5 Benefits a Nurse Advice Line Offers Your University

Posted by Christina Gurnari

College students are a unique subset of our population in need of 24-hour healthcare.

Some of the specific health challenges University Health Centers face, include: behavioral health, drug and alcohol abuse, sexual assault, communicable diseases, and even chronic conditions. 

In fact, demands on campus health centers might be higher and more complex than ever. With more students arriving with serious health needs, the addition of a personalized university nurse advice line is an ideal solution to meet growing demands, create an extension of the student health center and satisfy the health and safety demands of college students and their parents. The most highly regarded student health centers are establishing comprehensive service offerings, including access to a nurse advice line 24 hours a day, 7 days a week, 365 days per year. 

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Topics: Nurse Advice Lines

What does URAC Accreditation mean?

Posted by Melba Papamichael

The Utilization Review Accreditation Commission was incorporated in 1990 to offer health organizations an opportunity to have trained reviewers examine their operations and publicly ensure they are delivering care in a manner consistent with national standards. URAC accreditation is a way for a health care organization to demonstrate and highlight their commitment to Health Call Center quality and accountability.

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Putting Patients First to Ensure Appropriate Utilization of Resources

Posted by Christina Gurnari

It seems like it should go without saying that patients should be a healthcare provider’s primary focus. According to a recent national survey of NEJM Catalyst’s Insights Council, the current provider environment makes delivery of high-value, compassionate care a challenge. According to the survey, the biggest part of that challenge involves finding more time with patients so that clinical staff can spend the right amount of time to provide the right care. This time can greatly impact patient experience and satisfaction which are also driving factors in creating a high value compassionate care environment.

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Why Encounter Data is More Important Than Ever

Posted by Darryl Low

Earlier this month, the Center for Medicare & Medicaid Services announced that they will be calculating 2020 risk scores by adding 50% of the risk score using diagnoses from encounter data (supplemented with diagnoses from RAPS inpatient data) and FFS data and 50% of the risk score calculated (using the 2017 CMS-HCC model) using RAPS and FFS diagnoses. This doubles the current percentage of encounter-based risk scores used for the final calculation, meaning every encounter reported up stream will soon be more important than ever.

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Topics: technology

Value-Based Care Should Drive Competitive Differentiation

Posted by Alicia MacLeod

Value-based care offers Medicare Advantage Plans a Path to More Market Share.

Value-based care offers Medicare Advantage (MA) programs an important opportunity to capture market share. Ranging from cost savings from the reduction of medical errors, to providing benefits, such as transportation, it's clear why health plans are innovating on these options. Consumers though, still don’t know which plans are making investments to create better healthcare options for them. Their perception is that, aside from cost, most MA plans don’t differ, which is an opportunity for plans to differentiate themselves from their competitors.

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6 Steps To Impacting Medicaid ER Utilization

Posted by Alicia MacLeod

There was once an assumption that the expansion of Medicaid would yield recipients consuming more primary care services rather than seeking out the Emergency Room as their first stop in health care decisions. Several years after the inception of the Affordable Care Act, we’ve learned this is not the case. A recent Washington Times article pointed out that Medicaid expansion has, in fact, not pushed those using Medicaid benefits to PCPs, rather it has increased the traffic to emergency rooms. So, why are Medicaid recipients two times as likely to seek out care at the emergency room rather than a lower-cost option or using their primary care provider? Simply put, it comes down to benefit design, education, and ultimately consumer engagement. In populations like Medicaid, where benefit design and education on health care consumption are not widely understood or properly communicated, there is poor engagement, which perpetuates inappropriate benefit use. 

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Why Timing and Telephonic Communication Matters for Engagement

Posted by Alicia MacLeod

It's no secret that member confusion around how to use medical benefits continues to be a major driver in inappropriate health care spend.  For the Medicare population specifically, a recent Healthmine study showed that only 22 percent of Medicare Advantage members have knowledge of what star ratings mean when it comes to choosing their care.  This confusion and lack of knowledge often gets highlighted through the statistics shared around inappropriate benefit utilization (such as inappropriate emergency room visits) and the expenses incurred as a result of chronic conditions. 

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Targeted Outreach Improves Quality Scores, Closes Care Gaps

Posted by Alicia MacLeod

Finding and eliminating gaps in care continues to be one of the most challenging aspects of the shift to value and better outcomes. As perhaps the most influential payer of all, Medicare is emphasizing shared savings programs to incentivize delivering quality care. Additionally, there has been an industry-wide shift where the focus is no longer on disease management, but rather on population health management as a whole. This makes the opportunity to impact care gaps and quality a much higher priority for at-risk organizations.

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Boosting Patient Engagement Requires Proactive Outbound Efforts

Posted by David Morris

Thanks to the proliferation of technology, patient expectations are sky-high. After all, providers and plans are competing with some of the best brands in the world when it comes to delivering on consumer expectations. Which might be why patient engagement might actually matter more than ever. In fact, outbound engagement is proving to be an effective way to stay connected with members and control populations. Expanding access to healthcare solutions impacts the bottom line of providers given that better access often translates to prevention.

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Topics: Outbound Engagement, customer centric, customer service, healthcare

United Way Day of Action - Dirty Hands, Big Hearts

Posted by Annamarie Garmon

Our employees pulled up their sleeves, dug in the dirt and shoveled mulch as part of the United Way of Greater Portland’s Dirty Hands & Big Hearts Day of Action. Day of Action is an annual day of service sponsored by the United Way. Volunteers from all over greater Portland come together and spend the day completing 75+ enhancement projects at local non-profits and schools. Citra employees participated in three specific projects this year.

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Welcome To The New Era Of Healthcare

Serving 50+ IPAs and MSOs managing commercial, Medicare and Medicaid populations; 100+ Provider Groups, Hospitals, Universities and Integrated Delivery Networks throughout the United States and in Puerto Rico. Citra delivers technology and services resulting in more efficient operations.

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