# SolvEdge

> Simplifying Healthcare Experience


## Posts

- [Patient Engagement Strategies to Improve Healthcare Provider...](https://solvedge.com/blog/healthcare-reputation-management/): Patient Engagement Strategies to Improve Healthcare Provider Online Reputation Management In the digital era, tech-savvy consumers are proactively engaging in online forums and digital communications to express their ideas and viewpoints. Furthermore, word of mouth plays a significant role in choosing a healthcare provider online. In terms of healthcare, consumers are very selective and heavily […]
- [Top Strategies to Optimize Healthcare Revenue Cycle...](https://solvedge.com/blog/rcm-functions/): Top Strategies to Optimize Healthcare Revenue Cycle Management Functions Healthcare Revenue Cycle Management goes far beyond its financial angle. Leveraging cutting-edge technologies and implementing innovative strategies can lead to positive financial outcomes in the long run—while transforming patient financial experiences and boosting the Patient Satisfaction Index (PSI)—resulting in brand loyal consumers and happy patients! In this […]
- [Healthcare Data Exchange: Interoperability Best Practices](https://solvedge.com/blog/secure-data-exchange/): Healthcare Data Exchange: Interoperability Best Practices The Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access Final Rule has paved the way for healthcare leaders to rethink their technology strategies to support secure healthcare data exchange. Furthermore, the United States Department of Health and Human Services (HHS) highlights the significance of health information interoperability—fostering healthcare […]
- [Digitizing Self-Pay Collection in Healthcare to Accelerate Providers...](https://solvedge.com/blog/digitizing-self-pay-collections/): Digitizing Self-Pay Collection in Healthcare to Accelerate Providers’ Revenues Healthcare is one of the key industries most affected by the COVID-19 outbreak. Care providers are on the front lines—taking huge responsibilities to ensure the best of care delivery. Simultaneously, providers face major financial challenges due to the overall downward financial trend during the pandemic. Healthcare […]
- [Medical Billing - Resurgence after the COVID-19 Pandemic​](https://solvedge.com/blog/resurgence-after-the-covid-19-pandemic/): Medical Billing – Resurgence after the COVID-19 Pandemic The pandemic has caused substantial revenue losses and a global recession that will have a lasting impact on the healthcare industry. However, hospitals, practices and health systems can take proactive measures to mitigate the effects and build a more robust medical billing practice. This article discusses some […]
- [Artificial Intelligence Supported Empathy in Patient Engagement...](https://solvedge.com/blog/ai-patient-engagement-solutions/): Artificial Intelligence Supported Empathy in Patient Engagement Solutions Patient behavior, centricity, personalization and value based care are the critical patient engagement trends to watch for in 2020. Healthcare organizations are projected to spend over six billion dollars annually on artificial intelligence platforms, starting in 2021. This Healthcare Technology movement is setting the stage for hyper-personalized […]
- [Medical Billing Guidelines: Everything you need to Know...](https://solvedge.com/blog/medical-billing-reimbursement/): Medical Billing Guidelines: Everything you need to Know about Medical Billing Reimbursement Medical Reimbursement can make or break a healthcare business; being a significant part of Revenue Cycle Management (RCM). The healthcare landscape has shifted to value-based care models—and have placed tremendous focus on high-quality care, patient outcomes and patient-centered care—that are intertwined with reimbursements […]
- [Adopting Value-based care in the Current Healthcare Landscape](https://solvedge.com/blog/telehealth-service-benefits/): Adopting Value-based care in the Current Healthcare Landscape The Centers for Medicare and Medicaid Services (CMS) established new changes to accelerate payments for telemedicine services. As per Trump’s order on “Improving Rural and Telehealth Access,” CMS takes extensive measures to make the temporary telemedicine services permanent after the global health crisis ends. CMS had implemented […]
- [8 Questions to Ask Before you hire a Medical Billing Company​](https://solvedge.com/blog/medical-billing-question/): 8 Questions to Ask Before you hire a Medical Billing Company Discover why choosing an outsourced medical billing service can be your key strength to increase the cash flow and drive financial growth. This article shares how you can find a medical billing company that can deliver the support—and work as an extension of your […]
- [5 Trends that will Impact Life sciences in the Next 20 Years](https://solvedge.com/blog/lifesciences-blog/): 5 Trends that will Impact Life sciences in the Next 20 Years The dire need to develop a COVID-19 vaccine highlights how an unprecedented onset of a global pandemic can disrupt the life sciences industry and its established processes. This also increases speculation on major other disruptive factors that may alter the course of the […]
- [10 Reasons to Consider Outsourcing Revenue Cycle Management...](https://solvedge.com/blog/rcm-outsourcing/): 10 Reasons to Consider Outsourcing Revenue Cycle Management Services Healthcare providers face immense challenges with processing business transactions—as a result of manual processes, lack of automation and non-integrated business applications. Consider the fact that – of every dollar spent, 30 cents is never collected and 20% of all uncollected funds are attributed to incorrect coding […]
- [Achieving True Success in Healthcare Interoperability](https://solvedge.com/blog/interoperability/): Achieving True Success in Healthcare Interoperability From elevating patient experience, lowering healthcare costs, to maximizing outcomes, interoperability in healthcare offers a plethora of benefits. Healthcare organizations across the globe are realizing its value and leveraging the capabilities of next-gen technologies to create interoperability solutions. Markets and Markets research report reveals that the global healthcare interoperability market is prognosticated […]
- [5 Strategies to Improve Patient Volume during COVID-19​](https://solvedge.com/blog/patient-volume/): 5 Strategies to Improve Patient Volume during COVID-19 Recent research by the Medical Group Management Association reveals that medical healthcare practices saw a 60% decrease in patient volume since the COVID-19 outbreak. This is a result of patients canceling and delaying non-urgent procedures, preventive care, screenings, and follow-up visits. Now that a few states and […]
- [Enduring Trust with Healthcare Price Transparency](https://solvedge.com/blog/healthcare-price-transparency/): Enduring Trust with Healthcare Price Transparency The COVID-19 outbreak has growing concerns around two key aspects in healthcare—increasing hospital capacity to offer care, and price transparency in helping patients understand the cost of care. Recent regulatory updates have made clear announcements that COVID-19 testing is free of cost for patients with health coverage. However, patients […]
- [Achieving Digital Maturity in Healthcare — as Digital Health...](https://solvedge.com/blog/digital-maturity-in-healthcare/): Achieving Digital Maturity in Healthcare — as Digital Health Goes Mainstream As digital goes mainstream in the wake of COVID-19, the healthcare industry is in critical need of maturing in digital health. The global health crisis has sparked off drastic changes across the healthcare technology and innovation space. The adoption of digital health is at […]
- [3 Patient Engagement Strategies to Transform Health Economics](https://solvedge.com/blog/health-economics-patient-engagement/): 3 Patient Engagement Strategies to Transform Health Economics The economics of health care needs to be reimagined and for the benefit of patients, various factors are fostering this change. Healthcare expenses in recent decades have seen rapid growth, outpacing the overall economic growth. The U.S healthcare spending in 2019 was at $3.6 trillion or $11,172 […]
- [Enabling Hyper-personalized Care​](https://solvedge.com/blog/healthcare-personalization/): Enabling Hyper-personalized Care The global pandemic has accelerated data and AI-powered personalization by at least a decade! Are you prepped-up for the change? Our extensive use of technologies ranging from google and other search engines, online shopping, recognize a pattern in our behaviors – blended with massive amounts of data from millions of resources – […]
- [Top 3 Considerations in Building a Data-driven Healthcare Organization​](https://solvedge.com/blog/data-driven-healthcare/): Top 3 Considerations in Building a Data-driven Healthcare Organization The power of data analytics in healthcare cannot be understated. Today’s healthcare ecosystem is presented with huge volumes of operational and clinical data ⁠—paving new paths for actionable clinical intelligence. The high adoption of healthcare analytics is fueled by the need to manage complex and diverse […]
- [Population Health Management: Shifting Towards Value-based...](https://solvedge.com/blog/populationhealthmanagement/): Population Health Management: Shifting Towards Value-based Healthcare The surging demand for value-based care has led to a huge spike in the adoption of Population Health Management (PHM). The global Population Health Management market value was at $26.7 billion in 2019 and is prognosticated to grow at a CAGR of 25.6% to 166.7 billion by 2027. […]
- [Telemedicine Services: 7 Fool-proof Ways to Improve Practice....](https://solvedge.com/blog/practicerevenues/): Telemedicine Services: 7 Fool-proof Ways to Improve Practice Revenues Care providers must understand the financial impact of telemedicine investment. It is evident that telemedicine platforms benefit patients in innumerable ways from better access to care, reduced hospital readmissions, better health outcomes, improved convenience, and fewer days off from work, among many others. Care providers need […]
- [Remote Patient Monitoring—Facts You Don’t Want to Ignore](https://solvedge.com/blog/remotepatientmonitoring/): Remote Patient Monitoring—Facts You Don’t Want to Ignore Remote Patient Monitoring has been around for a bit. With its ‘I may, I can, I shall” attitude, it has been hovering on the fringes of the technology landscape for a few years now. However, there were signs in 2019 that this model of care providing was […]
- [6 Ways Telemedicine Services Improve Financial Results...](https://solvedge.com/blog/telemedicine-improving-practice-revenues/): 6 Ways Telemedicine Services Improve Financial Results of your Practice In the digital era, the widespread adoption of telemedicine solutions is the new norm—that tremendously improves consumer convenience, patient experience and quality of care. With the coming of the global pandemic COVID-19, there is a significant surge in demand for telemedicine services as health care […]
- [Improving Telemedicine Reimbursements: The Ultimate Guide](https://solvedge.com/blog/telemedicine-reiumbursements/): Improving Telemedicine Reimbursements: The Ultimate Guide The world has never needed virtual and remote health care more than now! The global pandemic has accelerated the need for a safer and secure care delivery solution—giving rise to incremental telemedicine services. This comes at a time when self-isolation and shelter-in-place are considered amongst the effective measures to […]
- [Proven Digital Strategies to Reduce Hospital Readmissions](https://solvedge.com/blog/hospital-readmission/): Proven Digital Strategies to Reduce Hospital Readmissions Annually billions of dollars are spent on hospital readmissions on account of avoidable occurrences in episodes of care. According to the Agency for Healthcare Research and Quality (AHRQ) report, readmissions within 30 days of discharge attribute to exorbitant Provider costs in excess of the U.S $41.3 billion, making […]
- [Definitive guide to Healthcare Cybersecurity during COVID-19](https://solvedge.com/blog/healthcare-cybersecurity/): Definitive guide to Healthcare Cybersecurity during COVID-19 Trust and technology have been at loggerheads for a long time. Users refuse to trust their data, especially their healthcare data with companies. This is compounded by the waves of breach of data privacy across the world. It is a data “gold rush” with the changing healthcare data […]
- [Virtual Health to Expand Health Capacity in the Face of COVID-19](https://solvedge.com/blog/virtual-health/): Virtual Health to Expand Health Capacity in the Face of COVID-19 As the COVID-19 pandemic sweeps the world, it has illustrated cracks in the global healthcare ecosystem. As a result, there in a massive spike in demand for ambulatory, inpatient services and virtual health. The most critical areas likely to be impacted include the healthcare infrastructure, […]
- [Digital Health to Manage Appointment Reminders](https://solvedge.com/blog/appointment-reminders/): Digital Health to Manage Appointment Reminders The global no-show rate for doctor’s appointment is at a staggering 20%. A single no-show a day can easily cost a healthcare practice anywhere between $40,000 and $1,00,000 annually per provider. With over 80% of consumers preferring text reminders for doctor’s appointments, it’s needless to say that appointment reminder […]
- [Market Drivers, Insights & Opportunities in the Changing...](https://solvedge.com/blog/whitepaper/): Market Drivers, Insights & Opportunities in the Changing Healthcare Landscape The healthcare ecosystem is experiencing tremendous changes, in the wake of COVID-19. While the pandemic has caused significant changes in the ecosystem, there is also a major tug of war between delivering quality care and driving sustainable businesses at such critical times. The financial implications […]
- [How AI in Healthcare Transforms Patient Engagement](https://solvedge.com/blog/ai-healthcare/): How AI in Healthcare Transforms Patient Engagement Artificial intelligence is transforming businesses in unprecedented ways. Global enterprises are adopting AI to improve operational efficiencies, elevate business outcomes and deliver superior customer experiences. The Healthcare industry has started to realize the need for AI-driven solutions to address some of the most pressing challenges in the industry. […]
- [COVID-19 Impact on Chronic disease management - Ways to overcome](https://solvedge.com/blog/chronic-disease/): COVID-19 Impact on Chronic disease management – Ways to overcome The present focus of the health services is in saving lives of patients and chronic disease management amidst the ongoing COVID-19 pandemic. Though various measures taken have positively impacted, efforts are likely to continue to have a major impact on the economy, leading to a loss […]
- [$2T Stimulus: Restructuring Healthcare Ecosystem​](https://solvedge.com/blog/2t20stimulus/): $2T Stimulus: Restructuring Healthcare Ecosystem Statistics reveal that Pharmaceutical companies need to identify unique patient engagement strategies, as failing to do so could lead to a negative impact on reputation. With the rising number of COVID-19 cases in the U.S, there is increased pressure on the healthcare ecosystem, especially from the health insurance perspective. Modernization […]
- [Top Strategies to Drive Patient Access to Care during COVID-19](https://solvedge.com/blog/patient-access/): Top Strategies to Drive Patient Access to Care during COVID-19 As the COVID-19 panic strikes the globe, there is about an equal amount of fear that stops the healthcare consumers from reaching out to the doctor’s office – the risk of exposure to the virus. Consumers are reluctant to visit their providers that they are […]
- [COVID-19 Update: Latest codes you need to crack on Telehealth...](https://solvedge.com/blog/covid-19-impact/): COVID-19 Update: Latest codes you need to crack on Telehealth and Billing As a result of the COVID-19 Pandemic, the Trump administration has announced broadened access to telehealth services to provide improved telehealth access to beneficiaries – without having to travel to the doctor’s office. Centers for Medicare & Medicaid Services (CMS) extends their services to […]
- [Accelerated and Advance Payment Program](https://solvedge.com/blog/advance-payment-program/): Accelerated and Advance Payment Program The COVID-19 outbreak has disrupted the healthcare industry in unprecedented ways. The global pandemic has affected a broad spectrum of the healthcare ecosystem including the patients, providers, pharma industry among the others. While the healthcare continuum is working together to fix the broken pieces, it is undeniable that the financial […]
- [Latest Updates on Telehealth Services](https://solvedge.com/blog/telehealth-services/): Latest Updates on Telehealth Services As the novel Coronavirus sweeps the world, the healthcare continuum is at a greater pressure to take swift and bold actions to stop the spread. Healthcare leaders are constantly innovating to provide better care — yet at a safer environment for patients and care providers alike. With social distancing and […]
- [Healthcare Tech with the Human Touch](https://solvedge.com/blog/heathcare-tech-with-human-touch/): Healthcare Tech with the Human Touch Patient behavior, centricity, personalization and value based care are the critical patient engagement trends to watch for in 2020. Healthcare organizations are projected to spend over six billion dollars annually on artificial intelligence platforms, starting in 2021. This Healthcare Technology movement is setting the stage for hyper-personalized healthcare. Connected, […]
- [Harnessing Care Pathway Management Solutions to Improve...](https://solvedge.com/blog/medication-adherence/): Harnessing Care Pathway Management Solutions to Improve Medication Adherence Medication nonadherence is a detrimental factor that could have a negatively long-lasting influence on the overall care journey, ultimately impacting health outcomes. To evaluate the issue and bring comprehensive solutions, we need to take a more holistic approach by analyzing the shared responsibilities of all stakeholders involved in […]
- [Unlocking Locked-down Data](https://solvedge.com/blog/healthcare-interoperability/): Unlocking Locked-down Data Everything you need to Know about Healthcare Interoperability during COVID-19. The need for connected and secure health information exchange network to share critical patient data has significantly risen — as a result of the novel coronavirus spread across the world, according to the U.S health officials. The Office of the National Coordinator for […]
- [Revenue Integrity and Reimbursement Strategies...](https://solvedge.com/blog/revenue-integrity/): Revenue Integrity and Reimbursement Strategies for better ROI Trending healthcare terms used by providers is revenue integrity. Healthcare Organizations realize the need to address revenue integrity to boost revenues and to ensure regulatory compliance. How do hospitals, physician groups and other healthcare providers go about the revenue integrity model? A proactive strategy that focuses on […]
- [Patient Engagement Trends to Watch in 2020](https://solvedge.com/blog/patient-engagement-trends-in-2020/): Patient Engagement Trends to Watch in 2020 Healthcare is redesigning the care models more towards patient-centricity. Patients are more inclined to be treated as a consumer in view that the demand for engagement is not only coordinated & convenient but customized and accessible anywhere and anytime. Technology will play an indispensable role in paving the […]
- [Unlock the Potential of Digital Therapeutics​](https://solvedge.com/blog/digital-therapeutics/): Unlock the Potential of Digital Therapeutics Advent of new technology continues to change the medical treatment paradigms. Digital therapeutics (DTx) is an emerging technology which utilizes digital solutions to prevent, manage or treat a disease or a medical disorder. Their existence as apps in smartphone, tabs, and computers can assist and coordinate a patient’s lifestyle […]
- [5 Trends Impacting Clinical Trials in 2020](https://solvedge.com/blog/clinical-trial-2020/): 5 Trends Impacting Clinical Trials in 2020 In 2020, the clinical trials industry will continue to focus its attention on value-based outcomes and on getting more real-world evidence. Leaders will develop outcome-driven strategies emphasizing the importance of medications to providers, enabling strong payer partnerships and enhancing patient relationships. Five key trends that are bound to […]
- [Social Determinants of Health: Broadening the Horizons](https://solvedge.com/blog/sdoh-data-driven-healthcare/): Social Determinants of Health: Broadening the Horizons with Data-Driven Healthcare Social factors including the economic stability, neighborhood, physical environment, education, food, community, safety and social context—all have direct impact on the mortality, morbidity, life expectancy, healthcare expenditures, health status, functional limitations, among many other factors that contribute to the overall health and well-being of individuals […]
- [It’s Time to Get Your Due! -TripleAim Approach to Tackling](https://solvedge.com/blog/billing-underpayments/): It’s Time to Get Your Due! -TripleAim Approach to Tackling Underpayments in Medical Billing Hospitals and Medical Practices continue to take new initiatives to prevent underpayments. However, reports indicate that claim denial rates are at an all-time high—with hospitals losing billions of dollars to underpayments in medical billing every year, and about a staggering 33% […]
- [Caring for the Caregivers: Harnessing Digital to Prevent](https://solvedge.com/blog/caring-for-the-caregivers-harnessing-digital-to-prevent-physician-burnout-and-promote-wellness/): Caring for the Caregivers: Harnessing Digital to Prevent Physician Burnout and Promote Wellness The global health emergency has presented unprecedented challenges for the frontline healthcare workers—shining a light on the vulnerabilities in the healthcare landscape, one of which is Physician mental health, demanding attention amongst all the chaos around the current scenario. Physician burnout is […]
- [Surprise Billing Need not be So Surprising: Mitigating the Cost](https://solvedge.com/blog/surprise-billing/): “Surprise Billing” Need not be So Surprising: Mitigating the Cost Impact of Out-of-Network Billing Surprise billing has been a long-standing battle between out-of-network providers and Payers. A slew of changes has been implemented including the value-based payment models and other regulatory changes to resolve payment disputes and support Physicians and Patients alike. Despite the constant […]
- [Designing and Implementing Care Pathway Management Solutions](https://solvedge.com/blog/designing-care-pathway/): Designing and Implementing Care Pathway Management Solutions: The Way Forward Digital health adoption has transformed care delivery models in unimaginable ways.But, what’s next? Building robust digital care pathways involve a combination of proven strategies, nextgen technologies, profound knowledge and domain expertise that work together to deliver delightful experiences, and a clear value proposition to the […]
- [Gaining Healthcare Insights to Elevate Patient Experiences](https://solvedge.com/blog/px-strategy/): Gaining Healthcare Insights to Elevate Patient Experiences Patient satisfaction is increasingly gaining significance and becoming a key differentiator—giving the current healthcare landscape a competitive edge. However, healthcare organizations most often may not primarily focus on tracking and monitoring patient satisfaction scores, a crucial aspect in enhancing Patient Experience (PX). The Centers for Medicare and Medicaid […]
- [How Care Pathway Management Solutions Transform Patient...](https://solvedge.com/blog/care-pathway/): How Care Pathway Management Solutions Transform Patient Outcomes? The healthcare ecosystem is designed around patients and patient-centricity is amongst the key factors elevating patient outcomes. To make this possible, Hospitals and Medical Practices leverage the capabilities of next-gen technologies, industry best practices and medical expertise to navigate complex procedures, while attempting to simplify healthcare experiences for […]
- [Medical Claim Denial Management Process: 6 Key Considerations...](https://solvedge.com/blog/denial-faqs/): Medical Claim Denial Management Process: 6 Key Considerations and FAQs In our 4Clover Approach to Denials Management, our team of strategists and technologists have designed a unique four-step strategy for effective denial management in healthcare—to reduce denials, while fostering timely and accurate reimbursements. This approach has helped us identify some of the key considerations around […]
- [Don’t Deny Denials: Here’s how Claim Denials Could be Costing...](https://solvedge.com/blog/prevent-claim-denials/): Don’t Deny Denials: Here’s how Claim Denials Could be Costing You Your Fortune! Claim denials are undeniably one of the trickiest and complex processes involved in healthcare revenue cycle management. Most of the healthcare organizations intend to keep denial rates between 2% and 4%. However, the reality is otherwise, especially in the last five years. […]
- [Automating Your Way to Denial Prevention and Denial...](https://solvedge.com/blog/denial-automation/): Automating Your Way to Denial Prevention and Denial Management in Healthcare A robust denial management strategy is essential in improving the efficiencies of your revcycle. Understandable, healthcare organizations are taking stringent measures like reducing operational costs to mitigate the financial impact of the public health emergency. However, driving down costs may hurt organizational efficiencies in […]
- [Harnessing Next-gen Technologies to Accelerate Patient Outcomes](https://solvedge.com/blog/accelerate-patient-outcomes/): Harnessing Next-gen Technologies to Accelerate Patient Outcomes Healthcare organizations cannot get back to the manual methods of patient engagement. They need to leverage the capabilities of next-gen technologies and high-touch personalized experiences to drive patient engagement and satisfaction. Social distancing and quarantining have led to over 33% of healthcare consumers postponing care. An American Hospital […]
- [Denial Management Process: The 4Clover Approach to an Effective](https://solvedge.com/blog/denial-management-process/): Denial Management Process: The 4Clover Approach to an Effective Denial Management Program Denial management process can make or break your revenue cycle. It’s one of the most critical phases in the overall revenue cycle process that can have a significant impact on a Medical Practice’s revenues and cash flow. The financial impact of claim denials […]
- [Telemedicine Security Best Practices: Shifting the Focus from...](https://solvedge.com/blog/robust-telemedicine-solutions/): Telemedicine Security Best Practices: Shifting the Focus from Rapid to Robust Telemedicine Solutions Telemedicine security is one of the most significant concerns as the world embraced telehealth solutions to offer safe and secure care to patients amidst the COVID-19 pandemic. However, data security in telemedicine might have taken a backseat during the initial phases-given the […]
