How Healthcare Reform Is Affecting Radiology - Presented by: http://www.healthimaging.com - speaker: Pam Kassing, MS, Senior Director of Health Policy, American College of Radiology. Presented at the GE Virtual Conference, September 14, 2011.
Dealing With Payers With Physician Driven Cost AndWilliam Cockrell
This is a presentation I just did for MGMA Alabama on how providers should develop their own cost and quality data. Thanks to RealTime Medical Data for their support.
The document discusses the financial incentives and requirements for healthcare providers to demonstrate meaningful use of certified electronic health records (EHRs) under the Medicare and Medicaid EHR incentive programs. It outlines the eligibility criteria for hospitals and eligible professionals to qualify for incentive payments, describes the reimbursement schedules with payment amounts up to $63,750 over 6 years for Medicaid and $44,000 over 5 years for Medicare, and explains the clinical quality reporting requirements and functionality measures that must be met to demonstrate meaningful use in each stage.
Strategic Management Presentation Final PPT Juan Valverde
This document analyzes the strategic position of Presence Mercy Medical Center. It conducts a situation analysis including a remote analysis of the healthcare industry, Porter's 5 forces analysis, and a SWOT analysis. It profiles Presence Mercy and its main competitor, Rush-Copley Medical Center. The document recommends a two-phase strategy. Phase one focuses on controlling costs through technology upgrades and developing physician relationships. Phase two suggests expanding services through new clinics in underserved areas to capture more market share from competitors like Rush-Copley.
The Vicissitudes of Valuing Value--Legal and Valuation Issues Associated with...PYA, P.C.
PYA Principal Carol Carden co-presented “The Vicissitudes of Valuing Value--Legal and Valuation Issues Associated with Value-Based Payment Models” at the 2017 American Health Lawyers Association Physician and Hospitals Law Institute, February 1-3, 2017, in Orlando, Florida.
The presentation addressed:
Emerging alternative payment models (APMs)
The application of fraud and abuse laws and IRS rules to provider network payments
Existing market data and regulatory guidance
Considerations in determining fair market value and commercial reasonableness
The Changing Healthcare System and Impact of MACRAPYA, P.C.
PYA Principal Lori Foley and Consulting Senior Aaron Elias co-presented “The Changing Healthcare System and Impact of MACRA” at the Physician Insurers Association of America’s CEO/COO Meeting.
The Medicare Access & CHIP Reauthorization Act (MACRA) dramatically affected Medicare reimbursements to healthcare providers, as well as provided a new framework for rewarding quality care and reporting on quality measurements. This incentive-based system has the potential not only to change how medicine is practiced, but influence patient perception of care. The presentation will provide the latest information on MACRA implementation, and will detail how the aforementioned changes will impact miscellaneous professional liability insurers.
R&D Med Tech is an Oklahoma LLC that provides EHR software and services to physician practices using Greenway's PrimeSuite EHR. The document discusses the financial incentives available for physicians to adopt EHRs, including stimulus payments up to $44,000 per eligible professional from Medicare and up to $63,750 from Medicaid. It also outlines cost savings practices can see from improved coding, reduced billing costs, and lower malpractice insurance rates that provide doctors with incentives to adopt EHRs.
Population Health Management & Meaningful UsePhytel
The government’s EHR incentive program is designed to transform healthcare delivery and dovetails with other healthcare reform initiatives. Population health management, the goal of these initiatives, requires advanced forms of health IT.
Dealing With Payers With Physician Driven Cost AndWilliam Cockrell
This is a presentation I just did for MGMA Alabama on how providers should develop their own cost and quality data. Thanks to RealTime Medical Data for their support.
The document discusses the financial incentives and requirements for healthcare providers to demonstrate meaningful use of certified electronic health records (EHRs) under the Medicare and Medicaid EHR incentive programs. It outlines the eligibility criteria for hospitals and eligible professionals to qualify for incentive payments, describes the reimbursement schedules with payment amounts up to $63,750 over 6 years for Medicaid and $44,000 over 5 years for Medicare, and explains the clinical quality reporting requirements and functionality measures that must be met to demonstrate meaningful use in each stage.
Strategic Management Presentation Final PPT Juan Valverde
This document analyzes the strategic position of Presence Mercy Medical Center. It conducts a situation analysis including a remote analysis of the healthcare industry, Porter's 5 forces analysis, and a SWOT analysis. It profiles Presence Mercy and its main competitor, Rush-Copley Medical Center. The document recommends a two-phase strategy. Phase one focuses on controlling costs through technology upgrades and developing physician relationships. Phase two suggests expanding services through new clinics in underserved areas to capture more market share from competitors like Rush-Copley.
The Vicissitudes of Valuing Value--Legal and Valuation Issues Associated with...PYA, P.C.
PYA Principal Carol Carden co-presented “The Vicissitudes of Valuing Value--Legal and Valuation Issues Associated with Value-Based Payment Models” at the 2017 American Health Lawyers Association Physician and Hospitals Law Institute, February 1-3, 2017, in Orlando, Florida.
The presentation addressed:
Emerging alternative payment models (APMs)
The application of fraud and abuse laws and IRS rules to provider network payments
Existing market data and regulatory guidance
Considerations in determining fair market value and commercial reasonableness
The Changing Healthcare System and Impact of MACRAPYA, P.C.
PYA Principal Lori Foley and Consulting Senior Aaron Elias co-presented “The Changing Healthcare System and Impact of MACRA” at the Physician Insurers Association of America’s CEO/COO Meeting.
The Medicare Access & CHIP Reauthorization Act (MACRA) dramatically affected Medicare reimbursements to healthcare providers, as well as provided a new framework for rewarding quality care and reporting on quality measurements. This incentive-based system has the potential not only to change how medicine is practiced, but influence patient perception of care. The presentation will provide the latest information on MACRA implementation, and will detail how the aforementioned changes will impact miscellaneous professional liability insurers.
