Putting A Price on Transparency: The Patient Payment Challenge for Payers and Providers

Mel Gunawardena

By Mel Gunawardena, managing partner, SYNERGEN Health.

The healthcare revenue cycle is an unnecessarily complex tangle of patients, providers, employers, and insurance companies. Patients and other parties are often frustrated with medical claim submission and reimbursement procedures, which can take months to resolve. This has forced a closer look at ways to increase the transparency of payment structures – offering the potential to address long-standing patient concerns while ensuring a more stable revenue source.

One of consumers’ chief concerns is the final cost of care. Over the last two years, many patients have lost their jobs and health insurance, leaving them highly cost-conscious. Patients require more cost predictability as they continue to navigate the financial impact of the pandemic. Insurance eligibility and payment estimation tools enable providers to generate reliable out-of-pocket costs at the time of scheduling. For cost-conscious consumers, this helps drive better-informed care decisions, provides options of payment plans or financing, and is an opportunity for providers to improve a critical patient experience.

Price transparency has been a long-standing concern for consumers, and recently the federal government and states have taken steps to address the problem. The Price Transparency Rule, established by the Centers for Medicare and Medicaid Services, took effect on January 1, 2019. Still, hospitals reluctant to comply with the rule now face the possibility of a hefty $2 million fine, and with the No Surprises Act set to take effect next year, it’s clear providers must embrace billing transparency, or the government will force them to accept a less-than-ideal option.

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What Innovations Are Currently Shaping Audiology?

It’s staggering to consider the degree to which technology has progressed, even within the past several decades. Hearing aids, for instance, went from clunky, unwieldy boxes clamped to the side of one’s head to sleek, modern hardware equipped with everything from Bluetooth functionality to companion apps.  And hearing aids aren’t the only hearing assistance technology to have grown more advanced.

Cochlear implants, too, have improved significantly and are now advanced enough to be beneficial to individuals with asymmetrical hearing loss. Moreover, because the majority of a cochlear implant’s components are housed externally, they can be upgraded with relative ease. Even people who received an implant many years ago can enjoy their benefits to the fullest.

Unsurprisingly, the evolution of hearing assistance tech has had a significant impact on audiology.  For one, patients no longer need to visit an audiologist to readjust their device regularly. Instead, they can do so through a smartphone app, tweaking and modifying the settings to their own unique auditory needs.

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Data and An Omnichannel Customer Experience Breathe Life Into Healthcare Consumerism

Chris Evanguelidi

By Chris Evanguelidi, director, enterprise healthcare market, Redpoint Global.

In a new Harris Poll survey commissioned by Redpoint Global, consumers ranked healthcare near the bottom among several industries in delivering an “exceptional customer experience.” Just 13% regarded their experiences as exceptional, about equal with travel/hospitality but significantly below retail (26%) and financial services (23%).

Interestingly, when asked which industry should be the best at providing such an experience, healthcare polled first in three of four elements of customer experience (CX). More than a quarter of all consumers surveyed expect healthcare should rank first in personalization, consistency and customer understanding. (Only financial services ranked ahead of healthcare in the privacy dimension, 34% to 28%.)

An expectation for a consistently personalized experience in which a healthcare provider or insurer exhibits a personal understanding of a consumer is the core of the healthcare consumerism movement, which is a recognition and affirmation that the healthcare consumer controls an individual healthcare journey. Yet consumers increasingly question why fragmentation along channels, locations and data seems to be the norm.

A face-to-face meeting with a physician may provide an overall positive experience, but for the patient, it is only part of a journey, which may have included research, questions and appointment setting before the doctor visit, and follow up care, prescriptions, payments and further research after the point of care.

When the customer journey is disjointed, it becomes very difficult for any stakeholder in the consumer’s care to have a personal understanding beyond their area of interest. This, in turn, further erodes a seamless experience because the next steps are not optimized based on a unified, up-to-date view of the consumer. Social determinants of health, engagement preferences, behaviors, existing care gaps and other data points need to be presented to payers and providers in real time, at the point of interaction, to deliver the consistent, personalized experience consumers have come to expect.

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Things To Consider Before Getting Professional Certifications or Diplomas Online?

Ultimate Guide for Attaining Your Caribbean Medical Degree ...Individuals aspire to continue their education online, adding various certifications and diplomas to their CV. With time, professionals have invested in learning skills and modules online as per their feasibility and requirements.

The online dental assistant program is designed for individuals who aspire to pursue a professional dental assistant as a career. If you are a college or university graduate aiming to make a substantial career in the field of dental hygiene, the dental assistant program is for you. To complete online certifications, one should always sign up on genuine and accredited websites offering quality education. It is estimated that about 6 million Americans are involved in online learning platforms, creating educational-friendly online platforms. 

