Blog
October 09, 2023
Tracking Quality Measures in Your Precision Medicine Specialty Practice
Value-based care is more than just a buzzword. This quality-over-quantity philosophy is gradually replacing the old fee-for-service model in the U.S. and worldwide for healthcare industry. The federal government, via…
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September 26, 2023
Turning Awareness into Action for Prostate and Ovarian Cancers
By: Dr. Simon Blanc, Sr. Medical Director and Clinical Lead of Quality Research Initiatives September is Prostate Cancer Awareness Month and Ovarian Cancer Awareness Month: a time to focus attention on two highly challenging…
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September 18, 2023
Why Do Healthcare Stakeholders Need to Leverage RWD/E To Inform Their Precision Oncology Decisions?
The FDA defines real-world data (RWD) as “data relating to patient health status, or the delivery of health care routinely collected from various sources.” Such sources include electronic health records…
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September 05, 2023
Alternative Payer Models vs. Fee-for-Service
Healthcare reimbursement models have been adapting to meet updated regulations and evolving patient needs, especially as the industry shifts toward a value-based care framework. Reimbursement models fall into fee-for-service and…
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August 21, 2023
Future Data Exchange Requirements to Support Value-Based Agreements
As the healthcare industry undergoes a sector-wide shift toward a value-based care (VBC) framework, stakeholders are connecting to discuss how data will be shared to support this paradigm best. Value-based…
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August 07, 2023
What Is Genomic Testing? How Does It Drive Precision Medicine?
Genomic testing, also called biomarker testing, is a method of cancer care that examines the interactions between a patient’s genes to inform diagnosis and treatment. Genomic testing should not be…
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July 24, 2023
What Are Quality Initiatives in Healthcare?
Quality initiatives in healthcare refer to official measures by government or industry organizations that aim to improve the quality of care. The most well-known are those introduced and managed by…
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July 10, 2023
Transforming Healthcare Delivery With Artificial Intelligence
The healthcare industry faces several challenges, including the need to shift to new payment models and deliver higher-value care while maintaining a qualified and capable staff. In this complex and…
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June 06, 2023
Rethinking Alternative Payment Models (APMs) for Health Plans
As the healthcare industry continues to transition from a framework dominated by fee-for-service reimbursement to one focused on value-based care (VBC), industry stakeholders are adopting more alternative payment models (APMs).…
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May 22, 2023
Improving Population Health in Cancer Care Through Advanced Analytics
Advanced analytics is an essential tool for improving population health management. It allows physicians and policymakers to examine and analyze critical data regarding treatments and procedures. These insights inform care…
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May 08, 2023
ISPOR: New data highlights need for increased EGFR testing in NSCLC; spots alarming gaps for Asian American patients
by Patrick Curry, Vice President and General Manager, Life Sciences at Integra Connect, PrecisionQ. Lung cancer is one of the most commonly diagnosed types of cancers, with the majority categorized…
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May 01, 2023
Five Characteristics You Should Consider When Evaluating the Right Kind of Real-World Data
Real-world data, or RWD, is gaining traction throughout the health care industry as it offers tangible benefits to all stakeholders. The United States Food and Drug Administration (FDA) incentivizes life…
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April 24, 2023
Strategies for Success in Value-Based Care Contracts
The healthcare industry is gradually undergoing a shift from the traditional fee-for-service model to a framework built on value-based care. This transformation process is supported by several initiatives from the…
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April 11, 2023
How Do Health Plans Succeed in Alternative Payment Models (APMs)?
The way that healthcare organizations structure services and payments is evolving. The traditional fee-for-service model is being phased out, and stakeholders are increasingly adopting a new value-based care (VBC) framework.…
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March 27, 2023
How Health Plans Can Leverage Alternative Payment Models (APMs) for Provider and Patient Success
The healthcare industry is shifting from the traditional fee-for-service economic model to a value-based care (VBC) framework. The Patient Protection and Affordable Care Act (ACA) and the Center for Medicare…
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March 10, 2023
Why Is Revenue Cycle Management (RCM) More Than Just Managing Revenue Cycle?
Revenue cycle management (RCM) refers to the financial process healthcare organizations use to track revenue and bill for patient services to payers. The process begins when a patient makes an appointment…
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February 10, 2023
Top Ten Areas to Review to Prevent Revenue Leakage
For financial healthcare executives, optimizing cash collections since the pandemic is a focus area. EMS calls have dropped 26 percent nationwide in U.S since the start of the pandemic1. Now…
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January 25, 2023
What Is Practice Transformation? And Why Is It Important?
