Healthcare Insights & Innovation
Expert analysis on healthcare technology, reimbursement strategies, and policy developments.
Pediatric vs. Adult Care Coordination: Key Differences
Pediatrics leans on schools and immunizations; adult care focuses on chronic disease and Medicare rules—tailor workflows accordingly.
Avoiding HIPAA Pitfalls in Information Sharing
“Minimum necessary” is rule #1—verify identity, avoid PHI in subject lines, and report breaches immediately.
Care Coordination Software: Must-Have Features Checklist
Demand task assignment, time stamps, risk-score integration, HIE feeds, and secure messaging; predictive analytics is a nice bonus.
Optimizing Staffing Models for Care Coordination
Match license to task—RNs for clinical judgment, LPNs for protocols, MAs for paperwork—to expand capacity without ballooning payroll.
Navigating Risk Contracts & Value-Based Metrics
Know your attribution list, track cost and quality monthly, and flag outliers early so shared-savings payouts aren’t a surprise.
Motivational Interviewing Techniques for Care Managers
Replace advice-giving with Engage-Focus-Evoke-Plan questions that elicit intrinsic motivation and respect autonomy.
Embedding Health Equity into Care Planning
Tailor interventions by language, culture, and access barriers, then track outcomes by demographics to close hidden gaps.
Post-Discharge Calls within 48 Hours: A How-To Guide
One scripted call—clarify meds, flag symptoms, schedule follow-ups—can slash readmissions by up to 30 %.
Telehealth Workflows: Seamless Virtual Care Coordination
Pre-visit tech checks, MA “virtual rooming,” and backup phone numbers turn potential no-shows into successful virtual visits.
Partnering with Community Resources for Better Outcomes
Treat CBOs like specialists: track outcomes, share metrics, and host quarterly lunches to build trust and speed emergency referrals.
Running Efficient Interdisciplinary Case Conferences
Five patients × ten minutes: share data, brainstorm, assign tasks, recap by email—structure prevents “coffee-chat creep.”
Managing High-Utilizer Patients: Proven Coordination Tactics
The top 5 % drive half of costs. Assign RN coordinators, schedule monthly check-ins, and give patients a direct line to curb panic ED visits.
Population Health Dashboards: Visualizing Data for Action
Sparklines and color-coded flags turn raw spreadsheets into morning-huddle motivation and real-time accountability.
Time-Tracking & Billing Compliance Tips for Care Teams
Use EHR timers or stopwatch apps, round to the nearest minute, and batch-sign daily to keep MAC auditors happy.
Care Coordination Documentation Standards That Save Time
Write notes like relay batons—problem-oriented headings and timestamped tasks—so auditors and teammates can follow the hand-off.
Secure Messaging & Patient Portals: Boost Engagement Safely
Portals are 24/7 extensions of care—standardize reply times, tag quick actions, and keep PHI out of subject lines for HIPAA-safe efficiency.
Using Health Information Exchanges to Reduce Readmissions
Subscribe to ADT feeds, auto-task coordinators for 24-hour outreach, and act on real-time data to cut readmissions.
Medication Reconciliation: Best Practices After Transitions
Verify pill bottles, reconcile e-prescribing fills, document changes, and share an updated list with caregivers to end “mystery meds.”
Social Determinants of Health: Screening & Action Steps
Screen with PRAPARE or CMS-HRSN, embed findings in the care plan, and keep a dynamic resource directory—screening without action breeds frustration.
Remote Patient Monitoring Protocols for Primary Care
Connected glucometers, BP cuffs, and scales feed data into a red-yellow-green dashboard so nurses act quickly instead of drowning in numbers.
Annual Wellness Visits: Turning AWVs into Care-Coordination Wins
AWVs are gap-closing powerhouses—update risks, launch CCM enrollment, and trigger screenings from a templated workflow.
Pediatric vs. Adult Care Coordination: Key Differences
Pediatrics leans on schools and immunizations; adult care focuses on chronic disease and Medicare rules—tailor workflows accordingly.
Integrating Behavioral Health into Primary Care: BHI 101
Embed a behavioral-health manager and consulting psychiatrist, screen with PHQ-9/GAD-7, and huddle weekly so warm hand-offs feel seamless—not siloed.
