Cacophony or Symphony? How to Orchestrate Population Health Management

Posted by Jim Hollis, Director of Marketing on August 22, 2016

Population health management (PHM) requires collaboration between clinicians across the care continuum, much like a symphony requires coordination among multiple musicians. In the case of the orchestra, everyone has matching sheet music, ensuring consistency and harmony.

When managing your population’s health, the “sheet music” that guides a cohesive, orchestrated approach to patient care is evidence-based medicine (EBM). Traditionally, physicians making diagnoses or treatment decisions based solely upon their individual experience and education. EBM can augment the physician’s experiential background or to set standards for enterprise-wide best practices.

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Topics: Hayes Blog

Leading the Way: Giving Genetic Testing Context

There are more than 65,000 genetic tests available on the market today and new genetic tests are added daily. According to the website GeneTests.org, there are currently more than 650 laboratories manufacturing tests for more than 4,500 disorders. The quick math? There are potentially thousands of different tests for a clinical indication. But how do payers and providers even begin to identify when genetic testing can be useful, let alone which test to use? 

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Getting Health Plans & Providers in Sync with Genetic Tests

The Hayes Client Symposium is under two months away and our accredited sessions are taking shape for our clients who are attending. Few areas of healthcare are changing as rapidly as the field of genetics—from new tests coming to market weekly, to proposed changes in regulation. We’re pleased to be offering a session focused on this evolving topic.

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When Vendors Say They Are “Evidence-Based,” What Does That Really Mean?


The term “evidence-based” has been juggled around in healthcare for years. Many companies use the term, but few provide the necessary details to support the claim. In particular, use of the term “evidence-based” has exploded among companies providing IT-based solutions for payers and providers. In the health plan space, insurance companies are required to meet a burden of proof that evidence-based resources are being utilized in order to qualify for National Committee for Quality Assurance (NCQA) accreditation status. Similarly, in the health system space, evidence-based guidelines have become the standard as physicians strive to reduce clinical variation.

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It’s FDA Approved! But is it Ready for My Coverage Policy?

Posted by David Wade, MD, FACS, Chief Medical Officer on June 22, 2016

The Hayes Client Symposium is just about 3 months away and we’re busy preparing our accredited sessions for our health plan clients who will be in attendance. I’m personally excited to be part of the session focusing on the FDA approval process and the impact this has on coverage policy. This is always a hot topic for our health plan clients.

Some background about the FDA:
The Food and Drug Administration (FDA) can trace its origins as a federal consumer protection agency to the passage of the 1906 Pure Food and Drugs Act. The 1906 Act was passed in response to public outrage at the startlingly unsanitary conditions in the Chicago meatpacking industry described by Upton Sinclair in his landmark book, The Jungle.

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The Quandary of Making Healthcare Technology Acquisitions without Evidence

Hospitals do not need to be reminded of technology acquisition mistakes they may have made in the past. They simply need to look in the operating room to see the pile of abandoned equipment.

Hospitals and healthcare systems can ill afford to make mistakes when evaluating and acquiring health technologies. However, technology by its nature is always changing. New products are constantly emerging but often there is limited evidence on safety, effectiveness, and cost.

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When Tamiflu Doesn’t Tame the Flu

Posted by Jim Hollis, Director of Marketing on June 8, 2016

Having the flu is a truly miserable experience—especially in the heat of summer. Symptoms include fever, chills, muscle aches, cough, congestion, runny nose, headaches and fatigue. Unfortunately, once flu germs have taken up residence in your body, there is little that can be done except to treat the symptoms and wait it out.

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Specialty Pharma: A Prescription for Controlling Catastrophic Costs

Serving nearly 85% of the health plan market’s covered lives, Hayes makes it a priority to stay in touch with clients about what keeps them up at night. With a variety of plans all over the nation varying in size and product offerings, you can imagine we hear a lot of concerns. One of the recurring themes we hear is specialty pharmaceuticals. In fact, we have heard so much on the topic, it has been included as an accredited session at our Hayes Client Symposium this September.

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Ameda or Medela: Which breast pump is better?

Posted by The Evidence Blog on May 5, 2016

In the last decade, there have been multiple revelations about the health benefits of breastfeeding. Babies that are breastfed exclusively in the first 6 months are less susceptible to ear infections and respiratory problems, and to developing allergies. As a result, the United States has experienced a 25% increase in nursing mothers since the mid-1990s. Even the IRS is weighing in on the issue; breastfeeding has been proven to be so beneficial, mothers get tax breaks for breast pumps.

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Topics: Hayes Blog

Aligning Doctors to Improve Quality at Memorial Hermann

Posted by David Wade, MD, FACS, Chief Medical Officer on April 21, 2016

HIMSS16 brought together more than 41,000 healthcare professionals, with presentations by carefully selected experts in healthcare technology. One of the best-received presentations was by Shawn Griffin, MD, chief quality and informatics officer for Houston-based Memorial Hermann Physician Network. Now let me quickly admit my bias—Memorial Hermann is a client of Hayes. But how can you not love this question from Dr. Griffin?

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Topics: Hayes Blog