HOW DO MEDICARE ADVANTAGE PLANS WORK

Medicare pays for medically necessary services for most individuals’ age 65 and older. Medicare may also cover those that have received disability benefits from the social security administration, or the railroad board. Traditional Medicare consists of several parts which combine coverage for hospital stays and medical services. Part A covers hospital care, care in a skilled nursing facility, or home health and hospice care services.

Spotlight

Capsa Healthcare

Capsa Solutions, Rubbermaid Healthcare, and Kirby Lester have been fully integrated to form Capsa Healthcare. Collectively, our passion as a single organization is born out of the same commitment and purpose that our customers have to providing superior patient care. We understand the delivery of healthcare cannot wait; our customers rely on our products and support to deliver superior clinical efficiency and medication management accuracy.

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Health Technology, Digital Healthcare

Impact of Incorporating Artificial Intelligence (AI) in the Healthcare Industry

Article | August 16, 2023

As medical science has improved rapidly, life expectancy around the world also has risen. Still, as longevity increases, healthcare systems are facing a growing demand for advanced services, increased costs, and a struggling workforce to meet various requirements of patients. Demand is driven by many unstoppable forces: a shift in lifestyle choices, shifting patient expectations, population aging, and the never-ending cycle of innovation are a few among others. Challenges Faced by the Healthcare Industry According to Mckinsey, one in four people in North America and Europe will be over the age of 65 by 2050. This shows that, soon, the healthcare industry will have to deal with a larger number of patients with more complex requirements. Catering to these patients is expensive and requires health systems for providing long-term focused and proactive care. To remain sustainable, healthcare systems need major transformational and structural changes. The industry also needs a larger workforce because according to the World Health Organization (WHO), globally there is a shortfall of approximately 9.9 million nurses, physicians, and midwives. Apart from attracting, training, and retaining these healthcare professionals, you also have to ensure that their time and effort add value to patient care. Utilizing the solutions powered by modern technologies, such as Artificial Intelligence (AI) in the healthcare industry, will add perfection and more value to human efforts. AI in the healthcare industry has the potential required to transform and revolutionize healthcare by addressing the challenges in the industry mentioned earlier. AI can better the outcomes, improve efficiency, and augment productivity in healthcare delivery. This article takes an in-depth look at the impact of AI in healthcare. Impact of AI in the Healthcare Industry In the coming years, AI in the healthcare industry will improve the day-to-day life of healthcare practitioners, augment the patient experience, improve care delivery, and can even facilitate life-saving treatments and revolutionize the industry. Additionally, AI will improve population-health management, operations, and strengthen innovations. According to Statista, the global AI healthcare market will increase to more than US$28 billion by 2025. Here is a detailed look into the areas where and how AI in the healthcare industry will be impactful. Chronic Care Management Chronic diseases, such as cancer, diabetes, kidney diseases, are the leading cause of disability and death in the US and the main drivers of the country’s annual health cost. Effectively managing various chronic diseases is an overarching and long-term process. But with the help of the right tool, healthcare providers can meet the needs of these patients without delay. Artificial intelligence tools in the healthcare industry can help healthcare providers overcome the complexities of chronic disease management and make it more effective and provide quality treatment. AI in the healthcare industry is increasingly being leveraged by organizations to improve chronic disease management, enhance patient health, and drive down costs, which will also eventually result in data-driven and personalized care. AI in the healthcare industry is expected to move the industry toward proactive care delivery from a reactive one and lead the industry to provide more individualized treatments. This is just one of the ways AI in the medical industry is going to revolutionize chronic care management in hospitals. Care Delivery Artificial intelligence in the healthcare industry is changing the way care is delivered; it is expected to make healthcare more efficient, accurate, and accessible. Reducing costs and improving health outcomes are the values health systems and hospitals are trying to deliver to patients every day. Hospitals are increasingly incorporating technologies, which are powered by the use of AI in healthcare to meet the challenge. According to the American Hospital Association (AHA), AI in the healthcare industry has unlimited potential to solve most of the vexing challenges in the industry. They identify AI use cases in the healthcare industry in four broad areas, which are administrative, operational, financial, and clinical areas. Administrative Use Cases for AI in the Healthcare Industry • Admission procedures • Appointment scheduling • Customer service responses • Discharge instructions • Hiring and orientation protocols • Licensure verification • Patient check-in procedure • Prior authorizations • Quality measure reporting Operational Use Cases of AI in the Healthcare Industry • Inventory management • Materials management • Supply chain management • Facilities management Financial Use Cases for AI in the Healthcare Industry • Billing and collections • Claims management • Insurance eligibility verification • Revenue cycle management Clinical Use Cases of AI in the Healthcare Industry • Predictive technologies • Interventional technologies By incorporating and utilizing these scopes with AI in the healthcare industry, the industry can be transformed into a next-gen level in no time. It also allows healthcare practitioners to focus more on patients, which would eventually help in raising staff morale and improving retention. Clinical Decision Support Recent advancements in AI in the health industry are capable of enhancing the currently used clinical decision support (CDS) tools to have value-based imaging and to improve patient safety. According to the National Institute of Health (NIH), the synergy between CDS systems and AI in the healthcare industry will be able to: • Reduce friction in radiology workflows • Identify relevant imaging features easily • Generate structured data to develop machine learning algorithms • Enable an evolution toward decision support for a holistic patient perspective • Suggest imaging examinations in complex clinical scenarios • Assist in identifying appropriate imaging opportunities • Suggest appropriate individualized screening • Aid health practitioners to ensure continuity of care AI in the healthcare industry is competent in making CDS a next-gen one, enhancing the experiences of radiologists and providers, and improving patient care. Diagnostics Slowly but surely, AI is improving almost every aspect of human life with innovations and advancements. The latest is that AI in the healthcare industry is impending a revolution in medical diagnostics by providing accurate risk assessments, accelerating disease detection, and boosting hospital productivity. By automatically prioritizing urgent cases and accelerating reading time, image recognition AI enhances the workflow of radiologists. It even helps in the prevention of diseases by the early detection of diseases. In medical images such as x-rays, MRIs, and CT scans, AI-driven software can efficiently be used to accurately spot signs of many diseases, especially in detecting many chronic diseases such as cancer. According to the NIH, AI will be widely applied in the healthcare industry especially for various tasks such as patient engagement and adherence, diagnosis, and treatment recommendations. So, there is no doubt that AI in healthcare will revolutionize the diagnostic process in the approaching years by detecting diseases, classifying diseases, and improving the decision-making process. The application of AI in the healthcare industry will make people live longer. Triage and Diagnosis AI can be effectively used to automatically triage cases. AI algorithms will analyze the cases and forward cases to pathologists after determining the priority based on the probability of cases according to the criteria set by labs. This makes the workflow of pathologists easier and efficient. Through the process the algorithm will be able to: • Verify the digital images attached to the case belong to that case • Validate the tests ordered and match the specimen type • Identify cases marked as stat • Determine the cases, which can be positive or are most likely to be negative Moreover, AI technologies in the healthcare industry also can be effectively used to provide more accurate and faster diagnoses. This speeds up the entire process of triage and diagnosis and is expected to revolutionize the healthcare industry soon. The Future Outlook for AI in the Healthcare Industry Over the next few years, AI in the healthcare industry has the best opportunities in hybrid models to support clinicians in diagnosis, identifying risk factors, and in treatment planning. This scope will result in faster adoption of AI technology in healthcare, which will show measurable improvements in operational efficiency and patient outcomes. With a plethora of issues to overcome, which are driven by documented factors such as growing rates of chronic diseases and the aging population, it is obvious that the healthcare industry needs new innovative solutions. AI-powered solutions in the healthcare industry will achieve a clear impact on the global healthcare industry in a short time. Frequently Asked Questions Which is the best application of AI in the healthcare sector? Cognitive surgical robotics is the best application of AI in the healthcare sector as it helps practitioners collect data from real surgical processes, which would help in improving existing surgical approaches. Why is artificial intelligence important in healthcare? Artificial intelligence in healthcare is vital as it can help make decisions, analyze and manage data, and have conversations. So, AI will drastically change the everyday practices and roles of clinicians. When was AI-first used in healthcare? The term, Artificial intelligence (AI) was first described in 1950, but the limitations of the term prevented its acceptance. In the 2000s, these limitations were overcome and people started to accept the term.

