White Papers

Learn about the latest regulatory changes affecting risk adjustment and how to ensure accurate risk payments in both business and clinical operations.

For organizations pursuing value-based care and improved population health management, a powerful rules engine is crucial to success. Get the white paper.

By utilizing robust population health management (PHM) technology and systems that assist with identifying gaps in care and pinpointing medication adherence challenges, care teams can focus harder on care transitions and the value-based model.

Behavioral health (BH) conditions affect a significant percentage of the country’s population. Many BH sufferers remain undiagnosed or unable to obtain appropriate care despite this prevalence, but with the right PHM solution, greater health is possible.

Artificial Intelligence (AI) is increasingly leveraged for population health management by healthcare organizations seeking to improve patient care while reducing costs. Used as a predictive tool, AI can identify at-risk and emerging-risk populations, enabling limited clinical resources to target patient populations that will most benefit from — and respond to — hands-on intervention.

As much as 80% of a person’s health is determined by the social and economic conditions of their homes and communities, their Social Determinants of Health (SDOH). Healthcare organizations pursuing value-based care must go beyond standard claims and medical data and integrate data sources that measure SDOH to effectively treat the whole person.

By utilizing robust population health management (PHM) systems that assist with identifying gaps in care and pinpointing medication adherence challenges, care teams can focus harder on care transitions and the value-based model.

FDR’s offer a long list of services to Medicare Advantage (MA) members that includes everything from utilization management (UM) to case management, health risk assessments, behavioral health care, home visits, and more. With each year that passes, that list expands, but the growth can be challenging.

In July of 2021, the Creating Access to Real-time Information Now (CARIN) Alliance released the CARIN Alliance Application Registration Manual (version 0.1), a guide discussing the best practices and recommendations for payers, app developers, and implementers of Fast Healthcare Interoperability Resources (FHIR®)-based APIs.

The CMS’ Advancing Interoperability and Improving Prior Authorization Proposed Rule: A Guide for Payers and Providers. How the new proposed rule will change the payer and provider landscape.

How will AI change the future of care management? Learn about the impact of ChatGPT/AI in Healthcare.