R&D Med Tech is an Oklahoma LLC that provides EHR software and services to physician practices using Greenway's PrimeSuite EHR. The document discusses the financial incentives available for physicians to adopt EHRs, including stimulus payments up to $44,000 per eligible professional from Medicare and up to $63,750 from Medicaid. It also outlines cost savings practices can see from improved coding, reduced billing costs, and lower malpractice insurance rates that provide doctors with incentives to adopt EHRs.
Population Health Management & Meaningful UsePhytel
The government’s EHR incentive program is designed to transform healthcare delivery and dovetails with other healthcare reform initiatives. Population health management, the goal of these initiatives, requires advanced forms of health IT.
This presentation covers the basics of Healthcare domain and the testing challenges faced there off.Good content for people having interest or working in Health Care domain.
Accounting Update Overview with a Healthcare SlantPYA, P.C.
PYA Principal and Director of Audit Services Doug Arnold presented during East Tennessee State University’s 38th Annual Accounting, Auditing, and Tax Updating CPE conference. His presentation covered many recent Accounting Standards Updates, but leaned toward their applications in healthcare.
The document provides an overview of health insurance in India. It defines health insurance and describes what a typical health insurance policy covers, including room and boarding expenses, nursing costs, surgeon fees, and medical treatment costs. It notes that over 80% of Indians lack health insurance coverage. The major types of health insurance policies in India include hospitalization plans, pre-existing disease plans, senior citizen plans, maternity plans, daily cash plans, and critical illness plans. The document also outlines several government-run health insurance schemes in India like RSBY, Ayushman Bharat, and state-specific programs. It concludes with a discussion of public and private agencies involved in providing health insurance in India.
How to Manage Population Health Effectively in Accountable Care OrganizationsPhytel
The Affordable Care Act authorized a Medicare shared-savings program for accountable care organizations, and private payers are also contracting with ACOs. To succeed, ACOs must learn how to manage population health effectively.
Value-Based Payments in Managed Care: The Legal Landscape - Crash Course Webi...Epstein Becker Green
This document discusses value-based payment arrangements in managed care and the applicable legal landscape. It provides an overview of key laws that often apply, including insurance laws, HMO laws, Medicaid reform laws, intermediary network entity laws, antitrust laws, corporate practice of medicine/fee splitting laws, and fraud and abuse laws. Two hypothetical value-based payment arrangements are presented and analyzed in terms of the involved payer, product, provider, payment structure, and applicable laws. The document aims to help navigate the legal issues that vary based on the type of payor, product, provider and payment methodology used in a value-based payment arrangement.
- Medicare's Accountable Care Organization program allows groups of doctors/hospitals to be paid for helping Medicare patients stay healthy. Over 200 organizations are deciding whether to continue in the program.
- New rules proposed by Medicare allow groups to remain in the lowest-risk program for 3 more years or join a new higher-risk/higher-reward program.
- While these groups have saved Medicare money, Medicare has retained more savings than the groups themselves due to the rules of the program. Some experts argue these groups could see higher rewards by taking on more risk through other Medicare programs.
The document summarizes key elements of the Medicare Access and CHIP Reauthorization Act (MACRA), which overhauls Medicare physician payment systems. MACRA establishes a two-track system beginning in 2019: 1) an enhanced fee-for-service model that incorporates quality-based payment incentives through the Merit-based Incentive Payment System (MIPS), and 2) alternative payment models (APMs) that reward value-based care. MIPS assesses providers on clinical quality, resource use, meaningful use of health IT, and clinical practice improvement, with payment adjustments based on a composite performance score. APMs offer additional bonuses to encourage providers to participate in models like accountable care organizations that assume performance risk.
Value-Based Payments and Managed Care Contracting - Crash Course Webinar SeriesEpstein Becker Green
Epstein Becker Green Webinar with Attorney Basil Kim - Value-Based Payments Crash Course Webinar Series - May 31, 2016.
As value-based payment relationships continue to grow in prevalence and complexity, a question remains: How do I effectively capture this arrangement on paper?
Topics include:
* Some of the key strategic questions to deliberate with regard to contracting in a value-based payment relationship
* Considerations for contracting under a value-based payment framework.
http://www.ebglaw.com/events/value-based-payments-and-managed-care-contracting-value-based-payments-crash-course-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Deployment of the Medicare Access and CHIP Reauthorization ActPYA, P.C.
PYA Principal Martie Ross and Senior Manager Graham Fox presented, “Mastering MIPS" at the American College of Healthcare Executives’ Congress on Healthcare Leadership.
Learning objectives included:
Gaining an understanding of MIPS—why it was implemented and how it will impact reimbursement, governance, and strategic planning for healthcare organizations.
Identifying questions organizations must consider during MIPS implementation that will lead to financial and operational success.
This webinar discussed financing options for electronic health record (EHR) adoption. It began with introductions of the panelists and their experience in healthcare and EHRs. The webinar then covered considering the full range of EHR costs, different licensing models, payment structures with EHR vendors, and low-cost financing from banks. Additional funding sources discussed included grants, incentives from CMS, and services from regional extension centers. Tax incentives and malpractice premium relief for EHR users were also reviewed. The webinar concluded with a discussion of the long-term benefits and cost savings of EHR use based on studies.
Transforming the Provider Market: What Pennsylvannia Hospitals Can Learn from...James Case
The Maryland hospitals have gone through an unprecedented transformation in how their payments and operations are regulated. This transformation was not taken lightly and can serve as a guide for hospitals outside the State of Maryland as they look to take on additional financial risk in value-based contracts.
