The document discusses metrics for evaluating Michigan's Primary Care Transformation Demonstration Project in its second and third years. In year two, the project will measure optimization of care management, quality metrics, and avoidance of high-cost care. Data will come from claims, practice reports, and clinical registry data. Metrics include hiring and training of care managers, notifications of admissions/discharges, and patient registry functionality for chronic illness tracking. The goal for year three is achieving improved quality, experience, and cost through the "Triple Aim."
This document outlines the policies and procedures for Kanartel's Customer Service Department. It defines the department's mission, strategy, and policies. It describes the roles and responsibilities of various positions within the department. It also outlines policies for expenses, employee grievances, salaries, travel, training, performance reviews, vacations, and customer care operations. Specific policies cover non-disclosure of company and customer information. References to other departments indicate some policies refer to separate documents from Human Resources and Finance.
This document summarizes a webinar for the Michigan Primary Care Transformation Demonstration Project. It announces that remaining webinars for 2012 are cancelled but will resume in January 2013. It also announces an upcoming meeting on December 12, 2012 to assess metrics and care management integration from the first year of the project. Various assessments of practice care management capabilities and findings from assessments are discussed.
This document summarizes a webinar for the Michigan Primary Care Transformation Demonstration Project. It discusses six month metrics reporting, including care manager hiring and patient registries. It also outlines plans to assess practices, provide education programs, finalize care management reporting, establish a Patient Advisory Council, and discuss town hall meetings and HEDIS measures for year one.
This document discusses Michigan's Primary Care Transformation Demonstration Project. It outlines the agenda for webinar #10, including discussions on Medicaid and Medicare payments, care managers, project committees and metrics. It then provides details on performance metrics and incentives, care manager roles, clinical quality measures, and expectations for participating medical organizations. The webinar aims to update practices on the project and support development of patient-centered medical home capabilities.
The document advertises the R-Team healthy lifestyle program for kids and teens. The 10-session program teaches healthy eating, exercise, self-esteem and goal setting. Each child receives an individual assessment before starting group sessions. Parents must attend all sessions with their child. Contact and registration information is provided for programs in Madison Heights, Woodhaven and Rochester, Michigan between March 2015 and November 2015.
The document provides an overview of URAC's Patient Centered Health Care Home (PCHCH) Practice Achievement Program. The program aims to recognize primary care practices that deliver coordinated, comprehensive, and patient-centered care through a multi-level achievement process. Practices can earn one of two levels of achievement by meeting standards across modules like access, care management, and quality reporting. The document outlines the program's requirements, standards, and application process.
This document summarizes a webinar for primary care physicians and practice teams from Medical Network One. It recognizes physicians who received Patient-Centered Medical Home designations from BCBSM. It outlines ongoing activities like care teams, collaborative projects, and enterprise-wide initiatives to support practices. These include the CMS MiPCT demonstration project, diabetes and behavioral health programs, care manager training, and organized systems of care. Attendees are asked for input on communication, collaboration, and future initiatives.
This document provides information about care coordination best practices and a Michigan primary care transformation demonstration project. It discusses that Hampton Medical Center received URAC accreditation. It also notes that federal spending reductions went into effect in April 2013. The document outlines metrics for year three, pay for performance details from year end 2012, and upcoming sharing activities and team learning events for practices participating in the demonstration project. It provides refreshers on what care coordination and effective care coordination entail, and discusses promising care coordination interventions and what distinguishes successful models.
This document outlines the policies and procedures for Kanartel's Customer Service Department. It defines the department's mission, strategy, and policies. It describes the roles and responsibilities of various positions within the department. It also outlines policies for expenses, employee grievances, salaries, travel, training, performance reviews, vacations, and customer care operations. Specific policies cover non-disclosure of company and customer information. References to other departments indicate some policies refer to separate documents from Human Resources and Finance.
This document summarizes a webinar for the Michigan Primary Care Transformation Demonstration Project. It announces that remaining webinars for 2012 are cancelled but will resume in January 2013. It also announces an upcoming meeting on December 12, 2012 to assess metrics and care management integration from the first year of the project. Various assessments of practice care management capabilities and findings from assessments are discussed.
This document summarizes a webinar for the Michigan Primary Care Transformation Demonstration Project. It discusses six month metrics reporting, including care manager hiring and patient registries. It also outlines plans to assess practices, provide education programs, finalize care management reporting, establish a Patient Advisory Council, and discuss town hall meetings and HEDIS measures for year one.
This document discusses Michigan's Primary Care Transformation Demonstration Project. It outlines the agenda for webinar #10, including discussions on Medicaid and Medicare payments, care managers, project committees and metrics. It then provides details on performance metrics and incentives, care manager roles, clinical quality measures, and expectations for participating medical organizations. The webinar aims to update practices on the project and support development of patient-centered medical home capabilities.
