In this presentation Dr. Robert Ciulla and Dr. Julie Kinn discuss why technology is effective in supporting behavioral health care and how the National Center for Telehealth & Technology is leveraging it.
An overview of the Initial Design and Prize Guidelines for a proposed $10M+ Healthcare X PRIZE, released for public comment on April 14, 2009. Please help us design the best competition possible in creating an Optimal Health paradigm that engages and empowers individuals and communities in a way that will dramatically improve health value.
MYnd Analytics, (NASDAQ: MYND) with its wholly owned subsidiary Arcadian Telepsychiatry Services LLC, is a technology-enabled telepsychiatry and teletherapy company that provides enhanced access to behavioral health services, improves patient outcomes and helps lower the costs associated with behavioral health issues. The MYnd Psychiatric EEG Evaluation Registry (PEER) is a predictive analytics decision support tool that helps physicians reduce trial and error treatment for behavioral health conditions. PEER provides the physician a personalized care plan with recommended treatment options based on a patient’s unique brain markers, reducing treatment time and treatment costs. Arcadian Telepsychiatry Services LLC provides a suite of complementary telemedicine services that can be combined with PEER, including telepsychiatry, teletherapy, digital patient screening, curbside consultation, on-demand services, and scheduled encounters for all age groups. MYnd’s customers include major health plans, health systems, and community-based organizations. To read more about the benefits of this patented technology for patients, physicians and payers, please visit: http://www.myndanalyticsinfo.com
Ændring af livstil ved hjælp af teknologi af Henrik WielandIBM Danmark
Hvordan kan IT og teknologi understøtte ændring i livstil og adfærd. Præsentation om handler hvordan nye devices og Shared Care kan motivere og understøtte øget fysisk aktivitet og dermed forbedre sundhedstilstanden hos den enkelte og i samfundet generelt.
Fra "DI ITEK netværk for sundhedsteknologi" 24/8 2011
Af Henrik Wieland, Associate Partner, Healthcare Industry Leader, IBM Denmark
Phone: +45 41203443, E-mail: hew@dk.ibm.com
Supporting Cancer Survivors in the Workplace and Managing CostsHuman Capital Media
There are more cancer survivors in the workplace than ever before — and that’s great news. But this poses a growing challenge to employers who are struggling to control health care costs and help their workers lead healthier lives.
There are tools to help employers meet that challenge through benefit design, online resources, wellness programs and other initiatives. Join this webinar to learn how your company can offer support to employees facing a frightening diagnosis and better manage the high cost of treating cancer.
Cancer costs employers an estimated $264 billion a year in medical care and lost productivity. Thanks to medical advancements, the vast majority of the 14 million survivors today return to work, and their numbers are growing.
We'll talk about:
The evolution of cancer in the workplace from taboo topic to public acceptance and awareness.
The latest research on cancer diagnoses and treatment costs.
Innovative approaches to benefit design and managing pharmacy costs.
An overview of "An Employer’s Guide to Cancer Treatment and Prevention,” a toolkit by the National Business Group on Health and the National Comprehensive Cancer Network (NCCN).
In this presentation Dr. Robert Ciulla and Dr. Julie Kinn discuss why technology is effective in supporting behavioral health care and how the National Center for Telehealth & Technology is leveraging it.
An overview of the Initial Design and Prize Guidelines for a proposed $10M+ Healthcare X PRIZE, released for public comment on April 14, 2009. Please help us design the best competition possible in creating an Optimal Health paradigm that engages and empowers individuals and communities in a way that will dramatically improve health value.
MYnd Analytics, (NASDAQ: MYND) with its wholly owned subsidiary Arcadian Telepsychiatry Services LLC, is a technology-enabled telepsychiatry and teletherapy company that provides enhanced access to behavioral health services, improves patient outcomes and helps lower the costs associated with behavioral health issues. The MYnd Psychiatric EEG Evaluation Registry (PEER) is a predictive analytics decision support tool that helps physicians reduce trial and error treatment for behavioral health conditions. PEER provides the physician a personalized care plan with recommended treatment options based on a patient’s unique brain markers, reducing treatment time and treatment costs. Arcadian Telepsychiatry Services LLC provides a suite of complementary telemedicine services that can be combined with PEER, including telepsychiatry, teletherapy, digital patient screening, curbside consultation, on-demand services, and scheduled encounters for all age groups. MYnd’s customers include major health plans, health systems, and community-based organizations. To read more about the benefits of this patented technology for patients, physicians and payers, please visit: http://www.myndanalyticsinfo.com
Ændring af livstil ved hjælp af teknologi af Henrik WielandIBM Danmark
Hvordan kan IT og teknologi understøtte ændring i livstil og adfærd. Præsentation om handler hvordan nye devices og Shared Care kan motivere og understøtte øget fysisk aktivitet og dermed forbedre sundhedstilstanden hos den enkelte og i samfundet generelt.
Fra "DI ITEK netværk for sundhedsteknologi" 24/8 2011
Af Henrik Wieland, Associate Partner, Healthcare Industry Leader, IBM Denmark
Phone: +45 41203443, E-mail: hew@dk.ibm.com
Supporting Cancer Survivors in the Workplace and Managing CostsHuman Capital Media
There are more cancer survivors in the workplace than ever before — and that’s great news. But this poses a growing challenge to employers who are struggling to control health care costs and help their workers lead healthier lives.
There are tools to help employers meet that challenge through benefit design, online resources, wellness programs and other initiatives. Join this webinar to learn how your company can offer support to employees facing a frightening diagnosis and better manage the high cost of treating cancer.
Cancer costs employers an estimated $264 billion a year in medical care and lost productivity. Thanks to medical advancements, the vast majority of the 14 million survivors today return to work, and their numbers are growing.
We'll talk about:
The evolution of cancer in the workplace from taboo topic to public acceptance and awareness.
The latest research on cancer diagnoses and treatment costs.
Innovative approaches to benefit design and managing pharmacy costs.
An overview of "An Employer’s Guide to Cancer Treatment and Prevention,” a toolkit by the National Business Group on Health and the National Comprehensive Cancer Network (NCCN).
ExerWellness - Connected Community Wellness for healthcare cost savings. Habit change and choice powers prevention and management of chronic conditions.
