The constant thread weaving through every healthcare organizational strategy should be adherence to the Triple Aim. But with uncertainty generated by the changes at the federal level, healthcare organizations may be tempted to put their value-based care plans on hold. This article explains why that’s not necessary and lists six strategies for thriving under a fee-for-value model: 1.) Use Leadership and Team Structure to Support Improvement 2.) Drive Down Costs 3.) Reduce Unnecessary Waste 4.) Encourage the Learning Organization 5.) Prioritize Patient Education 6.) Track Data and Outcomes This blog cites one small medical center with odds stacked against it, and how it is managing to not only weather the changes, but also distinguish itself by staying true to the values of the Triple Aim.
The Medicare Access and CHIP Reauthorization Act (MACRA) overhauls the payment system for Medicare providers. It’s a complex program that requires careful study so physicians can make the best choice for how they want to report. This choice ultimately impacts reimbursement and the potential bonuses or penalties associated with each reporting option.
This FAQ covers both tracks of the new rule, the Merit-based Incentive Payment System (MIPS), and the Advanced Alternative Payment Model (APM), with a background review and a comprehensive list of questions and answers.
It’s a practical guide complete with next steps for strategic and tactical planning.
As population health management goes mainstream, providers need robust, integrated software solutions to aggregate and analyze data, coordinate care, engage patients and clinicians, and provide full administrative and financial functionality. Population Health Management is a journey, and the number of approaches to population health are varied.
How to Use Data to Improve Patient Safety: Part 2Health Catalyst
Stan and Valere will discuss how using an automated trigger tool for all-cause harm reviews will provide timely, real-time patient safety data useful to drive down harm rates with earlier interventions. Additional benefits of this approach include having a more accurate and robust source of data for identifying harm trends to then be able to integrate the findings into existing quality improvement processes for further quality improvement efforts.
Attendees will learn how to:
Understand the importance of dedicating resources to impact downstream costs
Identify their key sources of Patient Safety data
Integrate Patient Safety data in to existing Quality Improvement Processes
Learn and improve from real-time safety analytics combined with a Culture of Safety
Five Strategies for Easing the Burden of Clinical Quality MeasuresHealth Catalyst
Healthcare systems need to view regulatory measures in a different light. Rather than approaching them as required processes that burden the system, they should be viewed as quality improvement opportunities that lead to best practices. It helps to have a strategy to get there:
Prioritize measures that truly impact patient care
Have a line-of-sight to reimbursement
Understand measure alignment across programs
Involve the right people
Get involved in measure development upstream
The right tools also help, but a plan for success is advised for healthcare system administrators and clinicians who need to ease the reporting burden and take advantage of every measure in a positive way.
Why We Need to Shift Healthcare Quality Measures from Volume to ValueHealth Catalyst
Healthcare quality reporting is integral to achieving the Triple Aim and improving outcomes. But the sheer volume of quality measures has become as much a part of healthcare as healing and prevention. Recently, CMS and AHIP took the unprecedented step of aligning and consolidating measures in seven care categories. This will go a long way toward reducing the amount of time physicians and staff spend every week on quality reporting, but it’s only a beginning. Healthcare’s focus needs to shift from volume to value of quality measures, such as those that concentrate on quality of life and patient-reported outcomes. The International Consortium for Health Outcomes Measurement is setting the right example for quality measures designed to actually improve outcomes rather than just processes.
The Happy Marriage of Hospital Finance and Frontline OperationsHealth Catalyst
The hospital finance department typically acts as administrator and controller over hospital operations, at least in the eyes of frontline clinicians. Additionally, finance is burdened with the day-today tasks of balancing the books. And all too often, finance thinks they know what their customers want, but customers think that finance is isolated, secretive, and bureaucratic. The hospital finance department needs a makeover. To transition into the role of valued business partner and financial expert, finance needs to reinvent itself by:
Simplifying the flow of, and expand access to, information
Repositioning financial analysts as experts
Understanding what customers value
Learn how these straightforward business practices can support operations in their outcomes improvement efforts, and ultimately benefit the entire healthcare organization.
How to Evaluate a Clinical Analytics Vendor: A ChecklistHealth Catalyst
Based on 25 years of healthcare IT experience, Dale outlines a detailed set of criteria for evaluating clinical analytic vendors. These criteria include 1) completeness of vision, 2) culture and values of senior leadership, 3) ability to execute, 4) technology adaptability and supportability, 5) total cost of ownership, 6) company viability, and 7) nine elements of technical specificity including data modeling, master data management, metadata, white space data, visualization, security, ETL, performance and utilization metrics, hardware and software infrastructure.
The Medicare Access and CHIP Reauthorization Act (MACRA) overhauls the payment system for Medicare providers. It’s a complex program that requires careful study so physicians can make the best choice for how they want to report. This choice ultimately impacts reimbursement and the potential bonuses or penalties associated with each reporting option.
This FAQ covers both tracks of the new rule, the Merit-based Incentive Payment System (MIPS), and the Advanced Alternative Payment Model (APM), with a background review and a comprehensive list of questions and answers.
It’s a practical guide complete with next steps for strategic and tactical planning.
As population health management goes mainstream, providers need robust, integrated software solutions to aggregate and analyze data, coordinate care, engage patients and clinicians, and provide full administrative and financial functionality. Population Health Management is a journey, and the number of approaches to population health are varied.
How to Use Data to Improve Patient Safety: Part 2Health Catalyst
Stan and Valere will discuss how using an automated trigger tool for all-cause harm reviews will provide timely, real-time patient safety data useful to drive down harm rates with earlier interventions. Additional benefits of this approach include having a more accurate and robust source of data for identifying harm trends to then be able to integrate the findings into existing quality improvement processes for further quality improvement efforts.
Attendees will learn how to:
Understand the importance of dedicating resources to impact downstream costs
Identify their key sources of Patient Safety data
Integrate Patient Safety data in to existing Quality Improvement Processes
Learn and improve from real-time safety analytics combined with a Culture of Safety
Five Strategies for Easing the Burden of Clinical Quality MeasuresHealth Catalyst
Healthcare systems need to view regulatory measures in a different light. Rather than approaching them as required processes that burden the system, they should be viewed as quality improvement opportunities that lead to best practices. It helps to have a strategy to get there:
Prioritize measures that truly impact patient care
Have a line-of-sight to reimbursement
Understand measure alignment across programs
Involve the right people
Get involved in measure development upstream
The right tools also help, but a plan for success is advised for healthcare system administrators and clinicians who need to ease the reporting burden and take advantage of every measure in a positive way.
Why We Need to Shift Healthcare Quality Measures from Volume to ValueHealth Catalyst
Healthcare quality reporting is integral to achieving the Triple Aim and improving outcomes. But the sheer volume of quality measures has become as much a part of healthcare as healing and prevention. Recently, CMS and AHIP took the unprecedented step of aligning and consolidating measures in seven care categories. This will go a long way toward reducing the amount of time physicians and staff spend every week on quality reporting, but it’s only a beginning. Healthcare’s focus needs to shift from volume to value of quality measures, such as those that concentrate on quality of life and patient-reported outcomes. The International Consortium for Health Outcomes Measurement is setting the right example for quality measures designed to actually improve outcomes rather than just processes.
The Happy Marriage of Hospital Finance and Frontline OperationsHealth Catalyst
The hospital finance department typically acts as administrator and controller over hospital operations, at least in the eyes of frontline clinicians. Additionally, finance is burdened with the day-today tasks of balancing the books. And all too often, finance thinks they know what their customers want, but customers think that finance is isolated, secretive, and bureaucratic. The hospital finance department needs a makeover. To transition into the role of valued business partner and financial expert, finance needs to reinvent itself by:
Simplifying the flow of, and expand access to, information
Repositioning financial analysts as experts
Understanding what customers value
Learn how these straightforward business practices can support operations in their outcomes improvement efforts, and ultimately benefit the entire healthcare organization.