- [Going Paperless: Your Three-point Checklist to Achieve Operational...](https://solvedge.com/blog/paperless-solutions/): Going Paperless: Your Three-point Checklist to Achieve Operational Excellence in Healthcare Going paperless can provide multiple benefits to the healthcare stakeholders. From relieving Hospitals, Practices and administrative staff from maintaining massive volumes of patient data— to helping them elevate Patient Experiences (PX), improve Patient Satisfaction Index (PSI), increase ROI—digital patient engagement solutions can liberate care […]
- [Denial Management Services: It’s Time to Collect Every Dollar Due!](https://solvedge.com/blog/denial-management-programs/): Denial Management Services: It’s Time to Collect Every Dollar Due! Denial Management Services have various components of which Claim denials is one of the most frustrating challenges faced by the medical billing team and the healthcare system executives. Claim denials have a direct negative impact on an organization’s bottom line, and claim appeals by itself is […]
- [Healthcare Personalization: Unlocking New Potential to...](https://solvedge.com/blog/healthcare-personalization-experience-2/): Healthcare Personalization: Unlocking New Potential to Transform Patient Experiences In the world of consumerism and value-based care, there has been a tremendous shift in patient engagement strategies and the way healthcare organizations deliver care. The immensely competitive healthcare landscape has paved way for hospitals and medical practices to innovate breakthrough technologies that can offer hyper-personalized […]
- [Top 3 Ways Mobile-First Technologies Drive Care...](https://solvedge.com/blog/patient-engagement-care-coordination/): Top 3 Ways Mobile-First Technologies Drive Care Coordination Healthcare organizations need to harness the power of mobile technologies like smartphone applications and solutions to accelerate patient engagement. From managing their daily activities, learning and education to exploring the world of opportunities presented to them in the palm of their hand, smartphones have established their strong […]
- [Healthcare for Everyone: Achieving Affordable Healthcare through...](https://solvedge.com/blog/population-health1/): Healthcare for Everyone: Achieving Affordable Healthcare through Population Health Management Inequities and lack of access to quality healthcare have been prevalent in the healthcare industry. Here’s how Population health management can bridge the gap and mitigate their impact. Several new innovations and next-gen technologies have disrupted the healthcare ecosystem in the past fewyears—including Artificial Intelligence […]
- [Denial Coding Guidelines](https://solvedge.com/blog/denial-coding/): Denial Coding Guidelines Claim denials are amongst the topmost sources of revenue loss that have a direct impact on the cash flow of healthcare organizations. Denied claims alone have costed Hospitals across the U.S, a staggering $262 billion a year—leading to major financial losses and increased recovery costs. Consider that an average claim denial rate […]
- [Key Takeaways from CMS’ Proposed $310M Boost for Home...](https://solvedge.com/blog/home-health-programs/): Key Takeaways from CMS’ Proposed $310M Boost for Home Health Programs The Centers for Medicare & Medicaid Services (CMS) has announced its FY 2022 Home Health Value-based Purchasing plan—setting the stage for expanding home health programs. This blog encapsulates the essence of the 387-page proposal—giving you a quick snapshot of what’s coming, and the strategic […]
- [Ensuring Data Privacy and Security in Population Health Management](https://solvedge.com/blog/population-health/): Ensuring Data Privacy and Security in Population Health Management Healthcare organizations across the globe continue to adopt population health management solutions and strategies to accelerate patient care and improve quality of life. These initiatives are largely supported by harnessing massive volumes of critical patient data that need to be accessed, exchanged and streamlined across various […]
- [Medical Billing Services: Strategies to Prevent the Most Common...](https://solvedge.com/blog/claim-denials/): Medical Billing Services: Strategies to Prevent the Most Common Causes of Claim Denials How often have you evaluated your healthcare organization’s claim denial rate? Well, if it is anywhere above four percent, it’s time to rethink your denial management service strategy. According to the latest report by the Medical Group Management Association (MGMA), Hospitals with […]
- [Leveraging Patient Generated Data to Deliver Rich Patient...](https://solvedge.com/blog/leveraging-patient-generated-data/): Leveraging Patient Generated Data to Deliver Rich Patient Experiences & Power-up the Marketing Mix Patient generated health data, for instance, categorized by zip code, can help you identify the ideal geographies for your high-value digital advertising campaigns. While Physicians are great at treating patients, they are not necessarily marketing specialists who can carve their marketing […]
- [Top Ways to Streamline Coding and Denial Management...](https://solvedge.com/blog/orthopedic-denials/): Top Ways to Streamline Coding and Denial Management Workflows in Orthopedic Billing The Centers for Medicare & Medicaid Services (CMS) has clearly set policies and reimbursement rates for providers and follows the Physician Fee Schedule guidelines to streamline the billing process. Medical billing and coding for orthopedic surgeries have very similar guidelines. However, the global […]
- [33% of Hospitals in “Danger Zone” with 10% Claim Denials...](https://solvedge.com/blog/denial-management-services/): 33% of Hospitals in “Danger Zone” with 10% Claim Denials: Here’s How to Change the Trend Medical billing Claim Denials among healthcare organizations are at an all-time high! While the average claim denial rates are between 6% and 13%, the COVID-19 outbreak has pushed over 30 percent of hospitals to the “danger zone” with a […]
- [Denial Codes: Optimizing Efficiencies Using Medical Billing...](https://solvedge.com/blog/denial-management/): Denial Codes: Optimizing Efficiencies Using Medical Billing Denial Management Services Strategies In these challenging times, we have evaluated some of the top reasons for claim denials and identified resolution strategies to help your organization prevent claim rejections. Claim denials are common in medical billing and though it is near impossible to completely prevent denials, a […]
- [Outsourcing Medical Billing Services: Everything You Need to Know](https://solvedge.com/blog/rcm-outsourcing-medical-billing/): Outsourcing Medical Billing Services: Everything You Need to Know Hospitals and Practices are facing major financial challenges in the wake of the global pandemic. Outsourcing medical billing services could drive down operational costs while improving outcomes and letting you single-mindedly focus on patient care. Healthcare organizations across the globe have various mission statements, but there […]
- [Telemedicine Protocols: The Complete Guide to Telemedicine...](https://solvedge.com/blog/telemedicine-protocols/): Telemedicine Protocols: The Complete Guide to Telemedicine Solutions Regulations Telemedicine solutions have gone through a paradigm shift in the wake of the global pandemic. The explosive growth of telehealth solutions in the shortest span of time has also enabled CMS to roll out several guidelines and protocols in terms of practicing telemedicine. Though telemedicine platforms […]
- [How to Implement a Telemedicine Solution: The Ultimate Guide](https://solvedge.com/blog/telemedicine-implementation/): How to Implement a Telemedicine Solution: The Ultimate Guide Change management has become the new normal in today’s healthcare scenario. There is some battle fatigue—from the constantly evolving regulations affecting the revenue cycle and reimbursements to major technology disruptions that have transformed the healthcare landscape forever. Consider that the Global Telemedicine Market was valued at […]
- [3 Ways Analytics Optimizes Clinical, Operational and Financial...](https://solvedge.com/blog/clinical-operational-financial-efficiencies/): 3 Ways Analytics Optimizes Clinical, Operational and Financial Efficiencies The explosion of digital technologies has transformed the healthcare ecosystem like never before. The robust flow of massive volumes of structured and unstructured data plays a significant role in powering sustainable solutions that help organizations deliver high-quality care. Healthcare leaders across the globe are focusing on […]
- [Make a Difference to Your Outpatient Joint Replacement...](https://solvedge.com/blog/joint-replacement-asc/): Make a Difference to Your Outpatient Joint Replacement Surgery: Orthopedic Care Coordination Solutions Not too long ago, Joint Replacement was one of the niche segments of orthopedic care handled by only a selective few facilities. However, with the massive adoption of next-gen technologies and path-breaking solutions in the pain management arena, orthopedic care coordination solutions have seen […]
- [Top Ways to Improve Denial Management Process...](https://solvedge.com/blog/claim-rejections/): Top Ways to Improve Denial Management Process and Accelerate Revenues Claim rejections are amongst the key reasons that negatively impact the bottom-line of a healthcare organization. Consider the below statistics. Mind-boggling Medical Billing Statistics You Should Know! 2% The average medical billing denials is at 2% 5-10% Claim denials in practices range between 5–10% 15-20% […]
- [Key Takeaways from CMS’ Final Rule on Comprehensive Care...](https://solvedge.com/blog/cms-orthopedics/): Key Takeaways from CMS’ Final Rule on Comprehensive Care for Joint Replacement Model The Final Rule announced by the Centers for Medicare and Medicaid Services (CMS) on April 29, 2021 encompasses a key set of changes to the Comprehensive Care for Joint Replacement (CJR) model. The CJR payment program was initially launched in April, 2016 […]
- [How Orthopedic Patient Engagement Solutions Help Thrive...](https://solvedge.com/blog/orthopedics-value-based-care/): How Orthopedic Patient Engagement Solutions Help Thrive in the World of Value-based care Healthcare organizations have primarily been adopting the Fee For Service (FFS) revenue models for many decades. However, the current value-based reimbursement models have enabled Hospitals and Practices to transition to value-based care rapidly. Many Orthopedic surgeons are neglecting the significance and impact […]
- [Population Health Management: Key Strategies to Mitigate...](https://solvedge.com/blog/population-health-management/): Population Health Management: Key Strategies to Mitigate the Impact of the Global Health Emergency Population health management requires a confluence of intensive collaboration, advanced analytics, next-gen technologies and various other components that makes it challenging for most of the healthcare organizations. This is even more difficult in the wake of the COVID-19 pandemic that has […]
- [Outsourcing Medical Billing Services: A Quick Guide to COVID-19...](https://solvedge.com/blog/medical-billing/): Outsourcing Medical Billing Services: A Quick Guide to COVID-19 Billing and Coding Telemedicine and Telehealth solutions that were emerging technologies are now at the forefront of healthcare delivery, playing a significant role in offering secure digital healthcare services to patients across the globe. In fact, the Centers for Medicare & Medicaid Services (CMS) has rolled […]
- [Value-based Care: The Post-pandemic Scenario and How...](https://solvedge.com/blog/value-based_care/): Value-based Care: The Post-pandemic Scenario and How Telemedicine Solutions Will Transform the Healthcare Landscape As healthcare leaders across the globe continue to grapple with the challenges and the complexities of the COVID-19 outbreak, the pandemic has shed light on the ground realities and the long-term impact that it could have on the healthcare policies, regulations […]
- [Acupuncture Billing and Coding: Everything You Need to Know...](https://solvedge.com/blog/acupuncture-billing/): Acupuncture Billing and Coding: Everything You Need to Know to Transform Your Bottom-line! Acupuncture billing and coding is among the key specialty billing that involve several complexities that result from constantly varying codes and wide variety of treatments that differ from clinic to clinic. Though pain-related acupuncture treatment is the most common form of treatment […]
- [Remote Patient Monitoring: Improving Privacy and Security...](https://solvedge.com/blog/data-security/): Remote Patient Monitoring: Improving Privacy and Security Post-pandemic The global pandemic has spurred the healthcare ecosystem into innovating new strategies and technologies to foster remote collaboration. With increasing social distancing measures, telemedicine solutions and digital healthcare platforms are gaining significance among patients and physicians alike. Consider the fact that telemedicine visits have increased by a […]
- [Improving Healthcare Revenue Cycle Management Reimbursements...](https://solvedge.com/blog/medical-coding-rcm-strategies/): Improving Healthcare Revenue Cycle Management Reimbursements – Six Key Strategies A Medical Group Management Association (MGMA) report reveals that improving coding accuracies and filing correct claims are key factors that influence a Hospital or Practice’s revenue and cash flow. Furthermore, the health economics landscape has undergone a paradigm shift in the evolving trends of value-based care […]
- [Increasing Patient Volume: Key Strategies to Mitigate the Impact...](https://solvedge.com/blog/patient-volume-key-strategies/): Increasing Patient Volume: Key Strategies to Mitigate the Impact of COVID-19 on Patient Volume Research by the Medical Group Management Association (MGMA) report reveals that independent Practices witnessed a staggering 60 percent decrease in patient volume, in the face of the global pandemic. Most often, patients are postponing or even canceling non-urgent procedures altogether to […]
- [Key Medical Billing Service Strategies to Optimize Eligibility...](https://solvedge.com/blog/eligibility-verification-rcm/): Key Medical Billing Service Strategies to Optimize Eligibility Verification The healthcare landscape has a very complex insurance structure that could be confusing not just for Hospitals and Practices but for patients as well. Most patients are oblivious of the insurance process as it involves patient responsibilities and other options. Patients are unaware of these insurance […]
- [Covid-19 Vaccine Communications: Achieving Maximum Efficiency...](https://solvedge.com/blog/covid-vaccine/): Covid-19 Vaccine Communications: Achieving Maximum Efficiency via Automated Care Coordination Solutions Hospitals and healthcare Practices are under tremendous pressure treating the overwhelming volumes of COVID-19 patients and the COVID-19 vaccination program is adding to the already burdened care providers—who relentlessly offer care services to patients. The announcement of the COVID-19 vaccine has raised some serious […]
- [Harnessing Digital to Accelerate Patient Collection Communications](https://solvedge.com/blog/patient-collection/): Harnessing Digital to Accelerate Patient Collection Communications With increasing patient financial responsibility, it is critical that care providers focus on effective patient communication strategies to improve patient collections. Transparent communication and patient education are some of the key components that drive successful patient collection, while enhancing their experiences in the process. Revenue cycle teams are […]
- [The Core 5: Essential Strategies to Make your Revenue Cycle...](https://solvedge.com/blog/revenue-cycle-strategy/): The Core 5: Essential Strategies to Make your Revenue Cycle Journey a Success Clinical efficiency is the cornerstone of any Hospital or Medical Practice. Healthcare organizations need to constantly innovate new strategies to improve patient engagement and satisfaction, while reducing costs and minimizing errors. To achieve holistic results—clinical, financial and operational outcomes, organizations need to […]
- [The TripleAim Approach: Healthcare Insights that Boost Clinical...](https://solvedge.com/blog/triple-aim-approach/): The TripleAim Approach: Healthcare Insights that Boost Clinical, Operational and Financial Efficiencies As the saying goes, every crisis is an opportunity in disguise. The global pandemic has highlighted the significance of generating and processing high-quality healthcare data. As the healthcare ecosystem is looking to rebound and mitigate the severe impact of COVID-19, organizations are under […]
- [How the Next-gen Patient Management Platforms Can...](https://solvedge.com/blog/patient-management-platform/): How the Next-gen Patient Management Platforms Can Improve Patient Care The Patient Management software market is swamped with new entrants making their way into healthcare every day. Practice management software companies are constantly looking to expand their market share with recent mergers and acquisitions, while broadening their portfolio of remote patient monitoring solution offerings. Hospitals need […]
- [Top Ways Automated Care Pathways Can Accelerate your Clinical...](https://solvedge.com/blog/automated-care-pathways/): Top Ways Automated Care Pathways Can Accelerate your Clinical, Operational and Financial Performance The paradigm shift towards consumerism and the era of value-based care has fostered healthcare organizations across the globe to design patient-centric solutions that simplify healthcare experiences. Automated care coordination solutions are proven to drive holistic results by improving the clinical, operational and financial […]
- [3 Effective Ways Your Medical Billing Services Partner Can Boost...](https://solvedge.com/blog/medical-billing-services-partner/): 3 Effective Ways Your Medical Billing Services Partner Can Boost Financial Efficiencies Healthcare organizations are undeniably going through a challenging financial phase. Hospitals and Practices are quickly revisiting their strategies to mitigate the economic impact, reduce operational costs and optimize profits, making them consider outsourcing medical billing services. Some healthcare organizations do have inhibitions in […]
- [Physician Referral Management for Improved Patient Care - Everything...](https://solvedge.com/blog/physician-referral-management/): Physician Referral Management for Improved Patient Care – Everything You Need to Know The Medical Group Management Association (MGMA) research indicates a massive negative financial impact on Physicians: Every physician faces excessive financial losses of over $200,000 on an average. The emergence of value-based care model has had dramatic effects on Hospitals and Physician Practices getting their […]
- [Transforming Care Coordination Solutions through Automation](https://solvedge.com/blog/transforming-care-coordination-solutions-automation/): Transforming Care Coordination Solutions through Automation Patient-centric care that actively involves patients and better care coordination has been the crux of patient care over the last decade. However, the large volumes of complex data structure and disintegrated systems have made collaborative care coordination across the continuum a challenge for healthcare organizations. The underlying issue: Coordinated […]
- [Automating Healthcare Revenue Cycle Management Services...](https://solvedge.com/blog/automating-healthcare-revenue-cycle-management/): Automating Healthcare Revenue Cycle Management Services for Faster Reimbursements s the healthcare ecosystem faces growing challenges in the wake of the global pandemic, hospitals and practices need to reimagine their strategies and processes. This includes the processes, operations, healthcare capacity and revenue cycle management. Patient-centric care means transparent and efficient medical billing processes and elevated patient financial […]
- [Challenges & Solutions in the Wake of COVID-19](https://solvedge.com/blog/healthcare-revenue-cycle-management/): Challenges & Solutions in the Wake of COVID-19 Just a year ago around this time, the press and television media across the world featured the sincere and dedicated efforts of healthcare professionals especially the frontline staff—who were tirelessly working together to combat the effects of COVID-19. Healthcare systems were quick to innovate new strategies like […]
- [How Automation and Care Coordination Solutions](https://solvedge.com/blog/automation-care-coordination/): How Automation and Care Coordination Solutions Can Transform Patient Care The world is witnessing one of the greatest pandemics of all time. However, the healthcare landscape is combating other major issues along with the COVID-19 scenario. Hospitals face growing challenges with increasing instances of chronic diseases like cancer and heart conditions amidst the pandemic situation. […]
- [Patient Financial Responsibility in the Wake of COVID-19](https://solvedge.com/blog/patient-financial-responsibility/): Patient Financial Responsibility in the Wake of COVID-19 Patient financial responsibility is one of the critical factors that transform Medical Billing services. However, the Public Health Emergency (PHE) has new insights on patient-centric healthcare revenue cycle management services. The COVID-19 era has brought a paradigm shift in healthcare consumer behaviors as patients spend more time at home […]
- [Key Patient Outreach Strategies to Transform Patient Care...](https://solvedge.com/blog/patient-outreach-strategies/): Key Patient Outreach Strategies to Transform Patient Care and Experience Patient Outreach is one of the critical processes that Hospitals and Practices need to focus on, as patient journeys most often begin with patient outreach. Automated Patient Outreach programs also enable healthcare organizations to connect and collaborate with patients seamlessly and efficiently. The highly competitive […]
- [Creating Positive Financial Experiences in the World...](https://solvedge.com/blog/positive-financial-experiences/): Creating Positive Financial Experiences in the World of Value-based Care The entire gamut of healthcare delivery revolves around patients. However, the financial end of the healthcare scenario has not been the same. Healthcare organizations depend on government and private payors to make their revenues and improve cash flow, thus making billing an afterthought. But the […]
- [Transition Planning for Healthcare Organizations: The Definitive...](https://solvedge.com/blog/transition-planning-imperative/): Transition Planning for Healthcare Organizations: The Definitive Guide A critical segment of the U.S Physician workforce is age 60 or over. Physicians are entering the field. In fact, approximately 32% of the current Physician workforce is over the age of 60, according to data analyzed from Infogroup USA. While this feeds the already expected Physician […]
- [Emergency and Urgent Care Centers: The Key Drivers and...](https://solvedge.com/blog/urgent-care-center/): Emergency and Urgent Care Centers: The Key Drivers and How They Impact Healthcare Providers The emergence of COVID-19 has given rise to innovative strategies, technologies, processes and contingency plans—to mitigate the impact of the pandemic, optimize efficiencies and ultimately drive better outcomes. From a hospital-based healthcare delivery model, there has been a paradigm shift to […]
- [Elevating Patient Experiences: Digitizing Patient Journeys](https://solvedge.com/blog/elevating-patient-experiences/): Elevating Patient Experiences: Digitizing Patient Journeys Administrative inefficiencies associated with arrival and registration are known causes of patient dissatisfaction. Patients must navigate private or public transportation and parking in a complex hospital campus, only to be confined to a cramped waiting room while they complete confusing and often duplicate administrative processes. This not only complicates […]
- [5 Killer Value-based Payment Strategies to Overcome the Impact...](https://solvedge.com/blog/value-based-payment-strategies/): 5 Killer Value-based Payment Strategies to Overcome the Impact of COVID-19 The era of COVID-19 global health pandemic has highlighted the importance of creating broader revenue opportunities for hospitals and practices. Most healthcare organizations are still following the traditional Fee-For-Service (FFS) payment model. However, the pandemic has changed the healthcare landscape forever on so many […]
- [Automating COVID-19 Vaccine Care Coordination](https://solvedge.com/blog/covid-19-vaccine-care-coordination/): Automating COVID-19 Vaccine Care Coordination COVID-19 vaccination efforts continue to evolve at a rapid pace. This also means added pressure for care providers and their admins in coordinating Vaccine communications—apart from managing the logistical burdens. It is a herculean task to vaccinate the entire staff and the patient populations in a seamless manner. Automating COVID-19 […]
- [CMS’s Rule on Automating Prior Authorization: A Deep Dive](https://solvedge.com/blog/automating-prior-authorization/): CMS’s Rule on Automating Prior Authorization: A Deep Dive On 10th December 2020, the Centers for Medicare & Medicaid Services (CMS) has announced a new rule on the Prior Authorization process automation—to facilitate and improve data exchange between Care Providers and the Payers. Healthcare data exchange between Payers and Providers has been a major administrative […]
- [How to Gain Physician Trust in Telemedicine Solutions](https://solvedge.com/blog/gain-trust-telemedicine/): How to Gain Physician Trust in Telemedicine Solutions and Digital Healthcare The global health emergency has spurred the adoption of telemedicine solutions around the globe. Research indicates that about 36% of the U.S healthcare consumers have now switched to telemedicine platforms for doctor visits. This paradigm shift has created a world of opportunity for the […]
- [How to Gain Physician Trust in Telemedicine Solutions](https://solvedge.com/blog/how-to-gain-physician-trust-in-telemedicine-solutions-and-digital-healthcare/): How to Gain Physician Trust in Telemedicine Solutions and Digital Healthcare Amongst a slew of other contingency plans and programs, the newly launched $1.9 trillion COVID-19 relief plan by President Joe Biden is all set to make its impact on healthcare providers in combating the effects of the global pandemic. This is part of the […]
- [Non-labor Cost Reduction Strategies that Healthcare](https://solvedge.com/blog/non-labor-cost/): Non-labor Cost Reduction Strategies that Healthcare Organizations can Apply Right Now! (Part 1) In the healthcare ecosystem, non-labor expenses alone contribute to about 40% of the overall operating costs. There is a constant battle between labor and non-labor cost reductions and the evolving challenges in budget allocations that may lead to inefficient financial and operational […]