The document advertises the R-Team healthy lifestyle program for kids and teens. The 10-session program teaches healthy eating, exercise, self-esteem and goal setting. Each child receives an individual assessment before starting group sessions. Parents must attend all sessions with their child. Contact and registration information is provided for programs in Madison Heights, Woodhaven and Rochester, Michigan between March 2015 and November 2015.
The document provides an overview of URAC's Patient Centered Health Care Home (PCHCH) Practice Achievement Program. The program aims to recognize primary care practices that deliver coordinated, comprehensive, and patient-centered care through a multi-level achievement process. Practices can earn one of two levels of achievement by meeting standards across modules like access, care management, and quality reporting. The document outlines the program's requirements, standards, and application process.
This document summarizes a webinar for primary care physicians and practice teams from Medical Network One. It recognizes physicians who received Patient-Centered Medical Home designations from BCBSM. It outlines ongoing activities like care teams, collaborative projects, and enterprise-wide initiatives to support practices. These include the CMS MiPCT demonstration project, diabetes and behavioral health programs, care manager training, and organized systems of care. Attendees are asked for input on communication, collaboration, and future initiatives.
This document provides information about care coordination best practices and a Michigan primary care transformation demonstration project. It discusses that Hampton Medical Center received URAC accreditation. It also notes that federal spending reductions went into effect in April 2013. The document outlines metrics for year three, pay for performance details from year end 2012, and upcoming sharing activities and team learning events for practices participating in the demonstration project. It provides refreshers on what care coordination and effective care coordination entail, and discusses promising care coordination interventions and what distinguishes successful models.
This document provides an overview and updates from the Michigan Primary Care Transformation Demonstration Project meeting on October 31, 2012. It discusses seeking a nomination for the steering committee, new care management reporting requirements, codes and fees for care management services, new data files for participating practices and physicians, the launch of a dashboard with baseline data, an upcoming care manager training program, documenting success stories, and upcoming practice events.
Interoperability the coming merger of clinical and financial dataMaggieLewis
1. Interoperability between clinical and financial data will increase as meaningful use requirements are implemented and healthcare moves towards value-based reimbursement.
2. Success in managing the transition to new technologies and standards like ICD-10, MU stages 2 and 3, and 5010 will require leadership commitment, choosing the right partners, effective communication, and dedicating time to training.
3. Revenue cycle management performance will be more important than ever given upcoming changes, and data-driven reporting and management will be key to navigating changes to coding, compliance, and reimbursement.
The document discusses the transition to value-based care models and accountable care organizations (ACOs). It outlines five core competencies needed for early success in an ACO program like the Medicare Shared Savings Program (MSSP): 1) physician-centered governance, 2) collection and reporting of quality metrics, 3) data analysis and spend identification, 4) developing a post-acute quality provider network, and 5) population management strategies. It provides examples from Methodist Health System's experience in an MSSP ACO.
This slideshow is about P4P model in health care and how it can transform the health care sector. It also talks about what is P4P it origin, budgeting methods, and how can it transform health care
This document provides an executive summary and analysis of key financial and operational metrics for various hospital peer groups. It analyzes metrics such as total profit margin, operating profit margin, labor costs, staffing levels, and accounts receivable collection rates for over 6 years of data across different hospital types. The metrics are stratified into quartiles to benchmark performance from poor to exceptional. Healthcare Management Partners collected this data to help hospitals assess their financial health and performance relative to peers.
Frontline Nursing Performance and Continuious Improvement 2014iCareQuality.us
This document discusses implementing a Continuous Daily Improvement (CDI) program to improve healthcare quality and reduce costs. It advocates converting unstructured work time for frontline staff into structured quality improvement activities. Key points include:
1) CDI programs allow staff to spend 10-15 minute blocks on quality audits, peer reviews and other activities to earn credits while improving care.
2) Results may include improved clinical outcomes, staff engagement, professional growth, and cost-neutral budgets.
3) By redirecting existing education funds to unit-based quality work, organizations can realize savings while boosting performance.
The document summarizes a presentation on updates related to Medicare Advantage. Key points from the presentation include:
1) Increasing reporting requirements in 2010 for Medicare Advantage plans related to care quality measures, medication therapy management, and data validation.
2) New requirements for Medicare Advantage plans to have a model of care that improves health outcomes and care coordination for enrollees.
3) Potential impacts of proposed health care reform legislation on Medicare Advantage, including changes to payments to plans tied to quality bonus payments and competitive bidding.
