COVID-19Population HealthSpecialized Registry
March 27, 2020

Roji Health Intelligence Launches Population Health Registry for Patients at High Risk for Severe COVID-19

To assist the health care provider community’s heroic efforts to combat COVID-19, Roji Health Intelligence has launched a new Population Health Registry for Patients at High Risk for Severe COVID-19. Our goal is to help providers track, monitor, and communicate with patients whose underlying health conditions will make them more vulnerable to the virus, particularly as resources are reallocated away from routine medicine to meet the exceptional demands of the pandemic. The program is being offered to current Roji Health Intelligence clients at no additional charge. To learn more, please contact us at info@rojihealthintel.com. Founded in 2002, Roji Health Intelligence…
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ACOsDirect ContractingFuture of Health CareValue-Based Health Care
February 27, 2020

ACO Path to Viability: Direct Contracting May Be the Opportunity

What if your best route to viability was the high-risk path you feared the most, because that failure might destroy you? That's the question Accountable Care Organizations (ACOs) have been asking this week—whether to participate in Medicare's new Direct Contracting (DC) initiative. With a shift in payments from Fee for Service (paid per-provider service), to Global Capitation (paid per-beneficiary), DC completely changes the incentives for the health care system. Whether Direct Contracting is a boon or a bust to ACOs depends on their ability to control the costs of patient care long-term—and whether they have the leverage to do so.…
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Artificial IntelligenceFuture of Health CarePopulation HealthValue-Based Health Care
February 5, 2020

How AI Can Engage Consumers to Reduce Disease Risk: The Case of Atrial Fibrillation

In our last article, we assessed how AI could be used to achieve clinical success for individual conditions, and to apply the technology to broad cost reduction efforts and population health interventions. But here's the real test: Can we effectively apply AI technology to help patients better engage in lifestyle risk reduction—particularly for specific conditions at higher risk? To examine the feasibility and issues, let’s take a closer look at Atrial Fibrillation (AFib), an increasingly common and expensive condition. In AFib, the upper part of the heart (the atrium) has ineffectual contraction, causing sludging of the blood and lessened cardiac…
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Artificial IntelligenceFuture of Health CareRiskValue-Based Health Care
January 29, 2020

Can Artificial Intelligence and Machine Learning Reduce Health Care Costs?

All the experts’ 2020 health care technology predictions have one trend in common—more Artificial Intelligence. AI and its subset Machine Learning are tagged as the winning ticket to advances not only in clinical medicine and research, but also in administration and management. The hype promotes so many potential applications for AI that it begs for an answer to one of its key claims: Can AI reduce health care costs? I'm referring particularly to Artificial Intelligence that is beyond clinical medicine and new medical technology. AI focused on clinical medicine, from genomics to the latest radiology and cardiology diagnostic capabilities, uses…
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Future of Health CareMedical Decision-MakingPrimary Care PracticesValue-Based Health Care
June 26, 2019

Follow the Pathway to PCP Success In Medicare Direct Contracting

Primary care physicians were sitting on the sidelines as Medicare developed financial risk models in various generations of ACOs. At best, they could only hope to participate in Medicare Advantage and/or join a larger ACO. But potential for financial gain was elusive when the physicians’ success depended on the actions of others to achieve savings. Now Medicare is offering a carrot to large primary care practices with its new Direct Contracting (DC) models, luring them with the possibility of capturing higher and more predictable revenues as well as shared savings. CMS recently announced an initiative to test risk-based reimbursement models…
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Future of Health CareValue-Based Health CareWomen and Health Care
June 19, 2019

Roji News Roundup: Industry Insights from CEO Theresa Hush

From women’s health care to the future of the Affordable Care Act, Roji Health Intelligence CEO Terry Hush has shared her insights with numerous industry publications in recent months. Here’s a sampling of current articles: Value-based arrangements in ASCs — 3 quotes from an industry CEO Becker’s ASC Review | June 11, 2019 Terry’s predictions, based on 25 years of industry experience, for what to expect for the future of risk-based agreements. Hint: Episodes of care and bundled payments will become increasingly important. The Future of Healthcare: “Make tools available for women so that they can have a real voice…
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Consumers & PatientsFuture of Health CareValue-Based Health CareWomen and Health Care
May 15, 2019

How Providers Must Improve Value in Women’s Health

Writing the Roji Health Intelligence® series on gender disparities and other women’s health issues has been a revelation. As a woman who has worked in so many parts of the health care industry, I was already aware of basic gender disparities, risk levels, incidence of disease, and economic issues that are predominant among women. Most women in health care have had their knowledge and judgment doubted as both patients and professionals. Women everywhere encounter the economic barriers associated with affordable health care, some much worse than others, and every woman who is a mother struggles with balancing the interests of…
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Consumers & PatientsFuture of Health CareValue-Based Health CareWomen and Health Care
May 1, 2019

Do “Women’s Health Centers” and Services Deliver on Value-Based Health Care?

Women make an astounding 80 percent of health care decisions for themselves and their families. But there’s a disconnect between what women need and how providers have organized health care for them. While Value-Based Health Care (VBHC) is struggling to achieve more value for every health care dollar spent, providers are simultaneously sabotaging women in their customer base. How? This might surprise you: through promotion of “women’s health” services. While providers may have good intentions for offering a dedicated place for women’s health needs, those services have actually fragmented care for women, especially those with more complex conditions. Let’s evaluate…
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ACOsPerformance ImprovementRisk
April 17, 2019

Bootstrapped ACOs Facing Risk? Adopt Cost Strategies With Long Term RoI

The experimental phase of Medicare ACOs has been officially declared dead, per CMS. Going forward, ACOs must agree to take on financial risk for expenditures beyond their targets. That’s sobering news for the majority of ACOs still struggling to succeed. The reality is that most ACOs are bootstrapped—light on extra funding and dependent on existing tools to do more. In fact, about two-thirds of ACOs report that funding is their most significant challenge. And that is probably understated, since patient engagement problems (also reported by two-thirds of ACOs) and lack of data (reported by 40 percent) are remedied by solutions…
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Future of Health CareMedical Decision-MakingPopulation HealthValue-Based Health CareWomen and Health Care
March 28, 2019

Women with Autoimmune Diseases Fight Uphill Battle on Every Health Care Front

Our articles on women’s health care issues have focused on areas that must change in order to provide better quality and outcomes, to lower costs, to advance treatment, and to treat women respectfully and equitably as patients and providers. We have demonstrated how women have been sidelined from getting the right health care because of two key systemic obstacles that must be addressed: Cultural bias that prevents accurate clinical assessment of symptoms and diagnosis, adoption or use of protocols relative to women’s biology, and effective health care therapies, and Inadequate basic science and clinical research that will illuminate sex-differentiated biology…
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