- [Creating effective digital patient journey framework](https://solvedge.com/blog/patient-journey/): Creating effective digital patient journey framework is an important process…. In the COVID-19 era, care providers face added pressure including the limited resources, and financial challenges, among other priorities that need to be addressed. While meeting the evolving needs, there is also significant pressure to streamline workflows, stay compliant and connected—in delivering consistent, personalized and […]
- [Medicare Physician Fee Schedule: CMS Update](https://solvedge.com/blog/medicare-physician-fee/): Medicare Physician Fee Schedule: CMS Update The Centers for Medicare & Medicaid Services (CMS) has recalculated the Medicare Physician Fee Schedule (MPFS) for the calendar year 2021, and has announced a 3.75% increase in MPFS payments. This update has been made, post the reversed rate cuts as part of the COVID-19 stimulus package in the final […]
- [Preparing for the New Normal: Healthcare Cybersecurity](https://solvedge.com/blog/cybersecurity-trends-2021/): Medicare Physician Fee Schedule: CMS Update According to the global healthcare predictions for the New Normal, the healthcare ecosystem will face increasing security challenges in terms of COVID-19 medicines, while data breaches are most likely to occur. 2020 has been a challenging year for the entire world, with significant additional responsibilities for the healthcare industry […]
- [Digital Care Coordination Solutions: Everything you need to Know](https://solvedge.com/blog/digital-care-coordination/): Digital Care Coordination Solutions: Everything you need to Know Digital transformation is leading the way across several industries including retail, consumer goods, and other sectors, However, healthcare has been slow in the adoption of digital technologies. Healthcare organizations are starting to realize the significance of adopting patient engagement strategies to achieve the holistic benefits of […]
- [Care coordination solutions can Accelerate COVID-19 Vaccine Rollout](https://solvedge.com/blog/covid19-vaccine-carecoordination/): Care coordination solutions can Accelerate COVID-19 Vaccine Rollout Let’s face it! Digital technology adoption in healthcare is not on par with the industry expectation, and this could be a major hindrance to achieving the desired immunity goals in 2021. The COVID-19 vaccine rollout is experiencing a high demand—highlighting the significance of the “last mile” in […]
- [Choosing the right vendor – How it Impacts your Financial Outcomes](https://solvedge.com/blog/rcm-vendor/): Choosing the right vendor – How it Impacts your Financial Outcomes Choosing the right vendor – How it Impacts your Financial Outcomes Creating positive patient financial experiences, while realizing your desired revenue goals are two of the healthcare RCM process’s primary objectives. Furthermore, the global healthcare revenue cycle process has garnered greater attention and significance […]
- [COVID-19 Vaccine Coding – The Ultimate Guide](https://solvedge.com/blog/covid-19-vaccine/): Choosing the right vendor – How it Impacts your Financial Outcomes Choosing the right vendor – How it Impacts your Financial Outcomes The COVID-19 Vaccine approval means that Hospitals and Practices would need to revisit their medical coding strategies to stay on top of the vaccination initiatives. The U.S Food and Drug Administration (FDA) announcement […]
- [Accelerating Outcomes in the World of Value-based Care](https://solvedge.com/blog/value-based-care/): Accelerating Outcomes in the World of Value-based Care The paradigm shift to value-based care has fostered tremendous changes in the entire healthcare ecosystem. The initial phases of value-based care had care providers working towards achieving their clinical and financial goals. However, evolving value-based care models factor in a broader spectrum of the healthcare ecosystems including […]
- [Bundled Payment Solutions – Driving Patient Financial](https://solvedge.com/blog/bundled-payments/): Bundled Payment Solutions – Driving Patient Financial Experiences and Delivering Value Bundled Payments are immensely altering the ways in which care is delivered. Bundled payments in healthcare is a patient-centric model that unlocks new potential—bringing value to patients whilst broadening their horizons. It additionally reduces cost, redefines provider strategies and elevates the overall patient care and […]
- [2021 OPPS Final Rule: Key Takeaways from the CMS Policy](https://solvedge.com/blog/cms-update-2021/): 2021 OPPS Final Rule: Key Takeaways from the CMS Policy The Centers for Medicare & Medicaid Services (CMS) has released its 2021 Outpatient Prospective Payment System (OPPS) final rule. This release includes some of the major updates like increasing Medicare outpatient costs by 2.4%, while also phasing out the inpatient only list, among many other […]
- [Improving Healthcare Operational Efficiencies](https://solvedge.com/blog/care-coordination-operational-efficiency/): Improving Healthcare Operational Efficiencies through Care Coordination Solutions The healthcare industry is going through massive changes in the face of emerging challenges and global health crisis—while there is the growing need to deliver superior care in safer and restricted environments including telemedicine solutions, remote patient monitoring, hospital beyond walls and other digital healthcare methodologies. Healthcare […]
- [How do Care coordination Solutions Impact your Financial Outcomes?](https://solvedge.com/blog/finanical-outcomes/): How do Care coordination Solutions Impact your Financial Outcomes? With increasing patient expectations, and the paradigm shift to value-based care models—there is a significant pressure on healthcare facilities to deliver hyper-personalized and coordinated care—all of which directly influence a provider’s bottom line. So, how can healthcare organizations achieve the desired financial outcomes by leveraging care […]
- [What’s next for Care Providers? - Your Definitive Guide](https://solvedge.com/blog/cp-financial-aid/): What’s next for Care Providers? – Your Definitive Guide to achieving your Financial Goals during COVID-19 The American Medical Group Association (AMGA) is taking new initiatives to expand the financial benefits by seeking further advances in Medicare reimbursements, improved flexibilities in digital health, telemedicine and remote patient monitoring capabilities —to mitigate the impact of the […]
- [Optimizing Clinical Efficiencies through Holistic Care](https://solvedge.com/blog/care-coordination-px/): Optimizing Clinical Efficiencies through Holistic Care Coordination Solution In the era of consumerism, healthcare consumers are experiencing superior and hyper-personalized Customer Experiences (CX) in industries like retail, banking and other sectors—and they expect the same from their care providers as well. However, research reveals that Patient Experience (PX) in the current healthcare landscape is far […]
- [Key Financial Enablers that Improve ROI in Healthcare](https://solvedge.com/blog/rcm-outsourcing-improve-roi/): Key Financial Enablers that Improve ROI in Healthcare: Outsourcing Revenue Cycle Management Healthcare Revenue Cycle Management (RCM) is undergoing constant change. Every time you develop a revenue cycle strategy, a new reimbursement challenge appears. Recruiting qualified professionals to manage medical billing and coding have become complex and expensive. Healthcare organizations including hospitals and practices are […]
- [Leveraging Care Coordination Solutions to Build Successful...](https://solvedge.com/blog/care-coordination/): Leveraging Care Coordination Solutions to Build Successful Care Pathways In the era of value-based care, hospitals and practices are increasingly realizing the significance of building holistic care pathways that enhance patient experiences and optimize patient outcomes. Clinical pathways or integrated care pathways are strategic roadmaps that support timely intervention and alignment of care pathways through […]
- [Maximizing Value-based Revenues – Key Tactics You Don't Want...](https://solvedge.com/blog/value-based-revenues/): Maximizing Value-based Revenues – Key Tactics You Don’t Want to Ignore Changing regulations are creating a transformational impact on the healthcare landscape. One of the key areas evolving is the fee-for-service payment models. Reports suggest that the Fee-For-Service or the FFS model is an established healthcare payment structure, which is soon to become obsolete. Here’s […]
- [Adopting-Value-Based-Care](https://solvedge.com/blog/adopting-value-based-care/): Adopting Value-based care in the Current Healthcare Landscape Value-based care has shifted from a choice to an imperative—driving healthcare organizations to reduce costs and enhance quality of care. However, statistics reveal that the pace of adoption is slow. Discover the key strategies for physicians to shift from volume to value-based healthcare Value-based care models are […]
- [Best Practices When Outsourcing Medical Billing Services](https://solvedge.com/blog/rcm-outsourcing-blog/): Best Practices When Outsourcing Medical Billing Services Care providers are faced with one of the worst economic crisis with the rise of the global pandemic. Outsourcing medical billing services to a healthcare revenue cycle management company could help you drive down operational costs, while letting you singly-mindedly focus on patient care. Healthcare organizations’ missions vary with different […]
- [Accelerating Social Determinants of Health (SDOH) to Maximize...](https://solvedge.com/blog/sdoh/): Accelerating Social Determinants of Health (SDOH) to Maximize Population Health Management Getting a 360-degree view of your patients’ critical health data—including the behavioral and environmental data is essential in realizing holistic healthcare benefits. With evolving healthcare innovations like analytics, value-based care, telemedicine solutions and remote patient monitoring, care providers are increasingly leveraging the capabilities of data, analytics and […]
- [8 Ways to Optimize Patient Payment Collections and Increase...](https://solvedge.com/blog/patient-payment-collections/): 8 Ways to Optimize Patient Payment Collections and Increase Practice Revenues Patients’ insurance programs have witnessed the most significant transformation in the last decade. Deductibles are higher than ever, and new copay structures have been designed leading to increased out-of-pocket expenses for healthcare consumers. With growing patient responsibilities, patient payments become a significant part of […]
- [Leveraging Remote Patient Monitoring Solutions to Mitigate...](https://solvedge.com/blog/remote-patient-monitoring-solutions/): Leveraging Remote Patient Monitoring Solutions to Mitigate the Impact of the Global Pandemic Patient recovery, especially from COVID-19, could be challenging. It may be difficult for patients to decide if they need to re-visit a physician during the pandemic times—increasing risks of exposure to the virus. Remote Patient Monitoring (RPM) tools enable digital care by […]
- [Healthcare Cloud Trends that Drive Patient Engagement Solutions​](https://solvedge.com/blog/healthcare-cloud-drive-patient-engagement-solutions/): Healthcare Cloud Trends that Drive Patient Engagement Solutions Today, the world is dealing with the COVID-19 pandemic, and the path forward is quite obscure and challenging. We see how the healthcare landscape is pressurized by the degree to which it has impacted the world. COVID-19 has become the “new normal” and embracing technology is no […]
- [5 Ways to Improve Healthcare Cybersecurity for Caregivers](https://solvedge.com/blog/5-ways-to-improve-healthcare-it-cybersecurity/): 5 Ways to Improve Healthcare Cybersecurity for Caregivers Healthcare consumers rely on their care providers to take care of their health needs. This also means that patients need to trust their providers with their sensitive health data. However, this trust may be compromised when there is a data breach that could collapse your healthcare organization’s […]
- [9 Proven Medical Coding Strategies You Don’t Want to Ignore](https://solvedge.com/blog/medical-coding-strategies/): 9 Proven Medical Coding Strategies You Don’t Want to Ignore As the healthcare landscape has transitioned from a fee-for-service model to value-based care, there is a growing challenge of staying financially healthy. Various factors that impact a practice’s revenue. Healthcare organizations need to work in tandem with their medical billing and coding company in creating winning […]
- [Leveraging Patient Reported Outcomes to Transform Care...](https://solvedge.com/blog/pro/): Leveraging Patient Reported Outcomes to Transform Care Coordination Solutions The paradigm shift to value-based care landscape has placed immense focus on healthcare analytics and outcomes measures. Furthermore, the rising consumerism and patient-centric care models have accelerated the need for Patient Reported Outcomes (PROs) and Patient Reported Outcomes Measures (PROMs) to evaluate and enhance health outcomes. […]
- [6 Strategies to Reduce No-show Rates](https://solvedge.com/blog/reduce-no-show/): 6 Strategies to Reduce No-show Rates It’s a busy world where people tend to forget about their daily events—and need reminders to keep up with important schedules—from the daily alarm and grocery shopping reminders to personal occasions, office meetings and monthly billing dues. The same goes for healthcare consumers who forget about their doctors’ appointments. […]
- [Top 4 Ways to Minimize Accounts Receivable (AR) Days](https://solvedge.com/blog/ar-management/): Top 4 Ways to Minimize Accounts Receivable (AR) Days An efficient revenue cycle is significant in maintaining the financial health of a healthcare organization. Healthcare revenue cycle ensures smooth operational functions by taking care of physician compensation, overheads, research, new technology investments and more. Revenue cycle process gaps can have a significant and direct impact on increasing Accounts Receivable […]
- [5 Simple Ways to Build a High-performing Doctor Referral...](https://solvedge.com/blog/referral-management/): 5 Simple Ways to Build a High-performing Doctor Referral Management System An efficient referral management system can transform three key aspects of your healthcare organization—Growth. Productivity. Revenue. However, practices face challenges with streamlining doctor referral programs and optimizing them for continuous growth. Consider the following statistics: How can you build a strong medical referral management […]
- [5 Key Strategies to Effectively Streamline and Overcome Prior...](https://solvedge.com/blog/prior-authorization/): 5 Key Strategies to Effectively Streamline and Overcome Prior Authorization Burdens Prior authorization is an essential process in medical billing as also the compelling need for care providers to get prior authorizations from payers before offering any care service could be one of the greatest hindrances to providing quality care. Consider that organizations are still following […]
- [4 Top Notch Ways to Integrate Patient Education into your...](https://solvedge.com/blog/patient-education/): 4 Top Notch Ways to Integrate Patient Education into your Care Coordination Journey As healthcare professionals realize the significance of meaningful patient engagement, care providers need to rethink their patient education strategies to align with their patient engagement solutions. Patients with a good understanding of their healthcare are the ones who take proactive measures on […]
- [6 Key Strategies to Improve Denial Management Services...](https://solvedge.com/blog/claims-management/): 6 Key Strategies to Improve Denial Management Services in Healthcare Revenue Cycle A Denial management services and reimbursements are constantly evolving in healthcare. The Affordable Care Act (ACA) has fostered major transitions in the healthcare landscape with a paradigm shift towards value-based and patient-centric care models—where Physician practices and hospitals assume a greater share of risks […]
- [Improving Patient Satisfaction Scores during and Post COVID-19...](https://solvedge.com/blog/patient-satisfaction/): Improving Patient Satisfaction Scores during and Post COVID-19: Patient Engagement Solutions and Strategies How can care providers leverage patient engagement solutions to optimize health outcomes? It’s a common question more prevalent among physicians and care coordinators, and one that has garnered attention in the face of the COVID-19 outbreak. Patients are skeptical about visiting the doctor’s office […]
- [Optimizing Healthcare Insurance Eligibility Verification: Getting Claims](https://solvedge.com/blog/eligibility-verification/): Optimizing Healthcare Insurance Eligibility Verification: Getting Claims Accepted on the First Go! The current healthcare landscape is more complex—not just for healthcare providers but for patients too. Studies show that most insurance claim denials happen due to gaps in patient information like—incorrect form filling, expired health insurance policies, missing claims form, lack of pre-certification, among […]
- [Bundled Payments 2026: How Post-Discharge Variance](https://solvedge.com/blog/bundled-payments-2026-post-discharge-variance-ortho-margins/): Bundled Payments 2026: How Post-Discharge Variance Silently Erodes Ortho Margins — Hip Fracture & Lumbar Care Leaks: When No Protocol Means No Profit Starting January 1, 2026, CMS’s mandatory bundled payment model (TEAM) will transform orthopedic reimbursement. Hospitals will be accountable for the entire episode of care, from surgery to post-discharge. But without standardized protocols, […]
- [The 80% PROMs Mandate: The Hidden $1.2M](https://solvedge.com/blog/80-proms-mandate-ajrr-gaps-readmissions/): The 80% PROMs Mandate: The Hidden $1.2M Risk Most Joint Programs Overlook – How AJRR Gaps and Rising Readmissions Are Putting 4-Star Hospitals on the Edge The Centers for Medicare & Medicaid Services (CMS) is raising the stakes for orthopedic programs with its new 80% Patient-Reported Outcome Measures (PROMs) mandate. Hospitals that fail to meet […]
- [10 Nursing Hours Lost Weekly: Manual Follow-Up vs](https://solvedge.com/blog/nursing-hours-lost/): 10 Nursing Hours Lost Weekly: Manual Follow-Up vs. Silent Post-Surgical Decline – Burnout and Undetected SSIs Are Creating a Crisis in Plain Sight Manual follow-up for post-surgical patients is a hidden crisis in hospital systems. Nurses spend an average of 10 hours weekly on manual follow-up, leading to burnout and undetected surgical site infections (SSIs). […]
- [From OR to 30 Days: A Practical Playbook for Hospitals, Surgeons](https://solvedge.com/blog/from-or-to-30-days/): From OR to 30 Days: A Practical Playbook for Hospitals, Surgeons & ACOs to Win Under CMS’s New Episode Bundles MS’s Transforming Episode Accountability Model (TEAM) fundamentally changes how Medicare pays for several high-volume surgical episodes by shifting financial accountability to hospitals for care from the index admission through 30 days post-discharge. TEAM is mandatory […]
- [Episode-Based Success: A SolvEdge Roadmap for Managing Clinical Risk,](https://solvedge.com/blog/episode-based-success/): Episode-Based Success: A SolvEdge Roadmap for Managing Clinical Risk, Post-Acute Networks and Shared Savings Under TEAM Healthcare in the U.S. is in the middle of one of its most important shifts in decades. The Centers for Medicare & Medicaid Services (CMS) has introduced the Transforming Episode Accountability Model (TEAM) — a mandatory, episode-based bundled payment program […]
- [Navigating the CMS TEAM Model FY2026 Final Rule: Key Insights](https://solvedge.com/blog/cms-team-model-fy2026-2/): Navigating the CMS TEAM Model FY2026 Final Rule: Key Insights for Healthcare Providers​ In the rapidly changing world of healthcare payment models, understanding the latest updates from the Centers for Medicare & Medicaid Services (CMS) is essential for hospitals and health systems looking to optimize care delivery and financial performance. The final rule for the […]
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- [The 3 Pillars of TEAM Success: Preparation, Data Integrity](https://solvedge.com/blog/pillars-of-team-success/): The 3 Pillars of TEAM Success: Preparation, Data Integrity, and Network Strength The TEAM Mandate isn’t just another CMS policy update—it’s a blueprint for value-based transformation. To succeed under TEAM, hospitals must do more than comply. They must align strategy, systems, and care teams under a single, high-performing framework. This requires deep work in three […]
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- [Harnessing Design Thinking in Healthcare to Reduce](https://solvedge.com/blog/design-thinking-healthcare/): Harnessing Design Thinking in Healthcare to Reduce No-shows and Accelerate Outcomes Harnessing Design Thinking in Healthcare to Reduce No-shows and Accelerate Outcomes very year, the U.S health sector witnesses several missed appointments or cancellations, for which the reasons remain unclear. Patient no shows and missed appointments can lead to operational challenges and difficulties in rescheduling […]
- [TEAM Mandate & Data Infrastructure: Why Network](https://solvedge.com/blog/network-readiness-is-critical/): TEAM Mandate & Data Infrastructure: Why Network Readiness is Critical When CMS rolls out new compliance mandates, most hospital leaders focus on policy and documentation. But with the TEAM (Transforming Episode Accountability Model) Mandate, there’s a new game-changer in play: data infrastructure. Hospitals that fail to modernize their data pipelines, EHR integrations, and reporting networks risk noncompliance, revenue loss, and audit […]
- [FY26 IPPS Policy Update: What’s Changing Under](https://solvedge.com/blog/ipps-policy-update/): FY26 IPPS Policy Update: What’s Changing Under the TEAM Mandate? With the FY26 Inpatient Prospective Payment System (IPPS) update, CMS is setting the stage for one of the most transformative compliance overhauls in recent history—the implementation of the TEAM (Transforming Episode Accountability Model) Mandate. Here’s what’s new in FY26—and what healthcare leaders must do to […]
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- [TEAM Model is Here: How Hospitals Can Win in CMS’s New Era](https://solvedge.com/blog/how-team-enhances-risk-capture-accuracy-2/): TEAM Model is Here: How Hospitals Can Win in CMS’s New Era of Accountability How Hospitals Can Win Under CMS’s TEAM Model CMS is rewriting the rules of post-acute care. With the Transforming Episode Accountability Model (TEAM) launching soon, hospitals must prepare to take full ownership of patient outcomes — not just during a hospital […]
- [Design Thinking: The Ultimate Guide to Building](https://solvedge.com/blog/building-a-robust-patient-outreach-platform/): Design Thinking: The Ultimate Guide to Building a Robust Patient Outreach Platform – Part 1 Digital healthcare technology adoption has reached new realms in the face of the global pandemic. We are witnessing major changes in the patient outreach strategies of healthcare organizations around the globe. Telehealth, Remote Patient Monitoring (RPM) and other virtual care […]
- [Creating Meaningful Patient Experiences by Integrating](https://solvedge.com/blog/interoperability-in-healthcare/): Creating Meaningful Patient Experiences by Integrating Interoperability in Healthcare Imagine this scenario: A patient is being admitted to a hospital somewhere in the country. There are multiple devices being connected to that single patient that generates massive volumes of data every few seconds. These data are securely locked in data silos, and monitored by different […]
- [From Bedside to Recovery and Beyond: Pre, during](https://solvedge.com/blog/care-coordination-outreach/): From Bedside to Recovery and Beyond: Pre, during and Post-operative Care Coordination From Bedside to Recovery and Beyond: Pre, during and Post-operative Care Coordination are coordination and patient outreach solutions aren’t entirely new concepts. Patient engagement platforms have been widely recognized to reduce no-shows and cancellations, reduce operational costs, transform Patient Experiences (PX) and accelerate […]
- [Harnessing Robust Telemedicine Strategies](https://solvedge.com/blog/robust-telemedicine-strategies/): Harnessing Robust Telemedicine Strategies to Transform Patient Experiences Harnessing Robust Telemedicine Strategies to Transform Patient Experiences Telemedicine solutions are undeniably the future of healthcare. It is one of the critical healthcare innovations that have increased accessibility to caregiving, improved quality of care, and decreased healthcare costs to a large extent. Consider that telemedicine platforms are […]
- [Patient Outreach Solutions: Top Things to Consider](https://solvedge.com/blog/remote-patient-monitoring-solution/): Patient Outreach Solutions: Top Things to Consider When Choosing a Patient Scheduling Software Patient outreach software plays a significant role in today’s healthcare ecosystem. From automating appointment reminders, scheduling and re-scheduling appointments, addressing first-level patient concerns, improving accuracies and speed of care delivery— an effective patient outreach software is strategically designed to connect patients and […]
- [Sure-fire Ways to Reduce Patient No Shows and Missed](https://solvedge.com/blog/reduce-patient-no-shows/): Sure-fire Ways to Reduce Patient No Shows and Missed Appointments Hospital no-shows are costing a fortune to the healthcare ecosystem. Consider that Noshows and missed appointments alone cost the U.S Healthcare system a staggering $150b every year. Healthcare organizations spend endless hours and efforts on mitigating the impact of patient no-shows and missed appointments. This […]
- [Engage. Educate. Elevate: Harnessing Interoperability](https://solvedge.com/blog/transform-patient-outcomes/): Engage. Educate. Elevate: Harnessing Interoperability to Transform Patient Outcomes Having comprehensive patient data can make a significant difference to patient access, engagement and health outcomes. A well-organized and structured data is essential in delivering uncompromised care to patients. For a broader understanding on data structure, here’s an overview of three levels of interoperability that define […]
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- [Key Personalization Strategies to Accelerate Your Patient](https://solvedge.com/blog/patient-outreach-program-2022/): Key Personalization Strategies to Accelerate Your Patient Outreach Program Key Personalization Strategies to Accelerate Your Patient Outreach Program In the world of consumerism, patient expectations have reached an all-time high. Patients as consumers are attuned to hyper-personalized digital experiences that simplify their interactions with a brand, and they expect the same from healthcare as well. […]
- [7 Reasons to Choose Digital Care Coordination Solutions...](https://solvedge.com/blog/joint-replacement-recovery/): 7 Reasons to Choose Digital Care Coordination Solutions to Accelerate Joint Replacement Recovery Joint Replacement surgeries especially in an outpatient environment was not as common as it is today. Technological advancements have played a significant role in transforming joint replacement care in the recent times. What’s more, Joint replacement surgeries are prognosticated to grow at […]
