Keeping Community Hospitals Thriving and Independentathenahealth
Research showing hospitals how to best maintain their independence while conducting a thriving business model in changing times of governmental regulation.
It's no secret that any EHR takes away essential time with the patient and doctoring in general. See what athenahealth is doing to help remedy these frustrations and to make the best out of a bad situation.
Convert with Confidence: Barriers and Benefits of the EHR Switchathenahealth
Is your current electronic health record not working the way you want it to? Switching to a new system can be difficult without the right partner with the knowledge and support to help.
Join athenahealth maven Dr. Tidwell as he explores issues surrounding independent practices who wish to remain so and what steps physicians can take to thrive on their own, with just a little help from an EMR.
The Latest Self-Pay Trends: New Burdens and Opportunitiesathenahealth
Let athenahealth guide you through the burdens of navigating through revenue collections from your patients to make sure your practice has access to all monetary opportunities to ensure financial success.
Go deeper with athenahealth specialists to discover all that you need to know and some things you may not know about Meaningful Use Stage 2 and the newest government updates.
Keeping Community Hospitals Thriving and Independentathenahealth
Research showing hospitals how to best maintain their independence while conducting a thriving business model in changing times of governmental regulation.
It's no secret that any EHR takes away essential time with the patient and doctoring in general. See what athenahealth is doing to help remedy these frustrations and to make the best out of a bad situation.
Convert with Confidence: Barriers and Benefits of the EHR Switchathenahealth
Is your current electronic health record not working the way you want it to? Switching to a new system can be difficult without the right partner with the knowledge and support to help.
Join athenahealth maven Dr. Tidwell as he explores issues surrounding independent practices who wish to remain so and what steps physicians can take to thrive on their own, with just a little help from an EMR.
The Latest Self-Pay Trends: New Burdens and Opportunitiesathenahealth
Let athenahealth guide you through the burdens of navigating through revenue collections from your patients to make sure your practice has access to all monetary opportunities to ensure financial success.
Go deeper with athenahealth specialists to discover all that you need to know and some things you may not know about Meaningful Use Stage 2 and the newest government updates.
Understand what patient engagement truly means, its benefits for both patients and providers, and how to increase patient engagement through marketing.
Patient-Centered Medical Home: Navigating through Recognition and Rewardsathenahealth
Join athenahealth as we delve into Patient-Centered Medical Homes and the complications that come with navigating through the regulations to achieve level three recognition status.
Population Health in 2016: Know How to Move Forwardathenahealth
Accountable care organizations (ACOs) present a significant opportunity to reduce health care expenditures and ensure quality care. Successfully managing the transition to an ACO is one of the most difficult challenges facing health organizations today. The key is to focus on the risk contract and approach population health management in a staged, incremental way.
Website: https://htworkslk.com/
Digital platforms for health information and communication can be used to increase patient engagement. But what do we mean by patient engagement and how does it affect health outcomes?
Blog: https://htworkslk.com/Medoment/what-is-patient-engagement/
Opportunities & Challenges: A Home Health and Hospice Executive SurveyMcKesson Corporation
In the ever changing health care environment, home health and hospice organizations face enormous challenges. Discover their top challenges, such as Medicare reimbursement cuts, and other statistics on health care reform in the 2014 McKesson executive survey.
New Ways for Predictive Analytics and Machine Learning to Advance Population ...Edifecs Inc
The team at University of Washington’s Center for Data Science and Edifecs have collaboratively built predictive tools that use machine-learning to identify patterns in morbidity progress and health status.
Learning Objectives
Hear how other industries are using the latest in predictive analytics and how this experience can be applied to healthcare
Discuss why healthcare needs machine learning and how it compares to traditional analytics
Explore the Data Tsunami and what the future holds for our industry
Network Optimization: Why Physician Quality Should Drive Your Benefits StrategyGrand Rounds
Employers and payers are increasingly interested in narrow network or "high performance" networks to control healthcare costs. But there's a science to reshaping your physician network to cut costs while avoiding member blowback. Learn how to optimize networks for cost and quality, while reassuring your employees that they can still access the care they need.
3 Perspectives to Better Apply Predictive & Prescriptive Models in HealthcareHealth Catalyst
In healthcare we tend to think of predictive or prescriptive model building and deployment as technical challenges. We do not put enough emphasis on the importance of change management. This disorientation leads to uneven adoption and results. In this webinar Jason Jones discusses and demonstrates three perspectives, accompanied by tools, to help you drive action and deliver better outcomes.
