Health Care Payer Data

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Industry Voices—Inside the most challenging data problem in h…

(9 days ago) People also askDo all-payer claims databases increase health care value?Issue: All-payer claims databases (APCDs) can facilitate state efforts to control the rising cost of health care and increase its value. By aggregating data on the health care services that health insurers and public programs pay for, they offer a broader perspective on cost, service utilization, and quality than any single entity can provide.State All-Payer Claims Databases: Tools for Improving Health Care Value commonwealthfund.orgWhat is the health care payments database (HPD)?The Health Care Payments Database (HPD) is California’s All Payer Claims Database or APCD. The HPD is a research database comprised of healthcare administrative data: claims and encounters generated by transactions among payers and providers on behalf of insured individuals.Health Care Payments Data (HPD) - HCAIhcai.ca.govWhat is health care claims data?Health care claims data is the most comprehensive source of real-world evidence available to researchers. HCCI is dedicated to unlocking insights into more accessible, affordable, and equitable care through data. Explore our Public Data Tools ESI Claims Data OverviewData - HCCIhealthcostinstitute.orgCan healthcare payers scale data management?But few payers have succeeded at scaling this approach to areas where data management is often more complex. Although healthcare payers have an abundance of data, they often lack the ability to make it accessible and amenable to analysis. They can learn from other industries, such as banking, that have become data driven in the past decades.Getting data architecture right: A guide for healthcare payersmckinsey.comFeedbackAgency for Healthcare Research and Qualityhttps://www.ahrq.gov/data/apcd/index.htmlAll-Payer Claims Databases Agency for Healthcare Research and …WEBAll-payer claims databases (APCDs) are large State databases that include medical claims, pharmacy claims, dental claims, and eligibility and provider files collected from private and public payers. i. APCD data are reported directly by insurers to States, usually as part …

https://www.fiercehealthcare.com/payer/industry-voices-inside-most-challenging-data-problem-healthcare#:~:text=Payer%20data%20are%20one%20of%20the%20most%20exciting,challenging%20data%20problem%20to%20exist%20in%20the%20industry.

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Healthcare Analytics for Payers: A Roadmap

(5 days ago) WEBEither way, an organization should use the Healthcare Analytics Adoption Model (Figure 1) as the context for a tailored analytics roadmap that progresses from a …

https://www.healthcatalyst.com/insights/healthcare-analytics-payers-roadmap

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Getting data architecture right: A guide for healthcare payers

(2 days ago) WEBAutomated consent and permission management. Health data is subject to a high level of regulation to protect patient information from cyberattacks, loss, or …

https://www.mckinsey.com/capabilities/mckinsey-digital/our-insights/tech-forward/getting-data-architecture-right-a-guide-for-healthcare-payers

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All-Payer Claims Databases: Unlocking Data to Improve …

(4 days ago) WEBAll-payer claims databases (APCDs) 1 are used to unlock this data by collecting healthcare claims and other data into databases that can be used by a wide variety of stakeholders to monitor and report on provider …

https://www.healthcarevaluehub.org/advocate-resources/publications/all-payer-claims-databases-unlocking-data-improve-health-care-value

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State All-Payer Claims Databases: Tools for Improving Health Care …

(2 days ago) WEBBy aggregating data on patient services that insurers and public programs pay for, all-payer claims databases can aid states’ efforts to control rising costs and …

https://www.commonwealthfund.org/publications/fund-reports/2020/dec/state-apcds-part-1-establish-make-functional

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Industry Voices—Inside the most challenging data problem in …

(2 days ago) WEBData data sharing Industry Voices Interoperability. Payer data are one of the most exciting assets in healthcare, holding the most promise for dynamic, …

https://www.fiercehealthcare.com/payer/industry-voices-inside-most-challenging-data-problem-healthcare

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What payer-led managed care models may look like

(9 days ago) WEBCare delivery is an increasingly important part of payers’ enterprise and M&A strategy. Payer-led activity in care delivery has continued over the past five years. M&A, strategic partnerships, and …

https://www.mckinsey.com/industries/healthcare/our-insights/innovation-and-value-what-payer-led-managed-care-models-may-look-like

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AHRQ Data Tools Agency for Healthcare Research and Quality

(7 days ago) WEBInformation on the health status of Americans, health insurance coverage, and access, use, and cost of health services. MEPS-HC Data Tools Explore trends and cross …

https://www.ahrq.gov/data/data-tools/index.html

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How Payer Forecasting Is Shifting Towards Real-Time Data Analytics

(1 days ago) WEBPayers are using real-time data to make predictions in various areas of the healthcare industry. For example, real-time data analytics can help payers forecast …

https://healthpayerintelligence.com/features/how-payer-forecasting-is-shifting-towards-real-time-data-analytics

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Healthcare Payer Analytics Tableau

(5 days ago) WEBUse the power of visual payer analytics to transform the member experience, improve your operational agility, and help close the health-equity gap. Optimal Patient Experience …

https://www.tableau.com/solutions/industries/healthcare-life-sciences/payer

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Payer Data Exchange Change Healthcare

(8 days ago) WEBExplore related solutions . Medical Claim Attachments Discover an electronic medical claim solution for providers, payers, and partners who want to eliminate manual processes to …

https://www.changehealthcare.com/medical-network/payer-data-exchange

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Health Care Payments Data (HPD) - HCAI