Transitional Care Management (TCM) Workflow Checklist
The TCM clock starts at discharge: phone call within 48 h, face-to-face in 7/14 days. A templated checklist (meds, red flags, follow-ups) keeps teams on track.
Medicare Chronic Care Management (CCM): A Clinic Guide
CCM promises 20+ non-face-to-face minutes monthly for patients with two or more chronic conditions—document time like billable hours and avoid double-counting with TCM or BHI.
Closing Referral Loops: Strategies for Faster Follow-Up
A loop closes only when the specialist note returns, is reviewed, and next steps reach the patient; automate 7- and 14-day alerts so paperwork never stalls care.
How to Create Comprehensive Care Plans that Work
A living care plan—single EHR tab, SMART goals, printable summary—guides every transition and prevents “stale-plan syndrome.”
Patient Risk Stratification: Tools & Techniques for Clinics
Layer claims algorithms, EHR flags, and provider intuition to label patients low, rising, or high risk—so outreach time goes where it matters most.
Care Coordination and Health Equity: Closing the Gaps for High-Risk Populations
Care Coordination and Health Equity: Closing the Gaps for High-Risk Populations
From Data to Action: Using EHRs to Drive Coordinated Care
From Data to Action: Using EHRs to Drive Coordinated Care
Using an EHR for Care Management? It Will Cost You.
Repurposing an EHR for care management ultimately costs providers in various direct and indirect ways.
Using an EHR for Care Management? It Will Cost You.
Repurposing an EHR for care management ultimately costs providers in various direct and indirect ways.
Reimbursable Services That Help Patients with Cognitive Impairment
These services present reimbursable opportunities to support patients living with cognitive impairment.
Reimbursable Services That Help Patients with Cognitive Impairment
These services present reimbursable opportunities to support patients living with cognitive impairment.
Value-based Care Must Evolve to Manage Multiple Chronic Conditions
A disease-centered approach often fails in value-based care. Active participation is vital to provider success.
Value-based Care Must Evolve to Manage Multiple Chronic Conditions
A disease-centered approach often fails in value-based care. Active participation is vital to provider success.
Medicare ACOs Leverage Telehealth to Manage Costs and Share in Savings
Telehealth helps Accountable Care Organizations deliver timely access while Remote Patient Monitoring provides continuous engagement.
Medicare ACOs Leverage Telehealth to Manage Costs and Share in Savings
Telehealth helps Accountable Care Organizations deliver timely access while Remote Patient Monitoring provides continuous engagement.
How Medicare ACOs Can Overcome Care Management Challenges
Care management aligns with the Medicare ACO model's fundamental goals and incentives.
How Medicare ACOs Can Overcome Care Management Challenges
Care management aligns with the Medicare ACO model's fundamental goals and incentives.
How to Effectively Manage Hyperlipidemia
In this video, we'll discuss how care management programs can work together to educate, manage, and support hyperlipidemia patients.
How to Effectively Manage Hyperlipidemia
In this video, we'll discuss how care management programs can work together to educate, manage, and support hyperlipidemia patients.
How Does Advanced Primary Care Management Compare to CCM and PCM?
Providers deciding whether to offer Advanced Primary Care Management, a new Medicare program, may be confused about how it relates to existing programs.
The Pendulum Swings: Are Physicians Returning to Independent Practice?
The number of independent practice acquisitions has slowed. More physicians seem to be retaining ownership.
How to Optimize Care Management Workflows
There's a science, discipline, and skill behind optimizing care management workflows.
Understanding Advanced Primary Care Management (APCM): Rules, Requirements, and Billing Explained
Advanced Primary Care Management is a program designed to enhance primary care delivery while supporting the transition from fee-for-service to value-based care.
How Care Teams Can Enhance Patient Engagement
Managing chronic conditions depends on a care team's abilities to effectively engage patients.
How ThoroughCare's Clinical Advisory Team Helps Providers Use AI
Leveraging AI-powered care coordination tools maximizes the value of every patient interaction.
How to Classify Your Healthcare AI Algorithm: Assistive, Augmentative, or Autonomous?