We develop predictive and prescriptive models in healthcare to improve Quadruple Aim outcomes—population health, patient experience, reduced cost, and positive provider work life. Successful adoption of predictive and prescriptive models heavily depends upon behavior change. This requires more than technical accuracy. While prediction algorithms abound, tools to facilitate change management remain scarce. During this webinar, we will discuss how to achieve model understanding using three perspectives: functional, contextual, and operational.
View the webinar to learn:
- Why a predictive or prescriptive model endeavor is more a change management challenge than a technical one
- How to apply three types of model understanding to a use case in your own organization
In this webinar, Jason Jones, PhD, Chief Data Scientist at Health Catalyst discusses and provides examples of our work using three perspectives of understanding to help clinical and operational leaders achieve value from predictive and prescriptive models. Investing time and effort to ensure model understanding is necessary for broad scale adoption.
Streamline denial management process with intelligent automationRuchi Jain
Claim Denial management is a challenging process. Increased Denials can adversely affect revenue cycle operations. Ensuring accurate medical records can be difficult, with exponential growth in the administrative cost of denial claims. It can affect care delivery and hamper cash flow processes.
Explains about Evolution of IT in Healthcare, how analytics can make a difference and evolution of IT in healtcare. For more information visit: http://www.transformhealth-it.org/
With all the buzz around machine learning, predictive analytics, and artificial intelligence (AI) there are a lot of misconceptions and misunderstandings surrounding the optimal use of modern machine learning tools. Healthcare.ai, a free software package developed by the Health Catalyst data science team, was recently released to help hospitals gain valuable insights and advance outcomes improvements from their immense data sets. The software automates machine learning tasks and democratizes machine learning by making it accessible to ‘citizen data scientists’. We have received several questions about machine learning in healthcare, such as how do you define machine learning, how is it different than AI, what are some common uses cases for machine learning in healthcare, and what are the pitfalls. This webinar will develop a common vocabulary around these ideas. We’ll cover the differences between the most cutting-edge predictive techniques, how a model can be improved over time, and use case vignettes to understand and avoid typical machine learning pitfalls. In today’s healthcare industry, the fastest path to healthcare outcomes is often achieved using the simplest predictive tools.
Mike Mastanduno, PhD, data scientist, and Levi Thatcher, PhD, director of data science, will discuss the landscape of healthcare-specific machine learning. Mike and Levi have extensive experience building and deploying impactful machine learning models using healthcare.ai and have worked at the cutting edge of medical research. During and after the discussion, they will answer viewer-submitted questions. This webinar will:
Compare and contrast machine learning and AI.
Discuss techniques that offer feedback into the system and when it’s necessary to retrain a model.
Give advice on how to avoid common pitfalls in machine learning implementation.
Provide use case example and vignette examples on how to apply the different classes of machine learning techniques.
HXR 2016: Data Insights: Mining, Modeling, and Visualizations- Jennifer GambleHxRefactored
Data is useless if it fails to inform, which is precisely what data experts are furiously working on: turning raw informatics into meaningful narratives that begin to shift our standards. From the individual to the population level, data is leading both policy and better decision making in the clinical sphere.
In this webinar, Dale Sanders will provide a pragmatic, step-by-step, and measurable roadmap for the adoption of analytics in healthcare-- a roadmap that organizations can use to plot their strategy and evaluate vendors; and that vendors can use to develop their products. Attendees will have a chance to learn about:
1) The details of his eight-level model, 2) A brief introduction to the HIMSS/IIA DELTA Model, 3) The importance of permanent organizational teams to sustain improvements from analytic investments, 4) The process of curating and maturing data governance, and 5) The coordination of a data acquisition strategy with payment and reimbursement strategies
The Healthcare Revenue Cycle: How to Optimize PerformanceHealth Catalyst
Health systems rely on effective revenue cycle management to follow the patient journey, navigate claims, and ensure the organization collects payment for its services. In today’s complex and fluid healthcare industry, in which revenue cycle management is about much more than billing and collecting payment, traditional revenue cycle approaches can’t meet escalating demands. Additionally, with lost volume due to COVID-19, organizations can’t afford to miss an opportunity for payment.
The contemporary healthcare landscape requires a comprehensive, standardized, and data-driven revenue cycle process. Health systems that leverage data to support revenue cycle management improve their financial outcomes in three significant ways:
1. Reduce denials.
2. Increase collections with propensity-to-pay insight.
3. Improve discharged-not-final-billed efforts.
Understand what patient engagement truly means, its benefits for both patients and providers, and how to increase patient engagement through marketing.