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Health Technology

Healthcare Video Marketing: Strategies and Best Practices

Article | September 12, 2023

The healthcare industry is witnessing an unparalleled phase of expansion and vitality. It is a phase of radical revolution due to the wake of digital transformation. Digital transformation has opened up enormous unique opportunities that were unimaginable until a few years back. These digital trends are bringing companies and individuals together. Data is the starting point of the digital revolution. These data are then transformed into relationships. Today, including healthcare companies, the success of every company is at stake. In other words, it is how you communicate with customers that matters. This blog is all about healthcare digital communication, especially healthcare video marketing. We’ll start by looking at data that demonstrates the power and effectiveness of the video marketing medium. There is nothing equal to the power and efficacy of video marketing in our world today. Then, we’ll look at the video marketing best strategies, healthcare video marketing best practices, and successful examples for healthcare video marketing. There’s Nothing More Effective than Video Marketing Here are some numbers that alone demonstrate why video is the most effective marketing medium in the digital age: More than 5 billion videos are viewed on Youtube every day; 78% of online users watch at least one video every week. And 55% watch one every day; According to estimates by Cisco, by 2022, 82% of all internet traffic will be generated by video. This percentage was already 72.3% in 2017; When it comes to video, 55% of people pay more attention than any other type of content; when viewing a video, the average user retains 95% of the message it contains; this percentage goes down to 10% when we talk about the text; about 100 million hours of video watched every day on Facebook; 82% of registered Twitter users consume video content constantly; on Instagram, posts containing video record 38% higher engagement on average than posts containing images; 54% of consumers say they want to see more videos from the brands they follow and support. Such statistics are compelling for brands, and brands are taking notice. As a result, brands are moving to implement videos as much as possible in their marketing strategies, with excellent results. Two statistics below offer additional proof: 87% of marketing professionals use video in their strategy. 88% of marketers are satisfied with the ROI generated by video marketing campaigns. This collection of data proves one thing: video is the most effective tool for healthcare digital marketing. And this also applies to the Healthcare sector. It’s even more accurate for this sector, which is intimately involved with consumers as part of their daily lives. Thus, healthcare video marketing is much effective and should be included in your healthcare marketing plan. Strategies and Best Practices of Healthcare Video Marketing So, let’s take a closer look at how we can build a video marketing strategy in the Healthcare sector, the fundamental points that must be included, the best practices, and some examples of success. Start from education It is often said that we live in the information age. Today, as never before, we have access to all the information we could need in just a few seconds, maybe with just a few taps on our smartphone during a coffee break. Health information is undoubtedly among the most sought-after online. In Italy alone, web searches made on this topic are 4 billion per year, a constantly growing trend. The downside of all of this is the difficulty of finding your way around this mass of information, which is sometimes complex, misleading, or even untrue. That is why the first task of a company in the Healthcare sector is education. Education is not just a responsibility; and it’s also an opportunity. In this sense, healthcare videos marketing prove to be the best ally. Healthcare video marketing is a way to provide the consumer with an effortless way to have access to transparent, precise, and authoritative information from your brand. That can be the first step toward establishing a relationship of trust with your brand. Be clear, but also calm In this case, let’s start immediately with an exciting and practical example. Targeted toward their younger patients, Miami Children’s Hospital created a healthcare video marketing campaign that explains what happens before, during, and after heart surgery. Understandably, this is a sensitive topic. With this effort of healthcare video marketing, the Miami