- [Virtual Healthcare Solutions: Here’s how Remote Patient](https://solvedge.com/blog/remote-patient-monitoring-solutions-2022/): Virtual Healthcare Solutions: Here’s how Remote Patient Monitoring can Drive Value elemedicine solutions, Remote Patient Monitoring (RPM) and other virtual healthcare innovations have redefined healthcare delivery forever. To get a glimpse of what the year 2022 has in store for the digital healthcare landscape, this blog encapsulates the essence of the next-gen virtual care solutions, […]
- [Healthcare Personalization: Unlocking New Potential...](https://solvedge.com/blog/healthcare-personalization-experience/): Healthcare Personalization: Unlocking New Potential to Transform Patient Experiences In the world of consumerism and value-based care, there has been a tremendous shift in patient engagement strategies and the way healthcare organizations deliver care. The immensely competitive healthcare landscape has paved way for hospitals and medical practices to innovate breakthrough technologies that can offer hyper-personalized […]
- [Healthcare Personalization: Unlocking New Potential](https://solvedge.com/blog/no-shows-cancellations/): Healthcare Personalization: Unlocking New Potential to Transform Patient Experiences Hospital no-shows are costing a fortune to the healthcare ecosystem. Consider that Noshows and missed appointments alone cost the U.S Healthcare system a staggering $150b every year. Massive amounts of time, resources and efforts of the hospital admin staff are spent on mitigating the effects of hospital […]
- [Insight-driven Healthcare to Create Superior Patient](https://solvedge.com/blog/superior-patient-experiences/): Insight-driven Healthcare to Create Superior Patient Experiences ata plays a transformative role in today’s healthcare ecosystem. From providing vital patient health information for better diagnostics and care to delivering personalized recommendations based on patients’ specific health needs and consumers’ preferences in terms of time and channels of engagement—healthcare organizations can leverage the capabilities of analytics […]
- [3-Point Checklist to a Successful Patient Outreach Program](https://solvedge.com/blog/patient-outreach-2/): 3-Point Checklist to a Successful Patient Outreach Program 3-Point Checklist to a Successful Patient Outreach Program n today’s digital era, it’s essential that hospitals and medical practices create unique patient outreach strategies to effectively engage their patients. However, healthcare organizations are faced with growing challenges around the paradigm shift to valuebased care and patient-centric ecosystem […]
- [Harnessing the Power of Insight-driven Healthcare](https://solvedge.com/blog/insight-driven-healthcare/): Harnessing the Power of Insight-driven Healthcare Outcomes Harnessing the Power of Insight-driven Healthcare Outcomes In the digital era, data-enabled solutions and digital care coordination tools can positively transform the healthcare ecosystem. However, the adoption of digital technologies in healthcare is comparatively lower than the other industries. Retail, banking and consumer brands are already leveraging data-driven […]
- [Embracing Digital Health Platforms to Revolutionize](https://solvedge.com/blog/embracing-digital-health/): Embracing Digital Health Platforms to Revolutionize Care Journeys The healthcare and the life sciences industry is at the forefront of creating comprehensive network-based care coordination platforms designed to enhance patient experiences and accelerate outcomes. Patient expectations have hit an all-time high! With industries including retail, banking and consumer brands delivering hyper personalized and high-touch digital […]
- [What the No Surprises Act Means for the Healthcare](https://solvedge.com/blog/surprise-billing-healthcare-community/): What the No Surprises Act Means for the Healthcare Community The No Surprises Act came into effect from January 2022. The Consolidated Appropriations Act of 2021 had the No Surprises Act as part of the bill to protect patients and improve directory information accuracy. This law announced a new set of guidelines for health insurance […]
- [Orchestrating a Holistic Patient Management Program](https://solvedge.com/blog/holistic-patient-management-program/): Orchestrating a Holistic Patient Management Program he collective goal of every healthcare organization is Patient Outcomes—the core objective that drives the patient management programs of Hospitals and Medical Practices. Patient engagement solutions cannot be treated as individual components. They need to cohesively work together with your existing systems in order to streamline workflows and create […]
- [Digital Care Coordination Solutions: Best Practices](https://solvedge.com/blog/digital-care-coordination-solutions-2022/): Digital Care Coordination Solutions: Best Practices to Follow in 2022 The healthcare ecosystem pre-COVID scenario was quite different where patients were not attuned to the digital health landscape as much as they are today. With the massive explosion of exponential technologies, virtual healthcare has revolutionized the ways in which care is delivered. In today’s digital […]
- [5-Point Checklist for a Successful Patient Outreach Program](https://solvedge.com/blog/patient-outreach-checklist/): 5-Point Checklist for a Successful Patient Outreach Program Patient outreach programs are customized processes designed as per a healthcare system’s unique and specific business requirements. However, there are some common guidelines that are applicable to all the patient outreach programs, proven to yield better results and outcomes. Here’s your five-point checklist for a successful patient […]
- [Digital Patient Engagement Solutions: Looking Ahead into 2022](https://solvedge.com/blog/digital-patient-engagement-2022/): Digital Patient Engagement Solutions: Looking Ahead into 2022 In recent years, Hospitals, medical practices and healthcare leaders across the globe have taken special initiatives to address the population health concerns and evolving need for demand capacity gaps in health systems. There have been robust efforts made to deliver superior and seamless care in an outpatient […]
- [Leveraging Digital Patient Engagement Solutions to Boost](https://solvedge.com/blog/digital-patient-engagement-solutions/): Leveraging Digital Patient Engagement Solutions to Boost Patient Experiences and Drive Outcomes In the evolving world of consumerism, global healthcare leaders have taken several initiatives to infuse digital technologies to meet the growing needs of tech-savvy consumers across the care continuum. Digitized and automated care coordination features including appointment reminders, patient scheduling, smart waitlist, secure […]
- [Healthcare 3.0: Here is how to thrive in the patient experience](https://solvedge.com/blog/improving-the-patient-experience/): Healthcare 3.0: Here is how to thrive in the patient experience economy.​ Thrive in the patient experience economy by focusing on areas that can truly make a difference in the patient journey. Here is how to adapt to healthcare 3.0. The patient experience is a journey with multiple touch-points. The movement to personalize and thread […]
- [Launch of our new orthotics and prosthetics business unit](https://solvedge.com/blog/solvedge-embarks-on-a-new-mission/): Launch of our new orthotics and prosthetics business unit. It is a new beginning. We have expanded our operations and have launched an all-new business unit to serve the orthotics and prosthetics and DMEPOS industry. As we’ve done countless times before we are committed to transform the financial outcomes of our clients. This is a […]
- [10 Best Practices on Claim Denials you need to Know](https://solvedge.com/blog/10-denial-management-strategies/): 10 Best Practices on Claim Denials you need to Know Right Now!​ Learn how health providers take advantage of innovative strategies and processes to reduce claim denials and accelerate the revenue cycle. The rise of digitization has fundamentally changed healthcare, increasing expectations for personalized and connected healthcare experiences. However, innovations in financial processes have been […]
- [Care Coordination Platform: Leveraging Digital Health Insights...](https://solvedge.com/blog/care-coordination-platform/): Care Coordination Platform: Leveraging Digital Health Insights to Drive Patient Volume Patient centricity is a significant component in today’s healthcare ecosystem. Patient expectations have grown to new heights and convenience is key in retaining and driving new patient additions. Healthcare organizations are quick to adopt automated and digitized patient-centered solutions that streamline workflows, optimize operational […]
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- [How to guide patients along the preoperative journey through patient](https://solvedge.com/blog/patient-engagement-software/): How to guide patients along the preoperative journey through patient engagement software​ Healthcare organizations face a staggering number of no-shows and backlogged surgeries. Patient engagement prior to a surgery can solve a lot of key problems, the chief among them being- patient trust Healthcare organizations are working hard to engage patients when they need care […]
- [Here is how independent practices can build financial strength](https://solvedge.com/blog/independent-practices/): Here is how independent practices can build financial strength during times of crisis​ Independent medical practices across the country are struggling to keep the lights on. Here are time-tested operational and financial strategies to cope with the current crisis. The next-normal phase in the healthcare industry is fraught with challenges. It is a time of […]
- [Tide over the Great Resignation crisis with the right growth partner](https://solvedge.com/blog/great-resignation-healthcare/): Tide over the Great Resignation crisis with the right growth partner- We will show you how​ The Great Resignation has impacted healthcare organizations and the existing staff shortage is only getting worse. What is the best way to protect revenue and ensure financial stability? Let’s find out. The Great Resignation has impacted the healthcare space […]
- [No Surprises Act: All you need to know in 2022](https://solvedge.com/blog/no-surprises-act/): No Surprises Act: All you need to know in 2022 and beyond​ The NSA has caused a stir in healthcare circles. Here is all that you need to know about this regulation and how it impacts providers and healthcare consumers. The No Surprises Act that aims to protect healthcare consumers from going into sticker shock […]
- [6 key strategies to help hospitals achieve a financial](https://solvedge.com/blog/financial-rebound-in-2022/): 6 key strategies to help hospitals achieve a financial rebound in 2022​ 6 key revenue cycle management strategies to reignite revenue growth. Hospitals across the country were blindsided by the pandemic. Here is how to thrive in the next normal A strong revenue cycle foundation is important to rebound from the revenue loss and uncertainty […]
- [5 ways to realize quicker ROI from your healthcare](https://solvedge.com/blog/healthcare-technology-hospitals/): 5 ways to realize quicker ROI from your healthcare technology investment​ How do achieve quick success with healthcare technology? This blog outlines 5 time-tested waysto get the best outcomes. Read on. There is a growing shift to consumerism in the healthcare industry and the patient-first movement has gained momentum. As every industry turned to technology […]
- [Power your revenue cycle through robotic process​](https://solvedge.com/blog/robotic-process-automation/): Power your revenue cycle through robotic process automation. See how.​ Optimize your revenue cycle through robotic process automation. Let RPA bots take care of high-frequency and low priority tasks. Read on to know how. The need to contain costs and implement revenue cycle best practices has never been more important or urgent in the healthcare […]
- [Improving the bottom line: Top medical coding](https://solvedge.com/blog/medical-coding-mistakes/): Improving the bottom line: Top medical coding mistakes and how to avoid them​ Medical coding is the foundation on which the entire revenue cycle lies. Incorrect codes have a cascading effect and impact various processes. Edit fatigue is real. And so is medical claims being rejected due to incorrect coding. The complexion of medical coding […]
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- [Improve Coding Efficiency- ICD-10 Codes To Know](https://solvedge.com/blog/improve-coding-efficiency/): Improve Coding Efficiency- ICD-10 Codes To Know Before October 2022​ Here is a handpicked list of ICD 10 codes that medical practices must know to improve the efficiency of their medical coding and clinical documentation process. Read on. The latest ICD-10 update is here. This blog will provide you a rundown of the latest codes, […]
- [Clinical Documentation Improvement - Remain](https://solvedge.com/blog/clinical-documentation-improvement/): Clinical Documentation Improvement – Remain Compliant and Profitable​ It results in higher reimbursement and better patient care. The downside? It is complex, time-consuming and increases the time clinicians spend on administrative tasks. Clinical Documentation Improvement (CDI) when implemented successfully bridges the gap between clinical documentation and coded data. It results in higher reimbursement and better […]
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- [How To Improve Patient Collections In 2022- Your Guide](https://solvedge.com/blog/improve-patient-collections-in-2022/): How To Improve Patient Collections In 2022- Your Guide To Getting Paid​ Do you want to improve patient collections? As today’s medical practices cater to empowered patients who are involved in their healthcare, it is important to provide a payment experience that is seamless and transparent. Do you want to improve patient collections? As today’s […]
- [The 2022 HBMA Fall Conference is here and we are](https://solvedge.com/blog/hbma-fall-conference-2022/): The 2022 HBMA Fall Conference is here and we are delighted to be a part of it!​ Event: HBMA Fall Conference @ Booth #24 When: 15th to 17th September 2022 Where: St. Louis, Marriott Grand Hotel. The HBMA Fall conference is here and SolvEdge is excited to be a part of it. We will be at […]
- [Behavioral health – Technology enabled Patient](https://solvedge.com/blog/technology-enabled-patient-outreach-solutions/): Behavioral health – Technology enabled Patient Outreach Solutions​ Healthcare organizations are extensively leveraging the capabilities of health insights, automation, AI and other immersive technologies to transform the impact of patient outreach solutions. Healthcare organizations are extensively leveraging the capabilities of health insights, automation, AI and other immersive technologies to transform the impact of patient outreach […]
- [Harnessing Automation to Deliver Omnichannel​](https://solvedge.com/blog/build-patient-trust/): Harnessing Automation to Deliver Omnichannel Consumer Experiences and Build Patient Trust​ The global pandemic has transformed the healthcare landscape forever, propelling healthcare organizations to provide essential services in a secure and remote setting. In the world of consumerism and value-based care, patient-centricity is at the heart of the healthcare ecosystem—allowing care providers to deliver superior […]
- [Design Thinking: The Patient-Centric Approach](https://solvedge.com/blog/healthcare-consumer-experiences/): Design Thinking: The Patient-Centric Approach to Transforming Healthcare Consumer Experiences Telemedicine solutions, Remote Patient Monitoring (RPM) and other virtual care coordination platforms are gaining popularity. Digital healthcare technology adoption has reached new realms in the face of the global pandemic. There has been a paradigm shift in terms of care delivery models and patient engagement […]
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- [Patient Outreach Strategies to Drive PX and Deliver](https://solvedge.com/blog/patient-outreach-health-outcomes/): Patient Outreach Strategies to Drive PX and Deliver Transformative Health Outcomes Patient Outreach Patient Outreach Strategies to Drive PX and Deliver Transformative Health Outcomes Meaningful patient engagement involves proactive patient outreach strategies and programs that can seamlessly engage the healthcare consumers throughout their care journeys. Meaningful patient engagement involves proactive patient outreach strategies and programs […]
- [Patient Outreach Strategies for Hospital and Medical](https://solvedge.com/blog/patient-outreach-strategies-hospital/): Patient Outreach Strategies for Hospital and Medical Practices: The Do’s and Don’ts Successful patient care coordination journeys and patient experiences start with proactive patient outreach programs. It is one of the most critical steps that enhance and elevate care pathway management programs of a healthcare organization. Successful patient care coordination journeys and patient experiences start […]
- [Effective Patient Outreach Strategies: Leveraging​](https://solvedge.com/blog/patient-outreach/): Effective Patient Outreach Strategies: Leveraging Next-gen Technologies to Transform PX​ Patients are engaged throughout their care journeys. A robust care coordination solution, integrated with automation and a strategic patient outreach program goes a long way in transforming patient experiences and driving health outcomes. Patient outreach is a significant part of every healthcare management system. It […]
- [7 Proven Strategies to Accelerate Your Healthcare](https://solvedge.com/blog/healthcare-web-and-mobile-application/): 7 Proven Strategies to Accelerate Your Healthcare Web and Mobile Application Security​ This blog is a deep dive into some of the healthcare industry’s proven best practices that help maintain highest standards of web and mobile application security From patient engagement platforms and care coordination solutions to holistic patient outreach solutions, building a healthcare application […]
- [Healthcare Data Security: Everything You Need to Know](https://solvedge.com/blog/healthcare-datas-security/): Healthcare Data Security: Everything You Need to Know About HIPAA Compliance in 2022 Healthcare Data Security: Everything You Need to Know About HIPAA Compliance in 2022 Health Insurance Portability and Accountability Act (HIPAA) is a federal law designed to prevent disclosure of sensitive patient health information without patients’ consent The need for having a robust […]
- [Patient Outreach Solutions: Top Things to Consider When Choosing...](https://solvedge.com/blog/patient-scheduling-software/): Patient Outreach Solutions: Top Things to Consider When Choosing a Patient Scheduling Software Patient outreach software plays a significant role in today’s healthcare ecosystem. From automating appointment reminders, scheduling and re-scheduling appointments, addressing first-level patient concerns, improving accuracies and speed of care delivery— an effective patient outreach software is strategically designed to connect patients and […]
- [Creating Desirable Patient Journeys: Digital Patient Engagement Solutions](https://solvedge.com/blog/creating-desirable-patient-journeys-digital-patient-engagement-solutions/): Creating Desirable Patient Journeys: Digital Patient Engagement Solutions Conventional methods of care pathway management could be detrimental to patients and care providers—resulting in operational inefficiencies, poor patient experiences and compromised health outcomes. In the world of consumerism and value-based care, healthcare organizations need to consider adopting intuitive patient engagement solutions that can accelerate health outcomes, […]
- [Harnessing Insight-driven Healthcare to Transform Patient...](https://solvedge.com/blog/patient-engagement-strategy/): Harnessing Insight-driven Healthcare to Transform Patient Experiences and Outcomes Data plays a significant role in elevating consumer experiences across industries. Leading industry segments including retail, banking and consumer goods have capitalized on exponential technologies including Artificial Intelligence (AI), big data and analytics to gain actionable insights, deliver customized solutions and personalize Customer Experiences (CX) at […]
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- [Insight-Driven Patient Outreach Program: Automating Patient...](https://solvedge.com/blog/patient-outreach-program/): Insight-Driven Patient Outreach Program: Automating Patient Management Solutions Healthcare organizations are increasingly adopting digital solutions to automate and personalize their patient outreach programs. From appointment reminders, patient referrals, patient scheduling, smart waitlists and secure chat to mobile patient intake, patient recall, multi-lingual messaging and reporting—the healthcare ecosystem is reimagining their patient outreach strategies by integrating […]
- [You’re in for a Big Surprise: Here’s what the Surprise Billing Act...](https://solvedge.com/blog/surprise-billing-2022/): You’re in for a Big Surprise: Here’s what the Surprise Billing Act has in Store for you in 2022! The No Surprise Billing Act 2022 has ironically raised eyebrows of many industry leaders across the healthcare landscape. According to the announcement made by the U.S. Department of Health & Human Services (HHS), this may be an end of […]
- [The Definitive Guide to Post-operative Care Coordination...](https://solvedge.com/blog/orthopedic-surgery/): The Definitive Guide to Post-operative Care Coordination Solutions for Orthopedic Surgery Post-surgical follow-up care in Orthopedic surgeries is critical in ensuring speedy recovery, reduced readmissions, and overall improvement in health outcomes. To maximize outcomes, healthcare organizations can consider adopting the best practices and proven strategies that can deliver true value to the post-operative care management […]
- [Don’t live in denial. Actionable tips to tackle and zero down...](https://solvedge.com/blog/denial-prevention/): Don’t live in denial. Actionable tips to tackle and zero down on claim denials Claim denials have hit record high levels in recent times. Consider these facts—Denials in healthcare have increased by a staggering 23% in 2020 compared to four years ago. 33% of hospitals are reported to be “exceeding the danger zone” with an average […]
- [No Shows and Missed Appointments Could be Costing You...](https://solvedge.com/blog/appointment-reminder/): No Shows and Missed Appointments Could be Costing You a Fortune: Here’s how No shows and missed appointments could have a ripple effect on medical practice’s clinical, operational and financial efficiencies. To start with, Hospital no shows alone cost the U.S healthcare system a staggering $150 billion every year. Furthermore, with care delivery models shifting to […]
- [Simplifying Joint Replacement Recovery: Digital](https://solvedge.com/blog/joint-replacement-program/): Simplifying Joint Replacement Recovery: Digital Care Coordination Solutions Here’s a deep dive into industry best practices, proven strategies and solutions on how healthcare systems can harness the capabilities of digital to transform and accelerate joint replacement recovery programs. From Physician discovery, self-scheduling, appointment reminders to pre, during, postoperative care, and recovery—digitization and automation plays a […]
- [Unlocking the Digital Potential in Orthopedic Care](https://solvedge.com/blog/orthopedic-care/): Unlocking the Digital Potential in Orthopedic Care This blog is a deep dive into the various components of the orthopedic healthcare system and how organizations can harness digital to transform patient engagement, experience and maximize outcomes. The musculoskeletal healthcare landscape has witnessed exponential changes over the past decade. From the paradigm shift from Fee for […]
- [Harnessing Digital Health Strategies to Drive Holistic](https://solvedge.com/blog/digital-health1/): Harnessing Digital Health Strategies to Drive Holistic Digital Business Transformation Digital healthcare models adopted by healthcare leaders around the world to give a leadership POV on the latest digital healthcare trends—that foster the healthcare digital transformation journey. There has been an explosion of digital technologies and patient management solutions in the past decade. Healthcare leaders […]
- [6-Point Checklist to a Successful Remote Patient](https://solvedge.com/blog/rpm/): 6-Point Checklist to a Successful Remote Patient Monitoring Program 6-Point Checklist to a Successful Remote Patient Monitoring Program The need for Virtual healthcare solutions have tremendously increased in the face of the Public Health Emergency (PHE) shining a spotlight on the digital health platforms including Remote Patient Monitoring and telemedicine solutions. Harnessing data-driven health insights […]
- [Building Digital Patient Experiences: A Deep Dive](https://solvedge.com/blog/digital-patient-experiences/): Building Digital Patient Experiences: A Deep Dive healthcare systems are increasingly adopting digital strategies to deliver automated and seamless patient experiences—thereby providing a competitive advantage to their healthcare consumers. In the world of value-based care, healthcare systems are increasingly adopting digital strategies to deliver automated and seamless patient experiences—thereby providing a competitive advantage to their […]
- [3 Key Digital Strategies to Deliver Accurate Patient](https://solvedge.com/blog/pghd/): 3 Key Digital Strategies to Deliver Accurate Patient Generated Health Data​ Hospitals and Medical Practices are also increasingly turning to digital healthcare technologies to foster collaboration, enhance patient experiences, drive health outcomes, boost reimbursements and financial outcomes. In the patient-centric world of care, patients as consumers have growing expectations from their care providers in terms […]
- [Harnessing Social Determinants of Health to Transform](https://solvedge.com/blog/population-healthmanagement/): Harnessing Social Determinants of Health to Transform Population Health Management Social Determinants of Health (SDOH) like how people live, learn, work, play and age can have a major influence on the health of a population. Various components including the economic stability, neighborhood and physical environment, education, food, community, safety and social context have a massive […]
- [Powering Patient Engagement Solutions to Boost](https://solvedge.com/blog/boost-value-based-care/): Powering Patient Engagement Solutions to Boost Value-based Care The Value-based Care trend has seen exponential growth in the past decade and is here to stay. However, it is essential that Hospitals, Medical Practices and Payors establish an analytics-powered, integrated patient engagement framework to optimize the business case of the value-based model. With evolving technologies and […]
- [Digital Care Coordination Solutions to Accelerate COVID-19](https://solvedge.com/blog/booster-vaccine/): Digital Care Coordination Solutions to Accelerate COVID-19 Vaccine Booster Initiative Digital care coordination solutions enable care providers optimize efficiencies and orchestrate outcome-driven strategies in streamlining the COVID-19 vaccine booster programs. This fall brings a new turn of events in terms of the COVID-19 booster vaccines. The Centers for Disease Control and Prevention (CDC) has expanded the eligibility […]