How to Evaluate a Clinical Analytics Vendor: A ChecklistHealth Catalyst
Based on 25 years of healthcare IT experience, Dale outlines a detailed set of criteria for evaluating clinical analytic vendors. These criteria include 1) completeness of vision, 2) culture and values of senior leadership, 3) ability to execute, 4) technology adaptability and supportability, 5) total cost of ownership, 6) company viability, and 7) nine elements of technical specificity including data modeling, master data management, metadata, white space data, visualization, security, ETL, performance and utilization metrics, hardware and software infrastructure.
Improving the Outcomes That Matter Most to PatientsHealth Catalyst
Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs) have been used in healthcare since the 1970s. But the industry hasn’t had meaningful, consistent PROs and PROMs definitions until ICHOM developed one. ICHOM, a pioneer in outcomes measurement and improvement, demonstrates that healthcare organizations focused on improving patient outcomes that patients actually care about are the ones most likely to transform healthcare.
PROs and PROMs complement clinical indicators in understanding the quality of healthcare a team is delivering. For example, an improvement program for prostate cancer patients that only focuses on improving blood loss or length of stay in the hospital completely misses a patient’s biggest fears: will they need to wear pads for the rest of their life? Will their relationship with their partner be the same as it was?
By focusing on outcomes that matter most to patients, health systems will be more successful at improving outcomes. ICHOM describes five strategies for getting started with PROs and PROMs:
Find the Believers (Identify Clinician Champions)
Organize a Cross-Functional Team (with Appropriate Governance)
Invest Time and Resources
Celebrate Progress Along the Way
Use Early Successes to Scale and Spread
The Top Five Recommendations for Improving the Patient ExperienceHealth Catalyst
Improving patient satisfaction scores and the overall patient experience of care is a top priority for health systems. It’s a key quality domain in the CMS Hospital Value-Based Purchasing (VBP) Program (25 percent) and it’s an integral part of the IHI Triple Aim. But, despite the fact that health systems realize the importance of improving the patient experience of care, they often use patient satisfaction as a driver for outcomes. This article challenges this notion, instead recommending that they use patient satisfaction as a balance measure; one of five key recommendations for improving the patient experience:
Use patient satisfaction as a balance measure—not a driver for outcomes.
Evaluate entire care teams—not individual providers.
Use healthcare analytics to understand and act on data.
Leverage innovative technology.
Improve employee engagement.
This article also explains why patient experience is so closely tied to quality of care, and why it’s a prime indicator of a healthcare organization’s overall health.
Surviving Value-Based Purchasing in Healthcare: Connecting Your Clinical and ...Health Catalyst
Reducing healthcare costs is a major driving force in bundled payments, home-centered medical care, and accountable care organizations. But each new delivery model is built on the premise of reducing revenue per patient. So how can a health system win? Find out what you can do financially survive in today’s environment.
Tackle These 8 Challenges of MACRA Quality MeasuresHealth Catalyst
The Medicare Access and CHIP Reauthorization Act (MACRA) appears to be a reporting challenge for many healthcare provider systems with few resources for managing the menagerie of measures. Indeed, with more than 270 measures in play, many systems have yet to jump in, but the deadline is inevitable. A plan of action is possible by recognizing and acting on these eight challenge areas:
Challenge #1: High-level performance insight
Challenge #2: Defining measure specifications
Challenge #3: Data quality reporting requirements
Challenge #4: Benchmarking data
Challenge #5: Proactively increasing measures surveillance to enhance outcomes
Challenge #6: Strategically aligning measures on which to base risk
Challenge #7: Identifying measures with the largest financial impact
Challenge #8: Taking risk in multi-year, value-based contracts
Mid-to-large size provider groups need a strategy around MACRA quality measures and a tool to help them make sense of all the reporting requirements.
Breaking All the Rules: What the Leading Health Systems Do Differently with A...Health Catalyst
Voluntarily or not, we are entering the Age of Analytics in healthcare. As the healthcare industry emerges from the deployment of EMR’s and health information exchanges, enterprise data warehouses represent the next significant opportunity in information technology.
However, the meaningful use of an enterprise data warehouse is much more difficult to achieve than the meaningful use of an EMR. There are scant few organizations in healthcare that have achieved excellence in the “meaningful use” of an enterprise data warehouse.
Fortunate to see both failings and successes, Dale Sanders has spent the last 18 years analyzing the characteristics of healthcare analytics and data warehousing leadership. Join him as he shares his observations and lessons to help you and your organization become one of the success stories.
Presentation Covers:
Why C-level involvement is important, but not a guarantee of success, and can sometimes be a hindrance
The pivotal characteristics of culture, strategy, and execution that are critical to data warehousing and analytics success
How to balance tactical analytic victories without sacrificing strategic adaptability and scalability
Why You Need to Understand Value-Based Reimbursement and How to Survive ItHealth Catalyst
There are clear signs the healthcare industry is in the midst of a shift to value-based reimbursement. The most noticeable signs are the recent and proposed 2015 rulings from CMS. There are four areas in value-based reimbursement that will be impacted by the end of 2015: the physician payment structure, bundled payments, Inpatient Prospective Payment Systems regulations, and commercial payers. To survive the shift to value-based reimbursement, it’s important for providers and payers to take three steps: provide access to rich data, share knowledge and learn from each other, develop strategies by doing assessments.
In Pursuit of the Patient Stratification Gold Standard: Getting There with He...Health Catalyst
Even the healthiest among us would benefit from some level of care management, but resources are limited and patients must be stratified to facilitate prioritized enrollment into care management programs. Therefore, health systems need to identify not only high-cost, high-risk, and rising-risk patients, but also patients who are truly impactable.
This article explains how systems can use healthcare analytics, at varying levels of maturity, to improve patient stratification and, ultimately, achieve the gold standard:
Level 1 (where to start): use healthcare analytics to identify high-cost, high-risk patients in a population.
Level 2: use healthcare analytics to identify patients with rising-risk profiles.
Level 3 (highest level of maturity): use healthcare analytics to identify patients who are truly impactable (the patient stratification gold standard).
Analytics is key to achieving the patient stratification gold standard, but should enhance (not replace) clinical judgement. Stratification lists need to go through workflows in which clinicians remove patients that aren’t appropriate for enrollment.
The Top 7 Outcomes Measures and 3 Measurement EssentialsHealth Catalyst
Outcomes improvement can’t happen without effective outcomes measurement. Given the healthcare industry’s administrative and regulatory complexities, and the fact that health systems measure and report on hundreds of outcomes annually, this blog adds much-needed clarity by reviewing the top seven outcome measures, including definitions, important nuances, and real-life examples:
Mortality
Readmissions
Safety of care
Effectiveness of care
Patient experience
Timeliness of care
Efficient use of medical imaging
CMS used these exact seven outcome measures to calculate overall hospital quality and arrive at its 2016 hospital star ratings. This blog also reiterates the importance of outcomes measurement, clarifies how outcome measures are defined and prioritized, and recommends three essentials for successful outcomes measurement:
Transparency
Integrated care
Interoperability
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.
Five Ways For Improving Hospital Revenue Cycle ManagementHealth Catalyst
Besides improving your information systems and educating your staff on the ins and outs of managing revenue, there are many more opportunities for improvement. Here are five suggestions to help health systems improve their revenue cycle management: 1. trend and benchmark your healthcare data; 2. use an enterprise data warehouse to mine your healthcare data; 3. constantly ask frontline staff for suggestions; 4. monitor all payer contracts; and 5. maintain convenient and caring touch points with patients.
