Four Steps Toward Creating a Culture of Compliance

September 07 2016 | by SCIO Health Analytics in Health Analytics

Many people (OK, more than likely most people) start paying attention to taxes in early April – scurrying to make sure they have everything in line for that ominous mid-month deadline. However, keeping taxes top of mind on an everyday basis would probably serve them well. Identifying potential deductions, saving receipts and maintaining order with all the requisite documents would enable people to not only zip through the necessary paperwork each April but also ensure they are keeping the money that they are due under the law.


Moving Beyond Big Data Paralysis

August 31 2016 | by Rose Higgins in Health Analytics

Just about everyone has at one time or another experienced brain freeze: That sudden stabbing pain in your forehead when eating ice cream or slurping up an ice-cold drink. More recently, though, many people have started to experience a different – but perhaps equally uncomfortable – type of brain freeze: The one where a deluge of information paralyzes your ability to make good decisions.


Risk Adjustment: Making the Most of Payment Opportunities

August 24 2016 | by SCIO Health Analytics in Risk Adjustment

H. Jackson Browne, Jr., author of the inspirational bestseller, Life’s Little Instruction Book, which contained 511 reminders about how to live a happy and rewarding life, once said: "Nothing is more expensive than a missed opportunity."

Healthcare organizations can relate to this truism, as many are missing the opportunity to collect additional reimbursement through risk adjusted payments, which offer increased payments for treating patients with one or more chronic conditions. For example, if Medicare Advantage normally pays $800 per member per month (pmpm) to the health plan, risk adjustment for a member who has diabetes with complications might be three times that amount.


Health Reform: Will it Really Affect Whether or Not Patients Undergo Surgery?

August 17 2016 | by Dr. Kevin Keck in Health Analytics

Under fee-for-service payment models, making the decision to move forward with many surgeries – such as total knee replacements – was not a difficult one to make.

Here’s an example of how it would commonly unfold: A patient experiences knee pain. The patient receives a prescription for painkillers. The condition deteriorates, and MRI is obtained and eventually the patient undergoes the total knee replacement as a matter of course. Because such surgeries were profitable for hospitals and orthopedists under the long-held fee-for-service model, no one bats an eye.


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