Sean Brady

New blog post by David Hewitt, "Top 6 Reasons Hospitals Must Focus On Uncovering The Dark Data In The Cost Cycle." Boost financial performance, decision-making, and patient outcomes by prioritizing dark data in 2024. #spendmend #healthcareData #darkdata #hospitals

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This article from Forvis Mazars US Healthcare Practice offers takeaways from the Centers for Medicare & Medicaid Services calendar year 2025 #OPPS Final Rule, impacting HOPDs and ASCs: https://lnkd.in/gy-mu5MV

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Hot take: Outpatient practice management software (aka EHR) companies never held distribution advantage. They held point solution purchasing power, but not distribution advantage like their inpatient enterprise counterparts. But now that AI is removing the CRUD layer that makes their software more than just a database due to its point solution integrations, there is no longer an advantage with its purchasing power. Think about this for a moment. 1. operating a 100-500 panel is not an enterprise product. 2. this means that the DB requirements are basically personal use with a bit more compliance. 3. the DB costs are pennies for a panel of this size. So if EHRs are no longer providing doctors with better pricing for point solutions and they’re just expensive DBs with 300-400x markups. Why do we think they’ll continue to be used in a post Agentic world that can build and host your DB for you? #PrivatePractice

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The devil is in the details. Learn why record retrievals for HEDIS and Risk can be challenging and how Inovalon solutions help

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Navigate the evolving healthcare landscape with proactive revenue cycle management strategies to ensure financial health & superior patient outcomes. Partner with experts like LBMC for guidance through regulatory shifts and compliance challenges. #HealthcareInnovation #PatientCare

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Thanks to Healthcare IT News for including SmarterDenials in their vendor #AI roundup, and to our partners at the University of Arkansas for Medical Sciences for sharing their experience! Hospitals have a big opportunity to address the rising tide of denials with clinical AI, all while recovering more revenue. "This couldn't have come at a better time," added Dr. Cam Patterson, CEO of UAMS. "At UAMS, we've seen how rising denials adversely affect our bottom line, which ultimately impacts our ability to invest more in patient care. With AI, we can create strong appeals in a fraction of the time, which is a game-changer." Check out the full read here: https://lnkd.in/ed47afFB

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At Reveleer, we understand that accurate data is the cornerstone of value-based care. The recent article by Eric Demers on the impact of inaccurate provider data highlights a pervasive challenge across the healthcare landscape -- fragmented, siloed, and outdated information obstructs care organizations from delivering the best patient care.    That’s why we’re using AI-driven automation to solve this problem — among others — to improve care quality, operational efficiency and optimize financial performance for value-based care payers and providers. And with our recent acquisition of Curation Health - a Reveleer company, we’re even better positioned to make value-based care more effective for everyone. It’s time to bridge the gap in provider data management—because value-based care only works when everyone has the right information at their fingertips.   #ValueBasedCare #DataIntegrity #Reveleer #HealthcareLeadership     https://lnkd.in/gjqixvPR

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🟨 Market Alignment Series: Trending and Spending 🟨 This week we will focus on PointClickCare vs. Real Time Medical Systems Inc.  focus on Robotic Process Automation (RPA) In a great article written by Aditya Singh, I pulled the below quotes about PointClickCare vs. Real Time Medical Systems. https://lnkd.in/eX23GuHR PointClickCare (abbreviated PCC by many) is a leading provider of EHR software, largely for long-term care (LTC) settings such as skilled nursing facilities (SNFs). On the other end is Real Time Medical Systems, an analytics firm much smaller than PCC and which relies on RPA to deliver its service to SNFs. In the case heard by Maryland Federal District Court Judge Paula Xinis, Real Time called for an injunction (requirement to stop) on impossible CAPTCHAs which PCC had deployed to prevent Real Time’s bots from operating. PCC considered an acquisition of Real Time and entered an NDA in early 2023. Real Time shared its proprietary business records including software design and use of RPA. Notably, despite PCC's loud protestation against “bots” today, PCC never raised with Real Time any concerns about its exclusive reliance on automated software. After Real Time shared with PCC that it maintained the highest level of security certification in the industry, that “was the end of the discussion" regarding the security of Real Time's automated environment. The court ended up ruling that PCC’s actions constituted violations of HHS’ information blocking rule and provided sufficient demonstration that there were no valid reasons for preventing Real Time’s bots from operating other than to deliver a specific negative impact to Real Time’s competitiveness. 🟨 My Take:  The Information Blocking Rule is part of the 21st Century Cures Act, aiming to prevent healthcare organizations from purposely restricting access to or sharing electronic health information. It's crucial for promoting competition because if health systems can't block information, patients can more easily switch between providers, and new entrants to the market can offer services without being locked out of important patient data. Larger companies are clearly taking advantage of smaller companies and violating this rule pretty regularly. Fired up to give you weekly updates of what’s going on in the U.S. healthcare markets-your go-to on Friday mornings! It’s my unique viewpoint on where you should place your bets as you make career decisions or determine where to allocate your FTE budgets.