Preparing for the Coming Change: An Overview of the Healthcare Analytics MarketHealth Catalyst
Jim Adams, Executive Director, The Advisory Board, discusses the two market forces in particular, population health management and the retail revolution, that are driving the need for new applications of analytics and business intelligence (BI).
Attendees will learn:
The role of analytics in population health and the growing retail market
The key challenges provider organizations are facing in developing analytics capabilities
The pros and cons of the core strategies providers are utilizing to develop analytics capabilities and the vendors that map to those strategies
Bring your most pressing healthcare problems and spend an hour listening to one of the most seasoned industry analysts talking through the top forces shifting the landscape of the healthcare market in 2015.
We hope you'll come away with some insight and refined thinking about solutions that will drive your work forward. Please do join us.
Care Management Part 2 - A Critical Component of Effective Population HealthHealth Catalyst
Care management plays a central role in the world of value-based reimbursements, at-risk contracts, and population health management. Such programs require high-touch and resource-intensive care as teams work to deliver on the substantial promise of delivering patient care improvements while reducing costs.
Healthcare Total Cost of Care Analysis: A Vital ToolHealth Catalyst
How can healthcare organizations set themselves up for success as the industry shifts from fee-for-service to value-based reimbursement? They need to understand risk of their patients and population to identify ways to reduce healthcare costs and improve quality of care. This makes total cost of care (TCOC) analysis a necessary skillset in this time of transition.
TCOC analysis leverages key elements of the healthcare analytics infrastructure to understand how money is being spent at the organization and identify the drivers of high cost:
An integrated EDW.
Payer reporting tools.
Claims and membership data.
Predictive capabilities.
Risk scores.
Scorecards and dashboards.
Analyst support.
The healthcare transformation from fee for service to fee for outcomes just got an adrenaline shot in the arm April 27th when the Department of Health and Human Services surprised many in the market by announcing a Quality Payment Program, a proposed set of new rules to take effect in 2019 based on key provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
How to thrive in the new value based care delivery worldHealth Catalyst
As Healthcare shifts from fee-for-service towards value-based care, many healthcare systems struggle with this challenging transition.
Join Tom Burton, Co-founder of Health Catalyst, as he describes the journey of many health systems working through the complexities, capabilities and strategies required to thrive through the transition.
You will come to understand:
How analytics can help to better manage at risk contracts in value-based care delivery settings
How network optimization through appropriate provider selection can reduce out of network leakage
How a balanced approach to care management increases your return on investment
The three key capabilities required for systematic population health management
How to survive cms's most recent 3% hospital readmissions penalties increase Health Catalyst
Hospital readmissions rates are now at 3 percent, which means that health systems are feeling the financial burden of decreased payments from Medicare. They also need to track two more 30-day readmission rates. While there aren’t any new penalty measures planned for 2016, coronary artery bypass grafts will be added as yet another measure to track in 2017. By using three strategies to reduce readmission rates, health systems will experience better outcomes and decreased penalties. The three strategies include the following: (1) implementing a data warehouse that provides a single source of truth; (2) engaging a multidisciplinary team to lead the improvement efforts; (3) installing a sophisticated analytics platform.
Becoming the Change Agent Your Healthcare System NeedsHealth Catalyst
I’ve met many clinical and operational leaders across the U.S. and seen how many have become progressively cynical and disengaged when faced with important healthcare reform issues like cost cutting and tight budgets. These clinicians would agree that equally important are quality and safety issues. However, most don’t have the tools available to actually measure that quality or patient outcomes. When clinicians do have access to the ability to measure, and the work together, I’ve seen enormous energy arise as they ask questions they really care about: What is quality? What do we measure? How do we achieve the best outcome?
How Physicians Can Prepare for the Financial Impact of MACRAHealth Catalyst
If all goes according to plan, the first performance period for the new Medicare Access and Chip Reauthorization Act (MACRA) is just around the calendar corner. It’s a complicated reimbursement structure with multiple tracks that are guaranteed to reward with bonuses or inflict pain through penalties in CMS’s new zero sum game. To the physicians and practices that adopt this new program early and position themselves for the best fiscal outcomes, go the spoils. But for many smaller practices and those that consistently underperform, the outlook may be glum regardless. Here are some highlights of the new program and the financial impact it will have on clinicians and practices.
Tackling the Challenge of Effective Patient Engagement: How Health Catalyst i...Health Catalyst
Effective population health management within a provider organization is an interesting combination of technology, change management, and modified financial incentives. Turns out, managing a team member population to the same goals requires a similar set of tools and effort. It is possible to improve team member clinical outcomes (both individually and as a population) while driving down both corporate and personal health costs.
Join Jeff as he draws parallels between managing these surprisingly similar groups, using tools and principles that guide our thinking across both our client patient populations and our corporate team member populations, and suggests strategies for corporations to improve outcomes for their most important asset – their people.
Wednesday, June 8
1-2PM EST
Attendees will learn:
Parallels between patient and employee populations, and how one group informs the other for success.
Effective strategies Health Catalyst employs for both populations.
The “gamification” of wellness programs, and how this will drive future patient engagement and care management.
10 Motivational Interviewing Strategies for Deeper Patient Engagement in Care...Health Catalyst
Care management programs are most successful when patients are deeply engaged in their own care. Using the motivational interviewing technique, care managers work with patients to identify personal care goals and motivators to follow the care management program.
Ten strategies guide the motivational interviewing process, each focusing on patient-centered insights (e.g., pros and cons to following care management and barriers to adherence). With mobile technology to support these interactions, motivational interviewing can become a seamless, and vital, part of the care management workflow.
The Key to Transitioning from Fee-for-Service to Value-Based ReimbursementsHealth Catalyst
The shift from fee-for-service to value-based reimbursements has good and bad consequences for healthcare. While the shift will ultimately help health systems provide higher quality lower cost care, the transition may be financially disastrous for some. In addition, the shifting revenue mix from commercial payers to Medicare and Medicaid is creating its own set of challenges. There are, however, three keys to surviving the transition: 1) Effectively manage shared savings programs to maximize reimbursement. 2) Improve operating costs. 3) Increase patient volumes. With an analytics foundation, health systems will be able to meet and survive today’s healthcare challenges.
Hospital Readmissions Reduction Program: Keys to SuccessHealth Catalyst
Avoidable readmissions are a major financial major problem for the healthcare industry, especially for government payers. To tackle this problem, CMS launched the Hospital Readmissions Reduction Program (HRRP). While some hospitals may be able to absorb the financial penalties under HRRP, they still need to track increasingly complex reporting metrics. Most tracking solutions are inadequate for today’s complicated reporting needs. A healthcare enterprise data warehouse and analytics applications, however, are designed to solve the numerous reporting burdens. When used together, they also deliver a robust solution that enables hospitals to track and drive real cost and quality improvement initiatives, all without the need for users to be technical experts.
Improving the Outcomes That Matter Most to PatientsHealth Catalyst
Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs) have been used in healthcare since the 1970s. But the industry hasn’t had meaningful, consistent PROs and PROMs definitions until ICHOM developed one. ICHOM, a pioneer in outcomes measurement and improvement, demonstrates that healthcare organizations focused on improving patient outcomes that patients actually care about are the ones most likely to transform healthcare.
PROs and PROMs complement clinical indicators in understanding the quality of healthcare a team is delivering. For example, an improvement program for prostate cancer patients that only focuses on improving blood loss or length of stay in the hospital completely misses a patient’s biggest fears: will they need to wear pads for the rest of their life? Will their relationship with their partner be the same as it was?