CAHPS proviCAHPS provides an apples to apples metric for public
reporting—additional measurement may be needed for ongoing
quality improvement activities and monitoring.
des an apples to apples metric for public
reporting—additional measurement may be needed for ongoing
quality improvement activities and monitoring.
BC Patient Safety Quality Forum (BCPSQC), Story board presented 2013. Highlights from research and projects engaging patients, families, public, physicians and health providers in improved access to health care resources and participating in decision-making. Also on http://www.slideshare.net/paulgallant/"paulgallant my other Slideshare account
The Challenges of Creating Mobile Games for Regulated Health SituationsSeriousGamesAssoc
For the past several years, game and media producer Beth Rogozinski has turned her attention to making games for mental and behavioral health – some of which have been submitted to the FDA to be regulated as a Class Two medical devices and are available only with a prescription. These games are based on clinical data and random control trials – making the process of developing fun and engaging games even more challenging. Add to that the FDA oversight and rigorous testing and QA specifications and game making becomes serious business indeed. But well worth it. Outcomes with these games and apps can far exceed treatment as usual and for mental and behavioral health patients these games can provide the privacy, dignity and access that they’re never before had.
Evaluation of the NZGG Self-Harm & Suicide Prevention Collaborative MHF Suicide Prevention
The evaluation describes the collaborative methodology, reviews quality of project implementation, impacts achieved, and stakeholder satisfaction of the New Zealand Guidelines Group Self-Harm and Suicide Prevention Collaborative. The collaborative was designed to improve crisis care in emergency departments and mental health services while recognising local situations, people and resources. Presented by Julian King and Michelle Moss. View this presentation from the 2010 SPINZ World Suicide Prevention Day Forum on YouTube: http://www.youtube.com/watch?v=FbY1QpBubtk
How can organizations maximize the resilience and productivity of the...SharpBrains
Historically, human resource departments have not had the toolkit to develop the most human resource of all – our brains. What are some large employers and insurers doing to apply emerging science and best practices in this domain, via wellness and training initiatives, and HR benefits?
- Chair: Andrew Lee, Vice President at Aetna, YGL Class of 2011
- Hyong Un, Head of Employee Assistance Programs at Aetna
- Evian Gordon, Executive Chairman of Brain Resource
- David Nill, Chief Medical Officer at Cerner Corporation
This session took place at the 2013 SharpBrains Virtual Summit: http://sharpbrains.com/summit-2013/agenda/
Immersive Environments, Machine Learning, Neuroimaging, & Wearable Sensing Te...Stanford University
Walter Greenleaf's presentation to the Virtual Medicine 2019 Conference at Cedars-Sinai Medical Center
Immersive Environments, Machine Learning, Neuroimaging, And Wearable Sensing Technology - Treating Depression, Addictions, and Facilitating Behavior Change Using A Precision Medicine Model
Based on the methods used in the ENGAGE Study
Walter Greenleaf, PhD
Virtual Human Interaction Lab | Stanford University
Precision medicine models for treating depression, managing addictions and achieving sustained behavior change are largely outside of current clinical practice. Yet, changing self-regulatory behavior is fundamental to the self-management of complex lifestyle-related chronic conditions such as depression and substance use disorder - two top contributors to the global burden of disease and disability.
To optimize treatments and address these burdens, methods to facilitate behavior change and self-regulation must be better understood in relation to their neurobiological underpinnings. Treatment strategies can then be developed that leverage the recent advances in immersive environments, machine learning, and wearable sensing technology and apply them to treat depression, manage addictions, and facilitate behavior change using a precision medicine model that is personalized to the individual.
This presentation will review the conceptual framework and protocol for a large multi-subject longitudinal study named Project ENGAGE. The ENGAGE study integrates neuroscience with behavioral science to better understand the self-regulation related mechanisms of behavior change for improving mood and weight outcomes among adults with comorbid depression and obesity. We collect assays of three self-regulation targets (emotion, cognition, and self-reflection) in multiple settings: neuroimaging and behavioral lab-based measures, virtual reality, and passive smartphone sampling.
By connecting human neuroscience and behavioral science in this manner within the ENGAGE study, we can develop a prototype for elucidating the underlying self-regulation mechanisms of behavior change outcomes and their application in optimizing intervention strategies for multiple chronic diseases.
https://www.ncbi.nlm.nih.gov/pubmed/29074231
Behav Res Ther. 2018 Feb;101:58-70. doi: 10.1016/j.brat.2017.09.012. Epub 2017 Oct 7.
The ENGAGE study: Integrating neuroimaging, virtual reality and smartphone sensing to understand self-regulation for managing depression and obesity in a precision medicine model.
Leanne M. Williams, Adam Pines, Andrea N. Goldstein-Piekarski, Lisa G. Rosas,
Monica Kullar, Matthew D. Sacchet, Olivier Gevaert, Jeremy Bailenson, Philip W.
Lavori, Paul Dagum, Brian Wandell, Carlos Correa, Walter Greenleaf, Trisha Suppes,
L. Michael Perry, Joshua M. Smyth, Megan A. Lewis, Elizabeth M. Venditti, Mark
Snowden, Janine M. Simmons, Jun Ma
Using technology-enabled social prescriptions to disrupt healthcareDr Sven Jungmann
As chronic diseases are increasingly straining healthcare systems, social factors are gaining importance. Since the birth of social medicine (19th century), we saw many failed attempts to beat the dominance of the biomedical model. Social prescriptions have come, raising hopes that non-biomedical solutions will improve outcomes and optimise resource use. Social Prescriptions connect citizens to support to address social determinants of health and encourage self-care for physical and mental health. Social prescriptions can make us healthier cheaper and with fewer side effects than most drugs. Social prescriptions can become a disruptive force as they can be personalised, improve lifestyle-related diseases, and support non-biomedical issues affected by social determinants of health.