Patient-Centered Medical Home: Navigating through Recognition and Rewardsathenahealth
Join athenahealth as we delve into Patient-Centered Medical Homes and the complications that come with navigating through the regulations to achieve level three recognition status.
Population Health in 2016: Know How to Move Forwardathenahealth
Accountable care organizations (ACOs) present a significant opportunity to reduce health care expenditures and ensure quality care. Successfully managing the transition to an ACO is one of the most difficult challenges facing health organizations today. The key is to focus on the risk contract and approach population health management in a staged, incremental way.
Website: https://htworkslk.com/
Digital platforms for health information and communication can be used to increase patient engagement. But what do we mean by patient engagement and how does it affect health outcomes?
Blog: https://htworkslk.com/Medoment/what-is-patient-engagement/
Opportunities & Challenges: A Home Health and Hospice Executive SurveyMcKesson Corporation
In the ever changing health care environment, home health and hospice organizations face enormous challenges. Discover their top challenges, such as Medicare reimbursement cuts, and other statistics on health care reform in the 2014 McKesson executive survey.
New Ways for Predictive Analytics and Machine Learning to Advance Population ...Edifecs Inc
The team at University of Washington’s Center for Data Science and Edifecs have collaboratively built predictive tools that use machine-learning to identify patterns in morbidity progress and health status.
Learning Objectives
Hear how other industries are using the latest in predictive analytics and how this experience can be applied to healthcare
Discuss why healthcare needs machine learning and how it compares to traditional analytics
Explore the Data Tsunami and what the future holds for our industry
Network Optimization: Why Physician Quality Should Drive Your Benefits StrategyGrand Rounds
Employers and payers are increasingly interested in narrow network or "high performance" networks to control healthcare costs. But there's a science to reshaping your physician network to cut costs while avoiding member blowback. Learn how to optimize networks for cost and quality, while reassuring your employees that they can still access the care they need.
3 Perspectives to Better Apply Predictive & Prescriptive Models in HealthcareHealth Catalyst
In healthcare we tend to think of predictive or prescriptive model building and deployment as technical challenges. We do not put enough emphasis on the importance of change management. This disorientation leads to uneven adoption and results. In this webinar Jason Jones discusses and demonstrates three perspectives, accompanied by tools, to help you drive action and deliver better outcomes.
We develop predictive and prescriptive models in healthcare to improve Quadruple Aim outcomes—population health, patient experience, reduced cost, and positive provider work life. Successful adoption of predictive and prescriptive models heavily depends upon behavior change. This requires more than technical accuracy. While prediction algorithms abound, tools to facilitate change management remain scarce. During this webinar, we will discuss how to achieve model understanding using three perspectives: functional, contextual, and operational.
View the webinar to learn:
- Why a predictive or prescriptive model endeavor is more a change management challenge than a technical one
- How to apply three types of model understanding to a use case in your own organization
In this webinar, Jason Jones, PhD, Chief Data Scientist at Health Catalyst discusses and provides examples of our work using three perspectives of understanding to help clinical and operational leaders achieve value from predictive and prescriptive models. Investing time and effort to ensure model understanding is necessary for broad scale adoption.
Streamline denial management process with intelligent automationRuchi Jain
Claim Denial management is a challenging process. Increased Denials can adversely affect revenue cycle operations. Ensuring accurate medical records can be difficult, with exponential growth in the administrative cost of denial claims. It can affect care delivery and hamper cash flow processes.
Explains about Evolution of IT in Healthcare, how analytics can make a difference and evolution of IT in healtcare. For more information visit: http://www.transformhealth-it.org/
With all the buzz around machine learning, predictive analytics, and artificial intelligence (AI) there are a lot of misconceptions and misunderstandings surrounding the optimal use of modern machine learning tools. Healthcare.ai, a free software package developed by the Health Catalyst data science team, was recently released to help hospitals gain valuable insights and advance outcomes improvements from their immense data sets. The software automates machine learning tasks and democratizes machine learning by making it accessible to ‘citizen data scientists’. We have received several questions about machine learning in healthcare, such as how do you define machine learning, how is it different than AI, what are some common uses cases for machine learning in healthcare, and what are the pitfalls. This webinar will develop a common vocabulary around these ideas. We’ll cover the differences between the most cutting-edge predictive techniques, how a model can be improved over time, and use case vignettes to understand and avoid typical machine learning pitfalls. In today’s healthcare industry, the fastest path to healthcare outcomes is often achieved using the simplest predictive tools.