By focusing on outcomes that matter most to patients, health systems will be more successful at improving outcomes. ICHOM describes five strategies for getting started with PROs and PROMs:
Find the Believers (Identify Clinician Champions)
Organize a Cross-Functional Team (with Appropriate Governance)
Invest Time and Resources
Celebrate Progress Along the Way
Use Early Successes to Scale and Spread
The Top Five Recommendations for Improving the Patient ExperienceHealth Catalyst
Improving patient satisfaction scores and the overall patient experience of care is a top priority for health systems. It’s a key quality domain in the CMS Hospital Value-Based Purchasing (VBP) Program (25 percent) and it’s an integral part of the IHI Triple Aim. But, despite the fact that health systems realize the importance of improving the patient experience of care, they often use patient satisfaction as a driver for outcomes. This article challenges this notion, instead recommending that they use patient satisfaction as a balance measure; one of five key recommendations for improving the patient experience:
Use patient satisfaction as a balance measure—not a driver for outcomes.
Evaluate entire care teams—not individual providers.
Use healthcare analytics to understand and act on data.
Leverage innovative technology.
Improve employee engagement.
This article also explains why patient experience is so closely tied to quality of care, and why it’s a prime indicator of a healthcare organization’s overall health.
Surviving Value-Based Purchasing in Healthcare: Connecting Your Clinical and ...Health Catalyst
Reducing healthcare costs is a major driving force in bundled payments, home-centered medical care, and accountable care organizations. But each new delivery model is built on the premise of reducing revenue per patient. So how can a health system win? Find out what you can do financially survive in today’s environment.
Tackle These 8 Challenges of MACRA Quality MeasuresHealth Catalyst
The Medicare Access and CHIP Reauthorization Act (MACRA) appears to be a reporting challenge for many healthcare provider systems with few resources for managing the menagerie of measures. Indeed, with more than 270 measures in play, many systems have yet to jump in, but the deadline is inevitable. A plan of action is possible by recognizing and acting on these eight challenge areas:
Challenge #1: High-level performance insight
Challenge #2: Defining measure specifications
Challenge #3: Data quality reporting requirements
Challenge #4: Benchmarking data
Challenge #5: Proactively increasing measures surveillance to enhance outcomes
Challenge #6: Strategically aligning measures on which to base risk
Challenge #7: Identifying measures with the largest financial impact
Challenge #8: Taking risk in multi-year, value-based contracts
Mid-to-large size provider groups need a strategy around MACRA quality measures and a tool to help them make sense of all the reporting requirements.
Breaking All the Rules: What the Leading Health Systems Do Differently with A...Health Catalyst
Voluntarily or not, we are entering the Age of Analytics in healthcare. As the healthcare industry emerges from the deployment of EMR’s and health information exchanges, enterprise data warehouses represent the next significant opportunity in information technology.
However, the meaningful use of an enterprise data warehouse is much more difficult to achieve than the meaningful use of an EMR. There are scant few organizations in healthcare that have achieved excellence in the “meaningful use” of an enterprise data warehouse.
Fortunate to see both failings and successes, Dale Sanders has spent the last 18 years analyzing the characteristics of healthcare analytics and data warehousing leadership. Join him as he shares his observations and lessons to help you and your organization become one of the success stories.
Presentation Covers:
Why C-level involvement is important, but not a guarantee of success, and can sometimes be a hindrance
The pivotal characteristics of culture, strategy, and execution that are critical to data warehousing and analytics success
How to balance tactical analytic victories without sacrificing strategic adaptability and scalability
Why You Need to Understand Value-Based Reimbursement and How to Survive ItHealth Catalyst
There are clear signs the healthcare industry is in the midst of a shift to value-based reimbursement. The most noticeable signs are the recent and proposed 2015 rulings from CMS. There are four areas in value-based reimbursement that will be impacted by the end of 2015: the physician payment structure, bundled payments, Inpatient Prospective Payment Systems regulations, and commercial payers. To survive the shift to value-based reimbursement, it’s important for providers and payers to take three steps: provide access to rich data, share knowledge and learn from each other, develop strategies by doing assessments.
In Pursuit of the Patient Stratification Gold Standard: Getting There with He...Health Catalyst
Even the healthiest among us would benefit from some level of care management, but resources are limited and patients must be stratified to facilitate prioritized enrollment into care management programs. Therefore, health systems need to identify not only high-cost, high-risk, and rising-risk patients, but also patients who are truly impactable.
This article explains how systems can use healthcare analytics, at varying levels of maturity, to improve patient stratification and, ultimately, achieve the gold standard:
Level 1 (where to start): use healthcare analytics to identify high-cost, high-risk patients in a population.
Level 2: use healthcare analytics to identify patients with rising-risk profiles.
Level 3 (highest level of maturity): use healthcare analytics to identify patients who are truly impactable (the patient stratification gold standard).
Analytics is key to achieving the patient stratification gold standard, but should enhance (not replace) clinical judgement. Stratification lists need to go through workflows in which clinicians remove patients that aren’t appropriate for enrollment.
The Top 7 Outcomes Measures and 3 Measurement EssentialsHealth Catalyst
Outcomes improvement can’t happen without effective outcomes measurement. Given the healthcare industry’s administrative and regulatory complexities, and the fact that health systems measure and report on hundreds of outcomes annually, this blog adds much-needed clarity by reviewing the top seven outcome measures, including definitions, important nuances, and real-life examples:
Mortality
Readmissions
Safety of care
Effectiveness of care
Patient experience
Timeliness of care
Efficient use of medical imaging
CMS used these exact seven outcome measures to calculate overall hospital quality and arrive at its 2016 hospital star ratings. This blog also reiterates the importance of outcomes measurement, clarifies how outcome measures are defined and prioritized, and recommends three essentials for successful outcomes measurement:
Transparency
Integrated care
Interoperability
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.
Five Ways For Improving Hospital Revenue Cycle ManagementHealth Catalyst
Besides improving your information systems and educating your staff on the ins and outs of managing revenue, there are many more opportunities for improvement. Here are five suggestions to help health systems improve their revenue cycle management: 1. trend and benchmark your healthcare data; 2. use an enterprise data warehouse to mine your healthcare data; 3. constantly ask frontline staff for suggestions; 4. monitor all payer contracts; and 5. maintain convenient and caring touch points with patients.
Preparing for the Coming Change: An Overview of the Healthcare Analytics MarketHealth Catalyst
Jim Adams, Executive Director, The Advisory Board, discusses the two market forces in particular, population health management and the retail revolution, that are driving the need for new applications of analytics and business intelligence (BI).
Attendees will learn:
The role of analytics in population health and the growing retail market
The key challenges provider organizations are facing in developing analytics capabilities
The pros and cons of the core strategies providers are utilizing to develop analytics capabilities and the vendors that map to those strategies
Bring your most pressing healthcare problems and spend an hour listening to one of the most seasoned industry analysts talking through the top forces shifting the landscape of the healthcare market in 2015.
We hope you'll come away with some insight and refined thinking about solutions that will drive your work forward. Please do join us.
Care Management Part 2 - A Critical Component of Effective Population HealthHealth Catalyst
Care management plays a central role in the world of value-based reimbursements, at-risk contracts, and population health management. Such programs require high-touch and resource-intensive care as teams work to deliver on the substantial promise of delivering patient care improvements while reducing costs.
Healthcare Total Cost of Care Analysis: A Vital ToolHealth Catalyst
How can healthcare organizations set themselves up for success as the industry shifts from fee-for-service to value-based reimbursement? They need to understand risk of their patients and population to identify ways to reduce healthcare costs and improve quality of care. This makes total cost of care (TCOC) analysis a necessary skillset in this time of transition.
TCOC analysis leverages key elements of the healthcare analytics infrastructure to understand how money is being spent at the organization and identify the drivers of high cost:
An integrated EDW.
Payer reporting tools.
Claims and membership data.
