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Reducing Healthcare Costs Through Company Wellness Plans

February 4, 2016 by Stephen Schimpff

Employers have seen their health care costs rise dramatically over the years. To compensate, they have expected employees to pay an increasing portion of the healthcare insurance premium, expected employees to pay significant co-pays with each physician visit and have purchased policies that restrict individuals to a narrow network of doctors and hospitals.[read more]

5 Healthcare Industry Issues of 2016

January 25, 2016 by Moira O'Connell

It’s only the beginning of 2016, but we've been keeping a close eye on the upcoming healthcare trends for the year. Thanks to the annual Healthcare Issues report by the Health Research Institute of PricewaterhouseCooper (that highlights 10 major issues for the healthcare industry), we are able to take a deeper look into what the New Year may hold for the healthcare industry as a whole. From mobile health to Mergers and Acquisitions, let’s look at the first 5 healthcare industry issues bound to take root this year.[read more]

The Benefits of Specialty Pharmacy: For Hospitals & Health Systems

December 12, 2015 by Moira O'Connell

The specialty pharmacy industry is booming, and as many pharmacies opt for moving down the specialty pharmacy accreditation path, many hospitals and healthcare systems are starting to realize opening their own specialty pharmacies (or partnership with one) could be a good idea.[read more]

The Importance of Targeted Care in Specialty Pharmacy

December 6, 2015 by Moira O'Connell

Specialty Pharmacy is one of the rapidly growing facets of the healthcare world. It’s projected that by the end of 2020 specialty drug spending will total $400 billion, accounting for 9.5% of national healthcare spending. Today we will discuss how the fast-growing industry is also paving the way in patient satisfaction and targeted care.[read more]

4 Healthcare Trends Set into Motion by the ACA

November 18, 2015 by Moira O'Connell

2015 marks the Affordable Care Act's 5th anniversary. Five years later, the ACA has sparked change in the healthcare ecosystem and is continuing to churn the wheel of change. But what changes should healthcare organizations expect for the future?[read more]

5 Key Elements of the Peer Review Process

November 13, 2015 by Moira O'Connell

Lately we have been talking about the importance of Independent Review Organizations (IROs) and peer reviews in the healthcare ecosystem. Today we continue this discussion and delve deep into the importance of the peer review process. So let’s take a look at the 5 core building blocks of the peer review process.[read more]

CMS Announces Meaningful Use Final Rules & Stage 3 Implementation

October 22, 2015 by Moira O'Connell

Now that the ICD-10 panic has subsided the healthcare world is focusing on something new: Meaningful Use. Despite mixed reactions from the public and congress, many of whom expressed concern about the proposed changes and rules,[read more]

Investor red flags- always logical?

October 20, 2015 by Ruchi Dass

A few of my interns recently did a brain-storming session with me. They were all enthusiastic to do something of their own and had many questions. Many of them I met at several accelerator competitions and hackathons. I am not an authority or a VC. So far, I have invested in 9 companies globally- all in healthcare or education. One thing...[read more]

From Lake Placid: Doc Generously Donates Surgeries, Resources

October 20, 2015 by Annette Hogan

While on a boat tour of Lake Placid over Labor Day weekend, I listened as the tour guide talked about Camp Carolina, the historic lakeside home of one long-time resident, Dr. Howard Smith. The guide went on to describe Dr. Smith’s many trips around the world organizing and donating surgeries for people born with cleft lips and palates....[read more]

Medicare Rates Set to Soar

October 15, 2015 by Phil C. Solomon

 The Fed is talking about raising interest rates and now Congress so far has failed to find a way to stave off an unprecedented premium increase for millions of recipients in 2016.Is our economy ready to take this one two punch? What say you? C....[read more]

Eliminating Risk with Independent Review Organizations & External Reviews

October 14, 2015 by Moira O'Connell

We’ve been talking a lot lately about how and where Independent Review Organizations, or IROs, fit into denial management. The Peer Review process, which brings in an unbiased third party to help alleviate the pressure of reviewing claims, is an essential part of denial management. We’ve touched on many of the different benefits of IROs in previous blog posts, from how they affect your ROI to how they bring specialized expertise to reviews. This blog post focuses on the four main ways IROs and external reviews can help eliminate risk within your organization.[read more]

Why do sick people quit their Medicare Advantage plans?

October 12, 2015 by David E Williams

Heading back to Mama FedHealth plans don’t like sick people. They rack up big medical expenses, drive up health plan administrative expenses, and generally knock down profitability. In the bad old days of Medicare managed care, some plans went out of their way to make sure their membership rolls were filled with healthy people. My...[read more]