Children’s Hospital manages to achieve the complex objective of providing clear and authoritative information while at the same time reassuring the viewer. How? They make the healthcare video marketing campaign compelling, authoritative, and reassuring by showing the faces of its staff members, demonstrating their professionalism, the environment, the healthcare technologies used, and everything related to the surgery. In this way, the high level of preparation and humanity of the people involved stand out to the viewer. Learn to be engaging As we saw above, you have to know how to correctly inform and educate your audience using influential healthcare video marketing trends, all with a calm demeanor. However, it’s also true that success also depends on your ability to excite and involve the viewer for healthcare video marketing in the sector. In short, the keyword is ‘storytelling. An excellent example is the healthcare video marketing campaign carried out by the dental health department of Bupa UK and addressed to children (but applicable and reachable to adults as well). Through a great use of animations and storytelling, the brand uses the well-known story of the tooth fairy and associates it with childhood memories. This healthcare video marketing campaign has proven to be an excellent vehicle for establishing a truly intimate relationship with the viewer (and, not surprisingly, the video has exceeded 1.3 million views on YouTube). Another effective way to be direct and engaging is to use influencers in your healthcare video marketing campaigns. An exciting example is the Australian pole vaulter, Amanda Bisk, diagnosed with chronic fatigue syndrome. On her Instagram channel, Bisk talks about her path to fight the disease through fitness, and she has quickly become one of the most famous figures in Healthcare on the platform. It’s important to note that today, more and more brands target top influencers and micro-influencers. Micro-influencers have a much smaller yet targeted and loyal following of fans. Therefore, their healthcare video marketing messages are perceived by the public as more authentic and personal. Personalization 94% of marketers believe that personalization is crucial for the future of the business in which it moves. But what do we mean when we talk about personalization? First of all, it’s not something new: knowing your audience has always been the best way to make a profit, calibrate your communication and your “tone of voice,” and increase engagement and loyalty. But what is the turning point of personalization today? It is a digital turning point. Today, we all leave traces online at every moment: geolocation, Google searches, preferences on social networks, apps (which in Healthcare are increasingly widespread), and so on. We are talking about a vast amount of data that benefits both companies and consumers from a win-win perspective. Therefore, it’s a matter of utilizing efficient systems to collect this data, dynamic systems designed with an omnichannel approach in mind. From the collection, the next step is to analyze and interpret this information. Then, you will want to divide your audience into many micro-targets with homogeneous and consistent characteristics to target with tailored communications and offers. In conclusion, these facts are all the more true in a sector like healthcare that impacts people’s daily lives. The best healthcare video marketing strategy for brands can only be to get closer and closer to customers. That is precisely where specialized companies like us, Media7, come into play. Through compelling B2B healthcare video marketing efforts, we create opportunities for interaction and the possibility to insert custom calls to action. FREQUENTLY ASKED QUESTIONS What is a video marketing strategy? Video marketing strategy is creating, curating, and utilizing videos for marketing products and services of companies to the targeted audience. Marketing teams design the strategy. The idea behind the strategy is to keep the audience engaged with the brand. Are videos effective for health tech marketing? Videos are much effective for health tech marketing as people prefer to watch things than reading. Also, people are likely to trust what they see than reading. Videos are the highly impactful medium of marketing for any domain of business, including healthcare. How to start with healthcare video marketing? The first step to healthcare video marketing is to define your video marketing strategy. Fix and analyze the target audience to understand the online behavior trends to get an idea about their video engagements and clicks on various social media channels.