Jerry Miller is the presenter and has over 33 years of experience in EMS and fire. He will discuss ambulance accreditation from CAAS and CAMTS and how it may impact reimbursement. Currently, CAAS does not emphasize accreditation for reimbursement but CAMTS is working with CMS to potentially tie reimbursement to accreditation. Over the next 5 years, accreditation may impact air ambulance reimbursement. MedPAC is studying ambulance reimbursement and larger reform that could include quality issues. Upcoming reimbursement challenges include sequestration cuts, expiration of temporary rate increases, and potential 3.5% loss in Medicare rates.
The document discusses CMS's Chronic Care Management program, which pays providers to coordinate care for Medicare patients with multiple chronic conditions. Key points:
- The CCM program pays providers $42 per patient per month to perform 20 minutes of care management and coordination activities outside of office visits.
- To qualify for CCM, patients must have Medicare fee-for-service and two or more chronic conditions expected to last over a year.
- Eligible providers must obtain patient consent and provide 24/7 access, care management, care coordination, and electronic care plans shared with other providers.
- The program aims to improve outcomes and lower costs for patients with multiple chronic conditions by encouraging coordinated chronic care management between visits
Splash 4 partners tele icu moving beyond the early innings Splash 4 Partners
This document discusses the tele-ICU industry. It defines a tele-ICU as using remote monitoring to provide intensive care support. The document outlines the history and growth of the tele-ICU market from its beginnings in 1998 to present day expanding adoption. It also compares tele-ICU to other acute telemedicine services and discusses limiting factors for telemedicine adoption like reimbursement rates and state licensing.
Splash 4 partners tele icu moving beyond the early inningsSplash 4 Partners
This document discusses the tele-ICU industry. It defines a tele-ICU as using remote monitoring to provide intensive care support. The document outlines the history and growth of the tele-ICU market from its beginnings in 1998 to becoming more widely adopted. It also compares tele-ICU to other telemedicine services and discusses limiting factors for telemedicine adoption like reimbursement rates and state licensing.
Affordable Care Act: Three A’s and the Triple AimPYA, P.C.
The document summarizes key provisions of the Affordable Care Act (ACA) related to expanding health insurance coverage and reforming healthcare delivery. It discusses the ACA's goals of making coverage more available, affordable, and adequate while improving care quality and efficiency. It outlines seven solutions under the ACA to achieve these goals, including establishing health insurance exchanges, imposing penalties on employers and individuals, and Medicaid expansion. It also discusses payment reforms focused on quality and integrated care to achieve the "Triple Aim" of improving patient experience, population health, and per capita costs.
Entering the Final Stretch - Preparing for New Affordable Care Act ObligationsPSOW
This document summarizes a presentation on how the Affordable Care Act will affect emergency medical organizations as employers and providers. Key points include:
- As employers, emergency organizations with 50 or more full-time employees must comply with "pay or play" rules starting in 2015, which require offering affordable health insurance or paying penalties.
- As providers, emergency organizations will face increased fraud enforcement from expanded oversight and penalties under the ACA. The Office of Inspector General will examine Medicare claims data and review transports for medical necessity.
- All non-grandfathered health plans must cover essential health benefits, including emergency transport services. Presenters advise emergency organizations to understand and prepare for new ACA obligations and opportunities.
This document discusses healthcare reform in the United States. It provides background on rising healthcare costs driven largely by chronic conditions. It outlines key provisions and timelines of the Affordable Care Act, including expanding insurance coverage, new taxes and fees, and delivery system reforms focused on value over volume. It also presents data on the impact of reforms in Massachusetts as well as lessons learned around rising costs, physician compensation, and hospital operating margins.
Compliance and Legal Risks in Laborist, Surgicalist, and Hospitalist Arrangem...MD Ranger, Inc.
Have you structured your hospital-based physician contracts to address all aspects of compliance?
Hospitalist agreements involve unique compliance and financial issues, particularly when global payments and advanced practice providers are involved. Risks include indirect compensation, billing and other compliance issues. This presentation will discuss compliance risks and provide guidance on how to structure compliant contracts and business arrangements.
This document provides an overview of McKesson and its history as a healthcare IT vendor. Some key points:
- McKesson is currently the largest healthcare IT vendor by revenue, generating $3.2 billion in 2012.
- The company traces its roots back to 1833 when it was founded to import and sell drugs wholesale.
- In 1963, Walt Huff started his healthcare IT career and later founded HBO, which was acquired by McKesson in 1999 for $14 billion.
- McKesson achieved its current size through numerous acquisitions over the decades, including HBO and other pioneers in the industry.
- The document outlines the upcoming episodes that will provide
Lee Aase presents on bringing social media to healthcare. He discusses Mayo Clinic's experience with social media, starting with use of blogs, YouTube, and Twitter in 2008. An elderly couple's piano playing video on YouTube gained over 8.7 million views after Mayo Clinic shared it. This validated that social media can spread health information widely. Aase advocates using social media as it is inexpensive and patients increasingly use it to research healthcare. He outlines establishing social media policies and champions to gradually expand use. The Mayo Clinic Center for Social Media now leads in applying social media in healthcare.
This presentation covers the basics of Healthcare domain and the testing challenges faced there off.Good content for people having interest or working in Health Care domain.
Accounting Update Overview with a Healthcare SlantPYA, P.C.
PYA Principal and Director of Audit Services Doug Arnold presented during East Tennessee State University’s 38th Annual Accounting, Auditing, and Tax Updating CPE conference. His presentation covered many recent Accounting Standards Updates, but leaned toward their applications in healthcare.
The document provides an overview of health insurance in India. It defines health insurance and describes what a typical health insurance policy covers, including room and boarding expenses, nursing costs, surgeon fees, and medical treatment costs. It notes that over 80% of Indians lack health insurance coverage. The major types of health insurance policies in India include hospitalization plans, pre-existing disease plans, senior citizen plans, maternity plans, daily cash plans, and critical illness plans. The document also outlines several government-run health insurance schemes in India like RSBY, Ayushman Bharat, and state-specific programs. It concludes with a discussion of public and private agencies involved in providing health insurance in India.
