With growing fears of the novel coronavirus rising and misinformation spreading rampantly, panic is everywhere. Having a population health management program implemented for your members is now more important than ever. During times such as these, pro-active strategy is key. Strategically approaching the care and education of your members is vital for their health and well-being, as well as the health of your organization, communities and our country. A key part of a population health management program is strategy and knowing who the high-r...

Written by Marina Brown, BSN, RN, CCM, CHC​, Vice President of Clinical Programs One of the most important aspects that separate good, knowledgeable sports coaches from the ones who win championships year after year is that the repeat winners understand they need to see and treat their players as individuals. They know what motivates one player to excel, whether it’s getting in their face and coming down hard or providing soft guidance and support, will cause another to fail miserably and they adjust accordingly. As former New ...

Anyone who has watched a dog chase after a firetruck and wonder what he will do if he catches it will understand one of the biggest dilemmas healthcare organizations are facing right now around data and analytics. Payers and providers are accumulating massive amounts of data about their members/patients, and many are beginning to use sophisticated analytics to try to make sense out of that data. While they may be creating reports, those organizations are still having trouble turning their reports and dashboards into action. Especially for th...

By Bruce Shutan In the Information Age, data analytics, predictive modeling, machine learning, deep learning, artificial intelligence (AI), blockchain and other technology solutions are changing the face of self-insurance. Disruptors are rapidly entering this space with digital toolkits that include anything from personalized dashboards that tap mobile apps or AI smart speakers to analytic platforms that spot high-cost claimants, care gaps, medical errors, etc. For self-insured employers, the use of advanced technology is as much about hu...

During the “Age of Exploration” it was the leaders of those expeditions – Columbus, Magellan, Cortes, Cabot, etc. – who received the bulk of the recognition and the glory. Not to mention the monetary rewards. But without the behind-the-scenes efforts of their navigators, those missions through treacherous and largely uncharted waters would likely have ended in disaster instead. Executives at payers and providers find themselves in similar circumstances to those early explorers. Thanks to electronic health records (...

By Ila Sarkar, Vice President of Analytics, eQHealth Solutions  While the nation’s eyes seem to be obsessively fixed on the high cost of prescription medications, the reality is they only comprise just under 10% of the total cost of healthcare. The real high-cost area is surgery, which accounts for roughly 40% of hospital and physician expenditures. Surgery also tends to compete with obstetrics for the highest-risk department in any hospital. That’s doubly bad news—surgical complications can dr...

Healthcare and health insurance have always been challenging for employees to understand and manage. The complexities of the healthcare system almost seem purposely designed to generate confusion and frustration. But in today’s world, where the growth of high-deductible health plans often means out-of-pocket costs for employees ranging in the thousands of dollars per year, there is more urgency than ever to reduce unnecessary spending on healthcare. Especially since 40% of Americans say they would struggle to cover an unexpected cost o...

By Mayur Yermaneni, Chief Strategy and Growth Officer, eQHealth Solutions  For many health payers, making sense of their data is like trying to solve a Rubik’s Cube. They have all of these individual data points. But the more they twist and turn them with their analytics, the further away from the goal they seem to get – and the more frustrated they get with the process.  Anyone who has learned to solve an actual Rubik’s Cube with regularity, however, knows the key is to understand and recognize the patter...

If there was ever any doubt, the last few years have proven that the race to achieve value-based care is a marathon, not a sprint. The first stage was just gaining acceptance for the concept of changing the core structure of an entire industry. The second was putting the mechanisms in place, such as digitizing health data and developing highly precise predictive analytics, to begin the actual transition. Those stages have largely been completed, which means we now have a much better idea of who the high-cost, high-risk members/patients ar...

By Ron Ritchey, MD, MBA, Chief Medical Officer, eQHealth Solutions Looking Back Reflecting on National Health IT Week has made me think of how far the industry has come in the effective use of health data and technology to reshape the way we deliver care to patients. The explosion of innovation and growth over the last 35 years, since I began my practice, has been miraculous to see and be a part of. In fact, I was reminiscing not so long ago – the capabilities we now have at our fingertips would have been thought to be out of a futu...