Predictive capabilities.
Risk scores.
Scorecards and dashboards.
Analyst support.
The healthcare transformation from fee for service to fee for outcomes just got an adrenaline shot in the arm April 27th when the Department of Health and Human Services surprised many in the market by announcing a Quality Payment Program, a proposed set of new rules to take effect in 2019 based on key provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
How to thrive in the new value based care delivery worldHealth Catalyst
As Healthcare shifts from fee-for-service towards value-based care, many healthcare systems struggle with this challenging transition.
Join Tom Burton, Co-founder of Health Catalyst, as he describes the journey of many health systems working through the complexities, capabilities and strategies required to thrive through the transition.
You will come to understand:
How analytics can help to better manage at risk contracts in value-based care delivery settings
How network optimization through appropriate provider selection can reduce out of network leakage
How a balanced approach to care management increases your return on investment
The three key capabilities required for systematic population health management
How to survive cms's most recent 3% hospital readmissions penalties increase Health Catalyst
Hospital readmissions rates are now at 3 percent, which means that health systems are feeling the financial burden of decreased payments from Medicare. They also need to track two more 30-day readmission rates. While there aren’t any new penalty measures planned for 2016, coronary artery bypass grafts will be added as yet another measure to track in 2017. By using three strategies to reduce readmission rates, health systems will experience better outcomes and decreased penalties. The three strategies include the following: (1) implementing a data warehouse that provides a single source of truth; (2) engaging a multidisciplinary team to lead the improvement efforts; (3) installing a sophisticated analytics platform.
Becoming the Change Agent Your Healthcare System NeedsHealth Catalyst
I’ve met many clinical and operational leaders across the U.S. and seen how many have become progressively cynical and disengaged when faced with important healthcare reform issues like cost cutting and tight budgets. These clinicians would agree that equally important are quality and safety issues. However, most don’t have the tools available to actually measure that quality or patient outcomes. When clinicians do have access to the ability to measure, and the work together, I’ve seen enormous energy arise as they ask questions they really care about: What is quality? What do we measure? How do we achieve the best outcome?
How Physicians Can Prepare for the Financial Impact of MACRAHealth Catalyst
If all goes according to plan, the first performance period for the new Medicare Access and Chip Reauthorization Act (MACRA) is just around the calendar corner. It’s a complicated reimbursement structure with multiple tracks that are guaranteed to reward with bonuses or inflict pain through penalties in CMS’s new zero sum game. To the physicians and practices that adopt this new program early and position themselves for the best fiscal outcomes, go the spoils. But for many smaller practices and those that consistently underperform, the outlook may be glum regardless. Here are some highlights of the new program and the financial impact it will have on clinicians and practices.
Tackling the Challenge of Effective Patient Engagement: How Health Catalyst i...Health Catalyst
Effective population health management within a provider organization is an interesting combination of technology, change management, and modified financial incentives. Turns out, managing a team member population to the same goals requires a similar set of tools and effort. It is possible to improve team member clinical outcomes (both individually and as a population) while driving down both corporate and personal health costs.
Join Jeff as he draws parallels between managing these surprisingly similar groups, using tools and principles that guide our thinking across both our client patient populations and our corporate team member populations, and suggests strategies for corporations to improve outcomes for their most important asset – their people.
Wednesday, June 8
1-2PM EST
Attendees will learn:
Parallels between patient and employee populations, and how one group informs the other for success.
Effective strategies Health Catalyst employs for both populations.
The “gamification” of wellness programs, and how this will drive future patient engagement and care management.
10 Motivational Interviewing Strategies for Deeper Patient Engagement in Care...Health Catalyst
Care management programs are most successful when patients are deeply engaged in their own care. Using the motivational interviewing technique, care managers work with patients to identify personal care goals and motivators to follow the care management program.
Ten strategies guide the motivational interviewing process, each focusing on patient-centered insights (e.g., pros and cons to following care management and barriers to adherence). With mobile technology to support these interactions, motivational interviewing can become a seamless, and vital, part of the care management workflow.
The Key to Transitioning from Fee-for-Service to Value-Based ReimbursementsHealth Catalyst
The shift from fee-for-service to value-based reimbursements has good and bad consequences for healthcare. While the shift will ultimately help health systems provide higher quality lower cost care, the transition may be financially disastrous for some. In addition, the shifting revenue mix from commercial payers to Medicare and Medicaid is creating its own set of challenges. There are, however, three keys to surviving the transition: 1) Effectively manage shared savings programs to maximize reimbursement. 2) Improve operating costs. 3) Increase patient volumes. With an analytics foundation, health systems will be able to meet and survive today’s healthcare challenges.
Hospital Readmissions Reduction Program: Keys to SuccessHealth Catalyst
Avoidable readmissions are a major financial major problem for the healthcare industry, especially for government payers. To tackle this problem, CMS launched the Hospital Readmissions Reduction Program (HRRP). While some hospitals may be able to absorb the financial penalties under HRRP, they still need to track increasingly complex reporting metrics. Most tracking solutions are inadequate for today’s complicated reporting needs. A healthcare enterprise data warehouse and analytics applications, however, are designed to solve the numerous reporting burdens. When used together, they also deliver a robust solution that enables hospitals to track and drive real cost and quality improvement initiatives, all without the need for users to be technical experts.
Is Value-Based Healthcare Here to Stay? Looking for Answers in New PoliciesHealth Catalyst
Healthcare leaders are eager for a modicum of clarity when it comes to the industry’s shift to value-based healthcare given the uncertainties of Congress and the new Administration.
Fortunately, an analysis of three key pieces of information tells us value-based healthcare is likely here to stay:
The 21st Century Cures Act (Cures).
The Executive Order on reducing the “burden” of the Affordable Care Act (ACA).
Tom Price’s comments at his confirmation hearings.
It is a relatively safe bet that value-based healthcare delivery and payment programs will continue to be supported by federal law and regulation for several reasons:
Bipartisan support: The success of Cures indicates that bipartisan cooperation will continue on key healthcare issues.
Market-based innovation: The emerging evidence is that Congress and the Administration will support innovation in payment and delivery models.
Support for Existing ACA Innovation programs: Although highly uncertain, there are some indications that not all of the ACA will be scrapped.
Introducing catalyst.ai and MACRA Measures & InsightsHealth Catalyst
Join Eric Just, Senior Vice President of Product Development, as he will discuss:
How machine learning is now included into our analytics platform and being built into all our applications.
The toolsets we have developed to automate and democratize machine learning tasks both within Health Catalyst clients and to the broader healthcare industry.
Processes to gain clinician buy-in, and engage the best machine learning engine in the world.
Demonstrations and examples of this life-saving technology.
Dorian DiNardo, Vice President, will share how the Health Catalyst® MACRA Measures & Insights product can help you:
Integrate hundreds of measures across financial, regulatory, and quality departments.
Monitor the behavior, activities, and other changing information needed to influence, manage, or change outcomes.
Tactically and strategically identify measures to take on risk in multi-year value-based care contracts.
Will New Healthcare Policy Impact Value-Based Healthcare?Health Catalyst
The final days of 2016 were fraught with uncertainty about what Congress and the new Trump Administration would do to the Affordable Care Act (ACA) and the healthcare regulatory landscape overall. So far, in 2017, we do not have much more clarity. Repeal, repeal and replace, repeal and delay, modify without repeal—there are now even more questions than answers and still no consensus Republican plan in sight. Yet healthcare executives would certainly appreciate some modicum of clarity, at least on the narrower topic of whether the shift to value-based healthcare models will continue under whatever new system is coming. This webinar attempts to add clarity by analyzing what we know so far, as reflected in the limited actual evidence that is available.
