Gaye Bok’s Post

We're proud to announce the publication of a new peer-reviewed study from researchers at Health at Scale, Personify Health, Massachusetts Institute of Technology, and University of Michigan. Key Finding: Successful deployment of AI-driven fraud, waste, and abuse detection technology drove an impressive 1.2% reduction in total spend for Personify Health, the largest US Third Party Administrator. The groundbreaking study, published in the NEJM Catalyst, spotlights the significant savings being left on the table by traditional methods of analysis that focus only on high dollar claims. It demonstrates how AI can help tackle this problem, through deployed technology that drove a $11.8 million reduction in paid claims. Full press release here: https://lnkd.in/dgYKkDFM The paper is available in the latest issue of the NEJM Catalyst: https://lnkd.in/dFfmvA4Y

As we approach September's RISE West Conference, FJA's VP of Risk Solutions Bryan Lee shares his insights from March's conference. The healthcare landscape is shifting rapidly, and understanding these trends is crucial for staying ahead. Bryan highlights several key points: 📈 Accelerated Change: Increased focus on compliance driven by regulatory oversight and AI. 🎤 Regulatory Emphasis: Unprecedented attendance by regulators, signaling the importance of aligning with CMS's direction. 🔄 Time to Pivot: A call to embrace innovation and adapt to new compliance requirements. 🔗 Read Bryan's full insights below and join us at Rise West 2024 in Colorado Springs September 11-13th! #ThoughtLeadership #RISEWEST2024 #MedicareAdvantage #riskadjustment #HealthcareInnovation #Compliance #AI #FJA #insurance #technology https://lnkd.in/eR4cvFf3

Now available in the new issue of Health Plan Weekly: Wall Street analyst predicts multiyear post-COVID utilization catchup, why execs say insures must constantly target AI bias, how email 'nudges' spurred exchange plan switching, and more top stories. Use the code SAVE10% at checkout for 10% off any AIS Health subscription, now through April 19. https://hubs.ly/Q02sKh-p0

Healthcare needs standardized and secure data sharing. Old systems and different data formats make this difficult. We need clear rules and strong leadership to overcome these challenges. We must use new tools, update old systems, work together, and put patients first. This will help break down barriers, share data easily, and improve healthcare. Patients deserve it. #Data #DataExchange #Healthcare #Interoperability

When it comes to #Interoperability, alignment is needed on terms, standards and governance. That's according to EHRA Public Health Workgroup Chair Hans Buitendijk of Oracle Health. Read more in Healthcare IT Today. Healthcare IT Today. https://ow.ly/IOjw50TfUYV

Here's another example of how Highmark is walking the walk when it comes to using data and technology to transform health care through its Living Health strategy. Combining Epic’s Payer Platform, which sends patient data between payers and providers, with Google’s analytics and artificial intelligence capabilities will allow quicker access to useful data about a patient, such as their upcoming visits, medical history, insurance claims and health plan benefits.

An Ultimate Guide to Healthcare Analytics [PDF] 🎁 Grab Your Free Sample Report: https://lnkd.in/dc9ju32u Healthcare analytics is a burgeoning field that leverages data analysis and insights to improve patient outcomes, enhance operational efficiency, and drive informed decision-making across the healthcare industry. In this comprehensive guide, we will explore the fundamentals of healthcare analytics, its applications, benefits, challenges, and the latest trends shaping the landscape. Applications of Healthcare Analytics - Clinical Decision Support: Assisting healthcare providers in making evidence-based decisions at the #pointofcare. - Population Health Management: Identifying and managing health risks within specific patient populations to improve outcomes and reduce costs. - Revenue Cycle Management: Optimizing financial performance by streamlining #billing, #coding, and #claims processing processes. - Fraud Detection: Identifying and preventing fraudulent activities such as insurance fraud and improper billing. - Drug Discovery and Development: Accelerating the discovery of new #drugs and #therapies through data-driven #research and #analysis. #HealthcareAnalytics #DataAnalytics #HealthTech #PredictiveAnalytics #PopulationHealth #DigitalHealth #AIinHealthcare #ClinicalAnalytics #BigDataHealthcare #Telehealth #PrecisionMedicine

The need for scalable exchange is particularly relevant in the context of #TEFCA (Trusted Exchange Framework and Common Agreement), which seeks to establish a nationwide health information exchange infrastructure. #TEFCA aims to facilitate secure and interoperable exchange of health information across the United States, addressing the challenges posed by disparate systems and promoting efficient and coordinated care delivery. Learn more: https://hubs.li/Q02m23SL0

Unlock the power of data and analytics in rural health. With the right data, providers can now optimize their financial performance and RCM, streamline operations and enhance the patient experience. #DataAnalytics #HealthcareRevolution

Unlock the power of data and analytics in rural health. With the right data, providers can now optimize their financial performance and RCM, streamline operations and enhance the patient experience. #DataAnalytics #HealthcareRevolution