HighPoint Blog

 

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Now that the first performance period for MACRA — the U.S. Medicare Access and CHIP Reauthorization Act of 2015 — is underway, it is vital that healthcare providers identify and implement strategies to ensure value-based reimbursement (VBR) success. MACRA, which expands and reforms quality-based Medicare clinician payments, has the potential based on program incentives to either increase or...

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Special thanks to co-writer Neelabh Saxena, Associate Director Pricing, Contracting, and Market Access. 

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The dawn of a new healthcare landscape is upon us. But what exactly it may look like when the dust of the new Trump Administration settles is anyone’s guess.

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While components of the Affordable Care Act (ACA) are expected to come under significant scrutiny from the Trump Administration and Congress, the ongoing “retailization” of healthcare will accelerate regardless of the dustups over Obamacare.

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It’s been nearly a month since Donald Trump won the election to become the next President of the United States. In those four weeks, industry experts and healthcare executives have been projecting and planning on what the win means given President-Elect Trump ran on a platform to repeal PPACA and transform Medicare. The overall tenor of the election was a demand for change and eliminating the...

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For any Managed Care rebating organization, formulary confirmation can mark a massive drain on resources, or simply an overlooked area of financial leakage. There is a wide range of solutions that companies use to work through the logistics and process necessary to adjudicate formulary-based rebates. The process of formulary adjudication is without a doubt the most varied area of managed care...

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When open enrollment 2016 closed for the Health Insurance Marketplace, U.S. consumers made nearly 13 million plan selections in which they were either first-time enrollees or they adjusted their plans. Add Medicare and commercial plans to the mix and open enrollment 2017 will mean another expansion of healthcare coverage nationally, as well as a deluge of claims to process.

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The game has changed

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Organizations across industries have made significant investments in their CRM strategy, implementation and on-going maintenance.  While each industry brings its own uniqueness with how they chose to interact and engage their customers, we have seen a common theme among nearly every large-scale CRM initiative.  It is a common pitfall most organizations do not plan for; or chose to...

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The Centers for Medicare and Medicaid Services (“CMS”) and the Centers for Disease Control and Prevention (“CDC”) announced the 2017 ICD-10 coding update to be implemented October 1, 2016 and it’s a doozy. The first annual update since the partial code freeze was enacted in 2011 includes the addition of 3,651 ICD-10 hospital inpatient procedure codes and 1,900 ICD-10 diagnosis codes (a...

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Written by Jim Goldfinger, VP Client Value Networks & Strategic Alliances 

As the world of healthcare has evolved over the past few years, we are seeing a dramatic shift in focus to the patient. Patients don’t necessarily need more medication, they need more support. We need to heighten our focus on healing, not just treating. Life Sciences and Healthcare companies need a technological platform...

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