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ZeOmega is kicking off a new blog series on risk adjustment to look at where we’ve been, what we’re facing today, what’s on the horizon, and how to best prepare. Over the next several weeks, our ZeOmega risk adjustment solution experts will provide a forecast of regulatory change

FHIR stands for Fast Healthcare Interoperability Resources. Learn about FHIR-based APIs hosted by payers and how this impacts access to health information.

See how new technologies enable nurse informaticists, health plans, providers, and community-based resource organizations to improve processes.

Let's take a look ChatGPT, what is unique about it, why it’s different this time, and the potential benefits in healthcare.

For any areas of healthcare where blocks of text are present, ChatGPT can offer a myriad benefits. See more.

We are living in turbulent times. On global and local levels, threats of force, and actual violence, are present almost everywhere we look. While many of us are fortunate or even privileged, no one with a conscience can ignore and not be troubled by the events around us.

Medicaid is the largest health insurance program in the U.S., covering approximately one in five Americans. That equates to 82.3 million low-income Americans, including millions of children, older adults, people with disabilities, and two million veterans. Medicaid is the single

Claw Backs and Beneficiary Protections in the Form of CMS Regulatory Changes – Massive Financial Implications

Much of the direction of the 2020 proposed rule is in the new proposed rule, particularly the sharing of prior authorization decisions/status with patients.

The Centers for Medicare and Medicaid (CMS) released the 2024 Medicare Advantage Proposed Rule on December 14, 2022 and the 957 page document is scheduled to enter the federal register on December 27th, 2022.

The® Centers for Medicare and Medicaid (CMS) released the 2024 Medicare Advantage Proposed Rule on December 14, 2022 and the 957 page document is scheduled to enter the federal register on December 27th, 2022.

To reduce the burden of the prior authorization, many providers and payers have come together to develop solutions. Learn more.

Contact rates for case managers were better than 50%, yet actual enrollment in our programs was less than 10%.

Member engagement has been a crucial component within the healthcare industry, and it is growing in importance.

Measure year 2022 saw record-breaking numbers of Medicare Advantage (MA) health plans achieving five-Star Ratings, but with pandemic adjustments—which focused on pre-COVID-19 data.

The prior authorization process is often viewed as a burden by providers, necessitating staff resources and delaying care. Generally, the experience is considered abrasive.

There has been a lot of talk about the cost of care, but what really is the “cost of care,” and can it be reduced? I propose striving to reduce the cost of care is a misunderstood concept.

What’s the difference between customization and personalization, and what does that have to do with enterprise-grade population health management applications?

Common wisdom holds that data is the critical component of population health. The key to success, however, comes from identifying relationships and meaning within the data that affect both broad populations and individuals within those populations.

One of the most significant challenges for population health programs is understanding how to connect macro-level population health patterns to engage people within those populations.

opulation health initiatives aim to help patients maintain optimal health and ultimately save money by managing and preventing disease.

It’s no secret that the Quadruple Aim – healthcare’s holy grail of reducing costs, improving population health, enhancing patient engagement, and improving the experience for healthcare providers.