Mike Mastanduno, PhD, data scientist, and Levi Thatcher, PhD, director of data science, will discuss the landscape of healthcare-specific machine learning. Mike and Levi have extensive experience building and deploying impactful machine learning models using healthcare.ai and have worked at the cutting edge of medical research. During and after the discussion, they will answer viewer-submitted questions. This webinar will:
Compare and contrast machine learning and AI.
Discuss techniques that offer feedback into the system and when it’s necessary to retrain a model.
Give advice on how to avoid common pitfalls in machine learning implementation.
Provide use case example and vignette examples on how to apply the different classes of machine learning techniques.
HXR 2016: Data Insights: Mining, Modeling, and Visualizations- Jennifer GambleHxRefactored
Data is useless if it fails to inform, which is precisely what data experts are furiously working on: turning raw informatics into meaningful narratives that begin to shift our standards. From the individual to the population level, data is leading both policy and better decision making in the clinical sphere.
In this webinar, Dale Sanders will provide a pragmatic, step-by-step, and measurable roadmap for the adoption of analytics in healthcare-- a roadmap that organizations can use to plot their strategy and evaluate vendors; and that vendors can use to develop their products. Attendees will have a chance to learn about:
1) The details of his eight-level model, 2) A brief introduction to the HIMSS/IIA DELTA Model, 3) The importance of permanent organizational teams to sustain improvements from analytic investments, 4) The process of curating and maturing data governance, and 5) The coordination of a data acquisition strategy with payment and reimbursement strategies
The Healthcare Revenue Cycle: How to Optimize PerformanceHealth Catalyst
Health systems rely on effective revenue cycle management to follow the patient journey, navigate claims, and ensure the organization collects payment for its services. In today’s complex and fluid healthcare industry, in which revenue cycle management is about much more than billing and collecting payment, traditional revenue cycle approaches can’t meet escalating demands. Additionally, with lost volume due to COVID-19, organizations can’t afford to miss an opportunity for payment.
The contemporary healthcare landscape requires a comprehensive, standardized, and data-driven revenue cycle process. Health systems that leverage data to support revenue cycle management improve their financial outcomes in three significant ways:
1. Reduce denials.
2. Increase collections with propensity-to-pay insight.
3. Improve discharged-not-final-billed efforts.
The Center for Medicare and Medicaid Innovation hosted a webinar on Thursday, October 8, 2015. The webinar provided an opportunity to learn more about efforts to solicit public comment on a variety of alternative payment pathways to increase value over volume.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Next Generation ACO Model team hosted an open door forum on Tuesday, January 31, 2017. During this open door forum Model team members provided an overview of the Model, along with information pertaining to the Letter of Intent (LOI).
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Presentation on payment reform and changing models given at 2016 Ziegler National Senior Living CFO Workshop, April 6-8, 2016 at The Sheraton New Orleans Hotel.
The alphabet soup of clinical quality measures reporting and reimbursement 2...Bill Presley
CMS is transitioning to what the they call "a new and more responsive regulatory framework" for quality reporting and reimbursement. CMS goals are "…electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people". Over the next couple years, we will see a transformation of fee for service into value-based care models driven by the VBP, Quality Payment Program, MACRA, Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Healthcare organizations will no longer be motivated by implementing and meeting Meaningful Use, but instead will be driven by value-based care and risk-based payment models that focus on quality outcomes for reimbursements.
In this Education Session we will review:
• How CMS is aligning clinical quality measures (CQMs) to reduce the reporting burden for healthcare organizations and providers. We will cover the vision and goals for achieving quality alignment for CMS.
• We will dive into the following CMS reporting programs and how they interact with each other: Value-Based Purchasing (VBP), Medicare Access and CHIP Reauthorization Act (MACRA), Merit-based Incentive Payments (MIPS), Hospital Inpatient Quality Reporting (IQR), The Joint Commission (ORYX), Outpatient Quality Reporting (OQR), and Alternative Payment Models (APM).
• How the Eligible Hospital and Eligible Professional reimbursement models will change in 2017 and going forward.
• Compare and contrast the requirements for quality measure reporting and identify strategies to ensure compliance.
• The potential impact to hospital reimbursement of current and proposed programs that will affect quality reporting for hospitals and providers.