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Health Technology, Digital Healthcare

Six Ways Technology Can Help Dialysis Centers Strengthen Their Revenue Cycle

Article | September 7, 2023

Dialysis providers face many of the same financial and operational pressures that affect other provider organizations, including flat or reduced reimbursements, chronic staffing shortages, and increasingly complex insurance requirements. Dialysis centers, nephrologists, and renal pharmacies also grapple with the impact of a growing shift in dialysis care to the home setting. End-to-End Automation Can Reduce Denials, Improve Cash Flow The good news is that despite these challenges, dialysis providers can sustain strong cash flow, reduce costs, and mitigate denials by applying advanced technology to the revenue cycle. Here are six ways technology can help strengthen the dialysis center revenue cycle in the today’s difficult operating environment: Identify undisclosed insurance coverage Because patients often present as self-pay even though coverage exists, determining their true insurance status can be challenging. Yet failure to identify existing insurance can result in significant write-offs. That’s why renal providers need technology solutions that can uncover patient coverage information before care is provided. Change Healthcare’s Coverage InsightTMsolution provides an expansive network and search-and-matching capabilities necessary to identify and confirm patient coverages at the outset of care. The solution uses machine learning algorithms—coupled with access to vast stores of available third-party-data—to develop robust patient profiles, which can then be linked to potential funding sources. Notably, it identifies a variety of indicators, including high probability of disability, income levels and financial status, insurance sources, and other actionable information to help you verify coverage and recover revenue. We can help identify undisclosed coverage for end-stage renal disease (ESRD) patients through Medicare/Medicaid, Disability/SSI, third-party liability, commercial insurance, state and county programs, social programs, and charity. Expedite seamless prior authorizations Streamlining the prior authorization process is essential to help ensure optimal reimbursement for renal care rendered, particularly with commercial insurance and Medicare. But traditional prior authorization processes are frequently time-consuming and labor-intensive and can delay necessary care. Our Clearance Authorization software addresses the chronic problem of prior authorizations with automated functionality that can determine if prior authorization is required and on file with the payer. The solution also will automatically check medical necessity requirements at the time of registration and electronically submit requests to integrated payers. Change Healthcare’s Connected Authorization Services go a step further by deploying pre-authorization experts to handle routine authorizations quickly using intelligent technology while working complex cases by exception to improve authorization efficiency and accuracy. Speed adjudication with electronic attachments As claims management processes have grown more numerous and complex, providers have struggled to ensure that the correct information is provided to the payer at the appropriate time. The result can be delayed, denied, or rejected claims. Assurance Attach AssistTMcontributes to faster reimbursement and reductions in denials, organizational expense, and administrative burden by automating the attachments process to meet payers’ increased demands for additional documentation. Attachments are automatically delivered and matched to the appropriate claim, and once the claim is released, claim and attachment status can be easily tracked. Expedite claims workflow for recurring services Creating claims for ongoing ESRD care requires repeatedly documenting the same details on each claim. Revenue Performance Advisor, an end-to-end medical billing platform, provides automation that allows dialysis staff to save time by quickly replicating unchanged data from prior visits while updating date-of-service and other information to expedite claims processing. Revenue Performance Advisor also includes eligibility and benefits verification and automated claims scrubbing that flags incomplete or incorrect claims prior to submission, resulting in a first-pass clean claim rate of 98%. Accelerate your Medicare claim cash flow Medicare is one of the largest payers of dialysis services, so ensuring a problem-free and expedited Medicare claims submission process is essential to strong cash flow. Our Assurance Medicare Direct EntryTMsolution provides a single system for the real-time submission and processing of Medicare claims. It can help expedite reimbursement, reduce AR days, and speed your Medicare primary claim cash flow by at least one full business day. Assurance Medicare Direct Entry also checks your Medicare claims for eligibility errors using the CMS eligibility transaction system (HETS). Claims needing attention are flagged and posted in Assurance Reimbursement Management for editing. You can quickly correct errors within the system before transmitting the claim directly to Medicare for validation and payment processing. Optimize patient liability Making it easy for patients to receive, understand, and pay their portion of the medical bill is key to ensuring a healthy revenue cycle, mitigating the need for collection services, and improving patient goodwill. With our Patient Billing and Statements solution, Change Healthcare serves as your strategic communications partner, delivering multi-channel, personalized print and digital statements to help expedite patient payment collection. The solution is designed to provide fast, effective statement and invoice processing, printing, and mailing—cutting your costs and getting you paid sooner. Our advanced statement printing allows you to bypass conventional and time-consuming folding, stuffing, and stamping. SmartPayTMconsolidates each step of the billing and payment process into one place, enabling you to collect more patient payments, get paid faster, reduce your collection costs, and lower patient write-offs. With multiple payment channels, including online, mobile, telephone and via mail, SmartPay helps expedite patient payments before, during, and after the encounter. A single, trusted partner Change Healthcare’s deep knowledge of the renal care landscape and our development of disruptive technologies to overcome traditional revenue cycle barriers can help dialysis centers achieve unprecedented revenue cycle excellence. And unlike many point solutions that only address a specific revenue cycle issue, Change Healthcare’s technologies are part of a comprehensive approach delivered through a single, trusted vendor. That translates into improved process integration and continuity, as well as simpler overall accountability.