How to Manage Population Health Effectively in Accountable Care OrganizationsPhytel
The Affordable Care Act authorized a Medicare shared-savings program for accountable care organizations, and private payers are also contracting with ACOs. To succeed, ACOs must learn how to manage population health effectively.
Value-Based Payments in Managed Care: The Legal Landscape - Crash Course Webi...Epstein Becker Green
This document discusses value-based payment arrangements in managed care and the applicable legal landscape. It provides an overview of key laws that often apply, including insurance laws, HMO laws, Medicaid reform laws, intermediary network entity laws, antitrust laws, corporate practice of medicine/fee splitting laws, and fraud and abuse laws. Two hypothetical value-based payment arrangements are presented and analyzed in terms of the involved payer, product, provider, payment structure, and applicable laws. The document aims to help navigate the legal issues that vary based on the type of payor, product, provider and payment methodology used in a value-based payment arrangement.
- Medicare's Accountable Care Organization program allows groups of doctors/hospitals to be paid for helping Medicare patients stay healthy. Over 200 organizations are deciding whether to continue in the program.
- New rules proposed by Medicare allow groups to remain in the lowest-risk program for 3 more years or join a new higher-risk/higher-reward program.
- While these groups have saved Medicare money, Medicare has retained more savings than the groups themselves due to the rules of the program. Some experts argue these groups could see higher rewards by taking on more risk through other Medicare programs.
The document summarizes key elements of the Medicare Access and CHIP Reauthorization Act (MACRA), which overhauls Medicare physician payment systems. MACRA establishes a two-track system beginning in 2019: 1) an enhanced fee-for-service model that incorporates quality-based payment incentives through the Merit-based Incentive Payment System (MIPS), and 2) alternative payment models (APMs) that reward value-based care. MIPS assesses providers on clinical quality, resource use, meaningful use of health IT, and clinical practice improvement, with payment adjustments based on a composite performance score. APMs offer additional bonuses to encourage providers to participate in models like accountable care organizations that assume performance risk.
Value-Based Payments and Managed Care Contracting - Crash Course Webinar SeriesEpstein Becker Green
Epstein Becker Green Webinar with Attorney Basil Kim - Value-Based Payments Crash Course Webinar Series - May 31, 2016.
As value-based payment relationships continue to grow in prevalence and complexity, a question remains: How do I effectively capture this arrangement on paper?
Topics include:
* Some of the key strategic questions to deliberate with regard to contracting in a value-based payment relationship
* Considerations for contracting under a value-based payment framework.
http://www.ebglaw.com/events/value-based-payments-and-managed-care-contracting-value-based-payments-crash-course-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Deployment of the Medicare Access and CHIP Reauthorization ActPYA, P.C.
PYA Principal Martie Ross and Senior Manager Graham Fox presented, “Mastering MIPS" at the American College of Healthcare Executives’ Congress on Healthcare Leadership.
Learning objectives included:
Gaining an understanding of MIPS—why it was implemented and how it will impact reimbursement, governance, and strategic planning for healthcare organizations.
Identifying questions organizations must consider during MIPS implementation that will lead to financial and operational success.
This webinar discussed financing options for electronic health record (EHR) adoption. It began with introductions of the panelists and their experience in healthcare and EHRs. The webinar then covered considering the full range of EHR costs, different licensing models, payment structures with EHR vendors, and low-cost financing from banks. Additional funding sources discussed included grants, incentives from CMS, and services from regional extension centers. Tax incentives and malpractice premium relief for EHR users were also reviewed. The webinar concluded with a discussion of the long-term benefits and cost savings of EHR use based on studies.
Transforming the Provider Market: What Pennsylvannia Hospitals Can Learn from...James Case
The Maryland hospitals have gone through an unprecedented transformation in how their payments and operations are regulated. This transformation was not taken lightly and can serve as a guide for hospitals outside the State of Maryland as they look to take on additional financial risk in value-based contracts.
Jerry Miller is the presenter and has over 33 years of experience in EMS and fire. He will discuss ambulance accreditation from CAAS and CAMTS and how it may impact reimbursement. Currently, CAAS does not emphasize accreditation for reimbursement but CAMTS is working with CMS to potentially tie reimbursement to accreditation. Over the next 5 years, accreditation may impact air ambulance reimbursement. MedPAC is studying ambulance reimbursement and larger reform that could include quality issues. Upcoming reimbursement challenges include sequestration cuts, expiration of temporary rate increases, and potential 3.5% loss in Medicare rates.
The document discusses CMS's Chronic Care Management program, which pays providers to coordinate care for Medicare patients with multiple chronic conditions. Key points:
- The CCM program pays providers $42 per patient per month to perform 20 minutes of care management and coordination activities outside of office visits.
- To qualify for CCM, patients must have Medicare fee-for-service and two or more chronic conditions expected to last over a year.
- Eligible providers must obtain patient consent and provide 24/7 access, care management, care coordination, and electronic care plans shared with other providers.
- The program aims to improve outcomes and lower costs for patients with multiple chronic conditions by encouraging coordinated chronic care management between visits
Splash 4 partners tele icu moving beyond the early innings Splash 4 Partners
This document discusses the tele-ICU industry. It defines a tele-ICU as using remote monitoring to provide intensive care support. The document outlines the history and growth of the tele-ICU market from its beginnings in 1998 to present day expanding adoption. It also compares tele-ICU to other acute telemedicine services and discusses limiting factors for telemedicine adoption like reimbursement rates and state licensing.
