Top 5 Mistakes in Claims Management – And How to Avoid Them
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By Greg Lanier, Chief Growth Officer, FinThrive
HIMSS ’23 saw more than 35,000 attendees, as healthcare executives from around the world gathered to tackle the industry’s toughest challenges. Several themes emerged from the conference surrounding interoperability, health equity, cybersecurity, and other areas. FinThrive shared the exhibit hall with health tech companies from finance to cardiac care. Attendees and visitors to our booth all experienced a content-packed week that drove real discussions on healthcare improvements in care and payment.
The event kicked off with an enlightening discussion from Hal Wolf, the CEO of HIMSS. He shared how important our role as healthcare executives, and how we are in the unique position to fix healthcare. “We learned much from the pandemic”, he shared, “and now we need to embrace digital health to move our industry forward”. He spoke of new technology, like ChatGPT, where he even tested it through asking, “How to solve global healthcare challenges?”ChatGPT answered, “The system needs a multifaceted approach involving multiple stakeholders from government, hospitals, and others to drive change…”. Mr. Wolf closed with highlighting the shift to hospital in the home, and how technology is here to enable that change.
Cris Ross, the CIO of Mayo Clinic, led a panel from leaders from Microsoft, Lovelace, Virtue and others where they debated ethical considerations for AI. They too discussed the opportunities with AI like ChatGPT, but shared a caution. It is predictive, not definitive. If used to diagnose cancer, for example, it might be 93% predictive, but 7% inaccurate. The panel talked about the societal responsibilities of these new datasets and the need for governance and policy as we develop use cases.
Healthcare economics are always a conversation at HIMSS, especially in Fintech. Kaufman Hall, CMS and other healthcare experts discussed the future of US healthcare. Timing of the rebound was debated, and positions hinged on performance with labor and investment portfolios. Short term, the group agreed it is going to be a tough road for hospitals. Long term however, value-based care strategies will accelerate provider payer collaboration efforts and drive better care and payment outcomes.
Other sessions through the conference touched on the usual suspects, prior authorizations, frictionless payments, interoperable data share and cybersecurity. Even retailers, such as Best Buy, through their Current Health acquisition, are partnering with large health systems such as Atrium Health. Through telehealth, remote patient monitoring and tech-enabling innovation, Current Health is changing the face of inpatient care. As the market continues to shift to ambulatory, technology shared at HIMSS and in other venues will drive low-cost, high-quality alternatives to traditional brick and mortar delivery.
An interesting session occurred on “designing the perfect health system”, where perspectives from China, Britain, Africa, Sweden, United States, and others were shared. Private and public payment models were shared from around the globe, as well as the pros and cons of each. The group was agreed on one item – healthcare, no matter where in the world, is complex and expensive. Models will evolve through the years, and our industry will see more change in the next five years than we have in last 50.
FinThrive hosted live podcasts with Alex Wendling from Utica University, and Geoffrey Roche from Core Education PBC. Both are passionate researchers and spoke of the power of data as we evaluate disparities in care. They shared that health equity is an “all in” endeavor for data, and as we learn, we must also act. When the data reveals, the policy must follow to afford better outcomes for all those that need to access healthcare. It was an inspiring session that highlighted how FinThrive datasets are helping organizations drive operational change for better health outcomes across communities.
HIMSS concluded with keynote sessions with Mark Zandi from Moodys Analytics and an inspiring message from NFL player Damar Hamlin. Mark shared an economic outlook globally, indicating that a recession for the US is possible, but there are some signs that may avoid it. He focused on opportunities and challenges to US healthcare, including the perseverance of labor shortages. He highlighted that technology, specifically AI and automation, are keys to move healthcare to profitability. He finished by pointing out that healthcare is almost 20% of the GDP. Healthcare is key to the economic health of the US – he emphatically stated, that “we need you…just do it quickly please”.
Damar’s speech could not have been more moving, as he and his trauma surgeon shared the innovation and processes that saved his life on that fearful day in Ohio. He was recently cleared to return to play in the NFL. Damar playfully shared that “his heart is still in it”, and has created a foundation, “Chasing M” dedicated to youth sports. He talked about his amazement with healthcare – its technology, ability, speed, innovation, and application. A few things that describe where we as an industry strive to be everyday.
About the Author
Greg Lanier
Chief Growth Officer, FinThrive
Greg Lanier is responsible for leading FinThrive's growth initiatives and sales team. Greg has more than 25 years' experience developing and implementing strategic initiatives to increase and accelerate growth across organizations. Greg is a proven high performance team builder and leader where he had success leading commercial teams at Oracle, SAP, Workday and other prominent companies.