Always Enroll on Authentic Platforms

Many online students do not confirm their courses and certifications before signing up on online learning platforms. As a learner, one is investing time, capital, and sheer efforts to earn an educational reward. It’s imperative to enroll on authentic platforms, offering genuine and renowned certifications online. Avoid getting involved in fishing and lucrative platforms that might engage you in cyberbullying or other potential threats. As a student or a learner, you can ask in your circle or on public platforms about the authenticity of e-learning platforms.

Always Consider Value for Money Options

Online certifications and training programs cost a fortune. It’s imperative to only enroll in those online certifications that add value to your resume or make you able to learn a new skill. Certifications such as Supply Chain Management, Project Management, Dental Assistant programs, etc., add value to your professional resume. If completing an online certificate or program increases your pay, or makes you competent enough in the job market, then you must go for it.

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Three Key Lessons For Digital Healthcare From The Consumer and Service Industries 

Alison Budor

By Alison Budor, consultant, Freed Associates. 

No one can deny the pandemic’s impact on the healthcare industry. While the pandemic has obviously strained healthcare capacity and workers, it has also helped evolve care delivery through non-traditional channels, particularly digital. This significant change in care provision has created a tremendous opportunity for healthcare to reimagine care within the context of a digital environment.

The challenge is that the healthcare industry has historically been behind other industries in offering impactful patient-facing digital technologies. Compare healthcare, for example, with financial services, allowing consumers to manage all their finances from a smartphone. It’s a similar story with online shopping, which has rapidly allowed consumers to conduct transactions on practically anything from the convenience of their homes.

As healthcare seeks to expand its digital services and better-serve patients, the industry would be well-served to adopt a new patient-centric mindset based on several key digital learnings from the consumer products and service industries. Why? Because as a general rule, these industries have developed their digital products based on valuing and embracing consumers’ needs and loyalty, regularly applying a test-and-adapt process to product and service development, and never wavering from knowing the consumer experience matters far more than any shiny new technology.

The New Digital Norm

In digital services, there is now a single, fundamental truth: the new normal is about being consumer-obsessed, delighting consumers and exceeding their expectations. Whether in healthcare or elsewhere, organizations that embrace this reality will rise to the top; those that don’t will likely be left behind.

For example, Netflix upended the movie industry by providing digital viewing options at the convenience of the consumer. Peloton revolutionized the fitness industry through engaging, digitally based personal experiences. Delta Airlines won top industry ratings with its focus on improving the entire consumer travel experience, from online to in-person. Is there any reason your healthcare organization couldn’t deliver similar results within its sphere of service and influence?

Based on my years of experience in consumer products and services, and now in healthcare, here are three key lessons to apply from the consumer realm to the healthcare industry:

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Dispelling 3 of the Most Persistent Myths About Modern Hearing Aids

By Pauline Dinnauer

If nothing else, the past year-and-a-half has been a demonstration of the harm of misinformation. It can cause someone to make a choice they might otherwise reconsider. It can be the reason someone fails to seek treatment for a particular disorder or cause them to do so with unrealistic expectations. 

In the context of hearing health, hearing aids remain one of the most frequent targets of myths and falsehoods — we’ll dispel some of the most common.

Hearing Aids Allow You To Hear Perfectly

The common assumption is that hearing aids work similarly to a pair of contact lenses or prescription glasses. Once you insert one, that’s it. Your hearing impairment is a thing of the past. 

The reality is that hearing aids cannot “cure” deafness, nor are they capable of restoring 100% of hearing functionality. Moreover, because hearing impairment has so many unique manifestations and everyone’s ears are a little different, what works for one individual may not work for another. That isn’t to say that hearing aids are no good, of course.

In the vast majority of cases, a hearing assistance device can have a noticeable positive impact on your hearing. Hearing aid technology has also come remarkably far, especially in recent years. As such, even if they aren’t a miracle cure, they may still significantly improve your quality of life.

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What Health IT In the Cloud Means To Providers

John Kelly

By John Kelly, chief technology officer, PatientKeeper, Inc.

If there’s a topic in healthcare IT that has absorbed more ink over the past decade than “interoperability,” I can’t imagine what it would be. (Well, going back to 2009, “meaningful use” may rank a close second.)

The federal government has taken a significant interest in advancing health IT interoperability. For instance, Title IV of the 21st Century Cures Act is all about it, and in 2020 ONC promulgated rules designed to push the industry along to make interoperability a practical reality. One specific way is through an application programming interface (API) approach that “supports health care providers’ independence to choose the ‘provider-facing’ third-party services they want to use to interact with the certified API technology they have acquired.”