- [7-Point Checklist to a Successful Claim Denial](https://solvedge.com/blog/denial-management-program/): 7-Point Checklist to a Successful Claim Denial Management Program Denial Management in Medical billing has witnessed a paradigm shift in the last five years, especially since 2020, when claim denials hit an all-time high! Reports indicate that over 33% of hospitals were nearing the “danger zone” with an average claim denial rate exceeding 10%. However, the […]
- [Digital Care Coordination Solutions: Automate your Way](https://solvedge.com/blog/care-coordination-digital/): Digital Care Coordination Solutions: Automate your Way to Maximize Reimbursements & Optimize ROI Healthcare reimbursements can be very tricky depending on various factors involved in the medical billing process. The complex framework includes the digital care coordination solutions and automated patient management platforms that can have a transformative effect on the financial experience of the […]
- [Ambulatory Surgery Centers: Affordable Care](https://solvedge.com/blog/ambulatory-surgery-center/): Ambulatory Surgery Centers: Affordable Care with Uncompromised Health Outcomes Ambulatory Surgery Centers: Affordable Care with Uncompromised Health Outcomes Ambulatory Surgery Centers (ASCs) can reduce costs for Payors by a whopping 59 percent by moving hospital outpatients to ASC setting. Ambulatory surgery centers or Hospital beyond the walls can create huge value for outpatient healthcare services. […]
- [Healthcare Interoperability: Proven Strategies to Build](https://solvedge.com/blog/healthcare-ecosystem/): Healthcare Interoperability: Proven Strategies to Build a Hyper-connected Healthcare Ecosystem Healthcare Interoperability: Proven Strategies to Build a Hyper-connected Healthcare Ecosystem Healthcare Payers are increasingly guided by new government regulations and compliance concerns, and amidst these changes, there is also a great opportunity to accelerate value by integrating interoperability strategies. The Centers for Medicare & Medicaid […]
- [Data-driven Personalization: Enhance Care Quality](https://solvedge.com/blog/data-driven-personalization/): Data-driven Personalization: Enhance Care Quality and Accelerate Patient Outcomes In the digital age, delivering tailored experiences and offerings to individual patients based on their habits and behaviors is now an expected role of care providers, but requires both huge volumes of quality data and the right strategy to ensure better Patient Experiences (PX) and outcomes. […]
- [Digital Healthcare: The Current State and the Way Forward](https://solvedge.com/blog/digital-health/): Digital Healthcare: The Current State and the Way Forward The past year has witnessed some extreme circumstances that changed the global healthcare landscape forever and steered Hospitals and Practices in taking innovative approaches to virtual care delivery, thereby shining a spotlight on digital health. Digital Health: The Pre-Covid Scenario The Digital healthcare industry, pre-covid was […]
- [5 Common Denial Management Questions & Their Answers](https://solvedge.com/blog/denial-qa/): 5 Common Denial Management Questions & Their Answers here’s been a whopping 20% increase in claim denials in the past five years. The global pandemic has only made this trend worse. The sudden spike in denials have put over 33% of Hospitals and Medical Practices in danger zone, creating massive pressure on especially independent Practices. […]
- [Delivering Patient Trust in the Digital Era: Going Above and Beyond](https://solvedge.com/blog/positive-patient-experience/): Delivering Patient Trust in the Digital Era: Going Above and Beyond in Creating Positive PX Trust is one of the critical factors in a doctor-patient relationship. Healthcare being one of the key industries that involve critical patient information and sensitive health data, building patient trust has been an inbuilt value and a core component in […]
- [Claims Denied! Claims Rejected! - A Root-cause Analysis Report](https://solvedge.com/blog/root-cause-denials/): Claims Denied! Claims Rejected! – A Root-cause Analysis Report to overcome these Nightmares Every problem has a solution. When we get to the root cause of it. Sounds easy doesn’t it? But is it as simple as it sounds? Well, it really depends. The more complex the issue, the deeper we need to delve into […]
- [ACOs stand to lose a MACRA bonus this year: The inside angle](https://solvedge.com/blog/acos-macra-bonus/): ACOs stand to lose a MACRA bonus this year: The inside angle on what’s happening. It is not the best of times for accountable care organizations. As the end date for a dependable MACRA bonus draws near, there is a lot of confusion in the air. Here is the inside angle. The end of 2022 […]
- [BPCI Advanced Participation Readiness Assessment](https://solvedge.com/assessments/bpci-advanced-participation-readiness-assessment/): BPCI Advanced · 12-Question Readiness Tool BPCI Advanced Participation Readiness Assessment Designed for hospital CFOs and bundled payment coordinators considering BPCI Advanced participation or evaluating their current program performance. Benchmarked against DataGen BPCI analytics benchmarks and CMS participant performance data. Answer honestly based on your current capabilities — this determines whether BPCI Advanced is a financial opportunity or a financial risk for your organization right now. 1. Do you currently have visibility into your hospital’s all-in episode costs (including post-acute and readmissions) within 30 days of the episode closing? No — we see this data only at CMS reconciliation, months […]
- [400-Bed Community Hospital Earns $1.8M in Net BPCI Advanced...](https://solvedge.com/case-study/400-bed_community_hospital_earns/): Case Study · BPCI Advanced · Orthopedic Episode Management 400-Bed Community Hospital Earns $1.8M in Net BPCI Advanced Savings Across LEJR Episodes From near-exit to top-quartile performance: how one hospital turned around its bundled payment program in 14 months by fixing the one thing most BPCI participants overlook. SolvEdge · 400-Bed Community Hospital Earns $1.8M in Net BPCI Advanced Savings 400-Bed Community Hospital Southeast US BPCI Advanced – LEJR + Hip Fracture Episodes ~320 Episodes/Year Meditech EHR $1.8M Net BPCI Advanced savings in Year 3 (first full year with SolvEdge) 22% Episode cost reduction vs. their own Year 2 baseline […]
- [PRO-PM CMS Reporting Checklist for Orthopedic Programs](https://solvedge.com/checklists/pro-pm-cms-reporting-checklist-for-orthopedic-programs/): Submission Checklist  ·  BPCI Advanced PRO-PM  ·  2026 PRO-PM CMS Reporting Checklist for Orthopedic Programs Step-by-step submission checklist for hospitals and orthopedic practices collecting HOOS Jr. / KOOS Jr. data under BPCI Advanced. Almost no comparable resource exists publicly – this is your competitive advantage. Completed: 0 / 14 items Baseline Collection Setup Pre-op workflow ✓ Confirm CMS-specified instruments are loaded in your collection system: HOOS Jr. (hip replacement), KOOS Jr. (knee replacement). Modified or translated versions are not accepted. Critical ✓ Set baseline collection window: PRO-PM baseline must be collected within 90 days prior to the anchor procedure. Build […]
- [Population Health Management Software RFP: 32 Questions...](https://solvedge.com/guides/population_health_management_software/): SolvEdge · Healthcare Resource Hub — Tools, Calculators, Checklists & Case Studies Free Template · 32 Questions · Benchmarked vs. Innovaccer, Arcadia, Epic Healthy Planet, WellSky Population Health Management Software RFP: 32 Questions Every ACO Should Ask These questions were built by asking health system CIOs what they wish they’d asked before signing a PHM contract. Some of them are uncomfortable questions. Ask them anyway. Section 1: Data Integration What is the latency between a clinical event in our EHR and its appearance in your platform’s risk model? Do you receive direct claims feeds from CMS and commercial payers, or […]
- [Regional ACO Reduces ED Utilization 24% Using PHM Risk...](https://solvedge.com/case-study/regional_aco_reduces_ed_utilization/): Case Study · Population Health Management · Regional ACO Regional ACO Reduces ED Utilization 24% Using PHM Risk Analytics — Without Adding Staff A 90-physician independent ACO replaced its legacy care management approach with a data-first model and achieved results that surprised even their own board. SolvEdge · Regional ACO Reduces ED Utilization 24% Using PHM Risk Analytics 90-Physician Independent ACO Mid-Atlantic US Medicare Shared Savings + 2 Commercial VBC Contracts ~42,000 Attributed Lives athenahealth EHR 24% Reduction in preventable ED visits across attributed panel $1.4M Annualized cost reduction from ED avoidance alone 62% High-risk patients reached within 72 hours […]
- [Midwest Health System ACO Achieves $3.1M in Shared Savings...](https://solvedge.com/case-study/midwest_health_system_aco_achieves/): Case Study · Value-Based Care · MSSP ACO Midwest Health System ACO Achieves $3.1M in Shared Savings in Year 2 From reactive to predictive: how a 12-hospital Midwestern ACO turned its population health analytics from a compliance tool into a revenue engine. SolvEdge · Healthcare Resource Hub — Tools, Calculators, Checklists & Case Studies 12-Hospital Health System Midwest US MSSP Track 2 ACO ~180,000 Attributed Beneficiaries Epic EHR $3.1MNet shared savings earned in Year 2 19%Reduction in total cost of care vs. benchmark 31%Drop in preventable ED visits in the high-risk cohort 4.2ptsMSSP quality score improvement year-over-year The situation before […]
- [How much Medicare revenue is your group leaving on the table?](https://solvedge.com/calculators-tools/medicare-revenue-gap-calculator/): SolvEdge · Medicare Revenue Gap Calculator Free Tool  ·  90-Second Estimate How much Medicare revenue is your group leaving on the table? Built on 2026 Medicare Physician Fee Schedule rates. Methodology benchmarked against Optum Advisory and Sg2 revenue optimization frameworks. Number of Eligible Physicians Primary Specialty Mix Primary Care (Internal Medicine / Family Medicine)CardiologyOrthopedicsMulti-Specialty Group % of Medicare Patients in Panel Approximate percentage of your total patient panel covered by Medicare or Medicare Advantage Currently Billing CCM/Care Management Codes? No — not billing CCM/PCM/TCMPartially — some providers billingYes — systematically billing Current MIPS Performance Level Not reporting MIPSReporting — below […]
- [CMS TEAM Model Readiness Assessment](https://solvedge.com/assessments/cms-team-model-readiness-assessment/): CMS TEAM Model Readiness Assessment: Find Your Margin Exposure in 60 Seconds Where does your organizationstand on CMS TEAM Model readiness? This is an internal audit framework – not a marketing material.Input your actual numbers across eight operational checkpoints and receive a personalized risk exposure report within 60 seconds. $1,300+Avg. cost gap per episode 40%Episode costs post-discharge 50%PROM threshold for clawback Jan 2026TEAM mandatory start date SECTION A – 3 RISK VECTORS The Hard Truths of the CMS TEAM Model Rate your organization’s current exposure. Your inputs are used to generate your personalized risk report. 01 REVENUE RISK The Revenue […]
- [CMS Quality Measures Compliance Checklist 2026](https://solvedge.com/checklists/cms_quality_measures_compliance_checklist/): SolvEdge · CMS Quality Measures Compliance Checklist 2026 2026 Compliance Checklist  ·  MIPS + HEDIS + VBP CMS Quality Measures Compliance Checklist 2026 For quality directors, MIPS coordinators, and compliance officers. Covers MIPS, MSSP ACO quality, HEDIS, and Hospital VBP – the four programs most US healthcare organizations manage simultaneously. Completed: 0 / 18 items MIPS – Quality Performance Category Reporting ✓ Confirm eligible clinician (EC) list for 2026 MIPS performance year – verify NPI-level eligibility in the QPP Participation Status tool. Q1 Priority ✓ Select and lock your quality measure set – Confirm your 6 quality measures (or specialty […]
- [Value-Based Care Readiness Assessment](https://solvedge.com/assessments/value_based_care_readiness_assessment/): SolvEdge · Value-Based Care Readiness Assessment Value-Based Care  ·  Maturity Assessment Value-Based Care Readiness Assessment Benchmarked against the operational maturity model SolvEdge uses across 60+ US ACO and health system engagements. Methodology informed by NCQA, KLAS Research VBC maturity framework, and Innovaccer ACO performance benchmarks. Select the answer that most accurately describes your organization’s current state — not your goal or plan. 1 How does your organization currently identify high-risk patients in your Medicare or attributed panel? We use physician judgment or referrals — no systematic risk stratification We run periodic reports from our EHR or claims system, but not […]
- [State of Healthcare IT 2026: Technology Investments](https://solvedge.com/assessments/state-of-healthcare-it-2026-report/): — Annual Report  ·  SolvEdge Research  ·  US Healthcare State of Healthcare IT 2026: Technology Investments That Are Delivering — and the Ones That Aren’t Benchmarked against public KLAS Research, Black Book Rankings, and HIMSS Analytics reports. Internal data from SolvEdge engagements with 60+ US health systems, ACOs, and physician groups. SolvEdge · State of Healthcare IT 2026: Technology Investments That Are Delivering — and the Ones That Aren’t Annual Report  ·  SolvEdge Research  ·  US Healthcare State of Healthcare IT 2026: Technology Investments That Are Delivering — and the Ones That Aren’t Benchmarked against public KLAS Research, Black Book […]
- [Medicare Reimbursement Rates 2026: Complete Guide...](https://solvedge.com/guides/medicare-reimbursement-rates-2026/): Medicare Reimbursement Rates 2026: What Physician Groups & Hospitals Need to Know Right Now Medicare Reimbursement Rates 2026: What Physician Groups & Hospitals Need to Know — SolvEdge Medicare reimbursement rates affect every physician group, hospital, and outpatient practice in the United States. The 2026 physician fee schedule brings rate changes, conversion factor adjustments, and policy updates that have direct impacts on your revenue — whether or not you’ve had time to read the full CMS final rule. This guide breaks down the 2026 Medicare reimbursement changes in plain language — what changed, how much, and what your organization should […]
- [PRO-PM Reporting for CMS: BPCI Advanced Collection...](https://solvedge.com/guides/pro-pm-reporting-for-cms/): PRO-PM Reporting for CMS: What Hospitals & Orthopedic Practices Must Know in 2026 Patient-Reported Outcome Performance Measures — PRO-PMs — represent a fundamental shift in how CMS evaluates care quality. For decades, quality reporting centered on process measures: did you do the right thing? PRO-PMs ask a harder question: did the patient experience a meaningful improvement? For orthopedic practices, surgical programs, and hospitals participating in BPCI Advanced and other CMS alternative payment models, PRO-PM collection and reporting is no longer optional. It’s a performance measure with direct financial implications. And the organizations that haven’t built systematic collection workflows are already […]
- [BPCI Advanced 2026: Participation Guide, Reconciliation...](https://solvedge.com/guides/bpci-advanced-2026/): BPCI Advanced 2026: Participation Guide, Reconciliation Strategy & How to Select a Convener BPCI Advanced is one of the most financially significant CMS alternative payment models available to hospitals and physician group practices – and one of the most poorly documented in publicly available content. Most organizations evaluating BPCI participation can’t find clear, current information on episode selection strategy, target price methodology, or what distinguishes a quality convener from one that will hurt your financial performance. This guide changes that. What BPCI Advanced Is – and What It Isn’t BPCI Advanced is a voluntary CMS alternative payment model in which […]
- [Healthcare IT Consulting Services for US Health Systems](https://solvedge.com/guides/healthcare-it-consulting-services-for-us-health-systems-and-the-state-of-healthcare-it-in-2026/): Healthcare IT Consulting Services for US Health Systems — And the State of Healthcare IT in 2026 The gap between health systems that use technology as a strategic asset and those using it as an operational cost center has never been wider. The organizations winning on quality scores, total cost of care, and patient satisfaction share a common thread: they made deliberate, well-sequenced technology investments – not reactive ones driven by vendor relationships or regulatory deadlines. SolvEdge works with US health systems, physician groups, and ACOs to design, implement, and optimize healthcare IT infrastructure that actually delivers on its clinical […]
- [How much could your hospital save on episode-based payments?](https://solvedge.com/calculators-tools/bundled-payment-savings-calculator/): SolvEdge · Bundled Payment ROI Calculator Free Tool  ·  No Login Required How much could your hospital save on episode-based payments? Estimates reflect Year 2–3 performance benchmarks from US BPCI Advanced participants with active PAC network management. Primary Episode Type Lower Extremity Joint Replacement (LEJR)Spinal FusionCardiac Valve / CABGSepsisHip FracturePneumonia Annual Episode Volume Number of qualifying episodes per year for this episode type Current Average Episode Cost ($) Your all-in episode cost (hospital + post-acute + readmissions) PAC Network Management No structured PAC networkBasic (informal preferred SNFs)Managed (tiered network with contracts) Current 90-Day Readmission Rate (%) Program Maturity Year 1 […]
- [Bundled Payment Vendor Evaluation Checklist](https://solvedge.com/checklists/bundled-payment-vendor-evaluation-checklist/): SolvEdge · Bundled Payment Vendor Evaluation Checklist 17-Point Framework  ·  Updated 2026 Bundled Payment Vendor Evaluation Checklist Benchmarked against criteria used by CFOs and bundled payment coordinators who have evaluated DataGen, NaviMedix, Archway Health, and Cedar Gate. Completed: 0 / 17 items Analytics & Data Core capability ✓ Real-time episode cost dashboard — Can care coordinators see live cost tracking, or does data arrive only at reconciliation? Critical ✓ Claims data refresh frequency — Ask for the claims lag time. Anything longer than 2 weeks is operationally too slow for active episode management. ✓ Post-acute utilization analytics — Can you […]
- [Bundled Payment Implementation Guide for US](https://solvedge.com/guides/bundled-payment-implementation-guide-2026/): Bundled Payment Implementation Guide for US Hospitals (2026 Edition)  What’s covered in this guide What bundled payments actually mean for your hospital’s bottom line CMS bundled payment models active in 2026 (BPCI-A, CJR, LEJR) The 5 operational steps to implement a bundled payment program Vendor evaluation: what to look for in a bundled payment solution ROI benchmarks: what US hospitals are actually seeing Common implementation failures – and how to avoid them If your hospital is still treating bundled payments as a pilot experiment, you’re leaving money on the table. The hospitals that have made bundled payments work – not […]
- [Episode-Based Payment Models: Complete Guide for Payers...](https://solvedge.com/guides/episode-based-payment-models-2026-payers-providers-guide/): Episode-Based Payment Models: Complete Guide for Payers & Providers in 2026 Episode-based payment models are the fastest-growing alternative payment structure in US healthcare — and the most underserved topic in healthcare content marketing. Most organizations searching for guidance on designing, managing, or analyzing episode-based contracts can’t find what they need. This is SolvEdge’s biggest short-term SERP opportunity. An episode-based payment is a fixed amount paid to cover all care services related to a specific clinical condition or procedure within a defined timeframe — typically 30 to 90 days. Unlike traditional fee-for-service, the provider or payer bears the financial risk for […]
- [CMS Quality Measures 2026: What Has Changed, What's...](https://solvedge.com/guides/cms-quality-measures-2026-guide/): CMS Quality Measures 2026: What Has Changed, What’s Coming, and How to Stay Compliant Every year, the CMS quality measure landscape shifts. New measures are added, old ones are retired, performance thresholds change, and the reporting mechanisms evolve. For quality directors and compliance officers managing MIPS, MSSP, HEDIS, and hospital VBP reporting simultaneously, staying current is not just an administrative task — it has direct financial consequences. This guide summarizes the key CMS quality measure updates for 2026, the compliance requirements you need to act on now, and a practical framework for building a quality reporting infrastructure that doesn’t require […]
- [Population Health Management Software Buyers Guide 2026...](https://solvedge.com/guides/phm-software-buyers-guide-2026/): Population Health Management Software Buyers Guide 2026: Features, Pricing & Vendor Checklist for ACOs Choosing the right PHM (population health management) software is one of the most consequential technology decisions an ACO or health system makes. Get it right, and you build the operational foundation for sustainable VBC performance. Get it wrong, and you spend three years managing a system your clinical teams don’t use. This buyers guide is written for the people who actually have to make this decision — CMOs, VP of Clinical Informatics, ACO Executive Directors — not for IT procurement teams buying generic enterprise software. The […]
- [The Value-Based Care Transition Playbook for ACOs...](https://solvedge.com/guides/value-based-care-transition-playbook-acos/): The Value-Based Care Transition Playbook for ACOs & Health Systems (2026) Value-based care is no longer a future-state vision. As of 2026, CMS has a stated policy goal of moving 100% of Medicare beneficiaries into accountable care relationships. Commercial payers have followed. The question for health system executives is no longer whether to transition it’s how fast and with what infrastructure. This playbook is built for organizations actively planning or mid-way through a VBC transition. It is not an introduction to value-based care. It’s the operational and strategic guidance that comes after you’ve already decided to go. 13.7M Medicare beneficiaries […]
- [The Between-Visit Gap: The Most Overlooked Data Problem...](https://solvedge.com/blog/between-visit-data-gaps-specialty-care-facility-reported-outcomes/): The Between-Visit Gap: The Most Overlooked Data Problem in Specialty Care Analytics If you mapped the analytics coverage of a typical orthopedic or specialty care episode, it would look something like this: a dense cluster of data at the initial consultation, another cluster at the procedure, a cluster at the inpatient stay, and then a long, largely empty stretch between discharge and the six-week follow-up appointment. That stretch isn’t empty clinically. Patients are recovering, or not. Rehab is happening, or being skipped. Pain is being managed, or becoming a complication. Care coordinators are supposed to be reaching out, or they’re […]
- [When Healthcare Analytics Becomes a Compliance Tool...](https://solvedge.com/blog/healthcare-analytics-compliance-vs-operational-intelligence/): When Healthcare Analytics Becomes a Compliance Tool — And Why That’s a Hidden Performance Crisis There is a version of healthcare analytics that works. Data flows in, insights emerge, care teams act on them, outcomes improve, and the organization gets smarter with every cycle. Most healthcare vendors will tell you that’s what their platform delivers. There is also a version that merely looks like it works. Dashboards are populated. Reports are generated on schedule. CMS submissions go out on time. Quality measure scores are tracked. And yet somehow the facility’s performance isn’t improving in any meaningful way. Readmissions stay stubbornly […]
- [Best Patient Engagement Platforms for Hospitals & Surgical...](https://solvedge.com/blog/best-patient-engagement-platform/): Best Patient Engagement Platforms for Hospitals & Surgical Centers in 2026 Choosing a patient engagement platform is one of the most consequential technology decisions a hospital, surgery center, or specialty practice can make. The right platform reduces readmissions, improves care team efficiency, and strengthens patient satisfaction scores. The wrong one adds complexity without delivering measurable clinical value. This guide compares the leading patient engagement platforms available in 2026 — with a focus on surgical and procedural care settings, where engagement requirements are most demanding. What to Look for in a Patient Engagement Platform Procedure-specific care pathways — Not generic reminders, […]
- [What Is an Intelligent Patient Engagement Platform? (And Why...](https://solvedge.com/blog/intelligent-patient-engagement-platform/): What Is an Intelligent Patient Engagement Platform? (And Why It Matters in 2026) Healthcare communication has a gap problem. Patients leave the clinic, surgery center, or hospital — and then, for days or weeks, they navigate recovery largely on their own. They miss warning signs. They skip follow-up exercises. They call the nurse line for questions that could have been answered with a timely message at the right moment. An intelligent patient engagement platform is the infrastructure that closes this gap. But the word “intelligent” matters — because not all patient engagement tools are built the same. This guide explains […]
- [Winning the 2026 Trauma Mandate: A Real-Time Analytics Blueprint](https://solvedge.com/infographics/2026-trauma-mandate-real-time-analytics-blueprint/): Winning the 2026 Trauma Mandate: A Real-Time Analytics Blueprint The CMS TEAM (Transforming Episode Accountability Model) mandate for 2026 introduces a major shift in how trauma centers are evaluated and reimbursed for 30-day surgical episodes. Success under this model depends on moving beyond retrospective reporting toward a real-time operational intelligence framework. This real-time analytics blueprint highlights a three-layer approach for trauma programs: 1. Real-Time Intra-Operative Surveillance Live alerts for antibiotic redosing and sepsis risk enable surgical teams to intervene during procedures, reducing downstream complications and preventable readmissions. 2. Predictive 72-Hour Post-Discharge Monitoring AI-driven screening identifies high-risk recovery trajectories early, enabling […]
- [Scaling Trauma Outcomes Analytics in High-Volume ORs Amid...](https://solvedge.com/blog/scaling-trauma-outcomes-analytics-high-volume-ors-2026-vbc/): Scaling Trauma Outcomes Analytics in High-Volume ORs Amid 2026 VBC Mandates The 2026 value-based care landscape has arrived — and Level I trauma centers are feeling it first. Mandatory TEAM participation for LEJR, spinal fusion, and surgical hip/femur fracture treatment has turned every 30-day episode into a financial scorecard. For high-volume trauma ORs already running at 3–6 rooms with 1,800–3,200 annual cases, the pressure is intense: maintain throughput, prevent sepsis and readmissions, deliver strong functional recovery, and still show positive contribution margin under risk-adjusted targets. The hospitals that are winning are not the ones with the most ORs or the […]