Understanding the AMA's classification framework and its impact on reimbursement, regulatory pathways, and market adoption. A practical guide for healthcare AI developers and entrepreneurs.
The Day Our AI Failed: A Healthcare Startup Survival Guide
A personal account of how a promising healthcare AI startup learned the hard way that technical excellence alone isn't enough. Learn from our journey and avoid the same mistakes.
The AI Reimbursement Pyramid: Navigating FDA, CPT, and CMS for Success
Master the three-tiered approach to healthcare AI commercialization: FDA approval, CPT coding, and CMS coverage. A strategic guide for healthcare innovators and developers.
The Day Our AI Failed: A Healthcare Startup Story
A personal account of how a promising healthcare AI startup learned the hard way that technical excellence alone isn't enough. Learn from our journey and avoid the same mistakes.
How to Classify Your Algorithm: Assistive, Augmentative, or Autonomous?
Understanding AMA's definitions and their impact on reimbursement. A practical guide for healthcare AI developers.
The AI Reimbursement Pyramid: FDA, CPT, CMS
Understanding the hierarchy of healthcare AI legitimacy: from FDA approval to CPT codes to CMS coverage. Learn how to navigate each level for success.
Building Your Healthcare AI Moat: Reimbursement as a Competitive Advantage
Learn how mastering healthcare reimbursement creates an unbeatable competitive advantage in the AI healthcare market. Practical strategies for building and maintaining your market position.
Building Your Healthcare AI Moat: Reimbursement as a Competitive Advantage
Learn how mastering healthcare reimbursement creates an unbeatable competitive advantage in the AI healthcare market. Practical strategies for building and maintaining your market position.
The Missing Moat: Why Reimbursement Is the Ultimate Competitive Advantage
In an era where AI models are increasingly commoditized, discover why mastering the reimbursement landscape creates an unassailable competitive advantage.
Building an Unbeatable Healthcare AI Business: The Revenue Moat Strategy
Discover how focusing on revenue infrastructure creates an unbeatable competitive advantage in healthcare AI. A strategic guide to building and maintaining market leadership.
From Code to Claims: A Developer's Guide to Healthcare AI Success
Join a senior developer's journey through the complexities of healthcare AI implementation. Learn how to bridge the gap between technical excellence and business success.
Beyond FDA Approval: A Complete Guide to Healthcare AI Market Success
Discover why FDA approval is just the beginning for healthcare AI. Learn the critical steps for achieving market success, from regulatory compliance to reimbursement and clinical adoption.
FDA ≠ PMF: Why Approval Doesn't Mean Adoption
FDA clearance without CPT coverage is like having a powerful engine without fuel. Learn why regulatory approval alone doesn't guarantee market success.
Beyond FDA Approval: A Complete Guide to Healthcare AI Market Success
Discover why FDA approval is just the beginning. Learn the critical steps for achieving true market success with your healthcare AI solution, from regulatory compliance to market adoption.
Healthcare AI Reimbursement Guide: Essential Steps for Scaling Your Solution
Master healthcare AI reimbursement with our comprehensive guide covering CPT codes, billing pathways, and revenue optimization strategies for 2025 and beyond.
Healthcare AI Reimbursement Guide: Essential Steps for Scaling Your Solution
Learn how to successfully integrate your healthcare AI solution into existing reimbursement frameworks. A comprehensive guide covering CPT codes, billing pathways, and revenue optimization strategies.
If It Doesn't Bill, It Doesn't Scale
Most AI health startups fail not from poor science, but from lack of integration into reimbursement infrastructure. Learn why billing infrastructure is crucial for scaling healthcare AI.
The Hidden Truth About Healthcare AI Success: A Founder's Journey
Follow one founder's eye-opening journey from FDA approval celebration to the stark reality of healthcare monetization. Learn the critical lessons that could save your AI startup.
The Future of AI-Powered Patient Engagement
Discover how artificial intelligence is transforming patient engagement and improving healthcare outcomes.
Improving Clinical Outcomes Through Voice AI
Learn how voice AI technology is revolutionizing patient monitoring and improving clinical outcomes.
How AI Is Transforming Chronic Care Management in 2025
Discover how artificial intelligence is revolutionizing chronic care management through automated monitoring, predictive analytics, and personalized care plans.
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