eQHealth Blog

Business Intelligence (BI) and healthcare analytics are mainstays in a robust population health management ecosystem. These capabilities are typically leveraged for quality and performance improvement in healthcare. Whether you are specifically looking at how to better complete risk stratification for your population identifying members that need preventative care to reduce the likelihood of serious illness, or intervention to help treat or cure an existing condition, BI and healthcare analytics can help.  While there are no crystal bal...

Chronic Care Management continues to be a valuable and effective tool in the race to manage chronic health conditions and disease. Though CMS continues to refine requirements, they recognize that Medicare Chronic Care Management (CCM) is an important component in a comprehensive program designed to provide quality care and deliver improved healthcare outcomes. In 2018, Federally Qualified Health Centers (FQHCs) and Regional Health Clinics (RHCs) are the big winners and most affected by the changes made in the CMS rulings. The main thrust of ...

About the same time personal computers became ubiquitous, the medical industry began to formalize talks and discuss the importance, in fact the necessity, of medical record sharing. Recognizing that the most effective sharing process would be computerizing or digitizing those records, the focus was on sharing patient information, not only to replace paper systems with expensive computers to maintain the status quo, but to make a step-function change in healthcare providing a more comprehensive medical record for patients - enabling more informe...

As individuals, we look to the new year and for whatever reason, habit or instinct; we think about what is to come. If you have been watching healthcare industry news, then you know that 2018 promises to be as fascinating as 2017, full of twists and turns, strange bedfellows and, if all goes well, some real improvements in how we manage care. 1. Health Information Technology is evolving to better meet clinicians’ needs. Health information technology in one form or another is the norm for most healthcare organizations at this point. ...

Happy Holidays, Merry Christmas, Happy Hanukkah and Happy Kwanza. No matter how or what you celebrate, the holiday season does not have to be stressful. Holiday stress can often result from setting high expectations and seeking perfection - when the two don’t match the situation becomes stressful.  To serve as a friendly reminder of how to be healthy, less stressed and more joyful over the holidays, these tips may apply to you and your patients too. Eat, drink and be merry in moderation It’s the most wonderful time...

Many of the clinicians planning to practice value-based care have taken at least a few steps toward that goal including some investment of both time and money. If you are among this group, then you have likely begun to build or have already built an engine to drive clinical integration to assure your practice or organization has the data needed to create a comprehensive health record for your patients. Additionally, you may already have staff focused in this area as well as a business and clinical intelligence toolset to risk stratify your popu...

The Medicare Access and CHIP Reauthorization Act (MACRA) is bipartisan legislation signed into law April 2015. Title I of MACRA is designed to accomplish several notable goals including providing new methods to incentify the shift from volume to value-based care. Key Goals of MACRA The Sustainable Growth Rate (SGR) Formula was repealed. Numerous quality programs were streamlined into one called the Merit-based Incentive Payments System (MIPS). Provided bonus payments for participation in eligible alternative payment model...

In 2015, when CMS began the Chronic Care Management Program, CPT Code 99490, according to Medicare claims data, only about 275,000 unique Medicare beneficiaries received Chronic Care Management (CCM) services (CPT Code 99490) an average of 3 times each, totaling $37 million in allowable charges.  Unfortunately, those early participants accounted for less than ~1% of those Medicare beneficiaries that actually were potentially qualified to participate in the CCM Program. So, ~99% of the beneficiary market was still potentially avai...

  The population health management (PHM) industry is still in its adolescence, but further evolution is necessary and inevitable to take care delivery to the next level. By now, most have a sense of the value PHM can add and understand the macro steps needed for a successful population health initiative. The industry is good at identifying the sick in our populations and even predicting who will be sick in the future. The market is also good at developing guidelines and treatment plans to help manage chronic disease. Where the i...

According to Heraclitus, a Greek philosopher, “change is the only constant in life”. While 2017 hardly represents a lifetime, this will be a year of profound change in healthcare. Look all around, the winds of change are blowing. We have surveyed the landscape and here a few of the topics and observations that captured our attention. The Healthcare Law of the Land – Accountable Care Act (ACA) or Obamacare, whatever your preferred name for the current healthcare law, there will be change. In a recent report, NPR noted that t...