• How to improve efficiency and quality by aligning measures across initiatives.
• Where to find current information (and breaking news) on each of these Quality Initiatives.
In the past, organizations participating in quality reporting initiatives involved abstractors sifting through a small sample set of unstructured data in paper charts to then manually convert their findings to discrete reportable data. This approach is time consuming and requires extensive amount of resources from both IT and Quality staff. Aligning quality initiatives can improve efficiencies and processes, and contribute to population health management efforts, both locally and nationally.
At the conclusion of this presentation, attendees will be able to apply what they’ve learned about aligning Clinical Quality Measures across initiatives specific to their organization to improve reimbursements, reduce their reporting burden, increase efficiencies, and realize the benefits of Population Health Management.
If you are responsible for hospital quality, IT, clinical quality measure initiatives or have a vested interest in making sure your organization is aligning quality measures reporting, this informational session is a must.
Hospitals and health systems are struggling to maximize the benefits of innovative technology to better manage uncompensated care and revenue integrity, suggests a HFMA/Navigant survey of 125 provider CFOs and revenue cycle management executives.
Discover How Allscripts Uses InfluxDB to Monitor its Healthcare IT PlatformInfluxData
Discover How Allscripts Uses InfluxDB to Monitor its Healthcare IT Platform
Allscripts is an industry leader in electronic health record (EHR) system integration and healthcare information technology. Its platform is used to help healthcare organizations drive better patient care, improve financial and operational outcomes and advance clinical results. Its solution connects healthcare professionals with data across the open platform. Allscripts uses a time series database to become data-driven by gaining observability into its platform to help healthcare organizations maximize application availability.
Join this webinar to learn about:
Allscripts effect on healthcare delivery
Its DevOps approach that has improved service uptime
How InfluxDB enables better data correlation and reporting
The healthcare reform law will have far-reaching impacts in areas of
Coverage
Insurance Reform
Insurance Mandates
Health Insurance Exchanges
Get the FACTS here a MUST see POWER POINT
Connected Healthcare - New PerspectiveSomenath Nag
An IDC source says, the healthcare industry is one of the highest-ranked industries for year-over-year growth and five-year compound annual growth rates with a worldwide average of 7.0% growth for FY12 in software.
There has been a significant investment in the form of health modernization and stimulus funding to leverage technology to cut down rising healthcare costs.
This presentation discusses the concepts of connected healthcare and how it will change the Healthcare Industry.
Clinical Integration: The Foundation for Accountable Care - Presentation delivered by Keynote Speaker Marvin O’Quinn, Senior Executive Vice President and Chief Operating Officer, Dignity Health at the National Healthcare CXO Summit held in Las Vegas Oct 19-21, 2014.
New regulations, rising costs and the consumerization of healthcare are fueling innovation in HCIT. Providers look to update their tech stacks in order to promote patient engagement, interoperability and operational efficiency, as well as to achieve financial success through alternative reimbursement models. Check out this report to learn how Catalyst Investors sees the provider solution landscape evolving.
Driving Value - Taking the Healthcare Revenue Cycle to the Next Level.pdfAGSHealth1
As hospitals and healthcare systems evolve to meet the needs of a growing and aging population, they find themselves struggling to remain financially healthy.
https://www.agshealth.com/blog/driving-value-taking-the-healthcare-revenue-cycle-to-the-next-level/
Ultimately, the key to success in a dynamic market environment is data, both financial and clinical. Practices must be able to demonstrate their value empirically. Anesthesia practices have more and better data about what happens in the operating rooms and delivery suites than any other source in the facility. The most successful practices have learned to use this to demonstrate their value to the facility. ABC’s suite of technology products allow practices to easily integrate the data they have into tools designed to collect more, provide insight and aid in decision making.
When the pandemic happened, this prominent healthcare provider from the Tri-State area couldn’t rely on their painfully slow and inflexible systems to create meaningful customer experiences. They partnered with TVS Next to rapidly modernize their systems and increase their appointment booking capability by 2000%, winning the hearts of the community they served.
Sun Knowledge Revenue Cycle Management ServicesSun Knowledge
Sun Knowledge Revenue Cycle Management gives you a clear visibility of your finances through payment follow-up. Prosthetics and orthotics billing are handled diligently.
In this MTBC Brochure you can find all information about MTBC medical billing services and all products related to electronic health record , patient management, and other mhealth apps etc.
Similar to Driving Efficiency in Community Health (20)
Learn about 2016 trends in government and private healthcare spending, employer costs, and the patient-as-consumer movement that's spurring new provider models.
