MediFormatica’s Post

Alivia Analytics is now a proud member of the Population Health Alliance. We are also a sponsor of the PHA 2024 Innovation & Adoption Summit, Oct 23-24, with many of the nation's top healthcare companies attending. Alivia is the industry’s leading payer analytics platform for commercial and government health plans. We reduce healthcare spending and prevent and recover financial losses from fraud, waste, abuse and overpayments. Our #ValueBasedCare solution centers around the Patient-Centered Episode System (PACES) to support 1000+ episodes of care covering nearly 90% of Medicare spending and 80% of commercial medical spending. We provide self-service analysis of your claims data that shortens payer and provider negotiations and lowers costs, with better outcomes. #AI and machine learning are leveraged, coupled with technology, clinical, and medical expertise to provide speed, accuracy, and seamless integration with claims systems. "We are delighted to welcome Alivia to PHA. Payment Integrity powered by AI vitally preserves healthcare dollars to be re-directed where it is needed most at the point of high value care”, said Rose Maljanian Chairman of the Board and Chair Emeritus, Population Health Alliance and Chairman & CEO HealthCAWS. #paymentintegrity #payeranalytics #episodesofcare

Today we launched PropheSee, our AI-powered predictive model that drives CGM adherence for people living with diabetes. This moment is over two years in the making, so I thought I’d share some key takeaways from the journey... AI is a Cross-Functional Effort PropheSee was not just something our tech team built. Early on, we recognized that, in order to build something that had value and impact, everyone needed to be involved. Finance... Marketing... HR... Clinical... Senior leadership... Executive Leadership... You get the idea. Our tech and data teams didn’t build this in a silo. Healthcare companies that recognize that AI strategies require cross-functional participation will see higher success rates and greater impact. Impact Above All Every day, we see healthcare companies drop “And now with AI!” announcements. This isn’t that – and that’s by design. From the outset, we prioritized impact. At every milestone, we asked ourselves: “Is this going to help our patients? Will it have a meaningful impact on our business?” Healthcare orgs that treat AI as an integrated part of their strategy will benefit most from it – and so will their patients. AI Was Built for Unstructured Data For decades, CCS has worked with people to manage chronic conditions like diabetes. This pursuit includes millions of interactions with patients, providers and payors to yield data. These data offer tremendous insights that — when properly unlocked — allow us to anticipate a patient’s need and offer a hyper-personalized experience to influence behavior. Insights are Good, Behavior Change is Better It’s one thing to derive insight from data but the right AI strategy *does* something with it. With PropheSee, we’re using insights to deliver hyper-personalized interventions that keep patients on therapy. In testing, we’ve observed increases in CGM adherence rates of more than 50% as measured by test and control groups. Increased adherence equals lower total cost of care. This is What Patients Demand... ... And it’s what they deserve. Our payor and provider partners must expect that AI insights will drive the supply and service of our chronic care patients today and well into the future. It’s not enough to serve the patient a product or service and fulfill a transaction. A value-based care future and answer to delivering a better integrated healthcare experience requires this kind of digital investment and fluency. With that, I invite you to learn more about PropheSee. https://lnkd.in/emP96Yhv

GenAI in Healthcare is the space to watch in 2024 👩⚕️👨⚕️ 🗣 Let’s talk about how to automate and accelerate your organization’s operationally intensive processes (yes, we mean faxes, too) with Qarik’s GenAI accelerator. What we’re seeing in the market: ⭐ Billing/Insurance Coding  ⭐ Patient Triage and Admissions ⭐ Medication Reconciliation ⭐ Drug Discovery and Development Acceleration ⭐ Supply Chain Optimization ⭐ Population Health Querying ⭐ Post-Discharge Summaries  Sound familiar? Get in touch ➡ https://lnkd.in/dHZPYGdy #GenerativeAI #QarikGoFurtherFaster #healthcare

#CEODesk Revitalizing Healthcare through Data: Qureight's Leap with $8.5m Investment In the nuanced tapestry of healthcare, the recent funding infusion to Qureight signals a pivotal moment in medical data analysis. Their AI-powered platform is positioned to revolutionize the way we approach complex heart and lung diseases, paving a path towards a future where treatment is rooted in precision and efficiency. 👩🔬 Transformative Data Analysis: Cambridge's own Qureight stands on the cusp of transforming the medical data sphere—aiming to automate and refine the analysis of intricate health data. This move promises to dial down both the temporal and financial costs of manual data processing and accelerate the pace of research progression. Strategizing Healthcare Advancements: Qureight’s alignment with the NHS is emblematic of strategic partnerships' power - marrying real-time medical data with their AI prowess to orchestrate a symphony of streamlined, structured analysis. Their vision goes beyond mere processing; it births virtual trial patients, a testament to their groundbreaking aspirations. Market Reshaping and Investor Confidence: With Hargreave Hale AIM VCT's notable $8.5m backing, Qureight demonstrates the market's budding faith in AI-assisted healthcare solutions. They stand at the vanguard of data analysis evolution, set to redefine industry norms and catalyze the discovery of emergent treatments through intentional biopharma alliances. 💡 AI’s Role in Futuristic Healthcare: Qureight's venture into AI for drug discovery and the ingenious crafting of virtual trial patients dovetails with the burgeoning embrace of technology across healthcare. It is a beacon of innovation, set to disrupt the circles of medical research and patient care profoundly. Investment Recommendations: A Strategic Health Investment 🔬 Highly Recommended: Qureight has forged an avenue brimming with potential - a beacon for investors keen on riding the healthcare innovation wave. 🔬 Trend Alignment: The shift towards tech-centric healthcare solutions is not just imminent, it's already unfurling. Qureight represents an alignment with an undeniable trend. 🔬 Long-Term Vision: In a world eagerly seeking advancements in heart and lung disease treatments, Qureight embodies the promise of a longer, healthier, tomorrow. The question that now dangles before us, like a chandelier in the grand hall of medical evolution: How might harnessing AI in healthcare shape not just future treatment but also the economic fabric of the health sector itself? Reach out to our CEO desk directly to discuss your big business problems and go to market strategies - rohith@marketunwinded.com Read More: https://lnkd.in/gXVEH5NR 🖊️ Rohith Sampathi #Qureight #HealthTech #AI #MedicalInnovation #DataRevolution #VentureCapital #StrategicPartnerships #FutureOfHealthcare

