS Interoperability and Prior Authorization Final Rule SynopsisThe Centers for Medicare & Medicaid Services (CMS) changed its prior authorization rules to simplify and digitize the process, and to reduce the burden on each of the three legs in the healthcare...
by Di Simplot | Sep 10, 2024 | news
Precision Medicine as key driver of next generation personalized health care The term “Precision Medicine” refers to the tailoring of clinical and other health care-related interventions based upon an individual’s unique make-up and circumstances. While...
by Di Simplot | Jul 31, 2024 | news
Part 1: The Current Landscape The remarkable growth in Medicare Advantage enrollment over the past twelve years is raising questions about both the cost and quality of that coverage as well as the ultimate impact on health equity and solvency of the traditional...
by Di Simplot | Jun 27, 2024 | news
Payment Integrity Evolution Over the past decade, the healthcare industry has seen payment integrity evolve from an under-resourced operational niche to a strategic asset that is central to the overall management of medical expense. A paradigm shift is underway,...
by Di Simplot | Jun 10, 2024 | news
Guiding Principles: Payment Integrity as a Strategic Enterprise Solution Today’s technology innovations and workforce challenges (need to drive toward greater efficiency) are prompting payers to take a closer look at payment integrity with an eye toward a more...