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7 Tips: In Managing Your Every Day Stresses and Anxieties

Article | August 27, 2021

Everybody deals with stress and anxiety, however the key is to know what to do when you’re stressed out. It is not always easy to keep your feelings from getting the best of you. With this in mind, here are seven tips that a person can use to help manage their daily stresses and anxieties before they get out of control. 1. Get all of the facts of the situation: Gathering the facts of a certain event can prevent us from relying on exaggerated and fearful assumptions. By focusing on the facts, a person can rely on what is reality and what is not. Most importantly, do not focus on your fearful thoughts when you’re stressed out. 2. Take a break: Sometimes, we get stressed out when everything happens all at once. When this happens, a person should take a deep breath and try to find something to do for a few minutes to get their mind off of the problem. A person could take a walk, listen to some music, read the newspaper, or do an activity that will give them a fresh perspective on things. 3. Carry a small notebook of positive statements with you: Another technique that is very helpful in managing fear is to have a small notebook of positive statements that makes you feel good. Whenever you come across an affirmation that relaxes you, write it down in a small notebook that you can carry around with you in your pocket. Whenever you feel depressed, open up your small notebook and read those statements. 4. You can’t predict the future: While the consequences of a particular fear may seem real, there are usually other factors that cannot be anticipated and can affect the results of any situation. We may be ninety-nine percent correct in predicting the future, but all it takes is for that one percent to make a world of difference. 5. Challenge your negative thinking with positive statements and realistic thinking: When encountering thoughts that make you fearful or depressed, challenge those thoughts by asking yourself questions that will maintain objectivity and common sense. Focus on the reality of your situation and not on your thoughts. Your fearful thoughts can make things worse so try to focus on something positive when you get anxious. 6. Divide your activities into separate steps: When facing a current or upcoming task that overwhelms you with a lot of anxiety, divide the task into a series of smaller steps and then complete each of the smaller tasks one step at a time. Completing these smaller activities will make the stress more manageable and increases your chances of success. 7. Take advantage of the help that is available around you: There are many individuals who have been expertly trained in the field of psychology to help you find ways to manage fear and anxiety. Seek out someone whom you trust to provide sound advice and guidance. This same professional can also help you create an action plan for dealing with your fears and anxieties in the future.

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Spotlight

Capsa Healthcare

Capsa Solutions, Rubbermaid Healthcare, and Kirby Lester have been fully integrated to form Capsa Healthcare. Collectively, our passion as a single organization is born out of the same commitment and purpose that our customers have to providing superior patient care. We understand the delivery of healthcare cannot wait; our customers rely on our products and support to deliver superior clinical efficiency and medication management accuracy.

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Digital Healthcare

TRC Healthcare Teams Up with Pharmacy Quality Solutions on Pharmacy Continuing Education Podcasts

