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Champion And Healthcare


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The healthcare reform law will have far-reaching impacts in areas of …

The healthcare reform law will have far-reaching impacts in areas of

Insurance Reform
Insurance Mandates
Health Insurance Exchanges

Get the FACTS here a MUST see POWER POINT

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  • What’s going on in the HC industry. People that influence the HC paradigm the most … Shifting to a Patient Centric ModelThrough govt work - Health ReformGovernmentProvidersHealth PlansLife Sciences4 main areas that influence and change the way healthcare is delivered … Access to Care: legislativeReduce uninsured SustainabilityImprove OutcomesCoodinated CareSharing HIE – allow docs to have info about the patientsReducing Active Health management – Shifting to a patient centric model – a major driver is health reform & ARRA – 4 areas We believe that there is a healthcare paradigm shift that is about to occur.For decades, the US has been an illness-based model of healthcare. We are now shifting to a wellness / health maintenance model.It’s odd that HC organizations need to be reminded to involve their patients in their own healthcare decisions.Access to CareReadmission Rates – Health Reform Bill - Mentioned 50 timesHospitals – 2013- above 75% - tile2013 – Preventable diseaseReimbursements – reduced …Major Points: HC Providers above 75 percentile - The proposal drafted by Democratic Chairman Max Baucus was designed to reduce costs, regulate insurers and expand coverage.
  • Transcript

