Technology

Consider hybrid alternatives when switching to cloud computing.

When it comes to predicting geographic variations in cost, what's true for Medicare doesn't necessarily hold for the commercial populations.

Patient privacy remains a key issue for health plans, according to a new survey conducted by PricewaterhouseCoopers (PwC).

Paying for performance will cause many health plans to rethink how they contract with provider networks, and experts say there are tremendous changes ahead.

Insurance exchanges have an ultimate deadline of January 2014.

To achieve a higher rate of clean claims, health plans have to be absolutely clear on what a "clean claim" means to all parties in the transaction.

In the rush to adopt EHRs and gain federal funding perks, providers could find themselves less connected than they anticipated.

The Federal Health IT Strategic Plan is an initiative of the Office of the National Coordinator for Health Information Technology, which aims to further its goal of working with the private sector to improve quality.

When it comes to all-payer claims databases, states are driving the trend.

Technology is helping insurers manage prior authorization requests.

States are relying on Medicaid systems for online health insurance exchange support

The promise of advanced diagnostics must be supported with infrastructure to have the greatest chance of success.

Any payer's approach to manage the transitions from ICD-9 to ICD-10 will have a lasting impact as an IT project and a transformative change to business.

Health plans are facing a regulatory jolt that could cost them millions of dollars annually in lost revenue. The first zap is the medical loss ratio provision of the Patient Protection and Affordable Care Act.

Healthcare industry leaders have had to adopt a new way of thinking to prepare for business interruption

As the healthcare industry pumps up its use of technology, digital health coaching is catching on.

Because of the disparate nature of health IT systems, the data is so fragmented it's actually hampering clinical decisions

Data flows among primary care physicians, specialists and other providers, theoretically providing access to complete clinical information

As many as one-third of office-based physicians submit prescriptions electronically.

Few providers or commercial payers have fully addressed implementing ICD-10

Administrative expenses, redundant tests ordered by providers and generally uninformed choices contribute to costs

For technology professionals leading IT efforts among health plans, the biggest changes haven't come from hardware and software, but rather, from their roles in implementing new business concepts.

Stakeholders seek uniformity of standards for several types of electronic health information transactions and specific operating rules, n one of which will be easy to implement.

One approach to aligning cost/quality outcomes is Value-Based Benefit Design which is designed to lower out-of-pocket costs for high-value services while providing greater quality of life for members

While politicians and legislators have elevated the visibility of the nation's healthcare challenges, regulations can't effect practical improvements in costs and quality, even during this turning point in public policy.

While not a panacea, emerging financial tools that facilitate members' interaction with the healthcare system--such as online treatment-cost estimators--hold the potential to become a truly effective technology that will help improve those problem areas.

There comes a time for all technologies when the drawbacks simply outweigh the benefits.

In March, Aetna launched Aetna On-the-Go, providing members access to online features, mobile applications, and text messaging.

The rapidly approaching shift from ICD-9 to ICD-10 is a massive system overhaul that many have underestimated.

Heterogenity is a huge hurdle for healthcare organizations that hope to capitalize on the wealth of data they possess.