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...

Chronic Care Management battles healthcare costs and improves care for patients with chronic diseases. The Centers for Medicare and Medicaid Services are working to improve Chronic Care Management health codes and programs to improve the quality of lives for those struggling with a chronic disease. 

Using Our 30 Years’ Experience to Facilitate Business Continuity and Minimize Disruption to Your Chronic Care Management Program If you are ready to get on the fast track to building a successful CCM program or if you or your practice been affected by a partnership dissolvement with a former chronic care management vendor, eQHealth Solutions is prepared to help get you started or facilitate your transition in 60 days or less. Why eQHealth’s CCM Solution eQHealth is a population health management company and leading provider...

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 ...