Join Dan Orenstein, General Counsel, Health Catalyst, as he analyzes these three key pieces of information:
The 21st Century Cures Act (Cures)
The Executive Order on reducing the “burden” of the Affordable Care Act (ACA)
Tom Price’s comments at his confirmation hearings
The market shift toward value-based care presents unprecedented opportunities and challenges for the US health care system. Instead of rewarding volume, new
value-based payment models reward better results in terms of cost, quality, and outcome measures. These largely untested models have the potential to upend health care stakeholders’ traditional patient care and business models.
Presentation Freud Group: Immobilier a Miami - francais 2016 - finalEFG Research
Cette presentation couvre:
- l'ensemble de nos services immobiliers en matiere d'achat, vente et gestion locatives sur miami;
- Les chiffres clefs de l'economie locale
- les chiffres clefs de l'immobilier locale
Detailed Clinical Models and their relation with Electronic Health Recordsyampeku
Presentation of my PhD dissertation. Contains three main subjects:
-Archetype representation of non-dual model architectures
-Archetype-based mapping between clinical information models
-Automatic generation of implementation guides from clinical information models
Healthcare Interoperability: New Tactics and TechnologyHealth Catalyst
Every provider agrees on the need for healthcare interoperability to achieve clinical data insights at the point of care. The question is how to get there from the myriad technologies and the volumes of data that comprise electronic medical records. It’s been difficult to organize among participants that have had little incentive to cooperate. And standards for sending and receiving data have been slow to develop. This is changing, but the key components that are still vital to realizing insights are closed-loop analytics and its accompanying tools, an enterprise data warehouse and analytics applications. This article defines the problems and explores the solutions to optimizing clinical decision making where it’s needed most.
Many healthcare organizations seem to have been in perpetual pilot stage while experimenting with value-based payment models. Healthcare organizations are focusing their efforts in two primary areas: developing the skills to successfully manage at-risk contracts and, preparing for the considerable business and care delivery transformation necessary for true population health management. But what are the foundational competencies needed to take on risk? Healthcare organizations should consider the following 5 key areas: 1) at-risk contract management, 2) network management, 3) care management, 4) performance monitoring, and 5) improvement prioritization. The value of analytics in each of these competency areas is to prioritize limited resources on the highest impact area.
Engaging Physicians to Be Good Financial StewardsHealth Catalyst
This article, first published by in July 2016 by hfma, outlines how hospitals can get physicians to understand the financial impact of their clinical decisions and become actively engaged in improving the value of care. Texas Children’s Hospital was successful through recognizing the need for cultural transformation and ensuring quality came first. The organization engaged clinicians with financial data, including educating them on key financial principles, linking quality improvement training with financial accountability, and accompanying financial choices with clinical choices.
Why Most Analytic Applications Will Never Be Able to Significantly Improve He...Health Catalyst
The availability of healthcare IT solutions can be overwhelming and all promise to solve an organization’s most pressing issues. While typical data and analytic applications are excellent at exposing opportunities for improvement that are impacting the bottom line, most are not effective at helping the organization determine what to do to address them and improve outcomes. However, a new approach to creating analytics applications is emerging. Analytics applications that incorporate best practices clinical content along with the best practices visualizations help everyone understand the problem and the solution. These applications also enable clinicians to better understand, adopt, roll out, and execute outcome improvement initiatives with healthcare systems. Health Catalyst has deliberately created a comprehensive, dynamic suite of applications that integrate clinical content and facilitate the orderly implementation of action plans.
Analytics and Small Hospitals: Embracing Data to Thrive in the New Era of Val...Health Catalyst
Value-based care has remade the healthcare landscape for small hospitals. Many are struggling to compete with the larger, better-funded medical centers in the communities they serve. Embracing data and analytics is no longer a luxury for these organizations if they are to succeed and remain competitive. Data analysis can assist senior leaders in identifying opportunities for improvement while balancing long-term goals with short-term pressures. Incorporating data in to the culture and making it a part of everyday decision making will enable smaller hospitals to not only survive, but thrive in the new era of value-based care.
Analytics and Small Hospitals: Embracing Data to Thrive in the New Era of Val...Health Catalyst
Value-based care has remade the healthcare landscape for small hospitals. Many are struggling to compete with the larger, better-funded medical centers in the communities they serve. Embracing data and analytics is no longer a luxury for these organizations if they are to succeed and remain competitive. Data analysis can assist senior leaders in identifying opportunities for improvement while balancing long-term goals with short-term pressures. Incorporating data in to the culture and making it a part of everyday decision making will enable smaller hospitals to not only survive, but thrive in the new era of value-based care.
How Healthcare Cost-Per-Case Improvements Deliver Big Bottom-Line SavingsHealth Catalyst
As health systems face more pressure than ever to deliver cost savings, they’re turning their attention to cost-per-case improvement projects. These strategies can produce quick wins for improvement teams looking to gain momentum and buy-in. This article addresses the following topics:
How to identify areas of opportunity.
The importance of costing accuracy.
Four strategies for implementing cost-per-case improvement projects.
Example projects for new teams.
How to sustain results.
Top 7 Healthcare Trends and Challenges for 2015 - From Our Financial ExpertHealth Catalyst
As the healthcare industry moves closer to value-based care, there are a lot of projections about the changes that will occur in 2015. This article discusses seven of the top trends the industry is focused on: (1) physicians start to feel the financial impact of CMS’s rules; (2) the use of technology in healthcare is exploding; (3) financial viability is a key concern for CEOs; (4) reducing exposure to risk performance is becoming more important; (5) interest in population health management continues to grow; (6) outcomes improvements will continue to increase; and (7) collaboration between providers and payers will increase.
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.
How to Measure Health Outcomes that Matter to EveryoneHealth Catalyst
To measure health outcomes that matter to everyone, it’s important to ask several questions before starting out:
How do regulatory requirements differ from outcomes improvement?
Do the measurements align with organizational goals and values?
Are the measurements worth the resources required to document them?
Will the metrics actually be applied to outcomes improvement?
Who are the beneficiaries of the outcomes improvement initiative?
The answers to these questions help save time and resources, sustain and expand the improvement effort, refine the list of measures to those that truly improve outcomes, and most of all, help avoid the outcomes measures graveyard.
Five Solutions to Controlling Healthcare's Cost ProblemHealth Catalyst
When expenses exceed revenue, business has a financial problem. In healthcare, the focus has been on revenue for so long, we’ve lost sight of runaway costs brought about by high labor and technology expenses, inefficient use of resources, and supply waste. Recognizing the cost problem is a big first step toward solving it.
Five expense-controlling strategies can play a significant role in returning healthcare systems to a stronger financial position:
Refocus on labor management.
Manage employed physicians.
Change the patient encounter environment.
Augment standard approaches with technology.
Manage patient access and flow through the healthcare system.
With new, value-based payment structures, shrinking margins, and decreasing reimbursements, this insight offers some new ways to think about expense inefficiency and how to get costs under control.
The Who, What, and How of Health Outcome MeasuresHealth Catalyst
Even though thousands of health outcome measures have the potential to impact the work we do every day, how well do we really understand them? In this article, we take a close look at the definitions, origins, and characteristics of health outcome measures. We break down the financial relevance of certain measures, the relationship between outcome measures and ACOs, and which measures impede, rather than enhance, a typical healthcare system. We review the role of an enterprise data warehouse and analytics, and we touch on the future of health outcome measures, all in an effort to provide deeper insight into some of the mechanics behind outcomes improvement.