Splash 4 partners tele icu moving beyond the early inningsSplash 4 Partners
This document discusses the tele-ICU industry. It defines a tele-ICU as using remote monitoring to provide intensive care support. The document outlines the history and growth of the tele-ICU market from its beginnings in 1998 to becoming more widely adopted. It also compares tele-ICU to other telemedicine services and discusses limiting factors for telemedicine adoption like reimbursement rates and state licensing.
Affordable Care Act: Three A’s and the Triple AimPYA, P.C.
The document summarizes key provisions of the Affordable Care Act (ACA) related to expanding health insurance coverage and reforming healthcare delivery. It discusses the ACA's goals of making coverage more available, affordable, and adequate while improving care quality and efficiency. It outlines seven solutions under the ACA to achieve these goals, including establishing health insurance exchanges, imposing penalties on employers and individuals, and Medicaid expansion. It also discusses payment reforms focused on quality and integrated care to achieve the "Triple Aim" of improving patient experience, population health, and per capita costs.
Entering the Final Stretch - Preparing for New Affordable Care Act ObligationsPSOW
This document summarizes a presentation on how the Affordable Care Act will affect emergency medical organizations as employers and providers. Key points include:
- As employers, emergency organizations with 50 or more full-time employees must comply with "pay or play" rules starting in 2015, which require offering affordable health insurance or paying penalties.
- As providers, emergency organizations will face increased fraud enforcement from expanded oversight and penalties under the ACA. The Office of Inspector General will examine Medicare claims data and review transports for medical necessity.
- All non-grandfathered health plans must cover essential health benefits, including emergency transport services. Presenters advise emergency organizations to understand and prepare for new ACA obligations and opportunities.
This document discusses healthcare reform in the United States. It provides background on rising healthcare costs driven largely by chronic conditions. It outlines key provisions and timelines of the Affordable Care Act, including expanding insurance coverage, new taxes and fees, and delivery system reforms focused on value over volume. It also presents data on the impact of reforms in Massachusetts as well as lessons learned around rising costs, physician compensation, and hospital operating margins.
Compliance and Legal Risks in Laborist, Surgicalist, and Hospitalist Arrangem...MD Ranger, Inc.
Have you structured your hospital-based physician contracts to address all aspects of compliance?
Hospitalist agreements involve unique compliance and financial issues, particularly when global payments and advanced practice providers are involved. Risks include indirect compensation, billing and other compliance issues. This presentation will discuss compliance risks and provide guidance on how to structure compliant contracts and business arrangements.
This document provides an overview of McKesson and its history as a healthcare IT vendor. Some key points:
- McKesson is currently the largest healthcare IT vendor by revenue, generating $3.2 billion in 2012.
- The company traces its roots back to 1833 when it was founded to import and sell drugs wholesale.
- In 1963, Walt Huff started his healthcare IT career and later founded HBO, which was acquired by McKesson in 1999 for $14 billion.
- McKesson achieved its current size through numerous acquisitions over the decades, including HBO and other pioneers in the industry.
- The document outlines the upcoming episodes that will provide
Lee Aase presents on bringing social media to healthcare. He discusses Mayo Clinic's experience with social media, starting with use of blogs, YouTube, and Twitter in 2008. An elderly couple's piano playing video on YouTube gained over 8.7 million views after Mayo Clinic shared it. This validated that social media can spread health information widely. Aase advocates using social media as it is inexpensive and patients increasingly use it to research healthcare. He outlines establishing social media policies and champions to gradually expand use. The Mayo Clinic Center for Social Media now leads in applying social media in healthcare.
McKesson Case Study: Pharmacy Systems & AutomationForgeRock
Patrick Stromberg, Architect, Pharmacy Systems and Automation, McKesson
Alexey Shmelkin, CISSP, Senior Security Architect, Information Security
Architecture and Services, McKesson
Following a brief update on the usage of ForgeRock products within McKesson, this session will
provide an overview of the integration between EnterpriseRx, a pharmacy management system, and
ForgeRock products. We will cover the challenges specific to the business domain along with a look
at how we got here and where we’re going. The challenges are interesting in that they deal with a
large number of customers, a native (non-browser) client and limited information about end-users.
McKesson Investor/Analyst Day (Part III: Information Solutions)finance2
- Graham King, President of McKesson Information Solutions (MIS), provided an update on MIS's continued operational improvement, strong momentum in the market, and improved financial performance.
- Key highlights included excellent employee and customer satisfaction scores, significant growth in software bookings and backlog, and four consecutive quarters of margin expansion.
- The presentation outlined McKesson's strategy to provide an integrated solution across the continuum of care, leveraging existing modular applications on an open architecture platform.
- Specific solutions discussed included physician access to patient information, comprehensive medication management, and closed-loop medical image management to drive operational efficiencies and improved patient outcomes.
McKesson Information Solutions HIMSS Briefingfinance2
McKesson Information Solutions is presenting on its business update and new product announcements. Customer satisfaction and employee satisfaction are improving based on survey results. Financial performance is strong with increased sales, income, and contracts. The Horizon software is ready for launch with momentum from existing customers. New products being announced at HIMSS include Pre-Service Manager, Horizon Care Access, and Horizon Business Folder to improve efficiency in resource management, revenue cycle, and medical imaging.
McKesson Corporation Investor and Analyst Day Presentationfinance2
This document summarizes the agenda and presentations for McKesson's 2006 Investor Day. The agenda included presentations from John Hammergren, Chairman and CEO, Jeff Campbell, EVP and CFO, Paul Julian, EVP, Group President, and Pam Pure, EVP, President of MPT, followed by a Q&A session. McKesson is well-positioned in growing healthcare services markets and has a track record of strong financial performance. It has leading market positions across its Pharmaceutical Solutions, Medical-Surgical Solutions, and Provider Technologies segments. Healthcare spending and drug consumption are expected to continue rising driven by demographics, with an aging population requiring more medication.