But, generally speaking, government mandates have paved a slow and bumpy road to any health IT goal.  They focus on rules and regulations rather than incentives (admittedly, meaningful use was a different case).  And thus far, that has been the fate of interoperability.

The metaphor our parent company, Commure, uses to describe healthcare today is a city without roads. We built the “city” of healthcare, populated with over 3,000 healthcare IT companies, without considering the pathways that would connect them. Healthcare lacks the proper infrastructure and connectivity to collect and serve up data in ways that will meaningfully transform the way care is accessed, coordinated, delivered, and experienced.

I believe healthcare IT is, at long last, on the cusp of finally realizing the much-hyped, yet elusive promise of true interoperability. Why now? Because of the cloud, and cloud vendors’ embrace of open standards in their APIs, notably FHIR.

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The Complicated Relationship Between Healthcare Technology and Sustainability

Woman in White Suit with Stethoscope Talking to a Person

By Adrian Johansen, freelance writer; @AdrianJohanse18.

Healthcare technology is transforming what care looks like. In the course of developing new health solutions, however, sustainability often gets pushed to the sidelines. Technologies of the future will determine our relationship with health and with the planet itself, but to strike a healthy balance, we must first explore the often complicated relationship between healthcare technology and sustainability.

Sustainability and technology intertwine more than you might recognize. By evaluating the good, the successes, and failures of this relationship, we can begin to build better care outcomes for both healthcare patients and the livability of our climate. Here’s what you should know.

Successes in Healthcare Sustainability

Let’s start with the good, which there is plenty of in the healthcare industry despite widespread sustainability issues. Sustainability in healthcare is being defined by the efforts of medical professionals as they seek to innovate new green practices through healthcare technology. One of the most instrumental of these sustainability tools has been the pivot to paperless business practices through Electronic Medical Records (EMRs).

EMRs comprise medical systems and databases that store patient information. As a result, patients no longer have to keep their important records in paper form at home and care facilities get the benefit of reducing their supply overhead as well as their consumption of resources. But healthcare sustainability goes far beyond the paperless process.

EMRs have also been instrumental in developing telehealth medical services. These have been vital throughout the COVID-19 pandemic, as telehealth allows patients to visit with a medical professional over a smart device and thereby mitigate the risks associated with traveling to a doctor’s office. Telehealth also means reduced resources, carbon emissions, and costs for patients and providers alike. The result is a more sustainable marketplace for health services.

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Common Technology Used In a Personal Injury Case

person holding white tablet computerA lawyer is always helpful to have on your side after a car accident. They use their experience and skills to fight for your right to adequate compensation.

However, in today’s modern age, they’re also getting a helping hand from technology. Alongside being able to put together a strong case with the many tools they have at their disposal, they’re also able to gather evidence like dashcam footage and medical IT reports to strengthen your position.

Here is some of the most common technology used in personal injury cases that may prove helpful in your own case.

Medical Reports

When a personal injury law firm like Onder Law has to put together a compelling case that proves your injuries were as severe as you say they were, you can rely on your medical reports to provide a full picture of the situation.

While hospitals and medical clinics used to rely on paper reports that could become lost, they now create digital records that outline your entire medical history, including every procedure you’ve had and the costs associated with them. With such an intensive and easily-accessible set of records, your case may be stronger than you thought possible.

Diagnostic Equipment

One of the most challenging parts of any personal injury case is proving that you’re as injured as you say you are, especially if you’ve been spotted on social media or in public looking perfectly fine. Even though your medical history might spell it out for the defendant and their lawyer, diagnostic equipment can drive the point home.

You can make use of scan imagery, x-rays, and other similar technology to identify fractures and other damage that can reflect the seriousness of the situation and the importance of receiving a decent settlement offer.

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Why The Healthcare Sector Is Soon To Be The Biggest Global Employer

The healthcare sector has seen some of the biggest changes over the last 24 months in its entire history. Some of these changes have meant that there is a phenomenal number of career opportunities in the sector at the moment. As the global market for healthcare is expected to reach a total of $12 billion by 2022, it is one of the few sectors that is expected to see this growth continue into the long term with certainty. This article will help you understand why and where these opportunities will be.

People are generally living longer

People are now expected to live longer than ever before, and as such, the healthcare sector will need to cater for the increased number of carers and health care practitioners that will be needed for this increase in demand.

There is thus huge demand for primary carers, live-in carers for the elderly, and an entire range of nursing and outreach staff to deal with this aging population.

The management and planning around healthcare have now become more complicated than ever before. Further education is proving a major advantage for those with postgraduate management skills specific to healthcare, such as the Excelsior Masters in Healthcare Administration.

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