6 Proven Strategies for Engaging Physicians—and 4 Ways to FailHealth Catalyst
For healthcare organizations to be successful with their quality and cost improvement initiatives, physicians must be engaged with the proposed changes. But many physicians are not engaged because their morale is suffering. While some strategies to encourage buy-in for improvement initiatives don’t work, there are six strategies that have proven to be effective: (1) discover a common purpose, (2) adopt an engaging style, (3) turn physicians into partners, not customers, (4) segment the engagement plan, (5) use “engaging” improvement methods, and (6) provide them with backup—all the way to the board. Once the organization has their trust, physicians will gain enthusiasm to move forward with improvement efforts that will benefit everyone.
Reducing Unwanted Variation in Healthcare Clears the Way for Outcomes Improve...Health Catalyst
According to statistician W. Edwards Deming, “Uncontrolled variation is the enemy of quality.” The statement is particularly true of outcomes improvement in healthcare, where variation threatens quality across processes and outcomes. To improve outcomes, health systems must recognize where and how inconsistency impacts their outcomes and reduce unwanted variation.
There are three key steps to reducing unwanted variation:
Remove obstacles to success on a communitywide level.
Maintain open lines of communication and share lessons learned.
Decrease the magnitude of variation.
Accountable Care Organizations and Physician Joint Ventures .docxAMMY30
Accountable Care Organizations and Physician Joint Ventures
Jeffrey P. Harrison
Chapter 9
“I will continue with diligence to keep abreast of advances in medicine. I will treat without exception all who seek my ministrations, so long as the treatment of others is not compromised thereby, and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient.”
—from The Hippocratic Oath (modern version)
Copyright 2016 Foundation of the American College of Healthcare Executives. Not for sale.
1
Learning Objectives
Demonstrate an understanding of the interparty relationships associated with healthcare joint ventures and accountable care organizations.
Understand some of the dynamics and controversies surrounding the concept of accountable care organizations as an alternative approach to the current marketplace.
Demonstrate a basic understanding of the patient-centered medical home with attention to how it supports network-based delivery systems.
Master the concept of physician–hospital alignment and health system integration including consumer, provider, and regulatory developments.
Assess the emerging role of medical groups and hospital-owned group practices across the continuum of healthcare services.
Copyright 2016 Foundation of the American College of Healthcare Executives. Not for sale.
2
Key Terms and Concepts
Accountable care organization (ACO)
Clinical integration
Equity-based joint venture
Hospitalist model
Integrated physician model
Medical foundation
Patient-centered medical home (PCMH)
Copyright 2016 Foundation of the American College of Healthcare Executives. Not for sale.
3
Introduction
A positive relationship between hospitals and physicians is important to the success of the US healthcare system, because hospitals and physicians can be both collaborators and competitors.
Many hospitals and healthcare systems have moved to various models of physician integration through which hospitals hope to capture market share and physicians seek financial security.
After the Affordable Care Act (ACA) was passed in 2010, physician–hospital alignment became driven by another factor: cost control and quality outcomes in the accountable care era (Reiboldt 2013).
Physicians work in a wide range of settings and serve in leadership positions that have significant responsibility for quality of care.
Copyright 2016 Foundation of the American College of Healthcare Executives. Not for sale.
4
Clinical Integration
What Is It?
Coordination of patient care between hospitals and physicians across the healthcare continuum— e.g., an accountable care organization (ACO).
Provides an opportunity to coordinate services through centralized scheduling, electronic health records, clinical pathways, management of chronic diseases, and innovative quality improvement programs.
Clinical integration is necessary to delivering high-quality, affordable care in the current environment (Jacquin 2014).
Clinical.
Five Data-driven Patient Empowerment StrategiesHealth Catalyst
Data plays a big role toward empowering patients to become more involved in their care. With data, digital tools, and education, patient empowerment can act like a blockbuster drug to produce exceptional outcomes.
Data empowers patients five ways:
Promotes patient engagement.
Produces patient-centered outcomes.
Helps patients practice self-care.
Improves communication with clinicians.
Leads to faster healing and independence.
Clinicians using creative, innovative care strategies, and patients with access to the right tools and technology, can produce remarkable results in terms of cost, health outcomes, and experience.
ACOs: Four Ways Technology Contributes to SuccessHealth Catalyst
With an increasing emphasis on value-based care, Accountable Care Organizations (ACOs) are here to stay. In an ACO, healthcare providers and hospitals come together with the shared goals of reducing costs and increasing patient satisfaction by providing high-quality coordinated healthcare to Medicare patients. However, many ACOs lack direction and experience difficulty understanding how to use data to improve care. Implementing a robust data analytics system to automate the process of data gathering and analysis as well as aligning data with ACO quality reporting measures. The article walks through four keys to effectively implementing technology for ACO success:
Build a data repository with an analytics platform.
Bring data to the point of care.
Analyze claims data, identify outliers, including successes and failures.
Combine clinical claims, and quality data to identify opportunities for improvement.
Four Keys to Increase Healthcare Market ShareHealth Catalyst
With leadership alignment, easy access to data, and a roadmap to reach their objectives, health systems can drastically increase revenue and grow market share by applying four principles:
Key 1. Alignment.
Key 2. Vehicles.
Key 3: Five tools: access to data, data acumen; finance, vision to execution, and prioritizing outcomes.
Key 4: Education.
Access to the right data can drive changes that generate $48M in revenue, surpassing the year three market share goals in year two.
Optimize physician workflow and you’ll contribute to optimizing patient care. But what is it physicians look for to improve diagnoses, decision-making, patient care, and ultimately, outcomes? To answer this, consider what constitutes ideal working conditions in any industry: the right tools, training, and information to maximize productivity and deliver results. Physicians need analytics integrated into the EHR to maximize their efficiency, a common quest among the chronically overworked. And by flowing the universe of global, local, and individual data back into an enterprise data warehouse, a healthcare system can close the analytics loop, and begin to realize true precision medicine.
Similar to Against the Odds: How this Small Community Hospital Used Six Strategies to Succeed in Value-Based Care (20)
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Unlock the Secrets to Optimizing Ambulatory Operations Efficiency and Change ...Health Catalyst
Today’s healthcare leaders are seeking technology solutions to optimize efficiencies and improve patient care. However, without effective change management and strategies in place, healthcare leaders struggle to strategically improve patient flow, space, to strategically improve patient flow, space, and schedule management, and implement daily huddles. The role of technology in supporting operational efficiency and change management initiatives is inevitable.
During this webinar, attendees will learn how to optimize Ambulatory Operational Efficiencies and Change Management. Attendees will also learn about the importance of visual management boards in enhancing clinic performance and insights into effective change management approaches.
Patient expectations are rising, and organizations are continuously being asked to do more with less.
Additionally, the convergence of several significant emerging market and policy trends, economic uncertainty, labor force shortages, and the end of the COVID-19 public health emergency has created a unique set of challenges for healthcare organizations.
Attend this timely webinar to learn about new trends and their impact on key healthcare issues, such as patient engagement, migration to value-based care, analytics adoption, the use of alternative care sites, and data governance and management challenges.
During this webinar, we will discuss the complexities of AI, trends, and platforms in the industry. Dive deep into understanding the true essence of AI, exploring its potential, real-world use cases, and common misconceptions. Gain valuable insights into the latest technology trends impacting healthcare and discover strategies for maximizing ROI in your technology investments.
Explore the profound impact of data literacy on healthcare organizations and how it shapes the utilization of data and technology for transformative outcomes. Understand the top technology priorities for healthcare organizations and learn how to navigate the digital landscape effectively. Furthermore, simplify industry jargon by defining common data elements, fostering clearer communication and collaboration across stakeholders.
Finally, uncover the transformative potentials of platforms in healthcare and how they can revolutionize scalability, interoperability, and innovation within your organization. Don't miss this opportunity to gain invaluable insights from industry experts and stay ahead in the ever-evolving healthcare landscape. Reserve your spot now for an enlightening journey into the future of healthcare technology!