- [Closing the Ortho Recovery Gap: A Digital Playbook for County...](https://solvedge.com/infographics/closing-ortho-recovery-gap-digital-playbook-trauma-centers/): Closing the Ortho Recovery Gap: A Digital Playbook for County Trauma Centers Why Post-Discharge Recovery Is the New Performance Frontier Orthopedic recovery outcomes are increasingly determined outside hospital walls. County trauma centers face rising readmission penalties, constrained staffing, and pressure to improve CMS Star ratings. The post-discharge recovery phase has become a critical lever for both clinical outcomes and financial sustainability. This infographic outlines a structured 5-step digital recovery playbook designed to help trauma centers close the orthopedic recovery gap by combining patient-reported outcomes (PROMs), social determinants of health (SDOH), and real-time AI-driven monitoring. What the Digital Recovery Playbook Solves […]
- [Closing the Ortho Recovery Gap: Using PROMs and Digital...](https://solvedge.com/blog/closing-rural-ortho-recovery-gap-proms-digital-follow-up-2026/): Closing the Ortho Recovery Gap: Using PROMs and Digital Follow-Up to Turn a Strained County Trauma Hospital Into a High-Performing CMS Star County trauma hospitals operate under relentless pressure. They serve as the regional safety net for high-acuity orthopedic trauma, gunshot wounds, complex fractures, and the entire spectrum of emergent musculoskeletal injuries—often with limited resources, high uncompensated care, and a disproportionate share of patients with significant social determinants of health (SDOH) barriers. Yet many of these same facilities have quietly achieved or sustained CMS 4- or 5-star ratings while simultaneously improving orthopedic outcomes and reducing avoidable readmissions. The common thread […]
- [Turning $30B in Medi-Cal Cuts into Financial Resilience for Safety-Net...](https://solvedge.com/infographics/safety-net-hospitals-medical-cuts-pros-financial-resilience/): Turning $30B in Medi-Cal Cuts into Financial Resilience for Safety-Net Hospitals California’s safety-net hospitals are facing unprecedented financial pressure as federal Medi-Cal funding reductions approach $30 billion annually. For organizations where 60–80% of inpatient revenue depends on Medi-Cal, these cuts threaten service continuity, staffing, and long-term viability. This infographic outlines how leading safety-net systems are using Patient-Reported Outcomes (PROs), readmission prevention strategies, and CalAIM-aligned care models to protect margins while improving patient recovery outcomes. $30B Medi-Cal funding cuts put safety-net hospitals at high risk of service reduction and closure Patient-Reported Outcomes (PROs) detect recovery issues 48–72 hours earlier Readmission reduction […]
- [Safety-Net Survival: PRO Tactics for $30B Medi-Cal Cuts in 2026](https://solvedge.com/blog/safety-net-medi-cal-cuts-2026-pro-tactics/): Safety-Net Survival: PRO Tactics for $30B Medi-Cal Cuts in 2026 California’s safety-net hospitals are on the front lines of a seismic funding shift. The Republican megabill H.R. 1, enacted in late 2025, is projected to slash $30 billion annually in federal funding for Medi-Cal—California’s Medicaid program—threatening coverage for up to 3.4 million residents and straining providers already operating on razor-thin margins. For safety-net facilities serving high Medi-Cal populations (often 60–80% of inpatient cases), this cut represents an existential threat. Combined with California’s 2025-26 state budget solutions that further reduce Medi-Cal benefits (e.g., eliminating dental coverage for undocumented adults and freezing […]
- [Scaling Rural Orthopedic Revenue: Growth Without Physical...](https://solvedge.com/infographics/scaling-rural-orthopedic-revenue/): Scaling Rural Orthopedic Revenue: Growth Without Physical Expansion Scaling rural orthopedic revenue without physical expansion is the defining challenge for community hospitals in 2026 — and it is now achievable with the right digital stack. This infographic illustrates how tech-enabled rural orthopedics can achieve 3.8x–4.7x higher contribution margins by layering PROM capture, SDOH risk analytics, and real-time episode quality dashboards onto existing clinical and operational workflows. These capabilities help reduce episode costs, prevent recovery drop-offs, and demonstrate superior functional outcomes—unlocking higher commercial reimbursement rates and sustainable program growth. For deeper insights into how CMS 5-star rural hospitals are driving up […]
- [Optimizing Rural Surgical Throughput: The Dual-Campus...](https://solvedge.com/infographics/rural-surgical-throughput-dual-campus/): Optimizing Rural Surgical Throughput: The Dual-Campus Strategy Rural health systems operating across multiple campuses often struggle with fragmented staffing models that suppress rural surgical throughput and lead to underutilized operating rooms. These operational gaps directly impact surgical throughput, staff satisfaction, and financial performance. This infographic outlines a proven dual-campus strategy for improving rural surgical throughput through unified digital and workforce integration across sites. By standardizing perioperative workflows, sharing float pools, and enabling real-time scheduling visibility, rural hospitals can increase surgical volumes, reduce OR turnover times, and unlock meaningful margin lift—while improving nursing satisfaction and readiness for CMS 2026 bundled payment […]
- [The $2M Recovery Roadmap: Maximizing Rural Surgical Revenue...](https://solvedge.com/infographics/rural-surgical-revenue-recovery-roadmap-2026/): The $2M Recovery Roadmap: Maximizing Rural Surgical Revenue in 2026 Rural Critical Access Hospitals (CAHs) face persistent revenue leakage from operating room inefficiencies, post-surgical readmissions, and limited network optimization. With increasing value-based purchasing pressures in 2026, these gaps translate directly into lost margin and operational strain. This infographic presents a practical, data-backed roadmap for recovering up to $2.2M annually through three proven strategies: Digitizing perioperative pathways to compress OR cycle time Risk-tiered post-discharge monitoring to prevent avoidable readmissions Swing-bed and network optimization to capture downstream revenue Together, these approaches enable rural hospitals to improve throughput, reduce leakage, and stabilize surgical […]
- [Bridging the Post-Discharge Recovery Gap with RecoveryCOACH](https://solvedge.com/infographics/post-discharge-recovery-gap-infographic/): Bridging the Post-Discharge Recovery Gap with RecoveryCOACH Post-discharge recovery is one of the most critical — and most invisible — phases of patient care. While clinical teams excel within hospital walls, patient outcomes are often shaped at home, where care teams lack real-time visibility into recovery progress, risks, and adherence. This infographic highlights the invisible recovery gap and how RecoveryCOACH enables proactive, intelligent post-discharge care — empowering patients, equipping care teams with actionable insights, and helping health systems reduce avoidable readmissions while improving outcomes. FAQ What is post-discharge recovery? Post-discharge recovery refers to the period after a patient leaves the […]
- [Proving Surgical Value: How PROMs Drive Hospital Margin, Market...](https://solvedge.com/blog/proving-surgical-value-proms-2026/): Proving Surgical Value: How PROMs Drive Hospital Margin, Market Share, and Payer Confidence In today’s evolving healthcare landscape, hospitals face increasing pressure to demonstrate not just clinical success but true value — outcomes that matter to patients, payers, and the bottom line. Patient-Reported Outcome Measures (PROMs) are emerging as a powerful tool to achieve this. By systematically capturing patients’ perspectives on their health, function, pain, and quality of life, hospitals can link these insights directly to financial performance indicators like margin, market share, and favorable payer contracts. Proving surgical value has become a strategic priority for hospital CMOs and surgical […]
- [Governing Generative AI in Spine Surgery: A 2026 Roadmap...](https://solvedge.com/blog/genai-governance-spine-surgery-orthopedic-hospitals/): Governing Generative AI in Spine Surgery: A 2026 Roadmap for Orthopedic Hospitals—Predictive Outcomes, PROMs, and Compliance GenAI governance in spine surgery is emerging as a foundational priority for orthopedic hospitals in 2026 — shaping how predictive outcomes, PROMs forecasting, and FDA compliance are operationalized across academic and community surgical programs, GenAI holds immense promise for enhancing predictive outcomes—particularly in forecasting reoperation risks and patient-reported outcome measures (PROMs)—while aligning with regulatory demands for transparency and compliance. This roadmap draws inspiration from leading academic institutions like Stanford, where physician-CIO leadership integrates cutting-edge research with operational excellence. Stanford’s Spine Artificial Intelligence Laboratory exemplifies […]
- [Building Hospital Supply Chain Resilience in 2026: Strategies...](https://solvedge.com/blog/hospital-supply-chain-resilience-2026/): Building Hospital Supply Chain Resilience in 2026: Strategies for Safety Net Hospitals Amid Ongoing Disruptions In 2026, hospital supply chain resilience is no longer optional—it’s a survival strategy, especially for safety net and public hospitals. Amid a persistent dual crisis of supply chain volatility and rising cost pressures, U.S. healthcare systems continue to face structural challenges beyond the COVID era. Geopolitical instability, tariffs, raw material constraints, and inflation are still driving up the cost of medical and surgical supplies, with projections estimating a 2.58% increase—placing added strain on already resource-limited facilities like county hospitals. For safety net hospitals serving vulnerable […]
- [Safety-Net Hospitals: Harnessing SDOH Analytics to Drive Health...](https://solvedge.com/blog/safety-net-hospitals-sdoh-analytics-health-equity-cms-2026/): Safety-Net Hospitals: Harnessing SDOH Analytics to Drive Health Equity, Reduce Disparities, and Boost CMS Performance in 2026 Safety-net hospitals, including public and county facilities, serve as critical lifelines for underserved populations, particularly in California where many rely on Medi-Cal coverage. These institutions often care for patients facing significant barriers due to social determinants of health (SDOH) — factors like housing instability, food insecurity, transportation challenges, and economic instability that profoundly influence health outcomes. In 2026, as value-based care models evolve and CMS continues to emphasize equity (even amid shifts in mandatory reporting), safety-net hospitals have a prime opportunity to leverage […]
- [Longitudinal PROMs: Unlocking VBC Gains in Musculoskeletal Care](https://solvedge.com/blog/orthopedic-proms-vbc-outcomes-2026/): Longitudinal PROMs: Unlocking VBC Gains in Musculoskeletal Care The shift from volume to value is no longer a peripheral conversation in orthopedics—it is the governing economic reality of 2026. As CMS activates the Transforming Episode Accountability Model (TEAM) and continues to refine the Comprehensive Care for Joint Replacement (CJR) mandates, the difference between a high-performing orthopedic program and a struggling one lies in the data. While many institutions treat Patient-Reported Outcome Measures (PROMs) as a static compliance checkbox, elite organizations are leveraging longitudinal tracking to unlock massive ROI and secure their competitive standing. The 2026 Mandate: From Snapshot to Story […]
- [Navigating the 2026 Federal Cuts: A Resilience Strategy for Safety...](https://solvedge.com/blog/resilience-strategy-safety-net-hospitals-federal-cuts-2026/): Navigating the 2026 Federal Cuts: A Resilience Strategy for Safety Net Hospitals The year 2026 marks a pivotal—and perilous—inflection point for the American healthcare safety net. With the full implementation of the One Big Beautiful Bill Act (OBBBA), colloquially known as HR1, and a tightening CMS reimbursement landscape, public and county hospitals are facing a combined $4.6 billion budgetary threat. For the C-suite, this is no longer a “down the road” policy concern; it is a direct threat to operational solvency. Achieving federal cuts resilience requires shifting from reactive cost-cutting to a sophisticated, technology-driven strategy centered on margin improvement and […]
- [Closing Rural Care Gaps in 2026: AI Strategies for Incidental...](https://solvedge.com/blog/rural-care-gaps-2026-ai-strategies-post-acute-outcomes/): Closing Rural Care Gaps in 2026: AI Strategies for Incidental Findings and Post-Acute Outcomes In 2026, a patient’s zip code should not be a predictor of their clinical destiny. Yet, for rural healthcare providers, the “rural care gap” remains a formidable adversary—a mix of limited staffing, geographic isolation, and an overwhelming “validation burden.” The tide, however, is turning. Innovative facilities are proving that being “rural” is no longer a barrier to high-quality, continuous care. By leveraging AI healthcare rural strategies, these organizations are transforming incidental findings from “lost files” into lifesaving interventions. The “Silent” Risk: Managing Incidental Findings at Scale […]
- [The $200-per-Minute Leak: Why "Manual" Ortho Care is a Financial...](https://solvedge.com/blog/ortho-ai-periop-care-2026-margins/): The $200-per-Minute Leak: Why “Manual” Ortho Care is a Financial Liability in 2026 By the time you finish reading this, another independent orthopedic program has likely “donated” thousands to Medicare through preventable readmissions and inefficient PRO tracking. In 2026, asking your nursing staff to manually track Patient-Reported Outcomes (PROs) isn’t just outdated—it’s a margin killer. With the CMS TEAM mandate now in full swing and Medicare reimbursement floor-dropping, the “wait and see” approach to AI periop care has officially become a strategy for insolvency. For the independent CFO and CQO, the choice is no longer about if you should automate, […]
- [Optimizing Perioperative Workflows Post-Hospital Acquisition...](https://solvedge.com/blog/perioperative-workflow-optimization-hospital-acquisition-cms-stars/): Optimizing Perioperative Workflows Post-Hospital Acquisition: Strategies for CMS Star Rating Gains in Consolidating Systems Introduction: The Perioperative Challenge in Hospital Consolidation Healthcare consolidation continues to accelerate across the United States, with over 1,200 hospital transactions recorded between 2016 and 2024. When two health systems merge, the operating room becomes a critical battleground where inefficiencies multiply, cultures clash, and patient outcomes hang in the balance. For facilities targeting CMS star rating improvement, the perioperative department often determines whether integration succeeds or fails. This comprehensive guide examines how consolidating systems can transform post-acquisition perioperative workflows to achieve measurable gains in quality metrics, […]
- [How Rural 4-Star Hospitals Protect CMS Ratings During Orthopedic...](https://solvedge.com/blog/rural-hospital-cms-star-ratings-orthopedic-pro-pm-compliance-2026/): How Rural 4-Star Hospitals Protect CMS Ratings During Orthopedic Expansion with PRO-PM Compliance (2026 Guide) Introduction: The Rural Orthopedic Growth Paradox Rural hospitals achieving 4-star CMS ratings face a delicate balancing act in 2026. Orthopedic service line expansion—driven by robotic surgery investments, outpatient facility development, and aging community demographics—represents both tremendous opportunity and significant regulatory risk. The very growth that promises financial sustainability can paradoxically threaten the quality metrics that distinguish these facilities in competitive healthcare markets. For rural hospitals maintaining above-average CMS star ratings, orthopedic volume increases introduce complex challenges around patient-reported outcome performance measures (PRO-PMs), patient safety indicators, […]
- [Surgical Synergy Post-Acquisition: Accelerating Rural Orthopedic...](https://solvedge.com/blog/post-merger-rural-orthopedic-recovery-unified-outcomes-2026/): Surgical Synergy Post-Acquisition: Accelerating Rural Orthopedic Market Leadership Through Unified Outcomes When TidalHealth acquired Atlantic General Hospital in March 2026, the integration promised scale, resources, and expanded reach for rural orthopedic patients across the Eastern Shore. Yet behind the press releases, the real challenge emerged: how do you unify two distinct surgical cultures, standardize workflows across campuses, protect hard-earned quality metrics, and justify $50M+ capital investments in OR upgrades and robotics—without triggering readmission spikes, SSI increases, or workforce burnout? The answer for Atlantic General and other rural systems navigating similar acquisitions lies in unified outcomes as the single source of […]
- [$670M Hospital Tower ROI: 5 Operational KPIs Delivering...](https://solvedge.com/blog/670m-hospital-tower-roi-operational-kpis-throughput-2026/): $670M Hospital Tower ROI: 5 Operational KPIs Delivering 15-20% OR Throughput Gains Your board just approved a $670 million tower expansion with 12 new operating rooms. The construction timeline is locked. But here’s the question keeping CFOs awake: How do you guarantee the operational throughput that justifies the investment? Multi-site perioperative research reveals a hard truth: Most health systems achieve only 40-60% of projected throughput gains post-expansion. They build new ORs without fixing the operational bottlenecks that constrained capacity in the first place. The financial impact? A typical academic medical center missing utilization targets by 20 percentage points loses $8-12 million […]
- [How Rural Hospitals Turn 88% Bed Occupancy Into 25% Surgical Growth](https://solvedge.com/blog/rural-level-iii-trauma-center-ortho-growth-2026-playbook/): How Rural Hospitals Turn 88% Bed Occupancy Into 25% Surgical Growth Without Adding Staff – Midwest Level III Trauma Center Playbook In rural Midwest Level III Trauma Centers, 88% average bed occupancy is the norm — and the silent killer of surgical growth. With inpatient beds consistently full, OR teams wait for recovery space, first-case starts slip to 62–68%, turnover stretches to 45+ minutes, and surgeons lose prime-time blocks. The result: ortho and general surgery volumes plateau at 75–85% of potential, costing facilities $1.8–3.2 million in annual contribution margin on a typical 1,200–1,800 case program. Yet a select group of […]
- [Rural Ortho PROMs Playbook: readmission reduction While...](https://solvedge.com/blog/rural-orthopedic-proms-for-readmission-reduction-and-volume-growth/): Rural Ortho PROMs Playbook: Reducing Readmissions While Scaling Surgical Volumes in 2026 Rural hospitals are entering the most consequential year for orthopedic margins in a decade. Starting January 2026, CMS TEAM bundles make LEJR and spinal fusion full-episode risk. HRRP penalties orthopedic surgery remain brutal. And CMS quality rural hospitals 2026 scoring now heavily weights patient-reported outcomes (PRO-PMs) for joint replacement—making orthopedic PROMs tracking CMS mandatory, not optional. The hospitals that treat PROMs as a compliance checkbox will bleed margin. The ones that treat PROMs as an active clinical + financial engine are reducing readmissions 22–38%, scaling safe surgical volume […]
- [3 Rural CAH Strategies to Capture $2M Surgical Revenue in 2026...](https://solvedge.com/blog/rural-cah-surgical-revenue-recovery-2026-checklist/): 3 Rural CAH Strategies to Capture $2M Surgical Revenue in 2026 Amid CMS VBP Pressures A leading 25-bed rural Critical Access Hospital is currently losing an estimated $1.8–2.2 million in annual surgical revenue—most of it leaking to larger metro facilities—simply because OR block utilization hovers at 78–85% and preventable readmissions erode margins on high-value ortho and general surgery cases. This is not an isolated issue. The average 25-bed CAH loses 15–22% of potential surgical contribution margin to throughput inefficiencies, avoidable readmissions, and post-acute leakage—equating to $1.6–2.4 million annually on a typical 450–650 case program. The good news: three high-impact, low-capital […]
- [CMS 5-Star Rural Hospitals: 4X Ortho Revenue Without Adding...](https://solvedge.com/blog/cms-5-star-rural-hospitals-4x-ortho-revenue-proms-sdoh-2026/): CMS 5-Star Rural Hospitals: 4X Ortho Revenue Without Adding Beds Using PROMs + SDOH Analytics Schneck Medical Center in Seymour, Indiana, operates a 93-bed critical access hospital and sustains consistent CMS 5-star performance while delivering orthopedic care in one of the most rural counties in the state. With roughly 55 total hip and knee cases per year, Schneck is representative of many high-quality rural facilities: excellent outcomes, limited volume, and very little physical capacity left to expand. Yet a select group of Top-20 rural hospitals (by CMS star rating + ortho case mix) are quietly generating 3.8–4.7× higher orthopedic contribution […]
- [Maximizing Limited OR Capacity: Rural Hospital Strategies...](https://solvedge.com/blog/maximizing-limited-or-capacity-rural-hospital-strategies/): Maximizing Limited OR Capacity: Rural Hospital Strategies for Orthopedic Growth Under 2026 CMS Mandates Magnolia Regional Medical Center—like most rural hospitals—operates with just 2 ORs while facing the same 2026 CMS mandates that urban centers do: mandatory TEAM bundles for LEJR and spinal fusion, escalating weight on patient-reported outcomes in star ratings and VBP, and continued pressure from HRRP readmission penalties. The math is unforgiving: Orthopedic and sports medicine cases represent one of the few positive-margin service lines Each additional case requires squeezing more safe throughput from the same two rooms Every preventable complication or readmission now carries amplified financial […]
- [Scaling Orthopedic Surgery Volume Through Perioperative...](https://solvedge.com/blog/physician-owned-hospital-ortho-scaling-perioperative-analytics-2026/): Scaling Orthopedic Surgery Volume Through Perioperative Analytics in Physician-Owned Hospitals Physician-owned surgical hospitals built their reputation on speed, precision, and outcomes. But when annual orthopedic case volume must rise from ~265 to 400+ in 12–18 months—while sterile processing bottlenecks, PACU gridlock, and post-acute handoff delays threaten $1.8–2.4M in annual throughput leakage—the old playbook fails. Houston Physicians’ Hospital (and similar physician-owned facilities in Webster, TX and across the U.S.) now face this exact inflection point. Phase 2 expansion adds capacity, but without integrated perioperative analytics 2026, the additional OR time simply creates longer queues, higher overtime, and elevated risk of TPS […]
- [Rural Hospital Financial Recovery in 2026: How Post-Discharge...](https://solvedge.com/blog/rural-hospital-financial-recovery-post-discharge-monitoring-2026/): Rural Hospital Financial Recovery in 2026: How Post-Discharge Monitoring Turns Projected Losses Into Sustainable Margins Brattleboro Memorial Hospital’s recently published FY26 financial projection—a $14.5 million operating loss—is not an outlier; it is the new baseline for many independent rural hospitals still navigating the post-OneCare Vermont landscape, GMBB-era cost pressures, and the impending 2026 CMS TEAM bundle deadlines. The single most powerful lever now available to reverse that trajectory is post-discharge monitoring—particularly when applied to high-cost, high-variation orthopedic and cardiac episodes. Systems that have already deployed structured, digital post-discharge programs report: 18–32% reduction in 30-day all-cause readmissions for index DRGs 12–22% […]
- [Scaling Orthopedic Excellence in Rural Hospitals During Multi-Campus Expansion: Maintain CMS 5-Star While Achieving 2X Growth 2026](https://solvedge.com/blog/rural-hospital-or-optimization-multi-campus-ortho-growth-2026/): Scaling Orthopedic Excellence During Multi-Campus Expansion: Lessons from 25% Volume Growth Multi-campus orthopedic programs are the new growth frontier for regional health systems in 2026. Adding a second or third surgical site promises 20–35% volume lift—yet the same expansion frequently erodes hard-earned quality metrics: readmissions rise 1–3 points, PROM scores flatten, and CMS 4-star ortho outcomes slip toward 3-star territory. High-performing systems are proving it’s possible to scale orthopedic hospital expansion while protecting or improving Blue Distinction hip knee recertification, Leapfrog grades, and CMS star ratings—even during the most disruptive 12–24 months of multi-campus activation. The difference? Treating surgical throughput, […]
- [Maintaining Top 1% SSI Rates During 25% Surgical Volume Growth...](https://solvedge.com/blog/rural-surgical-hospital-ssi-blueprint-top-1-percent-25-percent-growth/): Maintaining Top 1% SSI Rates During 25% Surgical Volume Growth: Rural Surgical Hospital Blueprint Rural and physician-owned surgical hospitals are under unprecedented pressure to grow orthopedic and spine volumes while preserving elite safety performance. Many facilities that achieve Top 1% CMS SSI performance rural ortho hospitals face the same question: how do you add 25% more cases—often moving from 4 to 5–6 ORs or integrating ASC-level throughput—without SSI rates creeping into the second or third quartile? The answer lies in SSI prevention strategies physician-owned surgical hospitals have refined over the last 24 months: layered real-time surveillance, standardized but flexible perioperative […]
- [Unlocking OR Throughput in Rural Hospitals: Digital Perioperative...](https://solvedge.com/blog/rural-hospital-or-optimization-glens-falls-2026/): Unlocking OR Throughput in Rural Hospitals: Digital Perioperative Pathways for Orthopedic Growth Rural hospitals face a silent growth ceiling. Despite strong demand for orthopedic services, OR block utilization stalls at 85–92%, leaving millions in potential revenue untapped and surgeons frustrated. Nursing shortages, fragmented workflows, and integration challenges with larger affiliates compound the issue—holding back expansion even as orthopedic bundle rural hospitals prepare for 2026 CMS TEAM mandates. Glens Falls Hospital and similar regional systems are breaking through with perioperative workflow standardization and digital pathways. These tools not only push utilization toward 95% but enable orthopedic service line growth while supporting […]
- [Bridging Rural Surgical Gaps: How Dual-Campus Hospitals Optimize...](https://solvedge.com/blog/bridging-rural-surgical-gaps-dual-campus-or-throughput/): Bridging Rural Surgical Gaps: How Dual-Campus Hospitals Optimize OR Throughput Amid Workforce Shortages In rural America, surgical access is a lifeline. Yet dual-campus hospitals serving vast regions face a perfect storm: surging demand (often 4,000+ cases annually), chronic nursing shortages, and the relentless pressure to maintain Healthgrades 5-star ortho rural excellence. Facilities like those in the Lifepoint Health network are proving it’s possible to optimize rural hospital OR throughput across campuses without burning out teams or compromising care. By embracing perioperative workforce solutions and smart digital tools, they’re increasing cases 18–25%, shortening turnover, and protecting margins—even amid ongoing staffing constraints. […]
