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How to Improve Consumer Perceptions of Care Quality and Experience

By Ellen Harrison, RN, MBA
Dec. 10, 2018

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How to Improve Consumer Perceptions of Care Quality and ExperienceDec. 10, 2018

‘Quality of care’ means different things to different people based on their perspective. As a result, defining and delivering quality…

AI’s New Healthcare Applications

AI’s New Healthcare ApplicationsNov. 16, 2018

Artificial intelligence (AI) was conceived by Alan Turing in his 1950 paper “Computing Machinery and Intelligence,” in which he introduced…

Protecting Employer Sponsored Health Plans by Controlling CostsNov. 8, 2018

Annual benefits enrollment has become something employees dread. Employers faced with increasing health plan costs are passing on a larger…

Addressing the Opioid Epidemic with Healthcare DataOct. 12, 2018

These days you cannot have a comprehensive discussion about the U.S. healthcare system without mentioning the opioid crisis — and…

Health Plan Member Engagement Natural Disasters

Member Engagement in the Face of DisasterOct. 4, 2018

In September we watched Hurricane Florence bear down on the U.S. east coast with dread. We collectively braced ourselves for…

medicaid trends to watch

Four Medicaid Trends to Watch in the Next Twelve MonthsSep. 26, 2018

If you work with Medicaid you know it’s always been a moving target, and the last year has not brought…

The Robots are HereJul. 19, 2018

This is the blog you are looking for. Learn more from Doug Williams about how “not far from now business and quite possibly individuals will have their own R2D2 and C-3PO”. I Bitley

The High Tech Behind Coordination of BenefitsJul. 13, 2018

When most people think of coordination of benefits, they envision those annoying letters from their health insurance company asking if…

Get to Know Health Plan Members

Get to Know Health Plan MembersMay. 31, 2018

Being a healthcare consumer can be so frustrating.  I don’t know about you, but I’m tired of interfacing with a…

Home 156

Can Healthcare Organizations Make the Switch to Digital Consumerism?Apr. 18, 2018

Earlier this month we learned that Walmart may be making a bid for Humana, one of the nation’s leading Medicare…

Home 158

Using Data, Analytics, and Technology to Combat the Opioid EpidemicApr. 5, 2018

There has been extensive documentation of the current opioid epidemic in the United States.

Life-transforming Therapeutic Recreation and Technology Offer Veterans New Opportunities

Life-transforming Therapeutic Recreation Technology Offer Veterans New OpportunitiesApr. 2, 2018

Over 400 veterans will convene this week in Snowmass Village, Colo. for the National Disabled…

Home 157

The Children’s Health Insurance Program: Congress’ Bipartisan MomentMar. 29, 2018

Over the past few months there has been a lot of political debate around the future of the Children’s Health Insurance Program or CHIP. Most of the discussion centered around whether Congress…

We Need Data and Technology to Fight the Opioid EpidemicMar. 21, 2018

The Senate Health, Education, Labor and Pension Committee recently held a congressional hearing on the opioid crisis. Unlike past hearings however, this…

Short-term Health Insurance Plans: Obamacare Foil or Real Consumer Choice Solution? 1

Short-term Health Insurance Plans: Obamacare Foil or Real Consumer Choice Solution?Mar. 14, 2018

Last month, the Trump administration proposed new rules that would make it easier for consumers to buy and keep short-term…

It's Flu Season! What's Up with the Vaccine Controversy? 3

Blockchain’s Emerging Healthcare ApplicationsJan. 29, 2018

While bitcoin and cryptocurrencies seem to go in and out of fashion on a monthly basis, the blockchain—the distributed system…

How Will Medicaid Work Requirements Impact Churn and Member Retention?Jan. 26, 2018

CMS’ recent guidance to State Medicaid Directors on work requirements for non-disabled, non-pregnant adults was anticipated to those of us…

It's Flu Season! What's Up with the Vaccine Controversy? 3

It’s Flu Season! What’s Up with the Vaccine Controversy?Jan. 18, 2018

It’s 2017. New controversies abound in America, but one that has persisted over time, even after being scientifically debunked over…

It’s Time to Re-think Healthcare Data Security 2

It’s Time to Re-think Healthcare Data SecurityJan. 8, 2018

2017 was not a banner year for healthcare data security. The U.S. Department of Health and Human Services Office for…

Six Things the Healthcare Industry Needs in 2018

Six Things the Healthcare Industry Needs in 2018Jan. 2, 2018

The start of a new year always brings promise; and as we enter 2018, we do so with the hope…