Physician-Hospital Integration Strategies to Maximize the Bottom Line for Ort...Wellbe
Economic pressures on physicians and hospitals have increased attention on integration and collaboration between providers. The passage of the Patient Protection and Affordable Care Act (ACA) has propelled physician-hospital integration onto the national stage, forcing physicians and hospitals to change and accelerate their alignment structures with each other to meet the ACA’s mandates: quality excellence, population health management, efficiency, and cost savings. This presentation provides a detailed overview of strategies for the orthopedic service line that have been successfully implemented in order to achieve the Triple Aim while enhancing alignment with the service line’s physicians.
About the Speaker:
DanielleDanielle L. Sreenivasan, MHA is a senior manager with The Camden Group with more than ten years of healthcare experience. She specializes in strategic and service line business planning, facility planning, financial feasibility analyses, and medical staff planning and alignment on behalf of community hospitals, healthcare systems, academic medical centers, and physician medical groups. Ms. Sreenivasan has worked with clients analyzing current and potential markets and developing population-based healthcare strategies.
Prior to joining The Camden Group, Ms. Sreenivasan directed the Virginia Cardiac Network, LLC for Inova Fairfax Hospital located in Falls Church, Virginia. Her responsibilities included the development of strategic business plans and scorecards for clinical quality and budgeting processes, as well as oversight for the implementation of operational performance improvement plans. Ms. Sreenivasan’s experience also includes departmental and operational audits, and reimbursement analysis.
Ms. Sreenivasan received her master’s degree in health administration from Medical University of South Carolina with Honors, and her bachelor’s degree in accounting, business administration, and finance from the College of Charleston. She is a member of the American College of Healthcare Executives.
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Improving Performance with Social Business Solutions - Featuring: Premier Hea...Perficient, Inc.
Learn how to leverage IBM Social Business solutions to innovate and collaborate more productively, and how to anticipate market needs and deliver exceptional customer experiences. Hear how Premier is integrating business processes with social and analytical tools from IBM to create a competitive advantage and pioneer a better way of doing business.
Bundled Payments in Healthcare – The Next Generation LIVE WebcastThomas LaPointe
A bundled payment is a single re-imbursement to a healthcare provider for all clinical services related to a single instance of medical care and away from fees-for-service.
Bundling of payments to healthcare providers will be used more frequently to reduce the cost of healthcare in the United States. Theoretically, bundled payment schemes will improve the quality of care, reduce un-necessary care, and reduce variation in cost among payers. However, research results are varied. Pilot projects such as Prometheus have been slow to develop because of the difficulty of agreeing upon which services can be bundled.
Provisions for bundled payments are included in both the Patient Protection and Affordable Care Act (PPACA) and the Affordable Health Care for America Act (AHCAA). The PPACA bill established a national Medicare program in 2013. The AHCAA bill requires reform of Medicare payments for post-acute services, including the bundled payments.
Healthcare legal counsel face a number of legal and regulatory issues in structuring bundled and gain-sharing payment systems. The legal challenges arise from insurance, state laws, provider relationships, and fair market value dis-agreements. In the past, these arrangements were found potentially to violate the Anti-Kickback statute and Civil Monetary Penalties Act.
Our panel of skilled practitioners will review bundled payment schemes and discuss the advantages and disadvantages of the schemes. The panel will discuss operational and regulatory concerns for healthcare providers, critical provision documentation, the effects of healthcare reform and other recent legislative, regulatory, and enforcement activities. Also addressed is gain-sharing.
Key Topics include:
Public and Private Bundled Payment Initiatives & Gain-sharing Arrangements
Bundled Payments Programs and Current CMS initiatives
Implementation and Operational Challenges
Accountable Care Organizations (ACOs) and Bundled Payments
Medicare Bundled Payments for Care Improvement (BPCI) Initiative
Bundled Payment Transparency and Risk Arrangements
Bundled Payment Documentation, Data Analysis, & Reporting
Legal and Regulatory Compliance Issues
To view the webcast go to this link: http://youtu.be/ITYISDHd7zY
To learn more about the webcast please visit our website: http://theknowledgegroup.org
ExerWellness - Connected Community Wellness for healthcare cost savings. Habit change and choice powers prevention and management of chronic conditions.
CAHPS proviCAHPS provides an apples to apples metric for public
reporting—additional measurement may be needed for ongoing
quality improvement activities and monitoring.
des an apples to apples metric for public
reporting—additional measurement may be needed for ongoing
quality improvement activities and monitoring.
BC Patient Safety Quality Forum (BCPSQC), Story board presented 2013. Highlights from research and projects engaging patients, families, public, physicians and health providers in improved access to health care resources and participating in decision-making. Also on http://www.slideshare.net/paulgallant/"paulgallant my other Slideshare account
The Challenges of Creating Mobile Games for Regulated Health SituationsSeriousGamesAssoc
For the past several years, game and media producer Beth Rogozinski has turned her attention to making games for mental and behavioral health – some of which have been submitted to the FDA to be regulated as a Class Two medical devices and are available only with a prescription. These games are based on clinical data and random control trials – making the process of developing fun and engaging games even more challenging. Add to that the FDA oversight and rigorous testing and QA specifications and game making becomes serious business indeed. But well worth it. Outcomes with these games and apps can far exceed treatment as usual and for mental and behavioral health patients these games can provide the privacy, dignity and access that they’re never before had.
Evaluation of the NZGG Self-Harm & Suicide Prevention Collaborative MHF Suicide Prevention
The evaluation describes the collaborative methodology, reviews quality of project implementation, impacts achieved, and stakeholder satisfaction of the New Zealand Guidelines Group Self-Harm and Suicide Prevention Collaborative. The collaborative was designed to improve crisis care in emergency departments and mental health services while recognising local situations, people and resources. Presented by Julian King and Michelle Moss. View this presentation from the 2010 SPINZ World Suicide Prevention Day Forum on YouTube: http://www.youtube.com/watch?v=FbY1QpBubtk
How can organizations maximize the resilience and productivity of the...SharpBrains
Historically, human resource departments have not had the toolkit to develop the most human resource of all – our brains. What are some large employers and insurers doing to apply emerging science and best practices in this domain, via wellness and training initiatives, and HR benefits?
