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Experts at Altegra Health are developing new ways to meet the needs of the healthcare industry. Read their insights here.

Transition to ICD-10 Smooth So Far. What Will an Audit Reveal?

Perhaps due to the multiple delays over the years, the healthcare industry’s switch to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) on October 1 has been surprisingly smooth, according [...]

October 28th, 2015|Uncategorized|Comments Off on Transition to ICD-10 Smooth So Far. What Will an Audit Reveal?

New MA Risk Score Calculation Requires Powerful Tools

As promised, the Centers for Medicare and Medicaid Services (CMS) announced earlier this year that it is changing the way it calculates risk scores for Medicaid Advantage (MA) plans in the 2016 payment year. In [...]

October 22nd, 2015|Uncategorized|Comments Off on New MA Risk Score Calculation Requires Powerful Tools

Data, Data, Everywhere and Not a Metric that Informs

“Water, water everywhere/Nor any drop to drink” is a famous verse from Samuel Coleridge’s epic poem, The Rime of the Ancient Mariner. Coleridge was writing about the sea, but healthcare provider organizations could write a [...]

October 15th, 2015|Uncategorized|Comments Off on Data, Data, Everywhere and Not a Metric that Informs

3 Ways Health Plans Can Increase Engagement

As the healthcare industry shifts from fee-for-service to value-based payment models, provider organizations are eagerly trying to engage their patients to improve clinical outcomes and reduce costs. This need is particularly urgent among organizations that [...]

October 7th, 2015|Uncategorized|Comments Off on 3 Ways Health Plans Can Increase Engagement

3 Ways to Engage High-Risk Members for Improved Care Utilization

Although they account for only 18 percent of Medicare beneficiaries, “dual eligibles,” which are Americans who are eligible for Medicare and Medicaid, were responsible for 33 percent of the spending in 2011. Per-capita spending on [...]

October 1st, 2015|Uncategorized|Comments Off on 3 Ways to Engage High-Risk Members for Improved Care Utilization

Top 5 Items Your Organization Needs in Its Chronic Care Management Tool Kit

Three out of four Americans age 65 and older have multiple chronic conditions. Many of these Americans have concerns beyond managing their conditions, including paying for care, keeping track of their numerous provider appointments, and [...]

September 23rd, 2015|Uncategorized|Comments Off on Top 5 Items Your Organization Needs in Its Chronic Care Management Tool Kit

5 Ways HEDIS Changed the Healthcare Landscape

Since 1992, the Healthcare Effectiveness Data and Information Set (HEDIS) has become the chief barometer of quality for health plans. More than 90 percent of health plans use HEDIS’s 83 quality measures across 5 domains [...]

September 16th, 2015|Uncategorized|Comments Off on 5 Ways HEDIS Changed the Healthcare Landscape

Five Goals for an Effective Member Engagement Strategy

Payers have long been focused on leveraging engagement efforts to maximize the quality of care for their members, but these costly programs were often either targeting the wrong individuals or using the same methods for [...]

September 9th, 2015|Uncategorized|Comments Off on Five Goals for an Effective Member Engagement Strategy

What if Everyone Followed HEDIS?

If you asked a dozen healthcare providers what their definition of high-quality care is, you’ll probably hear a dozen different answers. The closest standardized definition the industry has to high-quality care is called the Healthcare [...]

September 2nd, 2015|Uncategorized|Comments Off on What if Everyone Followed HEDIS?
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