(3 days ago) WEBThe Health Care Payments Database (HPD) is California’s All Payer Claims Database or APCD. The HPD is a research database comprised of healthcare …

https://hcai.ca.gov/data/cost-transparency/healthcare-payments/

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Health Care Payers, Providers, Systems, and Services BCG

(6 days ago) WEBBCG helps health care payers, providers, systems, and services develop new initiatives to reposition—and reimagine—their organizations for the future, and to thrive. The health …

https://www.bcg.com/industries/health-care/payers-providers-systems-services

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CO All Payer Claims Data Center for Population Health Sciences

(3 days ago) WEBDataset Description. All-payer claims databases (APCDs) assembled by states and include all types of medical claims including pharmacy, dental, and eligibility and provider files …

https://med.stanford.edu/phs/data/co-all-payer-claims-data.html

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The Payor Overview - Health Care Data

(5 days ago) WEBThe Payor Overview. Healthcare payors and delivery systems are facing disruptive changes as cost pressures are opening doorways to new business models. Healthcare …

https://healthcaredata.center/healthcare-delivery/the-payor-view/

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Revolutionizing Healthcare: The Transformative Power of AI

(Just Now) WEBAI’s integration into healthcare is set to usher in transformative changes, including the development of personalized treatment plans tailored to individual genetic …

https://www.aapa.org/news-central/2024/05/revolutionizing-healthcare-the-transformative-power-of-ai/

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Resource of health equity-related data definitions, standards, …

(2 days ago) WEBThis document is a technical resource of definitions, standards, and stratification practices for health equity-related data elements that can be used by organizations/entities such …

https://www.cms.gov/files/document/cms-2024-omh-data-definitions.pdf?hss_channel=lcp-5079845

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How TEFCA could drive payer-provider interoperability

(3 days ago) WEBHow TEFCA could drive payer-provider interoperability. While TEFCA has the potential to enhance payer-provider interoperability, its success hinges on addressing …

https://www.techtarget.com/searchHealthIT/feature/How-TEFCA-could-drive-payer-provider-interoperability

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Revolutionizing Revenue-Cycle Management Efficiency with AI

(5 days ago) WEBA new AHA Center for Health Innovation Leadership Scan episode, “Revolutionizing Revenue Cycle Management (RCM) Efficiency with AI,” will share …

https://www.aha.org/2024-05-21-revolutionizing-revenue-cycle-management-efficiency-ai

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Data Paramount in Hospice-Payer, Referral Partner Negotiations

(7 days ago) WEBgeralt. As hospice and palliative care providers move further into value-based care, data is becoming paramount to building payer and referral partner …

https://hospicenews.com/2024/05/23/data-paramount-in-hospice-payer-referral-partner-negotiations/

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Search Payer List by Name, ID, & Transaction Type Office Ally

(6 days ago) WEBQuickly search for insurance payer IDs with Office Ally's easy-to-use payer ID lookup tool & access our updated payer ID list to simplify your billing process. ACTIN Care Groups …

https://cms.officeally.com/payerlist

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Hospitals Charge Employers 254 Percent Over Medicare. The

(Just Now) WEBThis "employer-led transparency initiative" analyzed medical claims data from 2020 to 2022 in 49 U.S. states—except for Maryland, which sets its own rates for …

https://www.newsweek.com/hospitals-charge-employers-254-percent-over-medicare-why-gets-fuzzy-1900566

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Payer Data Exchange Overview Change Healthcare

(Just Now) WEBPayer Data Exchange Overview. Watch Overview. Data retrieval can often be unreliable, expensive, and time consuming. Payer Data Exchange allows care navigators, …

https://www.changehealthcare.com/insights/payer-data-exchange-overview

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Horizon NJ Health QUICK REFERENCE GUIDE

(7 days ago) WEBa conditional acceptance report is generated and sent to the hospital or health care professional immediately. After this acceptance, status of claims, adjusted claims, and …

https://www.horizonnjhealth.com/sites/default/files/Quick_Reference_Guide.pdf

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Damaging hacks expose the weak underbelly of America’s health …

(9 days ago) WEBA pair of recent ransomware attacks crippled computer systems at two major American health care firms, disrupting patient care and exposing fundamental …

https://www.cnn.com/2024/05/16/tech/damaging-hacks-expose-the-weak-underbelly-of-americas-health-care-system/index.html

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Measuring Primary Healthcare Spending Effective Health Care …

(4 days ago) WEBThe purpose of this Technical Brief is to build on these prior efforts and expand the included information, particularly as the number of State Governments …

https://effectivehealthcare.ahrq.gov/products/primary-healthcare-spending/tech-brief

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State of the U.S. Health Care Workforce, 2023

(4 days ago) WEBThe growth varies considerably by gender (Table 3). While the number of female medical school students has grown by approximately 15% between 2018 and 2023, the number …

https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/state-of-the-health-workforce-report-2023.pdf

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Payer ID Payer Name Comments - ABILITY Network

(2 days ago) WEBPayer ID Payer Name Comments 11090 Avera Health Plans 10067 AvMed Health Plans 13225 Bankers Life and Casualty 13656 Banner University Family Care

https://www.abilitynetwork.com/wp-content/uploads/2019/11/November_EligibilityPayer_List.pdf

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