- Chair: Andrew Lee, Vice President at Aetna, YGL Class of 2011
- Hyong Un, Head of Employee Assistance Programs at Aetna
- Evian Gordon, Executive Chairman of Brain Resource
- David Nill, Chief Medical Officer at Cerner Corporation
This session took place at the 2013 SharpBrains Virtual Summit: http://sharpbrains.com/summit-2013/agenda/
Immersive Environments, Machine Learning, Neuroimaging, & Wearable Sensing Te...Stanford University
Walter Greenleaf's presentation to the Virtual Medicine 2019 Conference at Cedars-Sinai Medical Center
Immersive Environments, Machine Learning, Neuroimaging, And Wearable Sensing Technology - Treating Depression, Addictions, and Facilitating Behavior Change Using A Precision Medicine Model
Based on the methods used in the ENGAGE Study
Walter Greenleaf, PhD
Virtual Human Interaction Lab | Stanford University
Precision medicine models for treating depression, managing addictions and achieving sustained behavior change are largely outside of current clinical practice. Yet, changing self-regulatory behavior is fundamental to the self-management of complex lifestyle-related chronic conditions such as depression and substance use disorder - two top contributors to the global burden of disease and disability.
To optimize treatments and address these burdens, methods to facilitate behavior change and self-regulation must be better understood in relation to their neurobiological underpinnings. Treatment strategies can then be developed that leverage the recent advances in immersive environments, machine learning, and wearable sensing technology and apply them to treat depression, manage addictions, and facilitate behavior change using a precision medicine model that is personalized to the individual.
This presentation will review the conceptual framework and protocol for a large multi-subject longitudinal study named Project ENGAGE. The ENGAGE study integrates neuroscience with behavioral science to better understand the self-regulation related mechanisms of behavior change for improving mood and weight outcomes among adults with comorbid depression and obesity. We collect assays of three self-regulation targets (emotion, cognition, and self-reflection) in multiple settings: neuroimaging and behavioral lab-based measures, virtual reality, and passive smartphone sampling.
By connecting human neuroscience and behavioral science in this manner within the ENGAGE study, we can develop a prototype for elucidating the underlying self-regulation mechanisms of behavior change outcomes and their application in optimizing intervention strategies for multiple chronic diseases.
https://www.ncbi.nlm.nih.gov/pubmed/29074231
Behav Res Ther. 2018 Feb;101:58-70. doi: 10.1016/j.brat.2017.09.012. Epub 2017 Oct 7.
The ENGAGE study: Integrating neuroimaging, virtual reality and smartphone sensing to understand self-regulation for managing depression and obesity in a precision medicine model.
Leanne M. Williams, Adam Pines, Andrea N. Goldstein-Piekarski, Lisa G. Rosas,
Monica Kullar, Matthew D. Sacchet, Olivier Gevaert, Jeremy Bailenson, Philip W.
Lavori, Paul Dagum, Brian Wandell, Carlos Correa, Walter Greenleaf, Trisha Suppes,
L. Michael Perry, Joshua M. Smyth, Megan A. Lewis, Elizabeth M. Venditti, Mark
Snowden, Janine M. Simmons, Jun Ma
Using technology-enabled social prescriptions to disrupt healthcareDr Sven Jungmann
As chronic diseases are increasingly straining healthcare systems, social factors are gaining importance. Since the birth of social medicine (19th century), we saw many failed attempts to beat the dominance of the biomedical model. Social prescriptions have come, raising hopes that non-biomedical solutions will improve outcomes and optimise resource use. Social Prescriptions connect citizens to support to address social determinants of health and encourage self-care for physical and mental health. Social prescriptions can make us healthier cheaper and with fewer side effects than most drugs. Social prescriptions can become a disruptive force as they can be personalised, improve lifestyle-related diseases, and support non-biomedical issues affected by social determinants of health.
Physician-Hospital Integration Strategies to Maximize the Bottom Line for Ort...Wellbe
Economic pressures on physicians and hospitals have increased attention on integration and collaboration between providers. The passage of the Patient Protection and Affordable Care Act (ACA) has propelled physician-hospital integration onto the national stage, forcing physicians and hospitals to change and accelerate their alignment structures with each other to meet the ACA’s mandates: quality excellence, population health management, efficiency, and cost savings. This presentation provides a detailed overview of strategies for the orthopedic service line that have been successfully implemented in order to achieve the Triple Aim while enhancing alignment with the service line’s physicians.
About the Speaker:
DanielleDanielle L. Sreenivasan, MHA is a senior manager with The Camden Group with more than ten years of healthcare experience. She specializes in strategic and service line business planning, facility planning, financial feasibility analyses, and medical staff planning and alignment on behalf of community hospitals, healthcare systems, academic medical centers, and physician medical groups. Ms. Sreenivasan has worked with clients analyzing current and potential markets and developing population-based healthcare strategies.
Prior to joining The Camden Group, Ms. Sreenivasan directed the Virginia Cardiac Network, LLC for Inova Fairfax Hospital located in Falls Church, Virginia. Her responsibilities included the development of strategic business plans and scorecards for clinical quality and budgeting processes, as well as oversight for the implementation of operational performance improvement plans. Ms. Sreenivasan’s experience also includes departmental and operational audits, and reimbursement analysis.
Ms. Sreenivasan received her master’s degree in health administration from Medical University of South Carolina with Honors, and her bachelor’s degree in accounting, business administration, and finance from the College of Charleston. She is a member of the American College of Healthcare Executives.
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Improving Performance with Social Business Solutions - Featuring: Premier Hea...Perficient, Inc.
Learn how to leverage IBM Social Business solutions to innovate and collaborate more productively, and how to anticipate market needs and deliver exceptional customer experiences. Hear how Premier is integrating business processes with social and analytical tools from IBM to create a competitive advantage and pioneer a better way of doing business.
Bundled Payments in Healthcare – The Next Generation LIVE WebcastThomas LaPointe
A bundled payment is a single re-imbursement to a healthcare provider for all clinical services related to a single instance of medical care and away from fees-for-service.
Bundling of payments to healthcare providers will be used more frequently to reduce the cost of healthcare in the United States. Theoretically, bundled payment schemes will improve the quality of care, reduce un-necessary care, and reduce variation in cost among payers. However, research results are varied. Pilot projects such as Prometheus have been slow to develop because of the difficulty of agreeing upon which services can be bundled.
