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Industry ExpertiseHealthcare & Life SciencesHealthcare Policy & Compliance
Effectively navigating the federal and state policy landscape is an essential skill for any organization whose business is in, or depends on, the healthcare sector. Even as complex government policy changes are made with respect to health insurance coverage and cost, fundamental changes related to reducing overall healthcare costs, measuring the effectiveness of healthcare, improving population health and using technology and analytics to drive future decisions, are all likely to continue in the coming years. The healthcare industry has always been heavily regulated, but the pace of change has significantly accelerated in recent years and the complexity of new policies can be challenging for any organization. Implementing new policy mandates and maintaining a sound compliance infrastructure in an ever-changing environment require a strategic balance of people, process and technology.

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Help me comply with the Transparency in Coverage regulations

Our healthcare experienced consultants have the knowledge and expertise to lead your plan through the critical strategy and business decisions that need to be made now as well as managing the planning, designing, developing, and testing necessary to stand up:

  • Machine-readable files by July 2022
  • Specific cost estimates for 500 defined services by January 2023
  • Specific cost estimates for ALL services by January 2024

Trexin’s team can help you navigate both the strategy and technical aspects of this federal regulation and make sure you are compliant with all of the designated deadlines.

Areas of Expertise:

  • Policy
  • Regulation
  • Compliance
  • Transparency in Pricing
  • Healthcare Costs
  • Strategy
  • Technology
  • Program Execution
  • Federal Government
  • Federal Regulation

Help me get compliant with the 21st Century Cures Act

Trexin’s Healthcare consultants, along with our Program Execution and Technology experts understand the critical aspects of the 21st Century Cures Act.  We can help you understand the policy implications, plan for compliance adherence, and implement the required technology to provide your members/patients the seamless and secure access to their health information as required by the 21st Century Cures Act.  This regulation requires the healthcare industry to adopt standardized application programming interfaces (APIs) to allow for users to access health information using smartphone applications in a structured fashion.  Trexin’s team can work with your organization to develop and implement a roadmap to follow to meet these major CMS technical compliance standards and milestones which will better position you as an early adopter and ensure avoidance of heavy fines.

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Help me plan effectively for federal healthcare changes

Trexin’s healthcare leaders help you devise, enhance, and update your strategy for healthcare reform to ensure that you are successful in navigating the policy landscape. Government sources now account for almost one half (46%) of all health spending in the U.S., making your organization’s policy strategy more important than ever. Using proven tools and methodologies, leveraging experience working with state and federal healthcare programs, and working collaboratively with your existing resources, Trexin’s Health Care Reform Strategy team will help you implement effective initiatives and thrive in an era of ever-changing policy.

Areas of Expertise:

  • Policy
  • regulation
  • strategy
  • government programs
  • compliance
  • healthcare reform
  • federal government
  • state government
  • funding
  • incentives

Help me capitalize on new Medicare and Medicaid payment models

Trexin leverages its extensive experience working in Medicare and Medicaid payment models to help organizations develop and implement new ways of delivering and paying for care in the evolving environment of value-based government healthcare programs. We help you assess and address gaps in technology, data analytics, workflow and performance measurement to ensure that your Medicare or Medicaid program is successful and meets the policy expectations for value-based healthcare.

Areas of Expertise:

  • Medicare
  • Medicare Advantage
  • Medicaid
  • payment models
  • payment policies
  • accountable care
  • Medicare shared savings program
  • dual-eligibles

Help me comply with new regulations

Trexin’s Regulatory Compliance Strategy services help your organization ensure that when new government policies that impact your business go into effect, you take a strategic view of the resources needed for compliance and understand the risks and benefits associated with regulatory mandates and deadlines. We also help ensure that you have the organizational resources and processes in place to meet government reporting and auditing requirements.

Areas of Expertise:

  • regulation
  • compliance
  • mandate
  • incentives
  • reporting
  • analysis
  • data integration
  • policy
  • audit
  • evaluation

Help me get compliant with HIPAA and HITRUST

Trexin’s Data Privacy and Security Strategy consultants understand how critical maintaining compliance with HIPAA and HITRUST are to your operations. We can help you assess your policies, procedures and adherence, and implement practices that minimize your risk of non-compliance. Given the rapid pace of regulatory and technological change, your data privacy and security policies must be continuously monitored and updated to ensure you have invested the right level of resources. HIPAA violations and data breaches come at an enormous cost to your operations. Your patients, clients and business associates expect trusted partners and Trexin can provide you with the support you need to safely and securely manage data and maintain their confidence.

Areas of Expertise:

  • federal policy
  • protected health information (PHI)
  • data privacy and security
  • covered entity
  • business associate
  • cybersecurity

Help me ensure my healthcare program is business ready in the eyes of my client

Whether implementing a new healthcare program or expanding the scope of an existing one, successful project go-live and sustainable program operation requires comprehensive business readiness planning.  This involves an objective, enterprise-level assessment of your end-to-end business capabilities, workflows and challenges, measured against the performance expectations and milestones for the program, with a strong focus on the perspective of the client and individual needs of the member.

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Revenue Cycle Management - Clinical Documentation Improvement

Revenue Cycle Management: Clinical Documentation Improvement

Elizabeth Souder dives deeper into one of the revenue cycle management optimization opportunities, Clinical Documentation Improvement (CDI) and explains how Trexin can help.

Tagged in: Healthcare & Life Sciences, Optimized Operations