Six Steps to a Health Plan’s Obligation with OpioidsOct. 25, 2017

There are many hot-button questions when it comes to the opioid epidemic in America, including a health plan’s obligation to…

Mobilizing to Help Health Plan Members in Challenging TimesSep. 26, 2017

Like many people who choose a career in healthcare, the prospect of helping people while working in a dynamic industry…

Recovery Audit Contractors: An Invaluable Program Integrity ToolAug. 9, 2017

This week, at the National Association for Medicaid Program Integrity (NAMPI) 2017 Conference, HMS and the Texas Health and Human…

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The Internet of ThingsJul. 11, 2017

Our devices learn a lot about us. Discover how we could use that data to shape healthcare outcomes.

Care Management: Implementation AcceleratedJun. 13, 2017

  Can payers and at-risk providers get a new care management system up and running in a flash? In a…

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Is Digital Health Dead? How to tackle costs, waste, and confusion in healthcareJun. 6, 2017

  Last month, an industry colleague shared in a presentation that he thought digital health was dead. I was a…

Preying on the Vulnerable

Preying on the Vulnerable: Sober Home FraudApr. 27, 2017

One of the hot fraud trends right now involves the increasing number of sober living homes (SLH) around the country….

It’s Time to Re-think Healthcare Data Security

The Blockchain in HealthcareApr. 11, 2017

Today we have a world-wide web of information. We send information as a complete package, like a document or PDF….

Know. Manage. Engage. Three Tools for Positive Healthcare Management.Apr. 4, 2017

We can hardly go a day, let alone several times a day without hearing various pundits comment on what to…

Finding Healthcare’s True North: Keeping fundamental principles at the forefront of healthcare reformMar. 8, 2017

The 115th Congress and the Trump Administration are embarking upon a new era for healthcare. Several proposals have been introduced…

Proactive Eligibility

Proactive Eligibility: Four tips for payers (and five for providers)Mar. 6, 2017

Insurance products have become more complicated, but eligibility and benefit validation have not caught up to the complexity. The idea…

Care Traffic Control

Care Traffic ControlFeb. 8, 2017

  I’ve spent the last 13 years designing, developing, and delivering care management software to payers in the healthcare industry….

Wave of the Present

Wave of the Present: The Surge in Working Spouse ProvisionsJan. 31, 2017

Twenty-seven percent of all U.S. employers used some form of a Working Spouse Provisions in 2015, a figure that may…

Eliminating FWA

Eliminating Fraud, Waste, and Abuse: A Keystone in Any Healthcare SystemJan. 24, 2017

As President Donald Trump’s cabinet takes office, think tanks and industry alike are working through scenarios not only on how…

2017: Grow Your Business. Drive Results. Leave an Impact!Jan. 5, 2017

  It’s the beginning of the year and many of us go through the intentional New Year’s resolution processes at…

Do it Now: Verifying Dependent EligibilityDec. 22, 2016

Enrollment. Members. Eligibility. The traditional open enrollment season for healthcare benefits is winding down just as the holiday season comes…

Empathy and Technology

Empathy and TechnologyOct. 12, 2016

Technology makes so many things better. Thank you Steve Jobs for letting me mow my lawn while listening to drawn-out…

TPL: Total Progress Liability?Oct. 4, 2016

For years, people have told me that the recoveries part of Medicaid third party liability, or TPL, is being replaced…

Audit Rights: Uncover Hidden Restrictions in an ASO Agreement

Audit Rights: Uncover Hidden Restrictions in an ASO AgreementAug. 23, 2016

  Administrative Services Only Agreements (ASO) contain an overwhelming amount of information. While most self-funded groups carefully review the pricing…

The Quick-start Guide to Selecting the Best Third Party Liability Vendor

The Quick-Start Guide to Selecting the Best Medicaid Third Party Liability VendorAug. 10, 2016

  Selecting the right Medicaid third party liability (TPL) vendor matters. Why? Because if you pick the wrong one –…

Program Integrity

10 Things State Agencies Need in a Program Integrity VendorAug. 1, 2016

You’re looking for a program integrity vendor, but you don’t know where to start. We get it, they deal with…

Curbing Healthcare Spend

Curbing Healthcare Spend Through Technology and BipartisanshipJul. 25, 2016

The political season is certainly upon us with the Republican National Convention and Democratic National Convention in full-swing. All the…

Initiating Change by Identifying FWA

Initiating Change by Identifying FWAJul. 22, 2016

Here’s a scenario that happens all too often. It’s one that you may have experienced, or even seen a co-worker…