Provisions for bundled payments are included in both the Patient Protection and Affordable Care Act (PPACA) and the Affordable Health Care for America Act (AHCAA). The PPACA bill established a national Medicare program in 2013. The AHCAA bill requires reform of Medicare payments for post-acute services, including the bundled payments.
Healthcare legal counsel face a number of legal and regulatory issues in structuring bundled and gain-sharing payment systems. The legal challenges arise from insurance, state laws, provider relationships, and fair market value dis-agreements. In the past, these arrangements were found potentially to violate the Anti-Kickback statute and Civil Monetary Penalties Act.
Our panel of skilled practitioners will review bundled payment schemes and discuss the advantages and disadvantages of the schemes. The panel will discuss operational and regulatory concerns for healthcare providers, critical provision documentation, the effects of healthcare reform and other recent legislative, regulatory, and enforcement activities. Also addressed is gain-sharing.
Key Topics include:
Public and Private Bundled Payment Initiatives & Gain-sharing Arrangements
Bundled Payments Programs and Current CMS initiatives
Implementation and Operational Challenges
Accountable Care Organizations (ACOs) and Bundled Payments
Medicare Bundled Payments for Care Improvement (BPCI) Initiative
Bundled Payment Transparency and Risk Arrangements
Bundled Payment Documentation, Data Analysis, & Reporting
Legal and Regulatory Compliance Issues
To view the webcast go to this link: http://youtu.be/ITYISDHd7zY
To learn more about the webcast please visit our website: http://theknowledgegroup.org
Kevin Fickenscher, M.D., CPE, FACPE, FAAFP
President, Healthcare Division
Chief Medical Officer
AMC Health, Inc.
Former President and CEO
American Medical Informatics Association
Bookends of the Patient Experience: Improvement Strategies from Admission to ...TraceByTWSG
In this webinar, Yvonne Chase of Mayo Clinic shares strategies to improve patient experience across the continuum of care - from pre-service to post-servcie activities. This presentation shares tools and processes used to streamline patient access, coordinate patient care and conduct patient follow-up post discharge - all while monitoring patient interactions to ensure clear and accurate communication from the first point of contact to the last.
Turkey Health System is presented with various aspects and with last 10 years focus. Transformations, developments and amendments are the main topic. Graphs, data and charts are used to demonstrate the changes.
The Formula for Optimizing the Value-Based Healthcare EquationHealth Catalyst
Two variables are required in the value-based healthcare equation if it is to add up to a profitable contract. One variable, optimizing the care for the patient population, is commonly included and is a focus for most healthcare systems involved in managing population health. However, a second variable, getting the right dollars in order to care for that population, is often overlooked. And yet this variable is easier to attain. It’s a matter of appropriately assessing the risk of the population by addressing inaccurate diagnoses coding. Here, we offer four methods for solving this variable: identifying high-risk gaps over time, persistent diagnosis tracking, identifying code adequacy, and identifying likely diagnoses.
Linking Clinical And Financial Data: The Key To Real Quality And Cost OutHealth Catalyst
Since accountable care took the healthcare industry by a storm in 2010, health systems have had to move from their predictable revenue streams based on volume to a model that includes quality measures. While the switch will ultimately improve both quality and cost outcomes, health systems now need the capability of tracking and analyzing the data from both clinical and financial systems. A late-binding enterprise data warehouse provides the flexible architecture that makes it possible to liberate both kinds of data to link it together to provide a full picture of trends and opportunities.
Due Tomorrow At 100 PMDiscussion Board #6HCA 340Discu.docxsleeperharwell
Due Tomorrow At 1:00 PM
Discussion Board #6
HCA 340
Discussion Board Assignment #6
Chapter 7--The Health Care Workforce and Chapter 8—Financing Health
Answer the following questions on Health Care Workforce/Personnel:
The majority of schools of medicine, dentistry, nursing, and other professions and their teaching hospitals are heavily subsidized by federal and state funds. Many of those graduates, when they become health practitioners, feel no obligation to society for their publicly supported education. Do health care providers who reap the benefits of high compensation and social position have an ethical responsibility to repay taxpayers by meeting the needs of the medically underserved?
Technical advances in health care have spawned an ever-increasing number of specialty- trained personnel. More recently, however, hospitals and other institutions are promoting the cross-training of personnel so that they can perform multiple tasks and work more flexibly, based on institution needs. What are the implications of cross training, in terms of quality of care, costs, and efficiency?
Men comprise a small segment of the nurse population, although their numbers are increasing. Given the good income potential of the nursing profession and continuing demand, what is your opinion about why nursing does not attract more males?
Answer the following questions on Health Care Financing:
Name one (1) way each of the following has affected the costs of health care in the US?
The health insurance industry
Advances in medical care technology
Changes in U.S. demographics
Government support for health care
Consumer expectations
If we accept the premises that resources available to meet the costs of health care are finite, and that continuing to increase dollars allocated for health care expenses carries “opportunity costs“ for the nation and society, discuss your position on the following: As a national policy should we allocate a set level of resources and apply them to achieving “the greatest good for the greatest number” (necessarily leaving some out) OR should we adopt the individualist approach of “those who can pay get, those who can’t pay, don’t?”
From the patient perspective, what might be some of the positive and negative aspects of “disease management programs?”
.
Healthcare is in crisis. While this is not news for many
countries, we believe what is now different is that the
current paths of many healthcare systems around the
world will become unsustainable by 2015.
This may seem a contrarian conclusion, given the efforts
of competent and dedicated healthcare professionals
and the promise of genomics, regenerative medicine, and
information-based medicine. Yet, it is also true that costs
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Technical advances in health care have spawned an ever-increasing number of specialty- trained personnel. More recently, however, hospitals and other institutions are promoting the cross-training of personnel so that they can perform multiple tasks and work more flexibly, based on institution needs. What are the implications of cross training, in terms of quality of care, costs, and efficiency?