TRC Healthcare | October 12, 2021

TRC Healthcare, a top provider of evidence-based medication advisory resources for clinicians announced a partnership with Pharmacy Quality Solutions (PQS), a leading technology provider of pharmacy performance management services. Along with PQS, TRC Healthcare will offer a pilot program for pharmacy continuing education (CE) through the PQS podcast, the PQS Quality Corner Show. The first podcast episode available for CE debuted August 2021 in TRC Healthcare's Pharmacist's Letter. With the pilot program, TRC Healthcare is exploring expansion of its CE channels with the inclusion of audio podcasts. Listeners of the PQS Quality Corner Show have the ease of podcast learning with the ability to earn CE credits through the Pharmacist's Letter website. "Our research has shown that many pharmacists are eager to explore different ways to digest CE content, and podcasts were at the top of the list. PQS is a leader in pharmacy quality and education and has developed a solid podcast listenership. We are very much aligned to make it more convenient for our pharmacy audience to access content on the go. We are excited to work with PQS in this endeavor." Wes Crews, CEO of TRC Healthcare The first set of episodes available for CE credit covers the topic of immunizations and can be downloaded on all major streaming services. "In our efforts to make each one of our episodes better than the last, we are pleased to evolve our content in 2021 and work with TRC Healthcare to provide continuing education for pharmacists. As our show has always been about education and improvement on quality, we have purposefully structured our show to follow a CE seminar format where we ask key questions and help our audience learn essential details." Quality Corner Show Host and PQS Senior Manager of Pharmacy Accounts, Nick Dorich, PharmD The second set of episodes covers geriatric care and is available on the Pharmacist's Letter and the Quality Corner Show. About TRC Healthcare TRC Healthcare (TRC) is a premier source of lifelong learning solutions for healthcare professionals. TRC is most recognized for their education and CE offerings within the highly-regarded Pharmacist's Letter, Prescriber's Letter, and Pharmacy Technician's Letter. TRC also offers Pharmacy Technicians University, the leading online training program for pharmacy technicians. The Natural Medicines database makes it easy for subscribers to find unbiased, evidenced-based research about alternative drug therapies. Through the acquisition of CriticalPoint and NetCE, TRC Healthcare recently expanded its offerings. CriticalPoint increases patient safety through a variety of educational compounding offerings concentrating on USP 797, 800, and 795. NetCE is an industry-leading, continuing-education platform, specializing in continuing education across multiple professions including nurses, physicians, and mental health. These additions give TRC Healthcare the industry's largest catalog of continuing education and advisory services, with thousands of courses trusted by healthcare professionals to provide accredited training that meets continuing education and licensing requirements. About Pharmacy Quality Solutions, Inc. (PQS) PQS is a healthcare quality technology company, connecting healthcare payers and providers who value measurement as the pathway to better patient outcomes. Partners of PQS represent nearly 90% of all Medicare Part D lives and 95% of community pharmacies. PQS delivers quality insights and guidance to support their customers' efforts to optimize the quality of medication management and use for their Medicare, Medicaid and commercial populations. PQS' industry-leading platform, EQUIPP®, provides standardized measurement and reporting on key medication use quality measures and value-based reimbursement programs focused on medication adherence, treatment outcomes and patient safety.

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Aetna and Oak Street Health want to help Medicare patients

Oak Street Health | August 03, 2017

Primary care for Medicare patients shouldn’t be so difficult right? That’s what Aetna and Oak Street Health think. The two are teaming up to improve care for said patient population in Illinois. Through their partnership, Chicago-based Oak Street will be able to see Aetna Medicare Advantage PPO and HMO patients. Currently, the agreement only applies to those living in Illinois. Founded in 2012 by three former members of the healthcare practice at The Boston Consulting Group, Oak Street operates 24 primary care clinics throughout Illinois, Indiana and Michigan. Thirteen of them are in Illinois.

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Whistleblowers: United Healthcare Hid Complaints About Medicare Advantage

United Healthcare | July 28, 2017

United Healthcare Services Inc., which runs the nation’s largest private Medicare Advantage insurance plan, concealed hundreds of complaints of enrollment fraud and other misconduct from federal officials as part of a scheme to collect bonus payments it didn’t deserve, a newly unsealed whistleblower lawsuit alleges. The suit, filed by United Healthcare sales agents in Wisconsin, accuses the giant insurer of keeping a dual set of books to hide serious complaints about its services and of being intentionally ineffective at investigating misconduct by its sales staff.