    • 1. Champion – Helping our Clients Address the Issues Facing the Healthcare Market Place
      Michael Hudak
      Champion Solutions Group
      800-771-7000 x 344
    • 2. The healthcare reform law will have far-reaching impacts
      Cost: $940B over 10 years
    • 3. The reform law is just the latest upheaval hitting healthcare
      Legislative reform
      Will bring $938B into the healthcare industry by 2019
      Stimulus: ARRA - HITECH
      Health IT market expands 31% as providers move to EMR
      7 times more medical codes
      Estimated $10B conversion costs
      New delivery models and
      reimbursement approaches
      Community Care NC delivers $150M annual savings
      Employers & Consumers
      AT&T announces $1B write-off
    • 4. We expect intense disruption in the next 18 – 36 months
      PCMH demonstration programs – Pilot, scale and expand
      ACO pilots in the private sector
      OCT 2013:
      ICD-10 Mandate Effective
      ICD-10 & HIPAA 5010 Conversion: ~$2B for Providers, ~$7B for Plans
      MU Stage 2: TBD – Advanced Care Processes
      MU Stage 1: Electronic capture and sharing; e-Prescribing; Clinical decision support
      Form Standards and Policy Committees
      Develop “Meaningful Use” definitions
      MU Stage 3: TBD – Improved Outcomes
      $380M for Health Information Exchanges
      $340M Regional Extension Centers
      $1.1B for Comparative Effectiveness
      LEGISLATION: Patient Protection and Affordable Care Act
      Bundled PaymentsPilots
      No Denials, Rescissions or Caps
      2014: Individual and Employer Mandates Begin
      Closing Medicare “doughnut hole” on Drug Reimbursement
      Imposition of 85% MLR Floor
      2014: State Run Insurance Exchanges for Consumers and Small Business
      $500M for Comparative Effectiveness
      Increased Fraud & Abuse Funding
      Mar 2010: PPACA
      Feb 2009:ARRA Enacted
    • 5. Reimbursement Rates (2008)
      Hospital Operating Margin by Year
      Commercial Plans
      Healthcare Provider pressures: lower costs, better quality
    • 6. Adjacent industries are entering the healthcare ecosystem to meet the changing needs of patients and communities
      Retail clinicswill continue to expand their services. They may offer services such as health insurance and telemedicine.
      Medical device manufacturers will sell directly to consumers in homes, packaging wellness and care management services with devices.
      Banks will grow participation in health savings accounts and in payment-related transactions and services.
      Networking providers will expand focus on hand-held devices and network services including UC2, selling devices to physicians’ offices, hospitals and long-term care facilities.
      Communications service providers will actively pursue health information exchange opportunities, as the enabling platform for information exchange and telemedicine.
      PBM’swill expand significantly, pursuing HIE networks, being visible at point of care and adding non-traditional medical services.
    • 7. Healthcare Provider Challenges
      Government budgets at national, state and regional levels under extreme pressure
      Healthcare related expenses often represent the largest budget item
      Healthcare access, quality and related public services highly politicized
      Costs to serve chronic conditions and elderly are largest portion of costs
      Fraud presents significant drain on cost, typically 3-8% of total HC costs
      Providers look for approaches to engage patients, improve service and quality and address system inefficiencies
      Delivery systems are:
      Competing for patients/physicians on basis of reputation for quality, safety, convenience
      Fostering connections between in-patient and outpatient settings
      Driving operational and productivity improvements to control costs
      Deploying more comprehensive measurement and information mgt systems
    • 8. Helping clients address their challenges today
      • Align behind health reform.
      • 9. Engage in pilots now - success helps to drive momentum.
      • 10. View your business holistically.
      • 11. New business models are a certainty. Partnerships are key.
      • 12. Lead collaboratively. Share best practices.
      Let’s build a smarter healthcare system together
    • 13. Healthcare ObjectivesImproving patient outcomes while managing costs and privacy
      Integrate and transfer medical information from various systems
      Improve real-time collaboration among care teams to consult on patient care
      Reduce medical errors and promote patient safety
      Connect IT at the hospital with remote patient care environments
      Enable effective compliance practices with myriad and ever-changing regulations
      Support staff training and continuing medical education
    • 14. Personalized
      Healthcare Value
      Retrospective to Prospective to Predictive Care Management
      Collaboration and Automation
      Information compliance, availability and security
      Integration /
      EMRs, Images, Records, Forms Lifecycle Management
      Health Integration Framework
      Helping clients become smarter along three key dimensions
      Deliver collaborative carefor prevention and wellness
      Achieve better quality and outcomes
      Improve operational effectiveness
    • 15. Health Industry Shifts to a Patient Centric Model
      Access to Care
      Reduce Costs
      Reduce the Uninsured
      Sustainability of Healthcare Systems
      Efficiencies/Health IT
      Quality Initiatives
      Coordinated Care
      Shared Information/HIE
      Fitness and Wellness
      Chronic Disease Management
      Protocol Adherence
      Active Health Mgt
      Improve Outcomes
    • 16. Partnering with Champion
      Our team of specialists would like to partner with your team to ensure that we fully understand your IT and business roadmaps. We would like to help your team extend these investments out into your partner and patient facing systems as well as into clinical systems.
    • 17. Optimizing hospitals
      The core infrastructure is the foundation for your systems and Champion would like to ensure your team is leveraging best practices and are maturing your processes so you can spend less time managing your infrastructure and more time supporting the key initiatives of the business.
      Following a Core IO assessment Champion’s Healthcare Group can also offer a ½ day best practices assessment to ensure you are optimizing your investments with the Connected Health Framework.
    • 18. Proof of Concept Offerings
      Business Productivity Online Services
      VoIP (Office Communications Services)
      Secure Healthcare Instant Messaging
      Automated Workflow
      Windows 7 Optimized Desktop Services
      Customer Relationship Management
      Chronic Condition Management
      Caregiver Collaboration
      Patient Experience
    • 19. Future Healthcare discussions
      Unified Intelligence System
      Coordinated Care Platform
      Chronic Condition Management
      HIPAA 4010 to 5010 / IDC9 to IDC10
      Policy and Procedure Management
      UC Caregiver Collaboration
      CMS Core Reporting
      Home Health
      Virtual Desktop Infrastructure
      Windows 7 / Windows 2008 R2
      Compliance Mgmt - Exchange 2010
      Extending SharePoint 2010
      Line of business integration - Office 2010