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§
The health insurance industry
§
Advances in medical care technology
§
Changes in U.S. demographics
§
Government support for health care
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Consumer expectations
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Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
1. Strategy Management in the Military
Health System: Achieving the
Quadruple Aim - Part One
Michael Dinneen, MD, PhD
Director, Office of Strategy Management
Office of the Assistant Secretary of Defense for Health Affairs
michael.dinneen@ha.osd.mil
6-1
2. The Problem
• Imaginary interaction from the August 10th
Military Health System Strategy Review and
Analysis
• Dr. Woodson, “If people at an MTF viewed the
data that we are looking at, would they respond to
make improvements and achieve the Quadruple
Aim?”
• Surgeon General representative, “First, I don’t
think that our front line workers get to see this
information, second, I am not sure we are giving
them the training to make improvements even if
they did, and third, I don’t think we have the right
incentives in place to reward them.”
2
6-2
3. FY12 Proposed MTF Report Card Measures
Readiness
• % of Active-Duty PHA Completed
Population Health
• HEDIS Preventative Screen Index (Mammography, Cervical, Well-Child visits)
Experience of Care
• 3rd Available Appointment (Acute and Routine)
• % of visits where MTF enrollees see their PCM
• Satisfaction with Visit (Primary and Specialty Care)
• HEDIS Adherence to Evidence Based Guidelines Index (Diabetes, Cardiovascular,
Mental Health)
Per Capita Cost
• PMPM (Per Member Per Month)
• ER Utilization per 100 enrollees
• Cost per RWP (In Progress)- Army recommended pulling out MH MDC 19/20
exploring feasibility
• Cost per Super RVU (APC* + RVU) Navy proposed breaking out PC and specialty
care
• Total Super RVU’s per enrollee per year
*APC = Institutional component of an ER and surgical center bill
6-3
4. The Potential Power of This
Course!
• “If you want to convert the culture of an organization, and that
organization contains n people you first need to convert the square
root of n.”
• Brent James, MD, Intermountain Health Care
• This MHS has a staff of how many?
• 140,000
• How many need to be converted?
• 375
• One problem – can we describe the needed change? Can we create
a shared vision of the future.
• An even bigger problem – can we accept a shared vision of reality.
• Can we inspire each of you to be a change agent and transform your
part of our complex system?
6-4
5. Goals for the Our Time
Together
• Remain awake, have fun and exercise
your brain
• Really understand the Quadruple Aim
• Recognize specifically how your
efforts support the achievement of the
Quadruple Aim every day.
• Commit to doing two things differently
once you return home
5
6-5
6. Today’s Approach
• Review our challenges
• Provide an overview of the Quadruple Aim
• Provide specifics regarding each of the aims
• Definition
• Imperatives
• Gaps and Targets
• Initiatives designed to close the gaps
• What you can do!
• Talk about how it all fits together
• Role of the integrator
• Motivating our people
• Making IT work for us
6-6
7. The Changing Nature of
Supply and Demand
Increase in health care demand
In the next decade and specifically in 2014, more people will be insured and looking for already scarce
primary care providers. In the MHS, the number of enrollees using private sector care is climbing. These
new enrollees will be competing with the newly-insured for a small number of primary care providers within
the private sector. Innovative thinking will be needed to create new models for delivering primary care.
Insured Americans Under 65 Expected U.S. MHS Enrollees
Physician Shortage
6-7
8. The Changing Nature of Supply and
Demand
Increased individual utilization of health care
Prevalence of the
Prevalence of the diagnosis of PTSD and
diabetes and obesity in the depression in adult
(#29) Prevalence of
US population beneficiaries in MHS
obesity and diabetes in
the U.S.
Meeting Notes: National lifetime average is 5-10%. The
increase in PTSD episodes require us to adapt to these
demands. The increase in PTSD can also be due to better
awareness and the reduction of stigma associated with 6-8
PTSD.
9. The Changing Nature of
Supply and Demand
The direct effect of ten years of war
(#25) Average number wounded Behavioral Health Outpatient
in action per month Encounters
Confirmed Cases of TBI
We are fighting one less war, but the Both the cumulative effects of ten
MHS continues to see significant years of war, as well as successful
numbers of combat trauma cases. anti-stigma campaigns have driven
The number of confirmed cases of demand for behavioral health
Traumatic Brain Injury has slowed,
9
services to new highs for Active Duty
but continues to grow. and their Families
6-9
10. Escalating Costs
Healthcare cost inflation
The slow but inexorable growth in health care costs in the US and in the Department of Defense continues.
Recent upticks in the percentage of health care costs relative to GDP and the DoD budget reflect overall
economic conditions and slowdowns in federal spending, rather than recent spikes in health spending. Yet,
these external circumstances further highlight the trade-offs between health spending and other national …
and national security…priorities.
U.S. Spending on Unified Medical Program as
Healthcare, as a a Percentage of DoD
Percentage of GDP Budget
6-10
11. Escalating Costs
Health care costs are shifting
As the costs for private sector health insurance continue to grow, most employers have shifted some of the
cost burden to employees. In 2011, DoD introduced very modest increases in TRICARE Prime enrollment
fees for retirees and their families - but the increases were well below the private insurance cost growth.
The trend of the last ten years – in which retirees drop their private insurance and return to TRICARE as
their primary insurance is likely to continue.
Private Insurance Premiums
Vs. Tricare Enrollment Fee (Retiree (<65) Health
(Family) Insurance Coverage
6-11
13. Big Picture –
“From Strategy to Action”
2009
Quadruple
Aim
Strategic
Imperatives
2010
Performance
Gap
Strategic Initiative Portfolio
•PCMH
2011 •Performance Planning
•Psychological Health
Our Focus for the Portfolio of •IMR Programs
•National Prevention Strategy
upcoming year is to Strategic •…
Develop & Manage an Initiatives
Optimal Set of Strategic
Initiatives to Improve
Our Performance Local
Initiatives
6-13
15. The Quadruple Aim
• Readiness
• Population Health
• Experience of Care
• Per Capita Cost
• What is it?
• What can we do about it?
• Why is it important?
• Exercise One – Discuss one aim then report.
6-15
16. The Quadruple Aim:
The MHS Value Model
Readiness Population Health
Ensuring that the total military Reducing the generators of
force is medically ready to ill health by encouraging
deploy and that the medical healthy behaviors and
force is ready to deliver health decreasing the likelihood of
care anytime, anywhere in illness through focused
support of the full range of prevention and the
military operations, including development of increased
humanitarian missions. resilience.