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Digital Healthcare

TRC Healthcare Teams Up with Pharmacy Quality Solutions on Pharmacy Continuing Education Podcasts

TRC Healthcare | October 12, 2021

TRC Healthcare, a top provider of evidence-based medication advisory resources for clinicians announced a partnership with Pharmacy Quality Solutions (PQS), a leading technology provider of pharmacy performance management services. Along with PQS, TRC Healthcare will offer a pilot program for pharmacy continuing education (CE) through the PQS podcast, the PQS Quality Corner Show. The first podcast episode available for CE debuted August 2021 in TRC Healthcare's Pharmacist's Letter. With the pilot program, TRC Healthcare is exploring expansion of its CE channels with the inclusion of audio podcasts. Listeners of the PQS Quality Corner Show have the ease of podcast learning with the ability to earn CE credits through the Pharmacist's Letter website. "Our research has shown that many pharmacists are eager to explore different ways to digest CE content, and podcasts were at the top of the list. PQS is a leader in pharmacy quality and education and has developed a solid podcast listenership. We are very much aligned to make it more convenient for our pharmacy audience to access content on the go. We are excited to work with PQS in this endeavor." Wes Crews, CEO of TRC Healthcare The first set of episodes available for CE credit covers the topic of immunizations and can be downloaded on all major streaming services. "In our efforts to make each one of our episodes better than the last, we are pleased to evolve our content in 2021 and work with TRC Healthcare to provide continuing education for pharmacists. As our show has always been about education and improvement on quality, we have purposefully structured our show to follow a CE seminar format where we ask key questions and help our audience learn essential details." Quality Corner Show Host and PQS Senior Manager of Pharmacy Accounts, Nick Dorich, PharmD The second set of episodes covers geriatric care and is available on the Pharmacist's Letter and the Quality Corner Show. About TRC Healthcare TRC Healthcare (TRC) is a premier source of lifelong learning solutions for healthcare professionals. TRC is most recognized for their education and CE offerings within the highly-regarded Pharmacist's Letter, Prescriber's Letter, and Pharmacy Technician's Letter. TRC also offers Pharmacy Technicians University, the leading online training program for pharmacy technicians. The Natural Medicines database makes it easy for subscribers to find unbiased, evidenced-based research about alternative drug therapies. Through the acquisition of CriticalPoint and NetCE, TRC Healthcare recently expanded its offerings. CriticalPoint increases patient safety through a variety of educational compounding offerings concentrating on USP 797, 800, and 795. NetCE is an industry-leading, continuing-education platform, specializing in continuing education across multiple professions including nurses, physicians, and mental health. These additions give TRC Healthcare the industry's largest catalog of continuing education and advisory services, with thousands of courses trusted by healthcare professionals to provide accredited training that meets continuing education and licensing requirements. About Pharmacy Quality Solutions, Inc. (PQS) PQS is a healthcare quality technology company, connecting healthcare payers and providers who value measurement as the pathway to better patient outcomes. Partners of PQS represent nearly 90% of all Medicare Part D lives and 95% of community pharmacies. PQS delivers quality insights and guidance to support their customers' efforts to optimize the quality of medication management and use for their Medicare, Medicaid and commercial populations. PQS' industry-leading platform, EQUIPP®, provides standardized measurement and reporting on key medication use quality measures and value-based reimbursement programs focused on medication adherence, treatment outcomes and patient safety.

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Aetna and Oak Street Health want to help Medicare patients

Oak Street Health | August 03, 2017

Primary care for Medicare patients shouldn’t be so difficult right? That’s what Aetna and Oak Street Health think. The two are teaming up to improve care for said patient population in Illinois. Through their partnership, Chicago-based Oak Street will be able to see Aetna Medicare Advantage PPO and HMO patients. Currently, the agreement only applies to those living in Illinois. Founded in 2012 by three former members of the healthcare practice at The Boston Consulting Group, Oak Street operates 24 primary care clinics throughout Illinois, Indiana and Michigan. Thirteen of them are in Illinois.

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Whistleblowers: United Healthcare Hid Complaints About Medicare Advantage

United Healthcare | July 28, 2017

United Healthcare Services Inc., which runs the nation’s largest private Medicare Advantage insurance plan, concealed hundreds of complaints of enrollment fraud and other misconduct from federal officials as part of a scheme to collect bonus payments it didn’t deserve, a newly unsealed whistleblower lawsuit alleges. The suit, filed by United Healthcare sales agents in Wisconsin, accuses the giant insurer of keeping a dual set of books to hide serious complaints about its services and of being intentionally ineffective at investigating misconduct by its sales staff.

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