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The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
The ABCs of Healthcare IT for 2014
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The ABCs of Healthcare IT for 2014

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This is a quick look at predictions for 2014 using the letters of the alphabet to talk through almost 26 predictions.

This is a quick look at predictions for 2014 using the letters of the alphabet to talk through almost 26 predictions.

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    • 1. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential © 2013 Health Catalyst www.healthcatalyst.comProprietary and Confidential January 2014 Buzzwords for 2014 100 120 140 160 180 200 220 240 260 280 1981 1986 1991 1996 2001 2006 2011IPdaysinmillions Inpatient Days
    • 2. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014 .. The year of ACO Accountable Care Organization 500 as of year end 2013, projected to double in one year Medicare added 123 new ACOs (MSSP) in January 2014 2 According to a baseline study of early Accountable Care Organizations (ACOs), ACO patients had 5.8% lower total costs of care than non-ACO patients ($7,694 vs. $8,164). Source: The Commonwealth Fund, January 2014
    • 3. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Bundled Payment 3 Acute Acute/Post Post Acute Payment Retrospective Retrospective Retrospective Prospective Participants 3 44 14 37 Organizations 32 192 165 75 Episode All acute patients, all DRGs Selected DRGs, hospital plus post- acute period Selected DRGs, post-acute period only Selected DRGs, hospital plus readmissions Services included in the bundle All Part A services paid as part of the MS-DRG payment All non-hospice Part A and B services during the initial inpatient stay, post- acute period and readmissions All non-hospice Part A and B services during the post-acute period and readmits. All Part non-hospice A and B services (including the hospital and physician) during initial inpatient stay 48 Bundled Payment Groupings Major joint upper extremity 483 Major joint and limb reattachment procedure of upper extremity with complication or comorbidity or major complication or comorbidity
    • 4. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of 4 Consumer Transparency These common-sense best practices bring consistency, clarity, and transparency to patient financial communications. Bill posted on Internet $55,000 for appendix operation
    • 5. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of High Deductible Plan 5 We have definitely been hearing from members that they are seeing an increase in bad debt and even in charity care for people with high-deductible health plans," Caroline Steinberg, vice president for trends analysis at the American Hospital Association, told KHN. "A lot of these folks tend to not understand the structure of their benefits until they get to the hospital, and they're not covered as thoroughly as they thought." The rate of workers in high-deductible plans has more than doubled since 2009 to 19 percent, KHN says, citing figures from the Kaiser Family Foundation. Additional buzzwords: Retail, reference pricing Source: Kaiser Family
    • 6. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Expenditure The number of people employed in healthcare dropped by 6,000 in December, the first time total healthcare employment declined since July 2003, CNN Money. 6 17.2% 10% 11% 12% 13% 14% 15% 16% 17% 18% 2000 2002 2004 2006 2008 2010 2012 Health Expenditure as % of GDP 3.7% 3.6% 3.8% 3.8% 2.0% 2.5% 3.0% 3.5% 4.0% 4.5% 5.0% 2012 2011 2010 2009 Healthcare Spending Growth
    • 7. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Frequent Conditions AHRQ 7 Principal CCS diagnosis Number of stays in thousands Stays per 10,000 population All stays 38,591 1,239 Liveborn (newborn infant) 3,818 123 Pneumonia (except that caused by tuberculosis and sexually transmitted diseases) 1,114 36 Septicemia (except in labor) 1,094 35 Congestive heart failure, nonhypertensive 970 31 Osteoarthritis 964 31 Mood disorders 896 29 Cardiac dysrhythmias 795 26 Chronic obstructive pulmonary disease and bronchiectasis 729 23 Complication of device, implant, or graft 699 22 Spondylosis, intervertebral disc disorders, other back problems 667 21 Table 1. Number of hospital stays and stays per 10,000 population by the most frequent principal diagnoses, 2011 Abbreviation: CCS, Clinical Classifications Software Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS), 2011 Frequencies
    • 8. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of SGR Sustainable Growth Rate Congress has 3 months to consider 2 very similar bipartisan bills in the House and Senate that would repeal Medicare's sustainable growth rate (SGR) formula for physician pay. Both measures would shift compensation from fee-for-service to pay-for- performance and consolidate 3 Medicare incentive programs, including meaningful use of electronic health records, into a single program. 8 Averted 20% decrease in Jan
    • 9. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of HAC 9 FY 2014 Final Inpatient PPS Rule Creates HAC Reduction Program with two Domain measurements that overlaps in its entirety with existing HAC program and VBP