Cashing in on Value Based Reimbursementathenahealth
Stay on top of changing governmental regulations and don't leave money on the table. Value based reimbursements can be tricky to navigate while managing a medical practice but not with athenahealth.
ICD-10 Progress Report: How Practices are Handling the Transitionathenahealth
Tracking network data from over 73,000 providers across the country, athenahealth monitors the success of our practices' transition to ICD-10. Find out how we made the change easy and effortless.
The Latest Regulations, Simplified: MU, PQRS & MIPSathenahealth
Changing governmental regulations for the advancement of healthcare is more than difficult and we have simplified these changes to keep you up to date.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
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.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
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.
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
3. “FQHCs are an extremely complex
corner of an already complex
system. Keeping up with the
reporting requirements is a constant
struggle.”
-Bobbie Wunsch
Founder, Pacific Health Consulting Group
4. April 16th
MACRA, H.R. 2, made law
• Medicare Access and CHIP
Reauthorization Act
• Replaced SGR formula
• EHR Incentive Programs to
be streamlined into one new
payment system
• Incentivizes the shift to
alternative, value-based
payment models
News from
Washington:
5. It’s not going to get any easier
SOURCE: The Medicare Access and CHIP Reauthorization Act of 2015; Advisory Board analysis.
2. APM participants who are close to but fall short of APM bonus requirements will not qualify for bonus but can report MIPS measures and receive
incentives or can decline to participate in MIPS.
Merit-Based Incentive Payment System1
2020:
-5% to +15%
2019:
-4% to +12%
2022 and on:
-9% to +27%
2021:
-7% to +21%
2018: Last year of separate MU,
PQRS, and VBM penalties
2019 - 2024: 5% participation bonus
2019 - 2020: 25% Medicare
revenue requirement
2021 and on: Ramped up Medicare or
all-payer revenue requirements
1. Positive adjustments may be scaled by a factor of up to 3 times the negative adjustment to ensure budget neutrality. Actual positive adjustments may
be lower than numbers shown here. In addition, top performers may earn additional adjustments of up to 10 percent.
Advanced Alternative Payment Models22
1
9. First, we view software as a technology
enabler, not as the product itself
9
SOFTWARE KNOWLEDGE SERVICESSOFTWARE
• EMR
• PMIS
• BI
• ACO
• PAC
10. Second, we deliver constantly updated
knowledge into the practice workflow
10
KNOWLEDGE SERVICES
• MU
• D2D
• ICD
• CPT
• DRG
• IPA
• TLA
SOFTWARE KNOWLEDGE
US Patent # 7,720,701
11. Finally, we handle all the back-office work
that technology doesn’t automate
11
SOFTWARE KNOWLEDGE SERVICESSERVICES
• EOB
• ANSI
• ERA
• CSI
• HL7
• CCD
• PCI
• SOC 1 (SAS70)
• FAX
12. Estimates of the proportion of primary care visits that might be attended
by PAs or NPs range between 50%-75%
Hospital-based
physician
Office-based
physician
Mid-level
provider
Support
staff
Patient
Bring the principle of comparative advantage to
the health care supply chain
12
13. Estimates of the proportion of primary care visits that might be attended
by PAs or NPs range between 50%-75%
Hospital-based
physician
Office-based
physician
Mid-level
provider
Support
staff
Patient
Bring the principle of comparative advantage to
the health care supply chain
13
14. Estimates of the proportion of primary care visits that might be attended
by PAs or NPs range between 50%-75%
Hospital-based
physician
Office-based
physician
Mid-level
provider
Support
staff
Patient
Bring the principle of comparative advantage to
the health care supply chain
14
18. 18
64,648
Providers on our network
200 million
Automated patient messages delivered in 2014
$3.84 billion
Collections posted per quarter
60 million
Patient records
1.2 billion
Data transactions processed annually
23. athenahealth was first to undergo
NCQA PCMH Corporate Review
23
athenahealth covers about 60% of the points required
for NCQA’s highest level of PCMH recognition
85
35.25
45.5
0
20
40
60
80
100
Minimum amount of points
for NCQA Level 3
Practice
Responsibility
4.25
athena-Enabled
Auto Credit*
NCQA
Level
1
NCQA
Level
2
*pre-validated NCQA points
*practice support points
athenahealth PCMH
Accelerator Program
24. FQHC billing is complex
24
Identification of
and creation of
“wrap around claims”
Flexible reporting
system to support
UDS
Claim splitting
“rules” reduce work
for billing staff
Poverty-based
sliding scales
support indigent care
25. 25
First of its Kind Dental Integration
Consolidated
UDS
Reporting
26. We are uniquely positioned to give FQHCs:
CASH, CONTROL and FOCUS ON THE MISSION
26
$
No up front
capital investment
DAR:
38 days
LPCR reduced by
3.73%
12%
increase in collections
%
100% of payment
is success-based
DAR Improvement:
46%
Same day encounter
close: 78%
Provider
documentation
time: 6.7
UDS
reporting
PCMH
accelerator
service
NO FAXES
We’re starting today with the bottom line of it all: It’s really hard to be an FQHC. Though we’re living in the age of “digitization,” FQHCs have more reporting requirements than any other organization.