Journal of applied clinical medical physics Vol 14, No 5 (2013)oncoportal.net
The document discusses the importance of CT protocol management and review for ensuring patient safety and image quality. It outlines responsibilities and qualifications for members of the protocol review team, which should include at least a lead radiologist, technologist, and medical physicist. The medical physicist's role involves meeting with the team, performing measurements, and reviewing images and protocols. An effective protocol review process evaluates all exam parameters, pays attention to scanner capabilities, consolidates outdated protocols, and stays up to date with current literature. Regular protocol review is crucial for quality patient care and making full use of CT system capabilities.
This document discusses downcoding and bundling of claims by health insurers, which can reduce physician reimbursement. It provides background on Current Procedural Terminology (CPT) coding, noting that CPT is updated regularly but does not dictate reimbursement amounts. While health insurers must accept CPT codes, they are not required to follow CPT guidelines and can interpret codes differently. The document advises physicians to code correctly but warns that insurers may still improperly downcode or bundle claims as tactics to reduce payments.
This document summarizes a presentation given by William F. Cockrell on strategies for success in healthcare. It discusses trends like the Affordable Care Act, decreasing healthcare costs, Medicare changes including value-based payments and alternative payment models, and commercial payers moving toward accountable care. Examples are given of UnitedHealthcare and Humana increasing accountable care contracts and aligning payments with quality and efficiency.
Stategies for Success in Today's Healthcare Environment - MGMA Birmingham Apr...William Cockrell
This document summarizes a presentation on strategies for success in healthcare given on April 16, 2014. It discusses the evolving healthcare environment including the Affordable Care Act, decreasing healthcare costs, Medicare changes focusing on value-based payments and alternative payment models, and data on Medicare physician payments now being publicly reported. Commercial payers are also moving towards these new models away from traditional fee-for-service.
This document provides an overview and assessment of issues impacting the healthcare environment and medical practices. It discusses key areas medical practices should assess to remain viable, such as participating in incentive plans, pursuing patient-centered medical home certification, and moving to ICD-10. The document also summarizes data on healthcare costs, the Affordable Care Act, Medicare payment reforms like alternative payment models, and changes being made by commercial insurers.
The document discusses emerging value-based healthcare payment models in the US and provides recommendations for stakeholders. It outlines recent legislation like MACRA that aims to shift Medicare payments from fee-for-service to value-based models. MACRA establishes the MIPS program which combines existing quality programs and the APM program which incentivizes participation in alternative payment models. It also describes various CMS pay-for-performance programs focused on readmissions, hospital value, and hospital-acquired conditions. The document concludes with recommendations for stakeholders to collaborate across the healthcare system to effectively transition to value-based models.
This presentation was shared with an audience at the AHLA Fundamentals of Health Law program in November 2008.
It contains some basic coding and compliance information to introduce health lawyers to the coding world including recent hot topics under scrutiny.
Radiologists in the United States are currently facing a dilemma as far as “meaningful use” (MU) of Electronic Health Records (EHRs) is concerned. The American College of Radiology (ACR) IT and Informatics Committee leaders and staff have met the National Coordinator for HIT (ONC) as well as Center for Medicare and Medicaid Services (CMS) staff to discuss the HR incentive program from the point of view of radiologists, on October 13, 2011.
State of the Musculoskeletal Service Line: What's New in 2013 and Beyond?Wellbe
Long a bastion of growth and profitability, the orthopedic service line has historically served as a reliable source of surgical volumes and attractive per case economics for hospitals and health systems.
However, the rate of profitable volume growth is progressively challenged by several recent trends, including soaring implant costs, wavering reimbursement, and intensifying competition, which includes the migration of care to ambulatory centers.
In addition, in the wake of the Patient Protection and Affordable Care Act (PPACA) of 2010, hospitals will increasingly be held accountable for delivering high-quality, low-cost orthopedic care. In this rapidly changing environment, the orthopedic service line will require careful management to ensure its continued success.
This presentation explores the most important business and structural challenges to musculoskeletal healthcare delivery, covering topics such as the impact of healthcare reform; physician alignment tactics; and strategies for organization, staffing, and structure.
Speaker Biographies:
Ms. Krista L. Fakoory, Manager
Ms. Fakoory has been providing healthcare management consulting services since 2006. Her background includes strategic and service line business planning, hospital/physician alignment, provider compensation planning, and merger and acquisition assistance. She has particular expertise in developing comprehensive orthopedic programs, strategic planning for physician-owned ambulatory surgery centers, and designing alignment models between health systems and independent orthopedic surgeons.
Mr. Todd W. Godfrey, Senior Manager
With nearly 15 years of healthcare experience, Mr. Godfrey has a focused background in musculoskeletal services. He regularly advises clients on performance-based incentives between surgeon and health systems as organizations position their musculoskeletal service line to assume risk and manage populations.
The document discusses health care reform and its impact on payment and quality initiatives for anesthesiologists. It summarizes that the health care reform law does not include a permanent fix for Medicare physician payment cuts. It outlines various provisions in the reform law aimed at tying physician payments to quality metrics and cost-effectiveness through programs like value-based purchasing, accountable care organizations, and bundled payments. It also describes the establishment of the Anesthesia Quality Institute and its National Anesthesia Clinical Outcomes Registry which will collect anesthesiology outcomes and practice data to help improve quality.
Clinical Decision Support & Value Strategy for At-Risk PopulationsMick Brown
1. The document discusses models for the successful deployment of clinical decision support (CDS) systems to ensure value in at-risk patient populations.
2. CDS has the potential to impact imaging utilization and costs when effectively integrated into healthcare workflows and championed by local physicians.
3. True utilization management requires coordinated efforts across people, technology, and processes to engage providers and ensure understanding and accountability.
EMR implementation: Money Maker or Bust?
