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Clinical data is a two-way street for payers. These organizations require timely and accurate patient data from their healthcare provider partners. Likewise, payers are mandated by the Centers for Medicare & Medicaid Services to make member data available to external stakeholders via application program interfaces. These bidirectional payer connections with mobile apps or to a provider’s electronic health records systems and practice management systems include clinical data exchange us
The CMS released highly anticipated MA enrollment data on Tuesday that showed UnitedHealth further tightening its grip on the privatized Medicare market.
In January 2025, the Department of Health and Human Services’ Office for Civil Rights received 70 reports of large-scale data breaches (affecting more than 500 patients) in the healthcare sector, impacting the protected health information of approximately 2,768,422 patients. As is often the case, hacking incidents were the leading cause behind the months reported breaches.
Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health
AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!
Cost projections for the embattled medical record modernization project range from the VA’s earlier estimate of around $16 billion to an independent evaluation of nearly $50 billion, according to the Government Accountability Office.
By Jason Lockbaum - As we progress through 2025, healthcare organizations are facing unprecedented pressure to deliver personalized and proactive experiences at scale. The reality is that patients and members now expect the same level of convenience, transparency, and customer-centric service they get from leading brands in sectors like retail and technology.
Medsender , the AI-powered workflow automation platform for healthcare providers, is pleased to announce a recent $5 million Series A investment led by Ballast Point Ventures. Medsender will use the investment to bolster its commercial team, accelerate its technology pipeline development, and drive industry-leading performance for its clients. Medsender is a leading AI platform trusted by thousands of healthcare providers across all fifty states to reduce administrative burdens.
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Health Care Compliance Brief brings together the best content for health law & compliance professionals from the widest variety of industry thought leaders.
Medsender , the AI-powered workflow automation platform for healthcare providers, is pleased to announce a recent $5 million Series A investment led by Ballast Point Ventures. Medsender will use the investment to bolster its commercial team, accelerate its technology pipeline development, and drive industry-leading performance for its clients. Medsender is a leading AI platform trusted by thousands of healthcare providers across all fifty states to reduce administrative burdens.
If it felt like we just attended a massive health IT conferece and now we’re about to attend another one, then you’d be right. We attende a lot of healthcare IT conferences every year, but there’s nothing quite like the nearly back to back conferences of ViVE and HIMSS. ViVE 2025 is now in the rear view mirror and next week we’ll be attending the HMSS conference where we’ll do our best to bring you some of the best health IT content from the event.
What You Should Know: – MEDITECH , a provider of electronic health record (EHR) solutions, today announced the launch of its new Expanse Outreach Portal. – The web-based platform empowers MEDITECH hospitals to expand their laboratory outreach programs, streamline operations, and improve collaboration with non-affiliated healthcare organizations.
The following is a guest article by Frank Forte , CEO at EnableComp The healthcare revenue cycle has never been more complex. As electronic health record (EHR) systems become nearly universal and interoperability initiatives gain momentum, many healthcare providers assume their revenue cycle challenges are solved. However, the reality is more nuanced, especially regarding complex claims management.
Based on comprehensive survey data from diverse healthcare providers, the 2025 HIPAA Benchmark Report delivers actionable intelligence for modern compliance programs. This report examines how organizations are restructuring HIPAA Privacy Programs to address emerging regulatory requirements. Through analysis of staffing models, program operations, and breach management protocols, it provides a clear picture of current best practices.
What You Should Know: – PointClickCare , a healthcare technology platform, and MassHealth, the Massachusetts Medicaid program launches a new Behavioral Health Treatment and Referral Platform. – The statewide initiative aims to improve the efficiency and coordination of behavioral health care by streamlining referral processes, enhancing communication between providers, and providing real-time visibility into inpatient psychiatric bed availability.
Reported payers and health insurance industry news from The Cigna Group, Blue Cross and Blue Shield, Humana, Cigna, Anthem Blue Cross and Blue Shield, AHIP, Independence Blue Cross, CVS Health, Aflac, and more. The post Revenue Cycle and Payer News – February 26, 2025 appeared first on Health IT Answers.
What You Should Know: – Philips announced a partnership with Amerigroup , CareSource Georgia , and Peach State Health Plan to provide remote patient monitoring (RPM) solutions for high-risk pregnancies in Georgia. – The initiative aims to expand access to quality maternal healthcare and improve outcomes for mothers and babies, particularly in underserved communities.
In the fast-paced world of healthcare, efficient time management and delegation enhances both personal and team productivity. Healthcare professionals often juggle multiple responsibilities, making it essential to prioritize tasks, delegate effectively, and manage time wisely. This course is equips healthcare professionals with practical strategies and techniques to improve efficiency, reduce burnout, and ensure the delivery of high-quality patient care.
Every health care provider that accepts federal payments must screen for excluded providers. Use this sample Exclusion Screening Checklist and Compliance Policy to evaluate and improve your organization’s compliance with the law. Payments from Medicare, Medicaid, and TriCare trigger screening requirements that may extend to employees, contractors, volunteers, board members, and network providers.
