CMSProvider Directory

Health Plans Take Another Hit on Provider Directory Accuracy

CMS completed the first of three planned reviews of health plan Provider Directory Accuracy and the results were not good.  A few stats jump out: Nearly half of provider directory locations listed were inaccurate. (i.e. provider was not at the location listed, phone number was incorrect, or provider was not accepting new patients when the directory indicated


Charitable Premium Assistance: Helping the needy or just plain greedy?

A few months back this story caught my eye: Insurers, hospitals clash over help paying ACA plan premiums. It describes an issue where insurers believe that hospitals are steering patients who are eligible for Medicaid or Medicare to private plans by subsidizing their premiums through charitable organizations. On the surface, that actually sounds like a nice


Replay: Medicaid Open IT with Open Health News

On this episode of The #hcbiz Show! we talk with  Roger A. Maduro and David Perara of Open Health News about the $7.5 Billion/yr Medicaid Open Health IT initiative. The state-based Medicaid Management System infrastructure is woefully out-of-date, disconnected, and increasingly expensive to maintain. Many of the platforms are 30-40 years old and were written in the


Medicaid Open IT with Open Health News (#hcbiz 34)

Join us on Wednesday, December, 7 at 12 PM EST for a panel discussion on CMS’ $5 Billion per year Open Medicaid IT strategy. CMS wants to move away from long-running, highly expensive, single-vendor projects and replace them with modular, open and agile initiatives. The goal is to promote innovation and collaboration in one of the biggest


Trumpcare: Innovation, Speculation and What’s Next

On this episode, Niam Yaraghi (Brookings Institute) joins me and Shahid Shah to discuss the future of healthcare and Health IT under the Trump administration and the Republican controlled congress. We cover a lot of ground (breakdown below), but the general consensus is that we shouldn’t anticipate any immediate “disruption”. Sure, change is coming and we don’t


Patient Engagement and Complex Communication Workflows (#hcbiz 34)

We all know patient engagement is important, but saying it and doing it are two different things. This week’s tweet chat will focus on the complex communication workflows that are being driven by new patient engagement practices and how they impact the business of healthcare. The chat will run from 12:30-1:00 PM EST on Wednesday,