The Ultimate Guide to Selecting a Payment Integrity Vendor

The Ultimate Guide to Selecting a Payment Integrity VendorJul. 20, 2016

  Payment integrity is critical to all health plans. Performed incorrectly, you risk losing millions of dollars, or worse: Patients’…

Internet in Healthcare Transformation

The Role of the Internet in Healthcare TransformationJun. 21, 2016

  Paying customers: The consumers of healthcare services We call them patients, members or employees depending on the context of…

communication

Context of Communication: Commencements, companies, and conversationsMay. 31, 2016

  Every year, the month of May drives several weeks of graduations and I casually read through transcripts of some…

Breaking the Three Barriers of Big Data

Breaking the Three Barriers of Big DataMay. 23, 2016

  The healthcare system is awash in big data. The challenge is turning it into actionable information that can be…

communication

Liberal Education, Big Data, and WisdomMay. 3, 2016

Fareed Zakaria, host of CNN’s Fareed Zakaria GPS and weekly columnist for The Washington Post, just wrote a thoughtful book:…

Two-midnight Rule

The Two-midnight Rule: Payments, Provisions and ProcessesApr. 28, 2016

After a decision by a Federal District Court in September 2015, the Centers for Medicare and Medicaid Services (CMS) announced…

Medicaid Data Access Expansion

Proposed Rule: Medicare Data Access ExpansionApr. 22, 2016

  HMS, provider of the broadest range of cost containment solutions for payers in the healthcare industry, recently provided comments…

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Stop Loss Reality and the Wisdom of Ben FranklinApr. 20, 2016

  According to the U.S. Department of Health and Human Services, 82% of all employers with more than 500 employees…

Four Ways Payers Can Cut Hospital ReadmissionsApr. 13, 2016

  The Centers for Medicare and Medicaid estimates that the Medicare hospital readmission rate in 2012 was 18.4%. Although not…

Is My Information Secure? - HMS Blog

Is My Information Secure?Apr. 7, 2016

Recently, my children were talking about their log-ins and their passwords. In our case, the conversation included the general frustration…

Big Blue SavingsApr. 5, 2016

  Since the error rate in Medicare and Medicaid claim payments runs from 8% to 12%, it’s easy to see…

What Airlines Can Teach HealthcareMar. 29, 2016

Long ago, such diverse industries as airlines and financial services opted to share data amongst stakeholders to achieve positive outcomes….

Seven ways new MCO rules will boost data sharing

Seven Ways New MCO Rules Will Boost Data SharingMar. 24, 2016

  This spring, the Centers for Medicare and Medicaid Services (CMS) will publish its final rule updating the regulatory framework…

Two Fixes for Behavioral Health FraudMar. 22, 2016

  Healthcare fraud is a $70 billion a year problem – and growing. An HMS webinar addresses two of the…

The Best Approach to Detect and Investigate FraudMar. 10, 2016

  Many health plan anti-fraud programs are trying to decide the best approach to detecting and investigating fraud: pre-pay, post-pay,…

What’s $100 Billion?Feb. 24, 2016

Have you ever asked, “What’s the value of a dollar?” Today I’m asking, “What’s the value of $100 billion?” According…

Three Game Changers to Lead and Drive InnovationFeb. 16, 2016

  Recently, I had the privilege to speak on a panel of leading chief information officers, where we discussed innovation….

Obamacare Health Plans: Can Data Save an Endangered Species?Feb. 3, 2016

  The healthcare and financial markets were rattled in November when the nation’s largest health insurance company, UnitedHealth Group, Inc.,…

The Real Cost of Prescription Drug AbuseDec. 4, 2015

  A 2013 Mayo Clinic study found that nearly 70% of Americans are on at least one prescription drug. Here…

Extremism and TechnologyNov. 20, 2015

  This is certainly a week of emotions, ranging from a somber sadness for families, friends, and countries suffering from…

Hospital Readmissions – How Payers Can Stop the Revolving DoorNov. 9, 2015

  Hospital readmissions continue to plague the healthcare system, causing increased risk to patients and significant unnecessary costs. It feels…

Dumping Paper for GoodOct. 27, 2015

  Traditionally, executing a dependent eligibility audit has been a very paper-driven process. Employers typically mail a series of letters…

Seeing Clearer With Visual AnalyticsOct. 19, 2015

  We live in an environment today where data is proliferating at paces unheard of in years past. Our human…

Déjà vu Two-Midnight Rule.Oct. 7, 2015

  One of the most controversial healthcare regulations in recent times has been the Two-Midnight rule. The Centers for Medicare…

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