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To survive in the telehealth market, virtual care models need to offer coordinated care that can integrate with brick-and-mortar providers as part of a hybrid model, experts say.

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HHS and CMS with some important updates around ACA compliance - check out the details outlined in the Edifecs post below. We take a closer look at the most relevant pieces of these three major updates.

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What is the bottom line if you have financial responsibility for a provider group? Your competitors have the ability to know your contracted rates for everything you do. That's the bad news. The good news is that you can know theirs to help you in your next negotiation.

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Clinical data is flowing more freely to health plans, but vital financial data is not getting to providers. U.S. provider organizations need to understand how information asymmetry will impact them and what to do about it. Here is my latest. https://lnkd.in/gZ-jnTJB #informationasymmetry #interoperability #valuebasedcare #healthtechmagazine

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New from the AMBIR Blog - Optimize #Vaccine Management in your practice by implementing an integrated #Barcode and #EHR solution. See how AMBIR, Keena Health and NextGen Healthcare are working to optimize the vaccine management process for healthcare providers of all sizes. https://lnkd.in/eMgzpE2U

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Generative AI can reduce patient frustration from long wait times. Leading healthcare providers are scaling applications in predictive triage and resource management, including patient flow, equipment usage, and appointment scheduling. These AI enhancements shorten wait times and optimize resources. https://bit.ly/3LO5wTB

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Transforming healthcare beyond EHRs... A recent article from Healthcare IT Today, "Oracle is Tackling More Than Just EHR Challenges", shines a light on something every healthcare leader should be considering - partnering with a provider that delivers more than basic solutions. As a consultancy which specializes in helping organizations make better use of their Oracle Health EHR systems, we’ve seen how Oracle’s approach goes far beyond what we traditionally expect from an EHR provider. They’re tackling workforce management, supply-chain optimization, and enabling Real-Time Healthcare Systems (RTHS), all while providing the robust EHR functionality healthcare organizations rely on. Here are a few standout takeaways from the article that resonate with the work we do alongside healthcare organizations every day: ➡ Workforce solutions - Oracle’s Talent Marketplace simplifies contingent staffing and provides tools for upskilling your team, helping combat the workforce shortages so many organizations face. ➡ Supply-chain innovation - With tools like the Inventory Shortage Workbench, hospitals can predict stockouts and redistribute supplies quickly, ensuring resources are always available where they matter most. ➡ Real-time decision support - Oracle’s RTHS leverages predictive, real-time data to empower leadership teams with situational awareness, streamlined workflows, and faster, smarter decision-making. Healthcare is complex, and the challenges your organization faces don’t come in silos. Oracle’s ability to connect clinical, operational, and administrative functions means they’re elevating healthcare IT into a true strategic enabler. If your organization is ready to unlock these capabilities, we encourage you to explore how Oracle can help you not just keep up, but thrive. #OracleHealth #HealthcareIT #EHROptimization #HealthcareLeadership

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AAPAN 2024 is right around the corner and provider data and directory management, provider integrity, and credentialing continue to be hot topics. We have a solution to the ongoing challenges of No Surprises Act compliance, unauthorized provider claims payments, and provider-provided data dependency. Monitor 100% of your providers' data continuously with near real-time alerts on demographic, directory, and integrity changes. Learn more about 4L Provider Intelligence powered by Integr8 AI Risk Prevention technology at AAPAN 2024. See you there. #AAPAN

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Providers and health plans have been working on their Fee for Service payment processes for decades (still work to be done there), but the data flows needed to support Value Based Care arrangements are in their infancy. Organizations involved in Value Based Care (VBC) should consider using modern processes (like APIs) and standards (like HL7 FHIR) to exchange: · Rosters of members attributed to VBC populations · Financial performance on VBC contracts · VBC contract details · Patient care gaps for VBC contracts · Clinical quality performance · And the list goes on In his interview with Rick Daly from HMFA, Deepak Sadagopan talks about why his team is building the data infrastructure to support VBC and why it should matter to you. https://lnkd.in/ggKeA985

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