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How Clinical Analytics Will Improve the Cost and Quality of Healthcare Delivery

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There’s never been a more critical time in the history of U.S. healthcare for providers to turn to clinical analytics to help them survive and thrive amidst healthcare reform. Clinical analytics can enable health systems with the following improvements as they shift from fee-for-service reimbursements to value-based purchasing: pinpoint waste reduction opportunities, identify specific margin improvement opportunities, systematically identify performance improvement opportunities, automate the tracking and reporting of quality measures, and understand the cost structure at a granular level. Clinical analytics can also help ACOs unlock the data from their EMR investment and provide real-time data for providers and payers to work together to provide value-based insurance design.

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How Clinical Analytics Will Improve the Cost and Quality of Healthcare Delivery

  1. 1. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. © 2014 Health Catalyst www.healthcatalyst.comProprietary. Feel free to share but we would appreciate a Health Catalyst citation. How Clinical Analytics Will Improve the Cost and Quality of Healthcare Delivery By Dan Burton
  2. 2. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Healthcare Clinical Analytics Healthcare reform has led to countless initiatives designed to improve both the cost and quality of care delivery. And now, for the first time in the history of U.S. healthcare, health systems need to measure and report on the care they’re delivering.
  3. 3. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Healthcare Clinical Analytics Healthcare reform has led to countless initiatives designed to improve both the cost and quality of care delivery. For the first time in the history of U.S. healthcare, health systems must measure and report on the care they’re delivering. As a result of the Centers for Medicare and Medicare (CMS) EHR Incentive Program providers have a rich source of data captured in their mandatory electronic health records (EHRs).
  4. 4. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Healthcare Clinical Analytics The next step is for health systems and providers to use clinical analytics to analyze their data to help them achieve success with the following three healthcare initiatives: Shift from fee-for-service reimbursements to value-based purchasing Accountable care organizations (ACOs) Value-based insurance design (VBID)
  5. 5. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Shift from fee-for-service reimbursements to value-based purchasing INITIATIVES CLINICAL ANALYTICS 1 Before the Affordable Care Act established the Hospital Value- Based Purchasing Program in 2010, hospitals received payment based on the volume of care they provided. This fee-for-service reimbursement program in some cases encouraged the overuse of healthcare services without necessarily improving care outcomes.
  6. 6. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Shift from fee-for-service reimbursements to value-based purchasing Health systems are facing the greatest financial challenge in their history as they transition to value-based purchasing. With payments now hinging upon quality, focusing solely on old metrics won’t bring financial success. Instead, health systems must concentrate on lowering healthcare costs while also providing greater value and higher quality. INITIATIVES CLINICAL ANALYTICS 1
  7. 7. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Shift from fee-for-service reimbursements to value-based purchasing In specific, clinical analytics make it possible for health systems to do the following: • Reduce waste • Improve margins • Improve performance • Streamline operations • Automatically track quality measures • Succeed in shared savings arrangements • Fully understand the cost structure INITIATIVES CLINICAL ANALYTICS 1
  8. 8. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Accountable Care Organizations (ACOs) Accountable care organizations (ACOs) are another healthcare initiative that encourages groups of providers to voluntarily give high-quality, coordinated care to populations of patients. The concept of an ACO is still evolving, but typically the groups of providers include doctors, hospitals, health plans, and others. INITIATIVES CLINICAL ANALYTICS 2
  9. 9. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Accountable Care Organizations (ACOs) The coordinated care an ACO offers is designed to give patients the right kind of care without adding extra expenses. ACOs avoid extra expenses by only ordering care with a proven benefit and by not ordering duplicating services, a significant shift from fee-for-service. In addition, ACOs are particularly concerned about making sure the chronically ill receive proper care. INITIATIVES CLINICAL ANALYTICS 2