Three Keys to a Successful Margin: Charges, Costs, and LaborHealth Catalyst
How can cost management and complete charge capture protect and enhance the margin?
In this webinar, we will look at 2024 margin pressures likely to impact your organization’s financial resiliency. This presentation will also share how organizations can move from Fee-for-Service to Value; bringing Cost to the forefront.
2024 CPT® Updates (Professional Services Focused) - Part 3Health Catalyst
Each year the CPT code set undergoes significant changes. Physicians and their office staff need to be aware of the changes in order to ensure a smooth transition into 2024. Join us for a discussion of the new, deleted and revised CPT codes and associated guidelines for 2024. This presentation will focus on the changes to the CPT dataset and the associated work RVU value changes that impact professional service reporting.
During this complimentary webinar, we will empower you to correctly apply the new and revised codes and discuss the rationale behind this year’s changes. You will leave with an understanding of the financial implications of the changes on your practice.
2024 CPT® Code Updates (HIM Focused) - Part 2Health Catalyst
Each year the CPT code set and the HCPCS code set undergo significant changes, and your coding staff needs to be aware of the changes in order to ensure a smooth transition into 2024. Join us for a discussion of the new, deleted and revised CPT codes and associated guidelines for 2024. This is part two in a three-part series.
During these complimentary webinars, we will empower you to correctly apply the new and revised codes and discuss the rationale behind this year’s changes. This presentation will be geared towards hospital staff with a focus on the surgical section of the CPT book in addition to surgical Category III codes.
2024 CPT® Code Updates (CDM Focused) - Part 1Health Catalyst
Each year the CPT and the HCPCS code sets undergo significant changes, and your staff needs to be aware of the changes in order to ensure a smooth transition into 2024. Join us for a discussion of the new, deleted, and revised CPT codes and associated guidelines for 2024. This is part one in a three-part series, with a CDM focus.
During these complimentary webinars, we will empower you to correctly apply the new and revised codes and discuss the rationale behind this year’s changes. This presentation will be geared towards hospital staff with a focus on the non-surgical sections of the CPT book.
What’s Next for Hospital Price Transparency in 2024 and BeyondHealth Catalyst
The Centers for Medicare & Medicaid Services (CMS) published updates to the hospital price transparency requirements in the CY 2024 Outpatient Prospective Payment System (OPPS) Final Rule. The updates will be phased in over the next 14 months and include several significant changes including the use of a CMS-mandated template, a requirement for an affirmation statement from the hospital, and several new data elements. Join us to discover what changes are scheduled for implementation in 2024 and 2025 and how they’ll impact your facility.
During this complimentary 60-minute webinar, we’ll analyze the key provisions of the Price Transparency regulations and provide insights to help you prepare for the upcoming changes.
Automated Patient Reported Outcomes (PROs) for Hip & Knee ReplacementHealth Catalyst
What was once voluntary reporting will soon be made mandatory with penalties.
On July 1, 2024, all health systems will be required to collect Patient Reported Outcome Measures (PROM) as part of the Centers for Medicare & Medicaid Services (CMS) regulation for the following measures:
Hospital-Level, Risk Standardized Patient-Reported Outcomes Performance Measure (PRO-PM) Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA)
Hospital-Level Risk-Standardized Complication Rate (RSCR) Following Elective Primary THA/TKA
Are you equipped to handle these new requirements?
Mandatory data collection begins April 1, 2024, and failure to submit timely data can result in a 25 percent reduction in payments by Medicare.
Attend this webinar to learn how mobile engagement can empower your organization to meet this requirement.
2024 Medicare Physician Fee Schedule (MPFS) Final Rule UpdatesHealth Catalyst
According to the Centers for Medicare & Medicaid Services (CMS), the calendar year (CY) 2024 MPFS final rule was created to advance health equity and improve access to affordable healthcare. This webinar will cover the major policy updates of the MPFS final rule including updates to the telehealth services policy and remote monitoring services and enrollment of MFTs and MHCs as Medicare providers. The conversation will also cover policy changes on split (or shared) evaluation and management (E/M) visits, and the Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging.
What's Next for OPPS: A Look at the 2024 Final RuleHealth Catalyst
During this webinar, we’ll analyze the key provisions of the OPPS final rule and identify the significant changes for the coming year to help prepare your staff for compliance with the 2024 Medicare outpatient billing guidelines.
Insight into the 2024 ICD-10 PCS Updates - Part 2Health Catalyst
Prepare for mandatory ICD-10 PCS diagnosis code updates, which take effect on October 1, 2023. By attending this 60-minute educational session, medical coders and healthcare professionals will gain a comprehensive understanding of the changes to the 2024 ICD-10 procedure codes and their guidelines, enabling accurate and compliant coding for optimal billing and reimbursement.
Vitalware Insight Into the 2024 ICD10 CM Updates.pdfHealth Catalyst
Prepare for mandatory ICD-10 CM diagnosis code updates, which take effect on October 1, 2023. By attending this 60-minute educational session, medical coders and healthcare professionals will gain a comprehensive understanding of the changes to the 2024 ICD-10 diagnosis codes and their guidelines, along with major complication or comorbidity (MCC), complication or comorbidity (CC), and Medicare Severity Diagnosis Related Groups (MS-DRGs) classification changes. With this information, professionals can ensure accurate and compliant diagnosis coding for optimal billing and reimbursement.
Driving Value: Boosting Clinical Registry Value Using ARMUS SolutionsHealth Catalyst
Many hospitals today face a perfect storm of operational and financial challenges. With increasing competition from outpatient facilities and rising care costs negatively impacting budgets, now is the time to boost your clinical registry’s value. However, collecting and analyzing data can be time-consuming and costly without the right tools. During this webinar, we will share insights and best practices for increasing the value of registry participation and how it’s possible to reduce costs while improving outcomes using the ARMUS Product Suite.
Tech-Enabled Managed Services: Not Your Average OutsourcingHealth Catalyst
During this webinar you'll learn the following:
The importance of optimizing performance, reducing labor costs and sourcing talent given current market challenges.
Highlighting the need for a balanced approach to cost reduction.
How to reap the benefits of outsourcing (cost cutting, expertise, etc) while protecting yourself from the collateral damage that often comes with them.
This webinar will provide an in-depth review of the CPT/HCPCS code set changes that will be effective on July 1, 2023. The review will include additions and deletions to the CPT/HCPCS code set, revisions of code descriptors, payment changes, and rationale behind the changes.
How Managing Chronic Conditions Is Streamlined with Digital TechnologyHealth Catalyst
Chronic conditions across the United States are prevalent and continue to rise. Managing one or more chronic diseases can be very challenging for patients who may be overwhelmed or confused about their care plan and may not have access to the resources they need. At the same time, care teams are overburdened, making it difficult to provide the support these patients require to stay as healthy as possible. A new approach to chronic condition management leverages technology to enable organizations to scale high-quality care, identify gaps in care, provide personalized support, and monitor patients on an ongoing basis. Such streamlined management will result in better outcomes, reduced costs, and more satisfied patients.
COVID-19: After the Public Health Emergency EndsHealth Catalyst
In this fast-paced webinar, we will discuss the impact of the end of the public health emergency (PHE), including upcoming changes to the different flexibilities allowed during the PHE and the timeline for when these flexibilities will end. We’ll also cover coding changes and reimbursement updates.
Automated Medication Compliance Tools for the Provider and PatientHealth Catalyst
When it comes to sustaining patient health outcomes, compliance and adherence to medication regimens are critically important, especially as providers manage patients with complex care needs and multiple medications. But, with provider burnout and staffing shortages at an all-time high, an efficient solution is critical. The use of automated medication management workflows to decrease provider burnout, while improving both medication compliance and patient engagement, is the way forward.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
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