DataWELL Informatics

Precision Medicine as key driver of next generation personalized health care The term “Precision Medicine” refers to the tailoring of clinical and other health care-related interventions based upon an individual’s unique make-up and circumstances. While personalization of care has long been the underpinning of best practice medicine, personalized care and Precision Medicine are not exactly synonymous. Precision Medicine is an expanded approach that uses information about an individual’s biological, environmental, and lifestyle characteristics to guide decisions related to their medical and health management.  #precisionmedicine #healthcare #healthcareanalytics #healthmanagement #wholepersoncare #healthcaremetrics

Part 1: The Current Landscape The remarkable growth in Medicare Advantage enrollment over the past twelve years is raising questions about both the cost and quality of that coverage as well as the ultimate impact on health equity and solvency of the traditional Medicare program. This is the first in a series of articles to follow, providing insight into the current landscape (both in terms of Medicare Advantage performance and growth) to help lay the foundation for steps that plan sponsors and provider organizations can be taking to prepare for the future. #medicare #medicareadvantage #healthcare #healthcaremetrics

Payment Integrity Evolution Over the past decade, the healthcare industry has seen payment integrity evolve from an under-resourced operational niche to a strategic asset that is central to the overall management of medical expense. A paradigm shift is underway, wherein many payers are recognizing that the status quo will not suffice in a volatile, disruptive market where, among other things, technology is advancing rapidly. Many are at the initial stages of fully understanding and implementing elements of a comprehensive future vision for payment integrity efforts, which in addition to dedicated analytic staff, comprise a team committed to ideation and innovation. Vital measures to track and drive performance of Payment Integrity (PI) initiatives, including the use of industry benchmarks and annual goal setting are gaining traction. #paymentintegrity #healthcare #healthcareclaims #metrics #processimprovement #claimsmanagement #claimsoperations

Today’s technology innovations and workforce challenges (need to drive toward greater efficiency) are prompting payers to take a closer look at payment integrity with an eye toward a more strategic framework. More and more payers are recognizing that the status quo will not suffice in a volatile, disruptive market where change is happening with increasing speed. Over the past decade, the healthcare industry has seen payment integrity evolve from an under-resourced operational niche to a strategic asset that is central to the overall management of medical expense, in addition to efforts to improve quality of care and foster mutually satisfying provider relations. Let’s look at some guiding principles establishing Payment Integrity as a strategic asset. #paymentintegrity #processimprovement #healthcare #metrics #claimsmanagement

Today’s technology innovations and workforce challenges (need to drive toward greater efficiency) are prompting payers to take a closer look at payment integrity with an eye toward a more strategic framework. More and more payers are recognizing that the status quo will not suffice in a volatile, disruptive market where change is happening with increasing speed. Over the past decade, the healthcare industry has seen payment integrity evolve from an under-resourced operational niche to a strategic asset that is central to the overall management of medical expense, in addition to efforts to improve quality of care and foster mutually satisfying provider relations. Let’s look at some guiding principles establishing Payment Integrity as a strategic asset. #paymentintegrity #processimprovement #healthcare #metrics #claimsmanagement

Chris Deimel has joined DataWELL Informatics as SVP Data & Analytics.   Chris is a seasoned data, analytics, and technology leader with over 20 years of experience in the healthcare industry. His expertise lies in data collection, management, and storage, and he is also responsible for analyzing data to drive valuable insights that empower key business strategies.   Outside of work, Chris draws inspiration from his wife and their three children. He cherishes spending quality time with his family and enjoys the great outdoors.   Welcome Chris!  

Payment integrity encompasses efforts on the part of payers and healthcare providers alike to navigate ongoing challenges relative to achieving accurate and efficient payment. Having a system of payment integrity processes in place is essential for ensuring financial accuracy, maintaining compliance with regulators, optimizing the overall healthcare delivery system, and removing administrative waste which can have a negative impact on patient care and quality outcomes.

Harnessing the Value of Artificial Intelligence (AI): AI at its core encompasses taking advantage of the rich and diverse sources of information that individuals and health care providers amass across the continuum of health-related behaviors, interactions, and management. Being able to better leverage these stores of data to enable predictions of health risk and more proactive engagement to promote better health care outcomes via AI tools and applications offers great promise. With this comes a responsibility to safeguard and ensure responsible stewardship of sensitive information. This includes both the use of the data itself as well as the output, predictions and actions that ensue. #AI #healthcaredata #healthcare #dataprivacy #datasecurity

Healthcare compliance risks and issues have moved to the forefront in the news. Cybersecurity issues, new and expanding regulations with both increased scrutiny and penalties have created a big demand for strong leadership. Come hear DataWELL’s CISO, Robin Smith, speak on Tuesday, March 26th at 12:30pm EST on Elevating Women in Compliance & Technology webinar. Webinar Link https://lnkd.in/eY5JWJtz #cybersecurity #compliance #healthcarecompliance

Happy Pi Day!