Practice transformation is a process of change within a healthcare organization, defined by the Centers for Medicare & Medicaid (CMS) as “a process that results in observable and measurable changes…
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January 16, 2023
Checklist for Selecting an RCM Partner
As the realities of the challenges of ‘The Great Resignation’ and the COVID-19 pandemic set in, many practices are finding it more cost-effective to leverage third-party vendors to manage their…
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January 06, 2023
What to Look for in a Real-World Data (RWD) / Real-World Evidence (RWE) Partner
Real-world data (RWD) and real-world evidence (RWE) are revolutionizing the way life science research and development are done. According to a recent study carried out by Deloitte, 80% of biopharma…
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December 05, 2022
Creating a Win-Win Alternative Payment Model Strategy for Payers
Advancements in technology are revolutionizing the healthcare industry. With the emergence of Alternative Payment Models (APMs), healthcare providers are adopting new best practices to succeed, while payers are looking for…
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October 07, 2022
What Is Value-Based Care and What Does It Mean for Providers?
What Is Value Based Care? Value-based care (VBC) is a healthcare model that reimburses providers based on the quality of care provided and the patient outcomes achieved. Put simply, with…
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September 22, 2022
Pros and Cons of Doing Revenue Cycle Management In-House vs. Choosing a Third-Party Partner
Healthcare providers are experiencing a number of challenges when it comes to their revenue cycle management (RCM): More time spent in accounts receivable (AR) Staffing shortages, with either too few…
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September 22, 2022
5 Reasons Life Sciences Companies Should Leverage an Real-World Data Partner for Clinical Trials
Real-world data (RWD) is data collected outside of a traditional clinical trial setting from sources such as electronic medical records (EMRs), payer claims, and disease registries. Real-world evidence (RWE) is…
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August 31, 2022
What Is the Enhancing Oncology Model (EOM)?
The Centers for Medicare and Medicaid Services (CMS) recently announced the Enhancing Oncology Model (EOM), the next iteration of its value-based, oncology care model. EOM is a five year program,…
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August 23, 2022
Reimagining Value-based Care in Oncology: How the Enhancing Oncology Model will Continue the Evolution of Oncology Care
by Dr. Jeffrey A. Scott, Chief Medical Officer. In our previous blog post, we broke down CMS’ assessment of the Oncology Care Model (OCM) and found that there were both…
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August 17, 2022
Reimagining Value-based Care in Oncology: What OCM Can Teach Us Ahead of the Enhancing Oncology Model
by Dr. Charles Saunders, CEO of Integra Connect. The Oncology Care Model (OCM) came to an end in June of 2022, giving oncology providers, payers, and other industry observers the…
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July 14, 2022
Preparing for the Enhancing Oncology Model: What Practices Need to Do Now
The Enhancing Oncology Model (EOM) will begin in July of 2023, giving practices a 12-month runway to prepare for the new value-based care program. Here’s what prospective participants need to do to…
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July 11, 2022
Revenue Cycle Management: How to Make Your “Front-End” Office More Efficient with Automation
Healthcare staffing challenges continue to prevail in 2022. The COVID-19 pandemic has impacted how healthcare organizations manage their revenue cycle. Staffing shortages mean that providers are forced to hire inexperienced…
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June 03, 2022
From ASCO: Early, rapid genetic testing can improve survival rates among late-stage lung cancer patients
Byline: Jeffrey A. Scott, MD, Chief Medical Officer, Integra Connect Advances in genetic testing have made it possible to determine, at a molecular level, which treatment options will best target…
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January 11, 2022
How the crew documentation drives medical necessity?
In this post, we will define medical necessity and how the determination of medical necessity is driven by the crew documentation. CMS (Centers for Medicare & Medicaid Services) defines medical…
Read moreDecember 19, 2021
Good practices that ambulance service providers can adopt to help ensure EMS billing is effective and successful
There are several good practices that ambulance service providers can adopt to help ensure EMS billing is effective and successful. Effective EMS billing is defined as billing that produces timely…
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December 13, 2021
Hospital to Hospital transports from an RCM perspective
Revenue Cycle Management(RCM) in the ambulance industry has a lot of moving parts to monitor to ensure the bottom line is met. Lower DSO, maintain a steady cash flow, keep…
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December 05, 2021
Factors that contribute towards patient centric billing approach
As recent as ten years ago, healthcare expense was straightforward from the patient perspective. You paid your employer a premium, then paid the physician $25 for an office visit, the…
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November 20, 2021
Compliance from a health care perspective – Are you covered?
Are you aware that payer enrollment is the Gatekeeper of your revenue cycle? Enrollment, along with credentialing, prevents fraud by validating all your company information. The CMS program utilizes the…
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October 04, 2021
5 things you need to know to survive a Medicare audit
Important facts to help prepare and successfully navigate the auditing process. It is not uncommon that ambulance providers are faced with Medicare audits. There are several types of audits performed…
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January 29, 2020
Authorizations, the problem child in healthcare
Prior authorizations, or Pre-Certifications are a formal permission that allows the provider to see and verify the following; member is active and eligible for services, guarantees to the insurance that…
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January 24, 2020
What Is EMS Revenue Cycle Management?
