C-Suite

Why Encounters Matter

Encounter data really didn’t matter much 5 – 10 years ago…so what has changed? Health plans typically viewed encounter data as just another output from the claims payment process; that’s…

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NCQA Updates Health Plan Accreditation for 2020

Improvements to evaluating health plans and increasing transparency. Focus on implementing standards and achieving outcomes. Reducing the administrative burdens for health plans. These are all prominent goals for NCQAs Health…

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TEFCA: The On-Ramp to Interoperability

The U.S. Department of Health and Human Services (HHS) has been given the colossal task of creating a Trusted Exchange Framework and Common Agreement (TEFCA) that supports a network-to-network exchange…

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One Health Plan’s Practical Example with Provider Directories

In a recent blog, we looked at provider directories, regulations around them, and fines levied against health plans for inaccurate directories. Now, we’ll look at how one organization improved the…

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NCQA Distinction: Helping Coordinate LTSS

More than 3 million people in the United States rely on Medicaid for Long-Term Services and Support (LTSS) in nursing homes, home care, and community-based settings. LTSS supports people with…

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Ending Data Co-Dependency [or, How to Love your Data Again]

Preface Data is critical to everyday processes in healthcare. Data helps tackle operational issues, offers insight into performance, improve quality, safety and standardizes process, and allows us to better understand…

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HighPoint Participating in Information Management Symposium

HighPoint is proud to be a Gold Sponsor at this year’s Information Management (IM) Symposium 2019 in Boise, Idaho. The IM Symposium provides plan business and technical representatives an opportunity…

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KLAS: Health Plans Considering New IT Vendors

While utilization management and care management solutions have been around for many years, health plans are now looking for technologies to help them manage multiple business lines and adapt to…

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Shopping for a ‘Real’ Project Manager

There are typically two camps on finding project managers (PM): buy them on the open market or make them. But, before you go shopping, stop and answer a few questions:…

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State Privacy Laws on the Rise

Privacy laws are being implemented around the world as most of us in the United States watch from our desks. At first the impacts were minimal, then Google was hit…

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