Health Language Blog

Mastering the Data Normalization Cycle

Posted on 06/28/16 | Comments

A healthcare provider or payer that goes through a data normalization project will want to make sure its investment in time and money continues to pay off down the road.

You’ve obtained executive buy-in, conducted a data inventory, identified key constraints, prioritized projects, established a governance structure, and embarked on your first initiative. Ideally your project resulted in more consistent and useful data, with demonstrable benefits for your organization. Your next order of business is to make sure your useful data stays that way. A healthcare organization that fails to continuously monitor its normalized model runs the risk of returning to its previous condition: data chaos.

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Topics: data normalization, governance, data normalization cycle

Maximizing MIPS Reimbursement

Posted on 06/08/16 | Comments

MACRA Part 2

Maximizing MIPS Reimbursement

Laying the Right Foundation for Data Management

In the first edition of this two-part series covering MACRA and MIPS, we provided an overview of MIPS and its impact on terminology management and quality reporting. Part 2 will discuss why terminology management is critical to maximizing reimbursement under the new rule.

The stakes for quality and cost performance continue to rise. The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 is a prime example of why providers need to prioritize data access and management on a higher level than ever before.

Semantic interoperability—or the ability of two systems to exchange data in a meaningful way—remains a barrier to accurate data analytics and reporting. As pointed out in the first installment of this series, effective data normalization and terminology management is critical to accurately capturing data. Below I outline why terminology management must become a priority to maximize reimbursement within MACRA’s Merit-Based Incentive Payment System (MIPS).

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Topics: MIPS, MACRA, Reimbursement

MIPS Raises the Stakes on Clinical Documentation and Quality Reporting

Posted on 06/01/16 | Comments

MACRA & MIPS Part 1

MIPS Raises the Stakes on Clinical Documentation and Quality Reporting

Is your data ready?

In this two-part series, we will explore the basics of MIPS and its impact on terminology management and quality reporting.

It’s no secret that quality reporting has presented notable challenges to hospitals and physicians. Access to clean, accurate data is necessary for reporting, yet providers continue to struggle with full and consistent capture of data and strategic management of patient information for forward-looking initiatives.

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Topics: MIPS, MACRA

Implications to Using Old and Outdated Codes

Posted on 05/18/16 | Comments

Many were relieved after the ICD-10 implementation deadline. But, though October 1st 2015 is now long past, it does not mean the end of dealing with healthcare terminologies and the complexities set into motion for healthcare providers and payers.  

As we all know, healthcare is a constantly changing industry. New medical breakthroughs as well as newly discovered diseases lead to new treatments and innovative solutions. All of these changes must be represented in evolving medical terminologies. Terminologies, standards for treatment and care, and scientific developments are rarely set in stone. Code systems and terminology sets may be updated daily. If you and your organization cannot keep up with all of the changes, your entire organization is at risk.  

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Topics: ICD-10, terminology, enterprise terminology management

Data Normalization: Mapping to Existing Standards vs Creating Local Standards

Posted on 05/11/16 | Comments

If you’ve followed the previous steps outlined in this blog series, you should have a good idea of how to pursue data normalization within your healthcare organization. But challenges will continue to arise once you get underway. One of the decisions a healthcare provider or payer will face in the course of a project is whether to use an existing industry standard or create a local terminology. As it turns out, the answer isn’t cut and dried, and will depend to a large degree on the use case involved.

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Topics: data normalization, selecting standards, mapping, local standards

The Benefits of Mapping CPT to LOINC

Posted on 05/04/16 | Comments

Payer-based care and utilization management programs are essential for managing member health, closing care gaps, and managing risk. Research data indicates that capturing members’ vast healthcare histories and normalizing that information for consumption can enable a care management program that enhances the effectiveness of provider-based care initiatives.

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Topics: LOINC, Payers, mapping, CPT, Care management

Are you Dealing With Lackluster Data Analytics?

Posted on 04/18/16 | Comments

Missed_Target.jpeg A recent HealthITAnalytics.com article, “Quality Metrics, Data Analytics are Top Value-Based Care Fears,” highlighted some of the problems that health systems and ACOs are having with data management and analytics. Author Jennifer Bresnick wrote, “...providers confess that the big data analytics competencies required to make the most of value-based reimbursements may be too much for them to handle.”

In fact, the article references a recent Xerox Healthcare Attitudes 2016 survey that revealed that 80% of providers “expressed some level of uncertainty about not being able to leverage their patient data for improved outcomes.” Additionally, the same number of providers said “a lack of claims data transparency may inhibit their ability to perform comprehensive data analytics and population health management.”

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Topics: Analytics

5,500+ Updates Are Coming to ICD-10

Posted on 03/30/16 | Comments

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It has been five years since those of us in the healthcare industry have had to prepare for updates to the ICD code set. During this time, updates were put on hold while the industry prepared for and underwent the ICD-10 transition. Now that ICD-10-CM and ICD-10-PCS have been successfully implemented, it is time to prepare for long-awaited revisions and additions. Beginning October 1, 2016, we can now expect that there will be annual revisions to the ICD-10 code set, bringing the industry back to the regular update cycle.

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Topics: ICD-10

How to Normalize Your First Project with Your Data Normalization Solution

Posted on 02/24/16 | Comments

 

So far we have outlined the steps from securing executive buy-in to establishing a governance process—you should be ready to start your first normalization project (I know I am!).

A project team that has gone through an impact analysis and prioritized its data normalization projects will probably have a short list of likely project candidates. The two critical factors to consider when selecting the initial project are size and impact. The project must be small enough to be manageable and likely to be completed in a reasonable time, but large enough to demonstrate a meaningful early win to key stakeholders. Resistance to changes (such as formal data governance processes) can be minimized if participants readily see how they will benefit.

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Topics: data normalization, selecting standards, mapping

Webinar Recap: Code Groups – The Building Blocks for Your Analytic Initiatives

Posted on 02/08/16 | Comments

Code groups and analytics initiatives—the two go hand-in-hand. Healthcare organizations are increasingly realizing that effective management of code groups (also known as value sets) is imperative for aligning with healthcare’s Triple Aim and positioning within the value based landscape.

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Topics: code groups