  10. 10. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Accountable Care Organizations (ACOs) With an ACO, there is now a greater financial reward to prevent illness rather than treating those who are already ill. Preventative care along with a new focus on using clinically- proven and effective therapies as opposed to choosing expensive, newly developed treatment options should dramatically improve care delivery. INITIATIVES CLINICAL ANALYTICS 2
  11. 11. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Accountable Care Organizations (ACOs) To support ACO goals, health systems need to have several critical information systems: an electronic Medical Record (EMR), a health information exchange (HIE), an activity based costing system (ABC), a patient reported outcomes system (PRO), and an EDW. Despite the considerable amount invested in these systems, providers have yet to realize a decent return on investment (ROI) because they are unable to measure the quality of care and financial risk. INITIATIVES CLINICAL ANALYTICS 2
  12. 12. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Accountable Care Organizations (ACOs) To unlock the data in their ACO EMR investment, health systems need an EDW. The EDW makes it possible for analysts to mine and analyze data from a single repository holding data from multiple source systems (clinical, financial, patient satisfaction, etc.). Yet, less than 25 percent of healthcare organizations have any type of EDW. INITIATIVES CLINICAL ANALYTICS 2
  13. 13. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Value-based Insurance Design (VBID) The sweeping changes occurring in healthcare require innovative models of care from providers and payers. One these new models is value-based insurance design (VBID). The basis of VBID is for providers to pay increased costs for specific patient populations early on in their care to reduce the costs of care later on. INITIATIVES CLINICAL ANALYTICS 3
  14. 14. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Value-based Insurance Design (VBID) For example, one hospital’s goal to target length of stay following an appendectomy as a key opportunity for quality and financial improvement. Using clinical data analytics they discovered that one specific, expensive antibiotic significantly decreased length of stay, more than making up for the difference in cost to provide the more expensive antibiotic. INITIATIVES CLINICAL ANALYTICS 3
  15. 15. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Value-based Insurance Design (VBID) When working to cut costs, prescribing a more expensive treatment doesn’t seem logical — unless evidence based data supports the entire story. By using clinical analytics and easy-to-understand dashboards, clinicians can use real-time data to discover treatments based on best practices and outcomes. Using this data, both providers and payers can achieve higher quality at lower costs. INITIATIVES CLINICAL ANALYTICS 3
  16. 16. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Healthcare transformation made possible with clinical analytics Healthcare transformation has a long way to go before true cost reduction and quality improvements are the mainstay. The journey won’t be easy — but it’s critical to improve the health of our nation and to curb the rising costs of healthcare
  17. 17. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. More about this topic How to Evaluate a Clinical Analytics Vendor: A Checklist Dale Sanders, Senior Vice President, Strategy Why An EMR Can’t Solve Your Most Important Healthcare Transformation Challenges Dan Burton, Chief Executive Officer Healthcare Informatics: A New Wave of Advanced Clinical Analytics Steve Barlow, Co-founder and Senior Vice President, Client Operations Building a High-quality Cancer Care Delivery System A Success Story from a Large Health System Healthcare Analytics 2.0: The Age of Analytics (free, on-demand webinar, slides, and transcript) Dale Sanders, Senior Vice President, Strategy
  18. 18. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. For more information:
  19. 19. © 2013 Health Catalyst www.healthcatalyst.com Other Clinical Quality Improvement Resources Click to read additional information at www.healthcatalyst.com Dan Burton serves as CEO of Health Catalyst, a healthcare data warehousing and analytics company. He became involved with Health Catalyst when it was a three-person startup. Mr. Burton is also the co- founder of HB Ventures, the first investor in Health Catalyst. Prior to Health Catalyst and HB Ventures, Mr. Burton led the Corporate Strategy Group at Micron Technology (NASDAQ: MU). He also spent eight years with Hewlett-Packard (NYSE: HPQ) in strategy and marketing management roles. Before joining HP he was an associate consultant with the Boston Consulting Group, where he advised healthcare systems and technology companies. Mr. Burton holds an MBA with high distinction from Harvard University, where he was elected a George F. Baker Scholar, and a BS in economics, magna cum laude, from BYU.

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