Revenue cycle management is the financial handling of a provider’s business. Through managing the many steps and layers involved in bringing a healthcare service to a billable claim, revenue increases.…
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January 21, 2020
The Balance Billing Landscape
What is balance billing? You may have heard the term on the news recently. Balance billing is getting national attention because of the large, out-of-pocket expenses some consumers are getting…
Read moreDecember 12, 2019
DSO, What Is It and Why Does It Matter?
What Is It? DSO stands for Days Sales Outstanding. It is also sometimes referred to as Number of Days in Accounts Receivable (AR). Most importantly, it’s a metric or Key…
Read moreJune 24, 2019
What is Ambulance Cost Data Collection?
Since the inception of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Centers for Medicare and Medicaid Services (CMS) has been taking broad strokes to optimize the…
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February 07, 2019
A New Year for Value-Based Oncology Care: Three Things Every Pharma Leader Needs to Know About
For many community oncology practices, 2018 was the year that value-based care became a financial and clinical reality. For example, CMS provided those participating in the Oncology Care Model (OCM)…
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November 28, 2018
OCM Performance Period 2 Results: Practices Still Addressing Performance Gaps and Challenges with CMS Logic
Since this article was originally published, Integra Connect supported OCM-participating oncology providers, practices, and payers for five years and across more than 200,000 patient episodes, representing one of the largest networks…
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November 14, 2018
The 8 Questions EMS Billing Companies are Hoping You Don’t Ask on Your Next RFP
The rising prominence of the Triple Aim has increased pressure on EMS providers to optimize patient satisfaction and reduce healthcare costs – all while still attending to medical emergencies. This…
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June 07, 2018
EMS Revenue Cycle Management JEMS Award
Integra Connect’s Revenue Cycle Management Solution for EMS services has received the JEMS “Hot Product” Award for 2018. The Hot Product award is exclusive to the Journal of Emergency Medical…
Read moreApril 23, 2018
OCM Practices React to Performance Period 1 Results, Plan to Contest MEOS Recoupment
OCM Performance Period 1 Results Revealed an Unwelcome Surprise In February, practices participating in the Oncology Care Model (OCM) program received their Performance Period 1 (PP1) initial reconciliation reports, which…
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February 28, 2018
New Medicare Card’s Impact on Providers & RCM
New Medicare Card Project Impacts Providers In 2015, as part of the Medicare Access and CHIP Reauthorization Act (MACRA), Medicare announced plans to transition the Medicare number from current state…
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December 20, 2017
EMS Pain Assessment
What do you do if you arrive on scene to find a patient who is pale and bordering on delirium in obvious pain? Your training kicks in – all of…
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September 27, 2017
Survey Reveals Specialists Still Unprepared for MACRA
It has been well-documented that many physicians are confused by value-based reimbursement models under the Quality Payment Program – but interestingly enough, little has been discussed about how prepared specialists…
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August 23, 2017
Shifting Culture in Support of Value-Based Care
By now, most physicians are aware of the transition to value-based care (VBC) and the financial ramifications that come with adopting various new reimbursement models. Under MACRA, clinicians must participate…
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August 01, 2017
The Evolving Role of the Specialist in Value-Based Care
Traditionally, primary care physicians (PCPs) have been the designated coordinators of care and the place where the rubber meets the road in population health and accountable care programs. However, for…
Read moreJune 21, 2017
Maximizing Revenue for Specialty Practices
As the healthcare system moves from fee-for-service (FFS) to value-based care, the next milestone comes as we approach 2018 – the first year that physicians will be required to report…
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May 24, 2017
Key Steps for Specialty Practices to Thrive in Value-Based Care
The transition to value-based care has proved challenging for providers of all types. Specialists, however, are faced with completely transforming their practice operations to both comply with and thrive under…
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May 12, 2017
Why 2017 will be the year of the specialist
Healthcare reform efforts over the last five years have brought progress in many areas, but a long road remains ahead. Most notably, specialty care providers have the potential to play…
Read moreMarch 21, 2017
HIMSS17 Recap and Key Takeaways
Another HIMSS is behind us and, with it, the curious combination of exhilaration and exhaustion that only that event can bring. The show floor was typically expansive to the point…
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February 20, 2017
Introducing Integra Connect, Your Platform for Value-Based Specialty Care
The ever-changing health care landscape has providers, payers, and administrators in a whirlwind of confusion. MIPS, MACRA, OCM, APM – the list goes on. The administrative, operational, and technological burdens…
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