AI learning .

Silicon Canals: Austrian health tech scale-up Xund extends seed round funding to €8M to digitise the patient journey: Here’s how

Artificial intelligence is reshaping the way we approach patient care and treatment decisions.By integrating AI as part of diagnostic services, healthcare organizations are facilitating faster diagnoses and treatment decisions that improve patient outcomes.

Cut the Red Tape in Healthcare: Streamline Prior Authorizations with 11TEN! Prior auths are a significant healthcare roadblock, slowing patients’ access to care & overwhelming providers. But change is coming! CMS announcements this January require reductions to prior authorization decision timelines starting in 2026- a massive change to industry standards which will drive increased innovation. 💡 🏎 Join 11TEN at the forefront: We build powerful healthcare ecosystems to tackle challenges collaboratively. 🤝 🏥 Click the link below to learn more about how our North Star Program is leading the charge to automate & simplify prior auths through industry-wide partnerships. ⬆ ⭐ https://lnkd.in/e97XMqXD Check out our Insights Article to learn more about the North Star Program and explore how 11TEN is addressing other access to care initiatives: •        Better Access to Care through Equitable AI Initiatives •        Earlier Access to Care through Scaled Genetic Screening Click here to learn more: https://lnkd.in/eqBnq94J #HealthcareInnovation #DigitalHealth #RealizingInnovationTogether #PriorAuthorization #AutomatingHealthcare

For Medicare Advantage (MA) and the spectrum of Health Plan entities it covers, such as Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), managing risk adjustment complexities can be demanding! 😰 Health Plans always wish for an easier way to achieve the following. ❖ Medical teams should focus their time on patient care rather than administrative chores. ❖ To better optimize risk scores despite changing regulations & compliance parameters. RAAPID INC’s Clinical NLP solution is embedded with suspect analytics, making those wishes come true. ✨ 𝗥𝗔𝗔𝗣𝗜𝗗’𝘀 𝟮-𝗽𝗿𝗼𝗻𝗴𝗲𝗱 𝗮𝗽𝗽𝗿𝗼𝗮𝗰𝗵 𝗱𝗼𝗲𝘀 𝗶𝘁 𝗮𝗹𝗹 : 📌 Patients' 360-degree longitudinal data, including charts, claims, etc., is analyzed using cNLP. 📌 Then, our advanced algorithm identifies and summarizes suspect conditions related to care gaps and emerging chronic conditions. Thus, whether it is a Single entity or a Group network “point of care,” the above approach saves time and resources, resulting in improved patient care and complaint ROI. Stop struggling with inefficient risk adjustment coding 🐌. Book a demo today and see how RAAPID can transform your Risk Adjustment process 🚀 - https://bit.ly/4azREXI . . . #medicareadvantage #healthplans #suspectanalytics

In case you missed it! TP-ACO experts Jay Simmons, MS-ISM and Lauren Stuteville, BSN, RN shared alongside Health Data Analytics Institute (HDAI)'s Julie Woods on how they worked to 𝙘𝙡𝙤𝙨𝙚 𝙩𝙝𝙚𝙞𝙧 𝙤𝙫𝙚𝙧𝙖𝙡𝙡 𝙃𝘾𝘾 𝙜𝙖𝙥 𝙗𝙮 9% 𝙞𝙣 𝙡𝙚𝙨𝙨 𝙩𝙝𝙖𝙣 𝙩𝙬𝙤 𝙢𝙤𝙣𝙩𝙝𝙨. The webinar, in collaboration with VBCExhibitHall, can be viewed on our website (link in the comments). What if your clinicians could reduce the time required to comb through pages of EMR data to determine appropriate annual coding for their patients?  The HCC Optimizer tool, included in HDAI’s Intelligent Health Management System, HealthVision, streamlines HCC recapture. Now, for every applicable HCC, you can compare each patient to those with similar patterns of condition diagnosis over 3 years. This helps clinicians answer, is this diagnosis likely to re-occur? How much weight does this diagnosis carry?  HDAI’s privileged access to the Medicare database allows us to identify patient-specific coding opportunities based on coding patterns from millions of patients across the country thus uncovering gaps in code recapture that are most likely to occur and to have an impact on complexity scores. For ACO beneficiaries, this includes opportunities that may have been previously captured outside of your system and your EMR.  HCC Gaps can be viewed by provider group and provider to enable prioritization and impactful action. The resulting list helps clinicians to streamline visit preparation and enhance provider-patient conversations.  How do your providers prioritize HCC coding efforts? #workflow #aiinhealthcare #qualityimprovement #AI #ML #populationhealth #accountablecare #valuebasedcare