- [Winter Ambulance Diversion Prevention: Predictive Surge...](https://solvedge.com/blog/winter-ambulance-diversion-prevention-predictive-surge-planning/): Winter Ambulance Diversion Prevention: Predictive Surge Planning for 25% Uninsured Catchments Winter surges hit rural and regional hospitals hardest. Seasonal respiratory illness, trauma spikes, and boarding crises push ED boarding reduction strategies to the breaking point—often forcing ambulance diversion that threatens Level 1 Trauma status and community access. For systems serving high-uninsured populations (25%+ in many catchments), these surges compound financial and operational strain. Leading facilities—like Conemaugh Health System and similar multi-hospital networks—are preventing diversion through hospital throughput optimization and predictive ED volume forecasting healthcare tools, achieving 20–30% better winter capacity management. The Winter Surge Reality for Regional Hospitals Common […]
- [Closing Rural Readmission Gaps: How Orthopedic Systems Use PROMs & Post-Acute Tracking for CMS TEAM 2026 Success](https://solvedge.com/blog/closing-rural-readmission-gaps-orthopedic-post-acute-outcomes/): Closing Rural Readmission Gaps: How Orthopedic Systems Track Post-Acute Outcomes Across Multi-County Footprints Rural orthopedic programs face a unique readmission challenge: patients scattered across vast, multi-county service areas with limited post-acute options. With CMS TEAM bundle rural hospitals launching mandatory episode accountability in 2026 for LEJR and spinal fusion, rural hospital readmission reduction is no longer optional—it’s essential for financial survival and quality scores. Leading rural health systems are closing these gaps through sophisticated orthopedic PROMs tracking and post-acute outcomes analytics, enabling real-time visibility across dispersed clinics and facilities. This approach not only cuts readmissions but positions programs for TEAM […]
- [Post-Merger Orthopedic Recovery Optimization: Sustaining 5-Star...](https://solvedge.com/blog/post-merger-orthopedic-recovery-optimization-cms-5-star/): Post-Merger Orthopedic Recovery Optimization: Sustaining 5-Star CMS Ratings Through Network-Wide Care Standardization Hospital mergers and network integrations promise scale, resources, and enhanced access—yet they often threaten hard-earned quality distinctions. For orthopedic and spine service lines, post merger hospital integration introduces variation in recovery protocols, readmission risks, and outcome tracking that can erode CMS 5 star hospital strategies. Grand View Health’s 2025 integration with St. Luke’s University Health Network exemplifies this dynamic: combining a consistent 5-star performer with a large multi-campus system to expand ortho/spine capacity while protecting elite ratings. Leading post-merger systems sustain excellence through network wide care standardization and […]
- [Navigating Rural Surgical Growth: Strategies to Cut Complications...](https://solvedge.com/blog/navigating-rural-surgical-growth-complications-revenue-integrity/): Navigating Rural Surgical Growth: Strategies to Cut Complications and Boost Revenue Integrity Post-Compliance Challenges Rural hospitals are pursuing surgical growth to secure financial stability amid shrinking margins and rising costs. Yet rural hospital surgical complications—particularly SSI and sepsis—remain stubbornly high, while CMS revenue integrity rural scrutiny intensifies following OIG audits and compliance findings. King’s Daughters Medical Center (KDMC) and similar regional systems face this dual challenge: expand ortho and surgical volumes while protecting revenue cycles post-compliance issues. Leading rural facilities are succeeding by integrating peri-op analytics, standardized pathways, and digital surveillance—cutting complications 25–35% and strengthening revenue cycle rural health systems […]
- [Optimizing Orthopedic Surgical Volumes for CMS TEAM Success...](https://solvedge.com/blog/optimizing-orthopedic-surgical-volumes-cms-team-rural-2026/): Optimizing Orthopedic Surgical Volumes for CMS TEAM Success in Rural Settings The CMS TEAM model rural hospitals face in 2026 introduces mandatory bundled payments for lower extremity joint replacement (LEJR) and spinal fusion—shifting financial risk to the full episode of care. For rural facilities performing 200+ hip/knee procedures annually, orthopedic bundles CMS TEAM rural outcomes now determine margins, quality scores, and penalty exposure. Leading rural orthopedic programs are optimizing orthopedic surgery rural hospital volumes and recovery pathways to thrive under TEAM, focusing on throughput, post-acute coordination, and real-time outcome tracking. This approach not only mitigates risk but drives value-based orthopedic […]
- [How Rural CAHs Can Use Patient-Reported Outcomes to Meet CMS...](https://solvedge.com/blog/rural-cahs-patient-reported-outcomes-cms-2026-ortho-mandates/): How Rural CAHs Can Use Patient-Reported Outcomes to Meet CMS 2026 Ortho Mandates and Boost Star Ratings The CMS 2026 PRO-PM ortho requirements are reshaping quality reporting for Critical Access Hospitals (CAHs). Starting in 2026, patient-reported outcome performance measures (PRO-PMs) for total hip and knee arthroplasty become mandatory elements in value-based purchasing and star rating calculations—placing new emphasis on rural hospital orthopedic outcomes and post-op recovery rural hospitals. For CAHs participating in MBQIP and aspiring to higher CMS star rating safety 2026 performance, CAH patient reported outcomes collection is no longer optional. Leading rural facilities are turning this mandate into […]
- [How Epic Stage 7 Hospitals Can 3x Ortho Volumes Without HAI...](https://solvedge.com/blog/epic-stage-7-hospitals-3x-ortho-volumes-without-hai-penalties/): How Epic Stage 7 Hospitals Can 3x Ortho Volumes Without HAI Penalties: Lessons from CMS HRRP 2026 Warnings Epic Stage 7 designation signals digital maturity—yet many high-performing hospitals still struggle to translate it into Epic Stage 7 ortho volume growth. With CMS HRRP 2026 penalties looming (240 hospitals facing >1% payment reductions) and HAI/complication scrutiny intensifying, scaling orthopedic services safely is critical. Leading Stage 7 facilities are achieving 3x ortho volumes growth—often from low baselines like 7–20 knees annually—without triggering CMS readmission penalties ortho 2026 or HAI hits. Their secret? Layering ortho recovery optimization analytics on Epic to enable proactive […]
- [Leveraging Patient-Reported Outcomes to Sustain CMS 5-Star...](https://solvedge.com/blog/leveraging-patient-reported-outcomes-sustain-cms-5-star-orthopedics/): Leveraging Patient-Reported Outcomes to Sustain CMS 5-Star Ratings in Orthopedic Centers Achieving CMS 5-star orthopedic hospitals status is a hallmark of excellence—yet sustaining it amid rising volumes, value-based care pressures, and 2026 CMS TEAM bundles is the real challenge. Leading centers, including top performers in Michigan and rural markets, are using patient-reported outcomes orthopedics (PROs) as the cornerstone to protect ratings while driving hospital readmission reduction ortho and functional gains. With CMS placing greater weight on PROs for joint replacement and spine episodes starting 2026, elite programs proactively integrate PROs to future-proof sustain CMS star ratings performance. Why 5-Star Orthopedic […]
- [Leapfrog D to A: Proven Strategies for Regional Hospitals...](https://solvedge.com/blog/leapfrog-d-to-a-safety-grade-improvement-strategies-2026/): Leapfrog D to A: Proven Strategies for Regional Hospitals to Conquer Safety Grades in 2026 Regional hospitals like Owensboro Health face mounting pressure to elevate Leapfrog hospital safety grade improvement from D to A. With 2026 updates—including temporary removal of Staff Responsiveness scoring and planned shift to Failure-to-Rescue metrics—hospital safety grade 2026 success demands proactive focus on infections, complications, and processes. Leading regional systems achieve this leap through data-driven surveillance, pathway standardization, and real-time outcome tracking—especially in high-impact areas like perioperative complications reduction rural hospitals and ortho programs. Why 2026 Makes Leapfrog Improvement Urgent Leapfrog’s evolving methodology amplifies key domains: […]
- [Why Top Ortho Groups Are Mandating AJRR Participation...](https://solvedge.com/blog/top-ortho-groups-mandating-ajrr-participation-2026-mips-deadline/): Why Top Ortho Groups Are Mandating AJRR Participation Before 2026 MIPS Deadline Leading orthopedic groups across the U.S. are issuing internal mandates: full surgeon participation in the American Joint Replacement Registry (AJRR) by mid-2025. With the 2026 MIPS ortho registry deadline looming and CMS TEAM bundles ortho launching mandatory episode accountability, registry enrollment is shifting from optional to strategic imperative. High-volume practices—especially multi-site groups performing thousands of joints annually—are recognizing that AJRR orthopedic participation delivers benchmarking, payer leverage, and compliance advantages competitors can’t match. Those lagging risk falling behind in quality rankings, contract negotiations, and bundle performance. The 2026 Ortho […]
- [Post-HCA Acquisition: Optimizing $100M Capital Investments for Maximum ROI in Ortho & Cardiac Service Lines 2026](https://solvedge.com/blog/post-hca-acquisition-optimizing-100m-capital-investments-ortho-cardiac/): Post-HCA Acquisition: Optimizing $100M Capital Investments for Ortho/Cardiac Bundle Success HCA Healthcare acquisitions bring capital, scale, and opportunity—but also intense pressure to deliver rapid ROI on hospital capital investment ROI. With $100M+ modernization projects now underway at former independent facilities, leaders face a critical question: How to deploy OR upgrades, robotic systems, and expanded surgical capacity while protecting quality metrics and preparing for BPCI Advanced ortho bundles and mandatory 2026 CMS TEAM episodes. Successful post-acquisition hospitals optimize these investments through disciplined orthopedic service line growth strategies 2026, OR throughput optimization, and bundle payment performance focus—sustaining CMS 5-star orthopedic surgery ratings […]
- [Scaling Orthopedic Services in Rural CAHs: Optimizing Low-Volume...](https://solvedge.com/blog/scaling-orthopedic-services-rural-cahs-low-volume-or-throughput/): Scaling Orthopedic Services in Rural CAHs: Optimizing Low-Volume OR Throughput for 20% Growth Rural Critical Access Hospitals (CAHs) are increasingly betting on rural CAH orthopedics to drive margin and community impact. With the U.S. orthopedic implants market projected to reach $50 billion by 2025 and ASC joint volumes up 19%, many CAHs see orthopedic growth critical access hospitals 2025 as a lifeline. Yet most face a stubborn bottleneck: low volume OR optimization. Facilities averaging 100–150 orthopedic cases per month—like Humboldt General Hospital—struggle with block utilization, turnover delays, and workflow fragmentation (often exacerbated by Cerner transitions). The result? Stalled growth despite […]
- [How CAH Robotic Ortho Programs Scale Volume + Prove...](https://solvedge.com/blog/cah-robotic-ortho-programs-scale-volume-expansion-roi-proms/): How CAH Robotic Ortho Programs Scale Volume + Prove $300M Expansion ROI with PROMs Critical Access Hospitals (CAHs) are increasingly adopting robotic orthopedic surgery CAH programs—often featuring Mako systems—to drive volume in rural markets. Yet justifying critical access hospital expansion costs, sometimes reaching hundreds of millions when including new wings and technology, requires hard evidence of return. Leading CAHs use PROMs orthopedics 2026—patient-reported outcome measures—to demonstrate superior functional gains, lower complications, and faster recovery. This data not only scales surgical volume but provides the orthopedic PROMs SROI analysis (social return on investment) needed to secure financing, grants, and board approval. […]
- [How Orthopedic Leaders Sustain #1 National Rankings During Multi...](https://solvedge.com/blog/sustain-number-one-ortho-rankings-multi-specialty-expansion/): How Orthopedic Leaders Sustain #1 National Rankings During Multi-Specialty Expansion Three nationally top-10 orthopedic hospitals lost their elite status within 24 months of launching multi-specialty expansions. Diluted focus, throughput strain, and outcome variability eroded the precision that earned them CareChex ortho excellence in the first place. Yet a select group—including rural powerhouses like Black Hills Surgical Hospital—maintain #1 orthopedic hospital rankings while successfully adding cardiac, spine, and other service lines. Their secret? Disciplined rural ortho outcomes tracking and bundle-ready infrastructure that protects core excellence during growth. The Hidden Risk of Multi-Specialty Expansion for Orthopedic Programs Top-ranked orthopedic hospitals face unique […]
- [Closing the Perioperative Quality Gap: How Top UHS Hospitals...](https://solvedge.com/blog/closing-perioperative-quality-gap-ssi-vte-reduction-uhs-hospitals/): Closing the Perioperative Quality Gap: How Top UHS Hospitals Cut SSI and VTE by 30% Through Data-Driven Bundles Surgical site infections (SSI) and venous thromboembolism (VTE) continue to challenge even the strongest hospital systems. Despite impressive accreditations—including Joint Commission Gold Seal and Leapfrog “A” grades—many UHS facilities, such as Texoma Medical Center, show complication rates above national benchmarks: SSI around 1.3–1.5% versus 0.8–0.9%, VTE at 5–5.5% versus 3.9%, and elevated acute kidney injury. Top-performing UHS hospitals are closing this perioperative quality improvement gap with comprehensive, data-driven bundles—achieving 30% reductions in both SSI and VTE while strengthening robotic surgery programs and […]
- [How Rural Hospitals Protect CMS Star Ratings During Major...](https://solvedge.com/blog/rural-hospitals-protect-cms-star-ratings-during-expansion-proms/): How Rural Hospitals Protect CMS Star Ratings During Major Facility Expansions Using Patient-Reported Outcomes Rural hospitals punch above their weight in quality care, often serving higher-risk patients with fewer resources. Yet with 46% operating on negative margins as of late 2025, CMS star ratings are critical for survival—driving Medicare revenue, patient choice, and community support. Major expansions are essential for growth but pose real threats to these ratings. Citizens Memorial Hospital (CMH) in Bolivar, Missouri—a consistent 4-star CMS performer with a Leapfrog “A” safety grade—is midway through its $100+ million south tower project: a 117,000 sq ft addition set to […]
- [How One Rural Hospital Turned Mandatory PROMs and Medicaid...](https://solvedge.com/blog/rural-hospital-mandatory-proms-medicaid-quality-growth-engine/): How One Rural Hospital Turned Mandatory PROMs and Medicaid Quality Measures into a Strategic Growth Engine In 2025, mandatory PROMs THA TKA are no longer optional for hospitals performing total hip and knee arthroplasties. CMS requires submission of patient-reported outcome measures, with penalties looming for non-compliance. At the same time, state-level Medicaid value based hospital program initiatives—like Colorado’s Hospital Transformation Program (HTP)—tie significant supplemental payments to hospital transformation program quality measures spanning readmissions, patient experience, and equity. For rural and regional hospitals, treating these as isolated reporting exercises is a trap. One forward-thinking rural system flipped the script: they built […]
- [Closing the Surgical Safety Gap: How Community Hospitals...](https://solvedge.com/blog/closing-surgical-safety-gap-post-op-complications-community-hospitals/): Closing the Surgical Safety Gap: How Community Hospitals Can Cut Post-Op Complications and Boost Functional Recovery Post-operative complications remain a stubborn challenge for community hospitals. Sepsis, respiratory failure, wound infections, and unplanned readmissions not only endanger patients but also drive up costs and erode quality scores. Nationally, surgical complications affect up to 15% of cases, with sepsis and respiratory failure prevention after surgery accounting for significant morbidity and excess LOS. Yet leading community systems are closing this gap through post-operative complication reduction strategies in hospitals that combine evidence-based pathways, real-time surveillance, and patient-reported insights. The result? Dramatic drops in adverse […]
- [From Bundles to Bedside Data: How Hospitals Can Make TEAM...](https://solvedge.com/blog/from-bundles-to-bedside-data-hospital-team-2026-strategy/): From Bundles to Bedside Data: How Hospitals Can Make TEAM 2026 Work for Clinicians, Finance and Quality The CMS TEAM model 2026 marks a pivotal shift in value based care hospital reimbursement. Starting January 2026, selected hospitals will bear full-episode accountability for high-volume conditions including lower extremity joint replacement (LEJR), spinal fusion, sepsis, and stroke. Success demands aligning cost containment with quality performance—where hospital bundled payment strategy meets real-world clinical execution. Leading hospitals are discovering that centralized surgical episode analytics and outcomes intelligence can bridge finance, quality, and clinical teams without disrupting bedside workflows. An episode and outcomes intelligence layer—built […]
- [From 3 Stars to 5: How Rural Hospitals Boost CMS Star Ratings Using PROMs & Patient-Reported Outcomes 2026](https://solvedge.com/blog/from-3-stars-to-5-rural-hospitals-patient-reported-outcomes-cms/): From 3 Stars to 5: How Rural Hospitals Can Use Patient-Reported Outcomes to Climb the CMS Quality Star Ladder Rural and critical access hospitals face intense pressure to improve hospital star rating performance. With CMS hospital star ratings directly influencing Medicare reimbursement, patient volume, and community trust, a drop from 4 to 3 stars can cost millions in lost referrals and revenue. Yet many rural facilities hover at 3 stars despite strong safety records—held back by gaps in patient reported outcomes in hospitals, readmission measures, and HCAHPS domains. The good news? Patient-reported outcomes (PROMs) are emerging as a powerful lever […]
- [Winning Under CMS TEAM: How Surgical Hospitals Can Protect...](https://solvedge.com/blog/winning-cms-team-joint-spine-bundles-surgical-hospitals/): Winning Under CMS TEAM: How Surgical Hospitals Can Protect Margin on Joint & Spine Bundles Without Sacrificing Outcomes The CMS TEAM bundled payments model launches January 1, 2026—mandatory for selected hospitals across key geographic areas. This five-year initiative holds facilities accountable for the full spine surgery episode of care and LEJR bundle optimization, from procedure through 30 days post-discharge. With target prices incorporating a CMS discount and quality adjustments, exceeding benchmarks means repayments; beating them unlocks shared savings. For orthopedic and surgical hospitals, this is the biggest shift since CJR. Orthopedic bundled payment strategy now demands precision across OR efficiency, […]
- [From Survival to Strategy: How Rural Hospitals Turn Outcomes Data...](https://solvedge.com/blog/from-survival-to-strategy-rural-hospitals-outcomes-data-growth/): From Survival to Strategy: How Rural Hospitals Turn Outcomes Data into Growth Rural hospitals are at a crossroads. With over 300 facilities at risk of closure since 2020 and margins averaging just 2.4%, survival mode has become the default. Yet a growing number of independent and community systems are flipping the script—using rural hospital outcomes analytics to stabilize finances, fuel service-line growth, and prove deeper community impact. The difference? They’ve stopped treating data as a compliance checkbox and started treating it as a strategy engine. Clinical metrics, patient reported outcomes platform insights, operational benchmarks, and hospital reported outcomes—pulled together into […]
- [Creating Meaningful Patient Experiences in Joint Replacements](https://solvedge.com/blog/meaningful-patient-experiences-tjr/): Creating Meaningful Patient Experiences in Joint Replacements Joint replacement surgeries involve complex processes that require intuitive solutions and coordinated care for a seamless patient journey throughout the episodes of care. A comprehensive care coordination solution is dedicated to delivering superior patient experiences in orthopedic surgeries. From giving actionable insights in terms of critical decisions including the need for a surgery, pre, during and post-surgical care, a holistic patient engagement platform ensures that patients are proactively participating in their care plans, enabling better outcomes, reduced readmissions and length of stays, while accelerating reimbursements. Digital care coordination solutions for Joints replacements are packed with […]
- [Reducing Orthopedic Readmissions: 5 Proven Strategies...](https://solvedge.com/blog/reducing-orthopedic-readmissions-5-strategies-cms-bundle-2025/): Reducing Orthopedic Readmissions: 5 Proven Strategies for CMS Bundle Success in 2025 Hospital readmissions remain one of the biggest financial and clinical burdens in U.S. healthcare—costing systems more than $52 billion annually. In FY2025, CMS’s Hospital Readmissions Reduction Program (HRRP) penalized over 7% of facilities, while orthopedic bundles like the Comprehensive Care for Joint Replacement (CJR) model continue to spotlight joint replacement readmissions. National rates hover at 14.9% for elective hip and knee procedures, putting mid-sized programs—many performing 2,500–3,000 inpatient surgeries yearly—directly in the crosshairs. For community hospitals like MidState Medical Center (156 beds, Leapfrog “A” safety grade), success isn’t […]
- [How Independent Rural Hospitals Turn Outcomes Data...](https://solvedge.com/blog/independent-rural-hospitals-outcomes-data-competitive-edge-2026/): How Independent Rural Hospitals Turn Outcomes Data Into Their Ultimate Competitive Edge in 2026 In the unforgiving landscape of rural healthcare, independence isn’t just a badge—it’s survival. With over 140 rural hospitals closing since 2010 and consolidation swallowing community anchors, the last standalone facilities in Northeast Texas are fighting to stay local. Titus Regional Medical Center (TRMC) stands as a beacon: a 4-star CMS rating, Leapfrog “A” safety grade, and aggressive ortho/sports medicine growth amid Level III Trauma demands. But even high-performers face 2026 realities—rural hospital quality improvement hinges on turning fragmented data into a competitive moat. The secret? Independent […]
- [Building TEAM-Ready Orthopedic Episodes: How Orthopedic...](https://solvedge.com/blog/building-team-ready-orthopedic-episodes-value-based-care/): Building TEAM-Ready Orthopedic Episodes: How Orthopedic Hospitals and ASCs Can Win in the New Value-Based Care Era The CMS TEAM 2026 preparation clock is ticking. Starting January 2026, the Transforming Episode Accountability Model (TEAM) will mandate episode-based payments for lower extremity joint replacement (LEJR) and spinal fusion in selected markets—expanding risk to orthopedic hospitals and ambulatory surgery centers (ASCs) alike. This shift accelerates orthopedic value based care, tying reconciliation payments to total episode cost, quality scores, and patient-reported outcomes. For ortho-focused providers, TEAM isn’t just another bundle—it’s an existential pivot. Success in joint replacement bundles and spine surgery bundled payments […]
- [From A-Grade Quality to 7% Margins: How Hospitals Turn Surgical...](https://solvedge.com/blog/from-a-grade-quality-to-7-percent-margins-surgical-outcomes-financial-strength/): From A-Grade Quality to 7% Margins: How Hospitals Turn Surgical Outcomes Into Financial Strength U.S. hospitals have made remarkable strides in safety and experience. Leapfrog “A” grades, top-quartile HCAHPS scores, and strong outcomes in CABG and orthopedics are now common among community and rural systems. Yet many still hover at sub-5% operating margins—or worse. Labor inflation, HRRP penalties, and capital constraints have exposed a painful paradox: hospital operating margin improvement lags far behind clinical excellence. Quality alone no longer guarantees rural hospital financial sustainability or urban competitiveness. The missing link? Disciplined execution that turns superior surgical outcomes and profitability into […]
- [From Digital-First Engagement to Measurable Outcomes...](https://solvedge.com/blog/digital-first-patient-engagement-measurable-outcomes-hospitals/): From Digital-First Engagement to Measurable Outcomes: How Hospitals Turn Every Patient Interaction into Better Care In 2026, patient engagement platform for hospitals isn’t a nice-to-have—it’s the operating system for value-based success. With HCAHPS scores directly tied to 2% of Medicare payments and CMS star ratings swaying patient choice, hospitals can no longer treat engagement as a siloed initiative. The new mandate: digital patient engagement strategies that start before admission, span every touchpoint, and close the loop with patient-reported outcomes (PROMs) in hospitals to drive improved HCAHPS scores and readmissions. Forward-thinking CMOs, CNOs, and CIOs are uniting around one truth: every […]
- [How Ortho-Focused Community Hospitals Are Using Digital Patient...](https://solvedge.com/blog/ortho-focused-community-hospitals-digital-patient-engagement-cut-readmissions-5-star-cms/): How Ortho-Focused Community Hospitals Are Using Digital Patient Engagement to Cut Readmissions and Protect 5-Star CMS Performance In the high-stakes world of orthopedic care, community hospitals face a perfect storm: orthopedic procedure volumes are surging—driven by an aging population and advances in joint replacement and spine surgery—while CMS 5-star ratings hang in the balance. One preventable readmission can tip a hospital from 5 stars to 4, triggering financial penalties, lost referrals, and reputational damage. For ortho-focused community hospitals, the math is brutal. A single 90-day joint replacement readmission can cost upwards of $15,000, and CMS’s Hospital Readmissions Reduction Program (HRRP) […]
- [From 2 to 5 Stars: How Post-Discharge Care Cuts Readmissions...](https://solvedge.com/blog/from-2-to-5-stars-post-discharge-care-readmission-reduction-cms-star-rating/): From 2 to 5 Stars: How Post-Discharge Care Cuts Readmissions, Avoids Penalties & Transforms Hospital Performance In today’s value-based care landscape, a hospital’s CMS star rating isn’t just a badge—it’s a financial lifeline. For multi-specialty acute care hospitals like Desert Regional Medical Center (DRMC) participating in Bundled Payments for Care Improvement (BPCI) programs, climbing from a 2-star rating to high-performance status can mean millions in reclaimed revenue, avoided Medicare readmission penalties, and strengthened community trust. But how do leading U.S. hospitals achieve CMS star rating improvement? The answer lies in mastering post-discharge care coordination best practices and leveraging hospital quality […]
