Daniel Gentry

Connecting providers statewide = better care and fewer unnecessary ED visits. With PointClickCare’s ED Optimization solution, Virginia Health Information (VHI) has achieved a 10% year-over-year reduction in ED utilization for patients visiting five or more times. By giving ED teams real-time visibility into patient history and care coordination data, VHI is empowering providers across the state to deliver faster, more informed care. ➡️ Learn more about how ED Optimization is driving better outcomes: http://bit.ly/4mlFB66 #CareCoordination #HealthIT #ValueBasedCare #HealthcareInnovation

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The future of healthcare revenue cycle management isn’t just automated—it’s agentic. Our new white paper explores how intelligent digital agents are transforming RCM through autonomy, adaptability, and real-time decision-making. Discover how to build a digital workforce that reduces denials, accelerates collections, and scales with your team. Download now: https://hubs.ly/Q03Fdrws0

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The 2026 CMS Final Notice brings both opportunity and increased complexity for Medicare Advantage plans. Coding accuracy, documentation standards, and operational alignment are all under greater scrutiny, making proactive risk adjustment strategy critical for long-term success. Our latest blog breaks down what plans need to know: https://lnkd.in/e5XkuNjG #AlwaysElevating #CMSFinalNotice #MedicareAdvantage #RiskAdjustment

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Care gaps aren’t just a clinical problem— they create real risks for patients and financial strain for your practice. The Veradigm Network connects EHR data, payer claims, and life-science insights in one platform to help you identify and address care gaps in real time. With automated workflows and embedded recommendations, your team can act faster and support better outcomes. Say goodbye to disconnected tools. Start closing gaps with a smarter, more unified approach. Learn more: https://okt.to/0nYZGQ

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Not all risk adjustment programs are created equal—and among payers, providers, and vendors, the level of understanding of those programs varies wildly. In this blog post, Edifecs Senior Solution Consultant Betty Stump takes a closer look at the three most common risk adjustment programs and the differences between each: https://lnkd.in/e_95V9NY #riskadjustment #providers #healthcaredata

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Tomorrow, Russell Teague teams up with healthcare industry leaders Jeff Hatfield, Mel J. Tobias, MBA, PMP®, Phil Gansz and Timothy Freedman at the HIMSS Georgia Chapter/GHA symposium to discuss best practices for EHR implementations. The panel will discuss how a proper security strategy can turn potential disruptions into seamless transformations. #HealthcareInnovation #EHR #HealthcareSecurity

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In celebration of #BlackHistoryMonth, Keith Leaphart, DO, MBA, EVP, Humana Chief Health Equity & Community Impact Officer at Jefferson, shares his perspective on how Jefferson ensures that healthcare is accessible and tailored to meet the needs of all communities. "At Jefferson, we are committed to ensuring everyone feels a true sense of belonging—whether they are our colleagues, patients, students, health plan members, or community members. Health disparities—such as unequal access to care or barriers related to spoken language, food security, or housing—can lead to worse health outcomes for many people. We address these unique needs by providing interpreters for patients with language barriers, offering affordable health plans, and partnering with hundreds of community-based organizations. We also equip our staff and students with the training and tools they need to deliver person-centered care, ultimately improving health outcomes for our communities."

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In a changing healthcare landscape, compliance isn’t just a checkbox—it’s a pathway to innovation. Payers are looking at the latest healthcare data sharing regulations as an opportunity to pivot to drive digital transformation and meet strategic business goals. Learn about this pivot to innovation: https://cnx.li/sdbLD

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If your MSSP ACO isn’t proactively preparing for 2025 eCQM reporting, you risk quality scores—and shared savings. Dive into our guide for step-by-step strategies, breaking down how to consolidate data from multiple EHRs, identify quality gaps, generate compliant QRDA-III & JSON files, and so much more. Learn what’s at stake and how to succeed with these six simple steps: https://okt.to/bjnAPs #eCQM #MSSP #ACOs #QualityReporting #ClinicalData

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💡 For health plans addressing CMS-0057-F requirements, it's important to understand that implementing the necessary FHIR APIs is just the beginning. 🔍 Underneath the surface of the initial requirements are hidden complexities–but also ample opportunities for prior authorization innovation. Learn more below about some of the key areas plans should focus on, then dive deeper in the blog 👉 https://lnkd.in/ecAabc9x.

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Another Blue Cross Blue Shield plan has joined the growing list of payers modernizing prior authorization with Availity’s Intelligent Utilization Management! With 76% of authorizations approved in under 20 seconds, this isn’t just digital transformation—it’s a new standard for transparency, speed, and control. Read how Availity is helping reshape utilization management: https://ow.ly/skuZ50VVcti #HealthcareInnovation #PriorAuth #Availity #HealthTech

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ICYMI, our Senior Director of Continuous Improvement & Automation, John Hataway, was quoted alongside other RCM experts in a piece from Healthcare IT Today on the importance of automation. Read his thoughts and more insights in the full article: https://bit.ly/3G7zxih #HealthcareITToday #HealthcareNews #RCMAutomation #SavistaRCM

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Do you understand the difference between BPO, TPA, and BPaaS? Each model offers unique benefits and challenges that significantly impact your health plan's long-term strategy and efficiency. For a deeper dive into these critical operational models, check out Raj Sundar's white paper. 🔗 https://lnkd.in/eQwyqMuJ Gain the insights you need to find the best fit for your organization. Contact UST HealthProof today to understand how these models can unlock your health plan's full operational value. #OperationalStrategy #BPaaS #HealthcareOperations #USTHealthProof

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AI is becoming an essential tool for health plans to tackle claims processing challenges. AI-driven DRG solutions like the HealthEdge Source™ DRG Guide helps payers detect claims errors earlier, reduce the need for rework, and limit compliance risks. See how the DRG Guide is already enhancing efficiency and streamlining claims processing for early adopters: https://ow.ly/9l5050WolYf

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How do you support affiliated providers who operate on dozens of different EHR systems while maintaining quality care standards? 💡 Claire Angley from Orlando Health found the answer: deliver meaningful insights from claims, clinical, and transactional data directly into providers' native workflows. Her team's approach to real-time data sharing has strengthened their network's ability to drive quality initiatives across all participating practices. 🚀 Discover how Innovaccer helped Orlando Health unify patient data across Florida's largest clinically integrated network: https://lnkd.in/gCkHsekS #VBC #PopulationHealth #HealthcareInnovation Brandon J. Burket, MHA | Robyn Bartek

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📣 ATA Member News: NCQA Releases Virtual Care White Papers for Payers and Care Delivery Organizations Before the pandemic, just 1% of outpatient visits were virtual. Today, it’s 10%—and rising. A series of NCQA white papers explores how payers and care delivery organizations can meet this growing demand by designing and implementing high-quality virtual care programs that are scalable, sustainable, and patient-centered. Whether you're refining your current approach or building from the ground up, these insights offer a roadmap to success. 🔗 https://lnkd.in/e_N7mW_5 #VirtualCare #Telehealth #DigitalHealth #HealthEquity #CareDelivery #HealthcareInnovation

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Staying on track with interoperability and ePA 🏁 🏎️ HTI-1 and HTI-2 interoperability regulations and CMS-0057-F electronic prior authorization final rule are coming. Is your EHR future-proofed and ready to roll? Our compliance racetrack puts each deadline in perspective and offers next steps for compliance, including: ☑️ Breaking down data silos with FHIR-based APIs ☑️ Implementing real-time ePA to avoid administrative slow downs ☑️ Putting data privacy and security strategies into overdrive Get the guide here ➡️ https://bit.ly/3HwbKcc

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