    • 10. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of ICD-10 10 Outlook grim for docs' ICD-10 readiness October 1, 2014 Physician practices are still behind schedule in terms of preparation for ICD-10, yet generally are optimistic about readiness for its implementation, according to a recent survey conducted by medical claims clearinghouse Navicure. Seventy-four percent of survey respondents said they still haven't started implementing their ICD-10s. What can be taken as a bit of good news is that 76 percent of respondents to a series of KPMG surveys indicated they have completed an impact assessment, widely considered the first key step en route to ICD-10.
    • 11. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Joint accountability with physicians 11 Two-thirds of primary care and one-third of specialists currently depend on an exclusive relationship with a hospital for some or all of their incomes. Many of these are employed. But private health insurers and large medical groups are options for physicians seeking cover, and the terms of their deals dis- intermediate traditional hospital referral relationships. Source: Deloitte
    • 12. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Risk 12 Potential for revenue losses to competitors or penalties from regulators is increasing
    • 13. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Lean 13 Pharmacy Workflow Project Business Impact: Reduced the number of trips to the hospital pharmacy due to inventory shortage by 8 trips per month Reduced the surcharges paid to the trucking company Reduced the pharmacy headcount by two full time equivalents (FTE)
    • 14. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of 14 A measure in the new Efficiency Domain A claims-based measure that include risk-adjusted and price-standardized payments for all Part A and Part B services provided from 3 days prior to a hospital admission (index admission) through 30 days after the hospital discharge Measure under VBP starting 2015 M & A Merger and Acquisitions Deals Hospitals 2010 72 125 2011 90 156 2012 100 247
    • 15. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Net Income – includes investments Operating Income- on operations Median in 2012 3.15%, California Median 3% 15 -3% -2% -1% 0% 1% 2% 3% 2013 2014 2015 2016 2017 2018 Operating Income Projections Projection with no interventions.
    • 16. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Outpatient- Growth Area Up 2.9% from 2011 16 JP Morgan- Revenue growth: in the expansion of outpatient care and in clinical integration leading to value-based care.
    • 17. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of PQRS 17 The Physician Quality Reporting System (PQRS) has been using incentive payments, and will begin to use payment adjustments in 2015, to encourage eligible health care professionals (EPs) to report on specific quality measures. EPs who do not participate in 2013 and receive a payment adjustment will be paid 1.5% less than the than the Medicare PFS amount for services provided in 2015. Increases to 2% in 2016. 2013 P2014 F2014 Measures 258 296 284 Measures Removed N/A 46 45 Also Population Health
    • 18. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Readmit rate 2015 18 2013 1% 2014 2% 2015 3% Readmission • 2013- 1% $280M for 2,213 hospitals - Average fine .42% • 2014- 2% $227M for 2,225 hospitals - Average fine .38% • Overall readmit rate for Medicare 18.4%(down from 19%) Adds hip/knee and COPD to program In FY 15 RAC Audit Reference pricing Retail
    • 19. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Supply Chain Represent 14% of expenses in California hospitals- second largest category of expenses 19
    • 20. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Two midnight rule Starting Oct 2013, CMS introduced the two midnight rule. The final rule for the 2014 Inpatient Prospective Payment System stated an appropriate inpatient admission is when the patient stays in the hospital for at least two midnights. 20
    • 21. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year Utilization 21 Inpatient grew at -1.5% over 2011 And Outpatient grew 2.9%. Inpatient Surgeries declined -2.2%. 100 120 140 160 180 200 220 240 260 280 1981 1986 1991 1996 2001 2006 2011 IPdaysinmillions Inpatient Days
    • 22. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Medicare Value Based Purchasing Adding 2 new outcome measures for 2015: PSI, CLABSI Adding new efficiency: Medicare Spending per Beneficiary 22 2013 1%` 2014 1.25% 2015 1.5%
    • 23. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of W 23 Workflow 2012 study by former Centers for Medicare and Medicaid Services (CMS) administrator Donald M. Berwick and RAND Corporation analyst Andrew D. Hackbarth estimated waste consumed $476 billion to $992 billion, or 18 percent to 37 percent of healthcare spending. Waste
    • 24. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential 2014… The year of Extra Yellow Zebra Year of the Horse 24
    • 25. © 2013 Health Catalyst www.healthcatalyst.com Proprietary and Confidential Questions 25 • Learn about the Health Catalyst approach http://www.healthcatalyst.com/catalyst- approach/ • Contact us to learn more about our solutions and communication tools www.healthcatalyst.com/company/contact-us

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