Purpose:
To identify whether EHR implementation will end up costing financially more than it benefits
To identify the recipients of any costs or savings
The document discusses the HITECH Act and the criteria for meaningful use of electronic health records (EHRs) in order to qualify for Medicare and Medicaid reimbursement bonuses starting in 2011. It outlines three stages of meaningful use criteria that providers must meet over multiple years to receive incentive payments. Stage one focuses on basic EHR usage and data capture, while stages two and three emphasize more advanced usage like clinical decision support and electronic data sharing. The criteria become more stringent over time to encourage higher levels of EHR utilization.
FLAACOs 2014 Conference - Cancer Care in an ACO LandscapeMARCYINC
This document provides an overview of cancer care in Accountable Care Organizations (ACOs) presented by Kelly Blair, COO of Oncology Resource Networks. It notes that cancer costs are rising without improved quality. The landscape is evolving towards value-based contracts between payers and providers and more ACOs. Oncology presents challenges for ACOs due to its complexity and costs, but oncologists are well-suited in some ways. The document provides advice on exploring partnerships with like-minded providers and establishing patient-centered care, aligned incentives, evidence-based guidelines, and monitoring performance to improve outcomes and lower costs in high-performing oncology networks.
This document discusses standardizing the use of CPT codes, guidelines, and conventions. It recommends legislating their standard implementation and processing to reduce administrative waste in healthcare billing. Currently, while CPT codes are standardized, guidelines are not, allowing insurers to process claims differently than intended. The document argues that standardizing CPT guidelines as well as codes, like ICD codes, would increase efficiency and transparency for physicians and patients.
The document discusses essential health benefits that must be covered by health plans beginning in 2014 under the Affordable Care Act. It outlines 10 categories of benefits that must be covered, including hospitalization, prescription drugs, and preventive services. It also discusses limiting out-of-pocket costs and proposing approaches to defining the essential benefits package.
Prepping for CCJR: Lessons Learned in Physician Alignment and Bundled PaymentsWellbe
With CMS’ recent announcement of its Comprehensive Care for Joint Replacement (CCJR) payment model and its plan to implement in seventy-five geographic areas, hospitals must be prepared to manage the entire episode of care from the time of surgery through ninety days after discharge. CCJR presents both opportunities and challenges for hospitals. In order to achieve success, organizations must manage their system of care delivery, ensure they are aligned with their physicians and post acute providers, and master the analytics necessary for driving high quality, low cost care.
MedAssets has worked with numerous providers to implement alignment models that bring hospitals and their physicians together, evaluate, identify, and implement changes to the care delivery system to improve quality and decrease cost across the continuum, and employ meaningful analytics for managing an episode of care.
Kevin Lieb, Senior Director for MedAssets’ Physician Alignment Solutions division, will share examples demonstrating how organizations have successfully implemented Episodes of Care. Mr. Lieb will also share examples from both hospital led and specialist led programs and provide lessons learned from these experiences.
This webinar will enable attendees to do the following:
• Identify alignment models within bundled payments and understand their applicability to your organization
• Understand the analytic capabilities necessary for success in a bundled payment environment
• Identify opportunities and strategies for cost reduction and quality improvement
About the Speaker:
Mr. Lieb has more than 20 years of healthcare-related experience focusing on quality improvement, market development and cost reduction initiatives for the hospital provider market. Mr. Lieb has worked for a number of well-known healthcare companies including GE Medical Systems, HCIA and LBA in Denver, Colorado. His responsibilities included healthcare consulting with a focus on process improvement and quality initiatives.
This presentation includes a detailed review of changes and updates discussed to the MDS 3.0 item set effective October 1, 2013. The presentation provides an overview of the most recent MDS 3.0 User’s Manual updates and reviews key elements for MDS coding, which will impact reimbursement based on the Federal Regulations in the FY 2014 Final Rule.
Similar to How Healthcare Reform Is Affecting Radiology, Pam Kassing (20)
Healthcare Leadership Forum’s Evidence at the Center of Care focused on implementing IT and evidence-based medicine in every day practice. This meeting brought together clinical and IT leaders in an interactive environment where attendees learned about best practices for integrating evidence into clinical practice, enabling more efficient, high-quality healthcare delivery.
Nov. 14-15, 2013 | Chicago
Sponsored by: ClinicalKey / Elsevier
Presented by: Clinical Innovation + Technology
Telemedicine expanded access to stroke care in Oregon. A survey found 43% of respondents had access to in-person stroke care, 76% to telemedicine care, and 40% to both. Counties with high telemedicine access had lower uninsured rates and older adult populations compared to counties with low access. Telemedicine reduced the population without access to stroke care from 57% to 20%.
The statin drug market is expected to decline significantly through 2018 due to increased generic competition lowering revenues. Global statin revenues are projected to drop from $20.5 billion in 2011 to $12.2 billion in 2018, while US statin revenues will plunge from $8.4 billion in 2011 to $6 billion in 2018 following the loss of patents for major drugs. The highly competitive generic market and limited new therapies will decrease interest in the statin market.
Step up to bat and practice dictating complex cases a residents guide to effe...TriMed Media Group
Findings:
There is a normal appendix
visualized in the RLQ. The
small bowel appears normal
without evidence of
diverticulum.
The document provides guidelines for effective radiology reporting, noting that residency training focuses
Impression:
little on dictation skills. It highlights the importance of concise, clinically relevant reports that answer the
No evidence of Meckel
diverticulum. Normal exam.
clinical question. The guidelines emphasize organizing findings logically, providing a clear impression, and
focusing reports on the clinical history and diagnosis rather than just describing images.