The FQHC program remains an essential tool for meeting the health care needs of the underserved nationwide. However, the federal program’s sometimes convoluted requirements, coupled with similarly elaborate — and often duplicative — state demands, can test even the most sophisticated organizations.
Bobbie Wunsch, founder and partner of San Anselmo, California-based Pacific Health Consulting group, a firm that provides management consulting to public sector health care entities.
Source: http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/C/PDF%20ClinicsTaleChasingFQHCStatus.pdf
On April 16th, the Medicare Access and CHIP Reauthorization Act (MACRA), H.R. 2 was signed into law, and is the basis for all of these recent changes. While this law permanently repealed the sustainable growth rate (SGR) formula, the new legislation also includes a small addition that has huge repercussions on the Medicare framework for paying physicians.
Sources: http://www.familydocs.org/payment-reform/macra
https://www.acponline.org/advocacy/where_we_stand/assets/macra_handout_need_to_know_2015.pdf
Image source: http://www.healthcarefinancenews.com/news/icd-10-debate-hits-washington-most-prepared-worry-persists
To dive a little deeper, per MACRA, providers will have two Medicare value-based reimbursement options: the Merit-Based Incentive Payment System (MIPS) or Alternative Payment Models (APMs). Put very simply: this bill represents the continued shift toward value-based reimbursement.
The bill proposes that CMS offer a significant incentive for practices to make the move to providing care through, what they’re calling “Alternative Payment Models” or APMs, that are proven to bring about greater levels of care coordination and patient-center health management, such as PCMH. The bill proposes that starting in 2019, providers receive an automatic 5% participation bonus simply for proving that they are participating in an APM.
AAFP - Additionally, the American Association of Family Physicians recommends that providers working in any size practice select option two, an APM such as a PCMH.
Additionally, it is estimated that 75% of FQHCs have achieved NCQA-PCMH Level III Recognition in 2013. Source: http://www.nmfonline.org/file/pclp-project-database/Abraham-Jerry-Paper.pdf
How to run a tight ship on a shoestring budget? With the cloud. Not necessarily with athena but here is what you have to look for, we’ll just use our model as an example today.
Like banking – which is 67% cloud, health care is slowly moving up the evolutionary curve when it comes to technology.
The key aspect when making any technology decision is
What is the economic and performance relationship between my supplier and my organization. Am I paying for a tool or Am I paying for a result. When I win does my supplier win, when I lose does my supplier lose?
How rapidly can my platform evolve with changing business conditions and how much is it going to cost me in terms of human capital and financial capital.
What’s the utility – is the tool set good?
Now let’s talk about where current technologies live on the evolutionary path.
Remind people of our business model:
We are a cloud-based business service and get paid based on results
Software + Knowledge + Work = results
Made immediately available
Complete PMS, EMR & Patient Communications Functions
Web-native, On-demand
Guaranteed availability
Intuitive, easy-to-use
No capital expense
Performance monitoring
Bullets:
Creates new rules for everyone on the Network
Monitors, fixes broken claims
Identifies and helps manage P4P data requirements so get every dollar you qualify for
Formulary checking
Drug /drug interaction
Clinical reminders
Bullets:
Reminder & results calls
Eligibility checking
Claim submission / follow-up
Denial & results handling
Build and maintain free lab & Rx interfaces
Meaningful Use Guarantee
Performance coaching
Handle document mgmt
Add number of closed loop orders
Post payments
Comparative advantage
Doctors shouldn't be doing paperwork - you do what you're best at and tell others what to do that they're best at
Comparative advantage
Doctors shouldn't be doing paperwork - you do what you're best at and tell others what to do that they're best at
Comparative advantage
Doctors shouldn't be doing paperwork - you do what you're best at and tell others what to do that they're best at
We are constantly learning and making changes to better equip FQHCs to win. We know that 93% of FQHCs have adopted an EHR but we also know just how much time using that EHR can take up, adding headaches and frustrations and taking you away from face time with the patient.