Per Capita Cost
Experience of Care Creating value by focusing on
Providing a care experience quality, eliminating waste, and
that is patient and family reducing unwarranted
centered, compassionate, variation; considering the total
convenient, equitable, safe cost of care over time, not just
and always of the highest the cost of an individual health
quality. care activity.
6-16
17. Readiness –
Three sub-aims
• Ready medical force
• Casualty care, disaster relief, humanitarian
assistance
• Medically ready force
• Fit, ready and deployable force
• Family readiness
• Healthy and resilient individuals, families and
communities
Success: Accomplish the Mission in
support of Combatant Commanders
6-17
18. How We’re Doing: Readiness
Readiness – Casualty Care
Observed vs. Predicted Survival Rate Amputee Functional Percentage of Patients
(Battle Wounds OIF & OEF Survival Ratios: JTTR U.S. Military Battle Injured
Reintegration, 2002 – 2011 Admitted Hypothermic,
Iraq 2003-2010
in Operations
Casualties
January 2007 - November 2011
Observed Survival Expected Survival First Joint Theater
100 Trauma System team
Enduring & Iraqi
90 into Iraq
80
70
Freedom)
60
50
40
30
m
%
o
d
u
0
3
e
a
y
v
S
c
r
t
)
(
i
20
10
0
a 7
M-0
a 8
M-0
a 9
M-0
a 0
M-1
a 1
M-1
r 7
a -0
r 8
a -0
r 9
a -0
r 0
a -1
r 1
a -1
a7
J -0
u7
J -0
e7
S -0
a8
J -0
u8
J -0
e8
S -0
a9
J -0
u9
J -0
e9
S -0
a0
J -1
u0
J -1
e0
S -1
a1
J -1
u1
J -1
e1
S -1
o7
N -0
o8
N -0
o9
N -0
o0
N -1
o1
N -1
M
M
M
M
M
n
n
n
n
n
p
p
p
p
p
l
l
l
l
l
v
v
v
v
v
y
y
y
y
y
Source: JTTR, January 2007 - November 2011 Date (month/year) of Injury
In FY2011, there were 221 major limb
Our providers have consistently amputations, the most of any year going back to
demonstrated trauma care outcomes 2004.
in Theater that exceed those of the
best trauma care centers in America.
18
6-18
19. How We’re Doing: Readiness
Readiness – Individuals and Families
Our efforts are focused on ensuring the individual medical readiness of the total force and increasing the
resiliency of Service members and their families.
Individual Medical Resiliency Assessments for
Readiness (IMR) Active Duty, Families, and
Civilians
Data
through 3rd
quarter
Though we continue to see improvements The GAT helps individuals track and improve
in IMR, our biggest challenge remains emotional, social, spiritual, family strength.
periodic health assessments and dental Participation in the Army’s Comprehensive
readiness in the Reserve component Soldier Fitness program GAT for Families
and Civilians has almost doubled in one
year (released in 2010)
6-19
20. How We’re Doing: Readiness
Readiness – Managing Psychological Health
Over the past five years we have successfully reduced resistance to referring patients for mental health
treatment and the stigma related to receiving treatment. Through our investments in psychological
research and program evaluation, we are discovering the most effective ways to treat these conditions.
Post Traumatic Stress Post Traumatic Stress Post Traumatic Stress
Disorder Referral Rate Disorder Engagement Disorder Remission Rate
Rate
Data through 2nd
Quarter
We are learning about the best treatment
protocols for PTSD. Patients that are in
our most successful program, RESPECT-
MIL, have a remission rate of 19%.
6-20
21. Population Health –
Three Sub-Aims
• Health determinants
• Health promotion and primary prevention
• Environmental “adjustments”
• Individual health risk
• Behavioral risk
• Physiological risk
• Resilience
• Illness and disease burden
• Tertiary prevention – reducing the impact of chronic illness
• Improved pathways of care for common conditions (eg PTSD
and Depression)
Success – We will empty our hospitals
6-21
22. Population Health
Encouraging Healthy Behavior – Curbing Obesity
Prevalence of Obesity Diagnosis Rate of obesity/ Counseling Rate of
in MHS Beneficiaries overweight beneficiaries, diagnosed beneficiaries
(Ages 40-49) FY2011 obese/overweight, FY2011
The rate of obesity in active duty Service Less than a third of obese patients Of those beneficiaries diagnosed as
members is significantly lower compared to and less than ten percent of being overweight or obese, only 10%
retirees of the same age. There may be an overweight patients have a weight and 20%, respectively, are counseled
opportunity to intervene to prevent waistline condition documented in their on ways to manage their weight. 22
growth with retirement. medical record.
6-22
23. Population Health
Encouraging Healthy Behavior – Tobacco Cessation
Tobacco Cessation
Smoking Rate, 18-24 Year Tobacco Use Rate, 18-24 Counseling Rate, Active
Olds Year Olds Duty
Latest National
Smoking Rate
Historically the smoking rate of active duty Recently we have expanded our 18-24 year-old active duty members
Service members has been one and a half measurement to consider all types of are less likely to be counseled to quit
times higher than their non active duty tobacco use. We still see a marked smoking than older active duty
peers. Over the last five years, the MHS difference between the smoking rates of members; this is a pattern we are
has seen a decrease in the rate of smoking active duty and non active duty looking to change.
in both populations. beneficiaries.
6-23
24. Population Health
Preventive Health
On many of the preventive measures where we have focused our improvement efforts, we are now
achieving performance in the top 10% of the nation. In the last year, we have expanded our focus to
measuring how we care for our children, an area of significant importance to a health system that delivers
2,400 births a week.
Cervical Cancer Children with Six Well- Exclusive Breastfeeding
Screening Rate Child Visits in First 15 During Newborn
Months Hospitalization
Women are more likely to have a Well-child visits is still a maturing measure Our direct care performance is 50%
documented cervical cancer screening and presents opportunity for improvement higher than the Joint Commission
if they are enrolled in one of our across the MHS. national rate.
military treatment facilities.
6-24
25. Experience of Care – Six Sub-Aims
“They remember me.”