Radiology Workflow: Recognizing Clinical & Financial Benefits of Implementing...TriMed Media Group
This document summarizes a presentation about implementing an integrated radiology information system (RIS), picture archiving and communication system (PACS), and reporting solution at Rutland Regional Medical Center. The system provides streamlined workflow from patient check-in through report delivery. It has led to improved efficiency through a unified system, faster report turnaround times, reduced transcription needs, better monitoring of metrics, and enhanced collaboration between radiologists and other physicians. The integrated system also allows for improved coding and billing processes as well as cost savings through staffing reductions.
James F. Padbury, MD and Betty R. Vohr, MD give a tour of the neonatal intensive care unit (NICU) at Women & Infants Hospital of Rhode Island. The NICU has multiple family rooms where loved ones can visit patients and staff host family events. All clinical staff carry mobile devices to communicate and receive alerts about patients. Families send thank you cards expressing gratitude to the nurses. The NICU was designed architecturally to feel like one connected space across two floors. High-definition imaging stations are available for doctors to view diagnostic images. Private patient rooms are identical to make navigation easier for staff.
Inside a Private HIE: Clinical, Economic and Operational Successes at The Was...TriMed Media Group
The Washington Health Information Network (WHIN) is a private health information exchange (HIE) that connects The Washington Hospital and physician practices affiliated with the Washington Physician Hospital Organization (WPHO). MobileMD is the backbone of WHIN. Denise Abraham, the health information exchange coordinator for The Washington Hospital, and Charles R. Vargo, executive director of the WPHO, work closely to keep this vital piece of caregiver connectivity alive. WHIN is having a positive impact on patient care and clinical practice by increasing physician knowledge and boosting efficiency by allowing physicians, nursing and key clinical staff secure access to key information such as lab and radiology reports and EKGs. The private HIE has united 13 EMRs from different vendors via interfaces to provide one data repository for enterprise access. Learn why they chose a private HIE, how it has evolved from 2006 until now and what advice they offer to other healthcare systems ready to embark on a private HIE project.
Meaningful Use and Its Impact on Medical Imaging: Part 1 - Presented by http://www.healthimaging.com - invited speaker: Arun Krishnaraj, MD, MPH, Massachusetts General Hospital. Part of the GE Virtual Conference September 14, 2011.
The document discusses different approaches to meeting meaningful use (MU) criteria. It identifies some "wrong ways" like "duck and cover", doing the minimum to get through year one ("one and done"), and just focusing on the money ("take the money and run"). The author advocates a better approach of linking the criteria to seven evidence-based quality improvement projects, plus ensuring patient privacy protections and effective training and communication. While certification can be complicated, the author believes their approach can help hospitals actualize improvements in a meaningful way to qualify for MU incentives.
This document summarizes strategies for clinician adoption after an EHR go-live presented by Dr. Justin Graham. It recommends embedding HIT into organizational strategy, evolving governance from projects to operations, having realistic EHR expectations, setting virtuous workflow cycles, preparing for requests, learning informatics team management, and keeping vision and momentum. Culture change takes time and an engaged clinical leader, informatics team, and communication plan are important for adoption.
This document discusses clinical decision support (CDS), which uses clinical knowledge and patient data to improve healthcare decisions. It outlines several types of CDS interventions like drug interactions checking and standardized order sets. Successful CDS requires delivering the right information to the right person in the right format through the right channel at the right time. Organizations should use CDS strategically to achieve priorities like reducing medical errors. The document provides recommendations for implementing an effective CDS program like gaining leadership support, appointing a champion, and continually communicating the program's value.
This document provides an overview of health information exchange (HIE) in Vermont. It discusses VITL, a non-profit organization that operates the statewide HIE, connecting hospitals, practices, and other providers. It describes how HIE is integrated into Vermont's health reform efforts like the Blueprint for Health, which uses clinical data to support practices' transformation to the patient-centered medical home model and provide population health management. The document also notes some learnings around vendor challenges, interoperability issues, and ensuring HIE sustainability beyond public funding as payment models evolve.
This document discusses communication strategies for an electronic health record implementation project. It emphasizes the importance of communicating clearly and honestly with all stakeholders, including physicians, nurses, and other staff. Effective communication requires understanding different audiences, crafting individualized messages, and selecting the right messengers who are respected within each group. The overall goal of communication is to help stakeholders understand and buy into the changes required to achieve the project's objectives.
The document outlines an agenda for a CMIO Summit on June 10th, 2011. The agenda includes definitions, an overview of LIPIX including its funding and mission, explanations of health information exchange and RHIO, LIPIX's goals, participating providers, technical architecture, use cases, products/services, and strategies for engaging providers. It aims to educate on LIPIX's role in facilitating health information exchange across the region and debunk common myths about HIE.
This document discusses collaboration strategies between the Chief Medical Information Officer (CMIO) and Chief Medical Officer (CMO) at Kings County Hospital. It provides background on Kings County Hospital, which is a 650-bed academic and tertiary hospital within the New York City Health & Hospitals Corporation public hospital system. It then outlines how the CMIO and CMO roles have evolved to focus more on analytics, reporting, and using health IT to improve quality, safety, and achieve regulatory and reform goals like accountable care. Specific examples of collaborations around computerized physician order entry, clinical decision support, and reducing hospital-acquired infections are also provided.
CCHIT provides EHR certification programs including an ONC-ATCB program and their own CCHIT Certified program. They also offer an EHR Alternative Certification for Healthcare Providers (EACH) program to help providers of self-developed or customized EHRs achieve certification. The presentation covered the certification landscape, certification processes, tips for providers, and the future of EHR certification.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
How Healthcare Reform Is Affecting Radiology, Pam Kassing
1. Pam Kassing, MPA, RCC Senior Economic Advisor Economics and Health Policy American College of Radiology How Healthcare Reform is Affecting Radiology September 14, 2011
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Editor's Notes
Partial capitation may be applied to highly functioning ACOs in future
Partial capitation may be applied to highly functioning ACOs in future