Jacob Johnson, CISO of ArmorPoint Few industries rely more heavily on sensitive personal information than the healthcare sector, and therefore few collect, store and share as much data. The Department of Health and Human Services (HHS) recently issued a notice of proposed HIPAA revisions HIPAA Security Rule to Strengthen the Cybersecurity of Electronic Protected Health Information which would bolster the current guidelines for policy updates.
Healthcare providers can strengthen their ability to manage workplace conflicts through the Conflict Resolution Training for Healthcare Personnel course. This training explores how unresolved conflicts impact patient care, team dynamics, and organizational culture. Providers learn to apply emotional intelligence to manage emotions effectively and use active listening techniques to prevent and resolve conflicts.
What You Should Know: – Google today announced a major advancement in wearable technology with the FDA clearance of its Loss of Pulse Detection feature for the Pixel Watch 3. – The feature can detect when a user experiences a loss of pulse, a potentially life-threatening event such as cardiac arrest, and automatically contact emergency services if the user is unresponsive. – Now, with FDA clearance, Google will begin rolling out Loss of Pulse Detection in the United States at t
Healthcare providers can enhance their ability to maintain composure and improve patient care through the Emotional Intelligence: Maintaining Composure for Healthcare Personnel training course. This course teaches how emotions influence decision-making, communication, and patient interactions, equipping providers with essential skills to recognize personal emotional triggers and practice active listening.
In healthcare, where patient data protection is paramount, effective vendor risk management isn't just good business—it's essential for maintaining compliance and trust. This comprehensive guide helps healthcare compliance professionals navigate the complexities of third-party vendor relationships in an increasingly interconnected healthcare environment.
National telehealth giant Teladoc reported a massive loss in 2024, dragged down by the declining value of its BetterHelp direct-to-consumer mental health business. | Teladoc released its full-year 2024 earnings on Wednesday.
Change is a constant in healthcare, shaping the way we work, learn, and deliver patient care. Yet, managing that change – adapting to new protocols, technologies, and organizational structures – can often feel overwhelming. In this course, we delve into the art and science of change management within the healthcare setting. For example, whether it’s navigating the shift to electronic health records, this training is designed to help you approach change with confidence.
The federal government must complete plans to fire even more workers and close down offices. HHS has special instructions to ensure health program care delivery is not disrupted.
What You Should Know: – Verato launches Verato MDM Cloud , a next-generation master data management (MDM) platform that provides a complete and trusted view of people, organizations, and networks across complex ecosystems. – The solution empowers organizations to unlock the full potential of digital transformation by solving the fundamental challenge of identity resolution.
Payroll compliance is a cornerstone of business success, yet for small and midsize businesses, it’s becoming increasingly challenging to navigate the ever-evolving landscape of federal, state, and local regulations. Mistakes can lead to costly penalties and operational disruptions, making it essential to adopt advanced solutions that ensure accuracy and efficiency.
An estimated $25.7 billion was spent by hospitals and health systems on claims adjudication in 2023, a 23% increase over 2022, according to a Premier member survey. Among the 15% of claims denied by insurers, more than two-thirds were ultimately paid out.
Look at what you can do, rather than just what you want, for maximum results Lets be 100% real you have all the ideas for maintaining your compliance program of what you want to do in 2025. You are going to put together a risk assessment and gap analysis, look at all of your data, assess patient needs with incident reports, and report all of it to corporate on a monthly basis.
Just over 34.4 million people were enrolled in Medicare Advantage plans as of Feb. 1, representing fairly slim growth across the program's annual enrollment period.
In today’s rapidly evolving healthcare landscape, effective performance management is more crucial than ever. This course explores the strategies and tools that empower healthcare professionals to optimize patient care and streamline operational efficiency. In this course, we’ll delve into the principles of performance management. For all healthcare workers, this training is designed to equip you with the insights needed to elevate your performance.
Healthcare communication has evolved from handwritten notes and paper charts to digital tools like EHRs, telemedicine, and AI-powered platforms. This blog explores how these advancements improve patient outcomes, streamline care delivery, and enhance provider collaboration. Learn about the role of mobile health (mHealth) apps, secure messaging, and social media in bridging communication gaps.
It can be very overwhelming scrolling though job board after job board in search of a position that fits your wants and needs. Let us take that stress away by finding a mix of great health IT jobs for you! We hope you enjoy this look at some of the health IT jobs we saw healthcare organizations trying to fill this week. Here’s a quick look at some of the health IT jobs we found: Oracle Health Perioperative Analyst – Stoltenberg Consulting Medical Compliance Manager – Washington
Senior Editor Heather Landi, Senior Writer Paige Minemyer and Staff Writer Emma Beavins reflect on their trip to the ViVE conference in Nashville and what they learned.
What You Should Know: – PocketHealth , a connected care company launches Image Reader , a new feature that uses AI to help patients better understand their medical imaging results. – Image Reader provides visual context within CT and X-ray scans, making it easier for patients to interpret their images and have more informed conversations with their healthcare providers.
Let's discuss the trusty pager—an old favorite that’s losing its shine in hospitals and clinics. While once a staple in hospitals and clinics, pagers now present significant limitations that hinder rather than facilitate communication among healthcare professionals. Healthcare professionals are constantly on the move, and they need communication tools that can keep up with their fast-paced lives.
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