Insights from the minds at Cognosante

Interoperability Part 2: Data Sharing to Improve Patient Experience

Achieving a fully interoperable healthcare system requires solving complex data challenges. As a founding member of the Da Vinci Project, Cognosante works with industry partners to build the foundation for smooth and safe movement of patient data throughout the healthcare system.   Currently, the Da Vinci Project team is working to enable prior authorization review and approval in […]
Data and Technology, Federal health programs, State health and human services

Interoperability Part 1: Addressing Complex Data Challenges Across the Healthcare System

One of the most complex data challenges in healthcare is interoperability. Data standards can improve the way we experience healthcare, but that means taking numerous stakeholders, multiple data standards, and transmission of large amounts of clinical and administrative data into consideration.  During these emergent times of COVID-19 pandemic management, it’s critical to ensure data moves […]
Data and Technology, Federal health programs, Military and Veterans' health, State health and human services

Effective Medicaid Consumer Engagement: Thinking Outside the Box

Person-centered approach Many individuals enrolled in Medicaid also access services from other state human services agencies and community-based providers. Deploying a “whole person” approach for enrollees—supported by modern tools and one-to-one support—can increase beneficiary engagement while lowering a state’s overall costs and administrative burden. The Medicaid landscape is changing Since implementation of the Affordable Care […]
State health and human services

Advancing payment reform with effective state health information exchange

Throughout the healthcare system, payers are shifting away from payment models that incentivize volume of services to models that incentivize quality, outcomes, and savings. Efforts to transform healthcare through value-based payment reform can be seen in state Medicaid managed care contracts that incentivize outcomes, delivery system reform efforts under Medicaid demonstration projects, State Innovation Model (SIM) efforts […]
State health and human services

National provider call center delivers exceptional customer support to provider community

Healthcare providers have been required to enroll in many disparate programs to provide and be reimbursed for services under Federal, state, and commercial healthcare plans. The move to a National Provider Identifier (NPI) and the enactment of legislation like the Health Information Technology for Economic and Clinical Health (HITECH) Act have increased the need for […]
Federal health programs, State health and human services

Modernizing Medicaid managed care

The “mega” Medicaid managed care rule released this spring by the Centers for Medicare and Medicaid Services (CMS) set in motion a long-overdue overhaul of managed care programs in Medicaid and the Children’s Health Insurance Program. As managed care plans oversee larger percentages of enrollees and benefits, the pressure on state Medicaid agencies to ensure […]
Federal health programs, State health and human services