- [Beyond the OR: How the Unmanaged 90-Day Post-Acute...](https://solvedge.com/blog/cms-team-2026-robotic-surgery-roi-post-acute/): Beyond the OR: How the Unmanaged 90-Day Post-Acute Period Erases Robotic Surgery ROI In today’s value-based care landscape, U.S. hospital leaders are investing millions in robotic surgery programs—like da Vinci systems—to deliver precision, attract top talent, and achieve strong robotic surgery ROI justification. But one overlooked vulnerability is quietly undermining these investments: the unmanaged 90-day post-acute period. With the CMS TEAM Bundle 2026 launching mandatory episode-based payments starting January 2026, hospitals will bear full financial risk for the entire 90-day episode. Without tight 90-day episode management, post-acute leaks can erase surgical gains through preventable readmissions, cost overruns, and lost margins. […]
- [The $10 Million Leak: How RecoveryCOACH + FRO Turn New...](https://solvedge.com/blog/recoverycoach-fro-cms-team-2026-hospital-expansion-roi/): The $10 Million Leak: How RecoveryCOACH + FRO Turn New Tower Capacity into CMS TEAM 2026-Ready Revenue You open a $120 million surgical tower. The ORs gleam. The board expects $30M new revenue by Year 3. Then the leak starts: OR case delays: 41 minutes between cases 90-day readmissions: 18.4% (vs. CMS TEAM target <12%) New beds occupied: 34% in Month 1 That’s $10.2 million in trapped capacity and penalties—before CMS TEAM 2026 even begins. SolvEdge fixes it with two platforms that work as one: RecoveryCOACH → Automates the 90-day post-op journey FRO → Optimizes OR scheduling, surgeon block utilization, […]
- [Beyond Penalties: How Predictive Digital Care Pathways...](https://solvedge.com/blog/value-based-care-strategy-predictive-digital-pathways-profit/): Beyond Penalties: How Predictive Digital Care Pathways Are Turning Risk into Real Money For years we’ve talked about value-based care like it’s a compliance exercise: “Don’t get dinged by CMS.” “Don’t lose 3% on HRRP.” “Don’t fall into the bottom quartile on readmissions.” That conversation is officially dead in 2025. The hospitals quietly pulling ahead—Aspirus-style systems, regional referral centers, and clinically integrated networks—have stopped playing defense. They’re using the same risk CMS hands them and turning it into six- and seven-figure recurring profit. They’re doing it with one shift: treating predictive digital care pathways like a revenue-generating asset instead of […]
- [Orthopedic Service Line Profitability: Fix Complications Fast 2025](https://solvedge.com/blog/orthopedic-service-line-profitability-fix-complications-fast-2025/): Orthopedic Service Line Profitability: Fix Complications Fast 2025 The True Cost of a 1.68 Complication Rate (Real 2025 Numbers) One serious surgical site infection or unplanned readmission doesn’t just hurt the patient. It wipes out the entire profit of 8–10 routine joint replacements. For rural and regional hospitals already surviving on razor-thin margins and heavy DSH payments, that math is brutal. A publicly reported CMS complication rate above 1.5 can literally decide whether your orthopedic service line stays in the black or bleeds red for the entire year. Most leaders assume complications happen in the OR. They don’t. They happen […]
- [Orthopedic M&A Multiple Destruction: Fix Clinical Variation](https://solvedge.com/blog/orthopedic-ma-multiple-destruction-fix-clinical-variation/): From Dilution to Dividend: How Inconsistent Care Pathways Are Silently Destroying Your Orthopedic M&A Multiple Private equity just paid 14× EBITDA for your orthopedic platform. You’re already counting the second bite of the apple.   Then the buyer finishes clinical due-diligence… and the multiple quietly drops to 9×–11×.   Why? Because your 18 newly acquired practices are running 18 different care pathways.   Same CPT code. Same implant. Same payer mix. Yet one site discharges 82% of joints home, another only 41%. One has a 1.8% infection rate, another 4.6%. One leaks $680K a year in preventable SNF spend, another […]
- [Closing the 30-Day Financial Leak: How Hospitals Are Finally Fixing](https://solvedge.com/blog/30-day-financial-leak-post-acute/): Closing the 30-Day Financial Leak: How Hospitals Are Finally Fixing the Post-Acute Black Hole in Mandatory Bundles (TEAM, BPCI, CJR) If you’re live with CMS’s new TEAM bundle in 2025 (or still grinding through BPCI/CJR), you already know the terrifying truth: You own 100% of the financial risk for the episode… but you control less than 40% of the spend.   The other 60%+ happens after discharge — in SNFs, IRFs, LTACHs, and home health agencies that don’t report to you, don’t use your EHR, and (let’s be honest) don’t particularly care if you hit your target price.   One […]
- [BPCI Advanced Survival Guide: How OCP Platforms Leverage](https://solvedge.com/blog/bpci-advanced-2025-avoid-readmission-penalty/): BPCI Advanced Survival Guide: How OCP Platforms Leverage Digital Automation to Avert the $5,000 Readmission Penalty and Protect Bundled Margins If you’re participating in CMS’s Bundled Payments for Care Improvement (BPCI) Advanced program in 2025, you already know the stakes are higher than ever. One unplanned 30-day readmission can now trigger a $5,000+ penalty per episode (and that’s before reconciliation eats into your already razor-thin bundled margins). The math is brutal: Average DRG episode payment: ~$22,000–$35,000 Target price set by CMS: often 2–3% below historical costs One preventable readmission: $12,000–$18,000 in extra cost → Net result: you lose money on […]
- [Hospital Partnerships in Orthopedic Rehab: A Data-Driven](https://solvedge.com/blog/hospital-partnerships-in-orthopedic-rehab-a-data-driven/): Hospital Partnerships in Orthopedic Rehab: A Data-Driven Approach to Bundled Payment Success The Strategic Value of Physical Therapy Partnerships for Hospitals Hospitals are under relentless pressure to avoid costly readmissions, coordinate care impeccably, and squeeze more value from bundled payments and risk-based contracts. Advanced digital care coordination solutions empower physical therapy networks to deliver powerful results. Seamless communication, standardized outcomes, and clear protocols turn hospital challenges into competitive advantages, forging tighter and more profitable alliances.​​ Physical therapy providers using integrated digital tools become invaluable partners for health systems. They provide hospitals with critical post-surgical support, improve patient experience scores, and […]
- [How Digital Care Pathways Elevate Physical Therapy Outcomes](https://solvedge.com/blog/how-digital-care-pathways-elevate-physical-therapy-outcomes/): How Digital Care Pathways Elevate Physical Therapy Outcomes at Scale Why Standardized Rehab Matters in Outpatient Networks Outpatient physical therapy networks are experiencing accelerated growth in regions like Southern California, where competition among clinics is fierce and patient expectations are high. For several facilities, maintaining both clinical excellence and a patient-centered brand across multiple locations requires more than top talent, it demands digital transformation. Robust care pathway solutions are reshaping how clinics unify their operations, making standardization not just achievable, but scalable. These solutions allow every site in a network, whether a flagship clinic or a new branch, to follow […]
- [Eliminating Orthopedic Cost Leakage in Total Joint Bundles](https://solvedge.com/blog/orthopedic-cost-leakage-total-joint-bundle-optimization/): Eliminating Orthopedic Cost Leakage in Total Joint Bundles: The Power of Real-Time Surgical Benchmarking Technology In the high-stakes world of Total Joint Bundles, where fixed reimbursements meet escalating supply and labor costs, undetected orthopedic cost leakage erodes margins faster than most ASC and MSO leaders realize. A single percentage-point swing in implant spend or 15 minutes of excess OR time can transform a profitable episode into a loss leader. Yet traditional case-costing systems and EHR reports leave surgical teams blind to these micro-variations—until the bundle reconciliation hits. This is where real-time surgical benchmarking technology—platforms akin to FRO (First Case On-Time, […]
- [Beyond the EMR: Automating PROMs Capture and Post-Discharge](https://solvedge.com/blog/automate-orthopedic-proms-capture-and-cms-compliance/): Beyond the EMR: Automating PROMs Capture and Post-Discharge Protocols to Protect Staff Capacity and CMS Compliance In orthopedic groups, ambulatory surgery centers (ASCs), and multi-site specialty practices, the transition from surgical volume to value-based reimbursement hinges on two non-negotiable metrics: reliable Patient-Reported Outcome Measures (PROMs) capture and airtight post-discharge protocol adherence. Yet most organizations still depend on EMR-centric workarounds and manual staff intervention—exposing them to MIPS penalties, staff burnout, and preventable readmissions. SolvEdge changes the equation with Orthopedic PROMs Automation and Digital Care Pathways that operate outside the EMR, enforcing clinical rigor at scale while removing 80–90% of the operational […]

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- [FRO | Real-Time Hospital Performance Analytics & Outcome Intelligence | SolvEdge](https://solvedge.com/hospital-performance-analytics/): Facility Reported Outcomes | Healthcare Analytics Platform Now Live – CMS Aligned & HIPAA Compliant Turn Fragmented Data Into Better Patient Outcomes In Weeks, Not Months Your facility generates thousands of data points daily. Most of it goes unused. FRO connects your siloed systems, surfaces what actually matters, and puts real-time insights where your teams need them – at the point of care. Watch the 60-second overview – See FRO in action 0:00 / 1:00 Product Demo Get Your Free Outcome Snapshot Book a 15-Min Demo HIPAA Compliant EHR Integrated CMS Quality Aligned Live in 30 Days Scroll to explore […]
- [RecoveryCOACH Demo | AI-Powered Post-Discharge Patient Engagement Platform](https://solvedge.com/recoverycoach-patient-engagement-platform-demo/): RecoveryCOACH | AI-Powered Patient Engagement Platform AI-Powered Patient Engagement Platform Recovery Doesn’t Endat Discharge Yours Shouldn’t Either RecoveryCOACH is the AI-powered patient engagement platform that keeps patients monitored, engaged, and on track – from discharge through full recovery. Watch the 60-second demo – See RecoveryCOACH in action 0:00 / 1:00 Product Demo Book a 15-Min Demo Watch Demo Again HIPAA Compliant EHR Integrated Setup in <48 Hours 24/7 Patient Monitoring Scroll to explore × Measurable Impact Built for OutcomesThe Smarter PatientEngagement Platform RecoveryCOACH is more than a patient engagement platform — it transforms post-discharge care with intelligent follow-ups, early warning […]
- [Thank you](https://solvedge.com/thank-you/): Thank You — SolvEdge Submission confirmed You’re in good hands. Thank you for reaching out to SolvEdge. A senior consultant will review your submission and be in touch — usually within one business day. What happens next 1 We review your submission A senior SolvEdge consultant reviews your details to understand your health system’s context before reaching out. Happening now 2 We reach out to schedule your call Expect an email within one business day with a calendar link to pick a time that works for you. 3 30-minute discovery call We’ll identify your biggest technology risk and opportunity — […]
- [CMS TEAM Episode Management Solutions](https://solvedge.com/cms-team-episode-management-solutions/): Book a Demo CMS TEAM Episode Management Stop Losing Money onSurgical Episodes.Start Winning UnderCMS TEAM. SolvEdge enables hospitals to excel under the CMS Transforming Episode Accountability Model (TEAM) with predictive intelligence that covers the full surgical episode—from pre-operative risk stratification to 30-day post-discharge monitoring. Take Readiness Assessment ⟶ HIPAA Compliant EHR Integrated Risk-Free Pilot Measurable ROI in 90 Days CMS TEAM Episode Management Stop Losing Money on Surgical Episodes.Start Winning UnderCMS TEAM. SolvEdge enables hospitals to excel under the CMS Transforming Episode Accountability Model (TEAM) with predictive intelligence that covers the full surgical episode—from pre-operative risk stratification to 30-day post-discharge monitoring. […]
- [testing - blocks](https://solvedge.com/testing-blocks/): Call to Action with Image Add beautiful boxes with title, image and button and encourage users to take action. Create your own Beautiful Landing Page with Elements Purchase now Experts Section – WordPress Ready Our experts, your challenges Read the Q&A with Kyndryl healthcare expert, Trent Sanders, VP Healthcare US Q Healthcare organizations are facing unprecedented challenges from mergers and acquisitions. How does aging technology affect patient outcomes? A Many healthcare organizations have been burdened with legacy systems stemming from mergers and acquisitions, resulting in aging technology and decreased efficiencies. Rising inflation, supply chain bottlenecks, and caregiver burnout add to […]
- [FRO](https://solvedge.com/fro/): Unlock the Power of Facility Reported Outcomes Track, transform, and triumph with a performance intelligence platform that reshapes how care outcomes are measured and improved. Schedule Demo Designed for Facilities. Made to Impact Patients. Hospitals, destination care centers, specialty practices, SNFs, post-acute care providers and the patients they serve gain lasting value from FRO. Schedule Demo Hospitals & Health Systems Drive Consistency, Performance & Outcomes at Scale An orthopedic hospital integrated FRO across departments, leading to a 15% rise in care consistency and an 18% improvement in value-based care scores—within just three months. How Hospitals elevate care with FRO Ambulatory Surgery […]
- [Intelligent Patient Engagement Platform | SolvEdge](https://solvedge.com/patient-engagement-platform/): Intelligent Patient Engagement PlatformThat Powers Continuous Care Deliver the right information, support, and check-ins at the right time without adding more to your care team’s plate. See it in Action Support Every Step of the Care Journey with a Smarter Patient Engagement Platform SolvEdge’s patient engagement platform keeps patients supported and informed from intake to recovery — through every step of their journey. By combining personalized education, proactive communication, and intelligent monitoring, our platform transforms fragmented care touchpoints into a seamless, guided experience. Patient Journey Care Pathway Long-term Care A Platform Built to Guide, Educate, and Communicate — at Every […]
- [Patient Engagement-SEO1](https://solvedge.com/patient-engagement-seo1/): Transform Patient Communication and Care Coordination Across Every Touchpoint Our patient engagement platform delivers personalized education, automated follow-ups, and real-time monitoring — without adding workload to your care teams. Schedule a Demo Support Every Stage of Care with Our Digital Patient Engagement Platform From pre-op preparation to post-discharge recovery, our patient communication software keeps patients informed, engaged, and connected — while reducing manual outreach for your care teams. Orthopedic Surgery Patient Journey Meet Sarah, a 62-year-old patient preparing for hip replacement surgery… Before Surgery Through the SolvEdge patient engagement platform, Sarah receives personalized pre-op education modules, mobility readiness checklists, and continuous automated […]
- [resources](https://solvedge.com/resources/): Resources Recently posted Specialty Care Analytics Recent Blog The Between-Visit Gap: The Most Overlooked Data Problem in Specialty Care Analytics Feb 05, 2026 5 min read Read More Specialty Care Analytics Recent Blog The Between-Visit Gap: The Most Overlooked Data Problem in Specialty Care Analytics Read More All Blog Infographics Guides Case Study Assessments Checklists Calculators and Tools
- [Med Device](https://solvedge.com/med-device/): Improving Surgical Implant & Robotics Outcomes Through Patient Intelligence Surgical outcomes shouldn’t be unpredictable. With SolvEdge, every patient journey is guided, every risk is flagged, and every implant is backed by real-world data—helping reduce complications, readmissions, and warranty claims. Discover SolvEdge’s Impact Next-Gen Outcomes for Robotics & Implants SolvEdge supports better surgical performance, patient recovery, and ROI—across the full continuum of care. From pre-op prep to post-op recovery, we help hospitals and MedTech companies achieve clinical and commercial success. Personalized Care Pathways Custom recovery plans tailored to each patient’s history, procedure, and implant—ensuring scalable consistency and reducing variability. Real-Time Patient […]
- [Cookie Policy](https://solvedge.com/cookie-policy/): INTRODUCTION This Cookie Policy explains that we believe in being transparent about how we use your information. In the spirit of transparency, this policy details on how and when we use cookies and similar tracking technologies like pixels, tags, web beacons (hereinafter collectively referred to as “cookies”) on our website and applications (mobile and hybrid, hereinafter referred to “applications”). This cookie policy applies to any SolvEdge Solutions product or service that links to this policy or incorporates it by reference. DOES SOLVEDGE SOLUTIONS USE COOKIES? SolvEdge Solutions uses cookies when you use any of the SolvEdge Solutions websites/applications. These are […]
- [Privacy Policy](https://solvedge.com/privacy-policy-2/): We SolvEdge, hereinafter referred to as the “Company” (where such expression shall, unless repugnant to the context thereof, be deemed to include its respective legal heirs, representatives, administrators, permitted successors and assigns). The creator of this Privacy Policy ensures a steady commitment to your privacy with regard to the protection of your invaluable information. This privacy policy contains information about the Mobile Application and Website https://solvedge.com/ (hereinafter referred to as the “website”). In order to provide you with our uninterrupted use of services, we may collect and, in some circumstances, disclose information about you with your permission. To ensure better […]
- [Terms & Conditions](https://solvedge.com/terms-conditions/): GENERAL We SolvEdge, hereinafter referred to as the “Company” (where such expression shall, unless repugnant to the context thereof, be deemed to include its respective legal heirs, representatives, administrators, permitted successors and assigns.) The creator of these Terms of Service ensures a steady commitment to your privacy with regard to the protection of your invaluable information. This document contains information about the website https://solvedge.com/ (herein after referred to as the “Company”). DEFINITION For the purpose of these Terms of Use (“Terms”), wherever the context so requires, “We”, “Our”, and “Us” shall mean and refer to the Company, as the context […]
- [Hospital](https://solvedge.com/hospital/): Elevate Surgical & System Outcomes SolvEdge empowers hospitals to optimize workflows, improve EMR utilization, and enhance patient engagement by connecting patients with their surgeons. See it in Action Why Hospital Leaders Choose Solvedge Hospital leaders face mounting pressure from surgical backlogs, workflow gaps, and compliance demands. SolvEdge’s integrated digital health solutions streamline THA care, reduce friction, and speed up decision-making. Accelerate THA throughput with streamlined pre-op readiness and post-op recovery tracking Unify clinical, surgical & administration workflows to eliminate silos and delays Enhance compliance & documentation accuracy through automated care pathways Unlock EMR-driven insights  for smarter resource allocation and performance reviews […]
- [ASC](https://solvedge.com/asc/): Scale Outcomes.Maximize ASC Efficiency SolvEdge connects surgery centers with integrated digital tools to streamline care coordination, enhance team workflows, and improve throughput from pre-admission to discharge across every surgical case. Explore the Platform Better Knee Coordination. Smarter Surgical Days. SolvEdge brings clarity and control to every knee replacement procedure from pre-op planning to post-op follow-through helping your ASC teams stay one step ahead, every step of the way. Seamlessly integrates with your existing EMR for efficient, accurate data exchange Automates pre-op readiness: patient education, consent forms, and checklists  Monitors OR flow and PACU transitions in real time to reduce delays Simplifies […]
- [Healthcare Analytics Platform for Facility Outcomes](https://solvedge.com/healthcare-analytics-platform/): Facility Reported OutcomesUnlock the Power of Healthcare Analytics A healthcare analytics platform built to do what generic tools can’t measure, connect, and improve outcomes at the facility level. Schedule Demo Designed for Facilities. Made to Impact Patients. Hospitals, destination care centers, specialty practices, SNFs, post-acute care providers and the patients they serve gain lasting value from FRO. Unlike broad-purpose healthcare analytics tools that require months of configuration, FRO is designed around how care facilities actually operate. Schedule Demo Hospitals & Health Systems Drive Consistency, Performance & Outcomes at Scale An orthopedic hospital integrated FRO across departments, leading to a 15% rise […]
- [Patient Engagement](https://solvedge.com/patient-engagement/): Transform Continuum of Care and CommunicationAcross Every Touchpoint Deliver the right information, support, and check-ins at the right time without adding more to your care team’s plate. See it in Action Support Every Step of the Care Journey Keep patients supported and informed from intake to recovery through every step of their journey. Patient Journey Care Pathway Long-term Care A Platform to Guide and Communicate With Patients. From onboarding to long-term care, empower patients with tools to stay engaged, informed, and in touch. Patients receive personalized education modules and mobility readiness checklists before surgery. Continuous follow-ups and guided care are […]
- [Practice](https://solvedge.com/practice/): Advancing Masteryin Clinical Practice SolvEdge enhances clinical efficiency and patient care with integrated EHR and analytics, streamlining workflows and transforming healthcare across all settings. Get Started Today Why Clinical Practice Leaders Trust SolvEdge From streamlining care pathway to improving TKA outcomes, SolvEdge equips clinical leaders with data-driven precision and unmatched care coordination. Seamless integration with Electronic Medical Records (EMR) and Electronic Health Records (EHR) for better patient tracking. Enhanced accuracy in surgical planning and post-op monitoring, improving patient outcomes. Streamlined workflows that reduce administrative burdens and improve clinical efficiency. Improved data sharing between orthopedic teams, reducing delays and errors in TKA […]
- [Procedures](https://solvedge.com/procedures-page/): Comprehensive Orthopedic Procedures for Every Stage of Life Explore a full spectrum of orthopedic procedures covering joint reconstruction, trauma, sports injuries, oncology, spine, and minimally invasive techniques-tailored to restore mobility and improve quality of life across all age groups. Schedule Demo Joint replacement Hip Replacement Knee Replacement Revision Arthroplasty Spine Surgery Cervical Spine Lumbar Spine Thoracic Spine SHOULDER & ELBOW SURGERY Rotator Cuff Repair Shoulder Replacement Elbow Arthroplasty FOOT & ANKLE SURGERY Sports Injuries Diabetic Foot Care Reconstructive Surgery FRACTURE & TRAUMA SURGERY Polytrauma Complex Extremity Trauma Pelvic And Acetabular Fractures MUSCULOSKELETAL ONCOLOGY Bone Tumors Soft Tissue Sarcomas Limb Salvage […]
- [Contact](https://solvedge.com/contact/): Connect with SolvEdge Purpose-Built Solutions for CMS Compliance, Patient Engagement, and Revenue Integrity The future of healthcare demands more than compliance it requires transformation. Whether you’re preparing for CMS TEAM mandates, boosting engagement across the patient journey, or unlocking new revenue opportunities through data-driven insights, SolvEdge is your partner in performance. Let’s Talk Strategy We work with hospitals, health systems, and ambulatory centers to: Navigate CMS mandates with confidence Improve outcomes using real-time Facility Reported Outcome (FRO) insights Engage patients through guided, scalable digital experiences Optimize your entire revenue cycle with intelligent automation
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- [About us](https://solvedge.com/about-us/): Where Outcomes Drive Excellence At SolvEdge, we help hospitals and ambulatory surgery centers unlock their highest potential with data-driven insights, clinical precision, and performance-centered strategies. Founded in 2004, we are a clinical and physician-led, outcomes-focused healthcare technology company delivering purpose-built platforms for surgical excellence, patient engagement, and performance improvement. Our solutions including RecoveryCOACH and Facility Reported Outcomes (FRO) are built to deliver exceptional results across orthopedic service lines like hip, knee, spine, shoulder, foot, and ankle. Available in English and Spanish, they power care teams with the tools, data, and insights needed to thrive in today’s value-based environment. Performance You […]
- [Home](https://solvedge.com/): Outcome-DrivenSurgical CareStarts Here Enhance surgical care with patient engagement, OR optimization, and data-driven decisions. Schedule DemoTrack ImplantOutcomes ThroughPatient Care Pathway Monitor surgical outcomes with implant data and engagement across the entire care journey. Explore Our ToolsOptimize Case CostsUsing HealthcareAnalytics Tools Use advanced analytics to uncover cost drivers, cut waste, and maximize case performance. See Our Impact Outcome-Driven Surgical Care Starts Here Transforming Surgical Care With Patient Engagement and Superior Analytics. Drive perioperative efficiency with real-time PACU insights, implant tracking, and data-backed decisions Schedule Demo Track Implant Outcomes Through Patient Care Pathway Gain real-time visibility into surgical outcomes by connecting implant data with patient engagement, ensuring continuous improvements in care, […]
- [Privacy Policy for Mobile App](https://solvedge.com/privacy-policy/): PRIVACY NOTICE This privacy notice for Solvedge Inc. (“Company,” “we,” “us,” or “our” ), describes how and why we might collect, store, use, and/or share (“process” ) your information when you use our services (“Services” ), such as when you: Download and use our mobile application, or any other application of ours that links to this privacy notice Engage with us in other related ways, including any sales, marketing, or events Questions or concerns? Reading this privacy notice will help you understand your privacy rights and choices. If you do not agree with our policies and practices, please do not use […]

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