Back In the 1990s, Todd Park and Jonathan bush tried to re-imagine the birth experience and expenses in this country as the “Starbucks” of birthing centers.
Took credentialed and skilled midwives to provide a safe, comfortable customer experience for mothers. Didn’t just treat pregnancy as an illness to be eradicated quickly.
Tackle the low-hanging fruit and the glaring inefficiencies in the birthing process.
Received a large portion of referrals from community health centers
Customers loved our service.
Births at our center resulted in C-sections 14% less often than the industry average. Our babies had 40% fewer days in NICU than the industry average.
All of this for less than the cost of giving birth at a hospital
We couldn't survive because we didn't have the infrastructure we needed to get paid.
We changed our business plan to build the information backbone to help yours and others succeed
One study estimated that doctors spend 168.4 million hours on administrative tasks per year while the average time spent with a patient during the exam is eight minutes.
http://www.pnhp.org/news/2014/october/administrative-work-consumes-one-sixth-of-us-physicians’-time-and-erodes-their-mor
The average U.S. doctor spends 16.6 percent of his or her working hours on non-patient-related paperwork, time that might otherwise be spent caring for patients. And the more time doctors spend on such bureaucratic tasks, the unhappier they are about having chosen medicine as a career.
51M patients
110,000 interfaces
EDIs per day?
50B web hit/year
1B electronic transactions/year
How we help FQHCs specifically
We have many FQHC clients just like you
PCMH accelerator program
Level 1 with NCQA requires 35 points and with athenahealth’s 35.5 baseline auto credits, you easily achieve Level 1 just by applying. What this means is, if you remember back to MACRA, this is an automatic earning of that 5% included within MACRA now.
We are one of three vendors offering auto credits in this way but we are the only ones offering so many that you achieve PCMH Level One status right from the start.
Only two other vendors who have any auto –creds
Animation: Automatic
athenaNet reporting supports (Unified Data Set) UDS requirements across all Medicare programs
athena has flexible reporting infrastructure and data warehouse availability to support data elements required for UDS reporting (we don’t have built in UDS, but we track the data)
athena has fields on language, race, ethnicity, veteran status, etc
athena has discrete data on OB/GYN episodes and HIV
We don’t do staffing and cost reporting
Poverty-based sliding scales support indigent care
There are certain tiers of federal poverty guidelines based on income and size of family
Once you enter income and size of family athenaNet auto-calculates their sliding fee (e.g. a 20% discount)
Ability to provide enhanced support for identification of and creation of “wrap around claims”
Other systems do this very poorly
If patient has insurance with a Medicare or Medicaid Managed Care Program (replacement program), we send the claim to the managed care program, but the managed care program may only pay a portion of what would have been paid by Medicare or Medicaid directly.
Athena automatically generates a second claim to send to Medicare or Medicaid to get our clients paid the difference between what the Managed Care company paid and what Medicare/Medicaid would have paid, with a unique revenue code that designates the wrap-around claim.
In some cases you can’t submit the claim for some time after the first submission to the Managed Care Program, so athena has rules to HOLD the claim for a sufficient amount of time.
Claim splitting “rules” reduce work for billing staff
Claim formatting and coding rules reduces requirement to have many CBO staff that have deep understanding of FQHC claim splitting and formatting requirements
With athenahealth, you enter charges one way and the same way for all claims, with a single charge entry screen
You don’t need to remember the crosswalks – athenahealth rules engine automates the crosswalks for our clients
We will split what goes to Part A vs Part B and then determine which provider numbers are needed for Part B vs Part A
The splitting logic is based on procedure code and some other more complex circumstances
Medicare has one standard set of rules for claim splitting across the country, but each Medicaid program may have different rules for their program (derivations of the Medicare program)
(e.g. if the state code 101 is required, the client doesn’t need to remember, athenahealth does it for you)
We do all of your reporting UDS and Dentrix
Results to prove how good we are
DAR improvement for FQHCs = 46%
We are constantly learning through our on-campus FQHC
Whole rooms dedicated to athena teaching that are learning rooms – observations all day long athenanet just built for FQHCs tiger team to continue to improve