• Effective - evidence based interventions
• Efficient – no waste
• Equitable – care for everyone
• Timely – no unwanted waits
• Patient Centered – no helplessness
• Safe – no needless death or injury
Success: Patients will say, “I received all of the care I
wanted/needed exactly when I wanted/needed it.”
Ref: Crossing the Quality Chasm – Institute of Medicine 2000;
Confessions of an Extremist, Health Affairs, Dr. Donald Berwick
6-25
26. How We’re Doing: Experience of Care
Safe Care
Antibiotics Administered Within 1 Wrong Site Surgeries
Hour of Surgical Procedure
Prophylactic antibiotics reduce the incidence of On average there are 14 wrong site surgeries per
postoperative wound infection. We have seen year in our system. We are focused on eliminating
consistent improvement in this measure over the through transparency, protocols, and better
last two years—our goal is100% compliance. communication between patient and surgical team.
6-26
27. How We’re Doing: Experience of Care
Effective & Efficient Care
Screening Rates for LDL Screening Rates for Conditions with Highest
Cholesterol Management Diabetes HbA1c Direct Care Hospital
Readmission Rates
10th Percentile
6-27
28. How We’re Doing: Experience of Care
Timely Care
Third Available Primary Satisfaction with Getting MEBs Completed within 35
Care Appointments Timely Care Days
Top performing, mature PCMHs: 90% for
Routine third available. Top performing PCMHs: R&A: Our satisfaction rate has remained R&A: Overall rate has been in decline; we
66% for Acute third available have noticed a modest upward trend over
relatively flat for the last year. the last quarter.
Last Year: At over 50% of MTF primary clinics, if a
beneficiary calls for an acute appointment they will
be offered at least three options within 24 hours.
6-28
29. How We’re Doing: Experience of Care
Patient-Centered Care
(#73) Primary Care (PCM) (#74) Satisfaction with (#69) Satisfaction with
Continuity Provider Communication Healthcare
On average, enrollees to military treatment
facilities see their assigned primary care
manager about half of the time. Note: The civilian benchmark is 93% Patients enrolled to TRICARE network
but the MHS has not achieved the providers report a higher satisfaction with
benchmark during the reported health care.
period nor made significant
Top performing/mature PCMHs: improvement.
72% primary care continuity
6-29
30. How We’re Doing: Experience of Care
Patient-Centered Care
Satisfaction with Inpatient Care (Overall Hospital Rating)
Last Year: Patients receiving obstetrical care at TRICARE network
hospitals report higher satisfaction with health care.
6-30
31. Per Capita Cost –
Two Sub-Aims
• Reduce cost per service
• Engineer efficient processes
• Reduce the number of services
• Eliminate waste
• Substitute high cost low value services with high
value, low cost services
Waste is disrespectful to:
•The taxpayer
•Workers
•Patients
Success: Bend the cost curve.
6-31
32. Per Capita Cost
Understanding Our Costs
The majority of MHS health care resources are spent on TRICARE Prime enrollees; per capita costs for
Prime enrollees have grown significantly since 2005. Much of that growth has been due to rising
ambulatory utilization. Traditionally we’ve tried to cut costs at HQ/overhead, but we need to focus our
energy on private sector costs (large proportion of the MHS budget) and quality of health care -
specifically cost per year per person, which is rising dramatically.
MHS Budget, by Budget Activity Group
Enrollee Per Year Costs
Purchased Direct Consolidate Base Headquarters
Care Care d Operations
Health and
Support Communicatio
ns
Educatio Information
n Management
and
Training
The total cost of providing care for an average
The MHS dedicates nearly all of its budget directly to the
MHS Prime enrollee is just over $3,500
care of its beneficiaries, investing $25B annually in
annually, with almost two-thirds of the total
TRICARE Prime enrollees.
being for ambulatory services. These costs
are driven by increased utilization.
6-32
33. Per Capita Cost
Cost Drivers
Reducing emergency room use and improving care management represent can viably
control our costs. As we develop our data analytics capabilities, we will be better able to
understand our cost drivers which will allow us to create tailored solutions.
Emergency Room (ER)
Utilization per 100 enrollees
National
Benchmark
Emergency room utilization for Prime enrollees
continues to climb and is more than double the rate
of insured individuals in the United States.
6-33
35. Per Capita Cost
Managing Pharmacy Costs
Average Annual Prescription Projected Growth in the
Costs Per Beneficiary Over 65 Population Home Delivery Trend
The MHS spends, on average, over Currently one in five MHS beneficiaries is Savings from home delivery prescriptions
$2,000 per year on each senior over the age of 65, and this population is have been significant, and the use of this
beneficiaries’ pharmaceutical costs per quickly growing. venue for delivery continues to increase35
year.
6-35
36. The MHS Value Equation
Experience Population
Readiness + + Health
of Care
Value =
Cost (Over a Span of Time)
Creating a high value Military Health System is
predicated on defining and measuring value.
6-36
37. Current State
• We don’t have a fully functional health team
• We wait for patients to become ill
• Our health care system is fragmented
• We do not reimburse for coordination of care or outcomes
• Economic incentives reward sickness over health
• Fee for service rewards volume over value
• Up to 40% of health care spending is on waste
• We fail to transfer knowledge to practice
• We follow well established clinical guidelines less than half of the time
• We can’t seem to cross from basic science to common practice in under a
generation (it is risky)
• We fail to apply principles of system engineering to health processes
• “Work arounds” are the norm
• Comparative and concurrent data are not part of the American health care
culture
6-37
38. The Solution: Over the Next 3-5 Years
MHS Will Transition Both Payment and
Delivery Systems to
Achieve the Quadruple Aim
Delivery System
Fully
Integrated
Delivery
Ideal
System
ent
n of paym
utio nd
vol tion a
-e za
Co ni
Level 2/3 a
PCMH
o rg
Medical Transition
Homes
Volume-driven Today Performance Planning
fragmented Pilots
care
Fee-for-service Pay for Bundled Incentive and
Performance; Payment, Pay for Reimbursement
Primary Care Sub- Value, Partial System
38
Capitation Capitation 6-38
Adapted From “From Volume To Value: Better Ways To Pay For Health Care”, Health Affairs, Sep/Oct 2009.