HR517-B02 Managerial Accounting
Assignment #2
1
ASSIGNMENT #2: COST SUMMARY FOR TRAINING SESSION & ONGOING
EDUCATION
Miller Clinic is a privately owned Naturopathic Clinic in Winnipeg, Manitoba that specializes in
classic Traditional Chinese Medicine (TCM) treatment. As part of a five-year plan, Miller has
recently completed its expansion into four major areas of Winnipeg. It now offers treatment at
locations in Fort Gary, St. Boniface, Tuxedo and North End. In order to maintain consistency in
its services across all four of its locations and offer high-quality treatment, Dr. Miller has
decided to offer training and ongoing education for its team of 87 staff and practitioners.
Management is trying to decide between two methods of Knowledge-Based training and has
asked for your help.
Self-Directed Computer-
Based Distance Training
Classroom Training
Development time*
Initial: five months
Yearly updates: one week
Initial: one month
Yearly updates: one week
Internal developers
Three subject matter experts
(Dr. Miller, his wife and
assistant)
Three subject matter experts
(Dr. Miller, his wife and
assistant)
External developers
Web-based training developer
at $200,000
None
Training population
All primary participants
Maximum fifty participants
per session
Frequency
One time per participant
Presented quarterly;
participants attend as needed
Length
Administrative staff: one day
in total; at leisure
Practitioners: four days in
total; at leisure
Administrative staff: one day
Practitioners: four days
Location
In office or at other location
Rental space at $2,500 per
day all expenses included
* The development time estimated here is based on the fact that the owners have subject matter experts with
experience in developing training curricula and that basic modules will be used in each of the population-specific
training packages. If development time exceeds our estimate, training costs will increase.
If the company decides to offer the classroom training, the staff and practitioners will be paid to
attend the training and will be exempt from performing regular duties. The company estimates
that revenue for four days of normal business practices is approximately $40,000 among the four
locations. At each location, Miller employs two full-time administrative staff who make $200 a
HR517-B02 Managerial Accounting
Assignment #2
2
day and two part-time administrative staff that make approximately $80 a day and work 20 hours
per week (exactly half the hours of the full-time staff). The remainder of Miller’s employees are
practitioners. The practitioners’ average salary is $500 per day. The Millers will be providing
lunch if they decide to implement the classroom training which they budgeted $1000 per day.
Write a report to Dr. Miller explaining which training method you recommend he implement for
his employees ...
The document provides an overview of the University of Utah Community Physician Group (CPG). It discusses how CPG hired consultants to evaluate its current compensation plan and provider feedback. The consultants found weaknesses in the existing plan and areas of consensus for a new plan. The new plan aims to be transparent, incentivize productivity and quality, and establish minimum productivity standards. It uses a 3-tiered methodology based on speciality and guarantees compensation for new and established providers.
This document provides an agenda and details for a webinar about the Medical Network One MiPCT project. The webinar will provide updates on communication plans, self-management training, care manager training and onboarding, patient registries, patient portals, transformation payments, and pay for performance. It will also discuss 2012 launch preparedness activities, participating practices and physicians, implementation plan reviews, the performance incentive program, and 2012 6-month performance metrics.
University of Toledo Medical Center Patient Experience Improvement Strategic ...Ioan Duca
The document outlines UTMC's plan to improve service excellence from 2011-2012. It discusses analyzing performance data, aligning leadership to address issues, selecting engaged employees, and developing a patient-centered culture. The goals are to narrow gaps in outcomes vs experience, engage physicians and staff, and prepare for pay-for-performance programs emphasizing quality and satisfaction.
The 2020 Quality Payment Program Final Rule makes several changes including:
1. Increasing the MIPS performance threshold from 30 to 45 points to avoid a penalty and increasing the exceptional performance threshold from 80 to 85 points.
2. CMS will post 2018 MIPS performance scores on Physician Compare in late 2019 and include minimum, maximum, and final scores.
3. Category weights remain the same for 2020 but must be equally weighted between cost and quality by 2022.
4. The data completeness threshold increases to 70% for all quality measures.
The document summarizes Arbitron India's attempt to implement a Balanced Scorecard approach to human resources management. It outlines goals and key performance indicators in financial, customer, internal process, and learning and growth perspectives. Arbitron India aimed to track strategy implementation across functions using this common framework, with monthly review meetings. Next steps included revisiting metrics, effective communication, and evaluating technology enablers to support the Balanced Scorecard rollout.
The document discusses using metrics and analytics to improve physician practice management at ENT and Allergy Associates. It provides examples of key metrics tracked such as cash collections, charges entered, days in accounts receivable. Metrics are reviewed daily, monthly, and quarterly and shared with staff. The practice uses analytics to evaluate processes, set benchmarks and goals. Physician productivity reports aggregate data on procedures, office visits, audio collections and compare individuals to practice averages. Benchmarking and peer grouping allows practices to track growth and identify opportunities.
Evaluation of Information Systems in Health Care Must be in APA .docxPOLY33
Evaluation of Information Systems in Health Care
Must be in APA format with references
As the new Director of Information Management, you have been tasked with implementing a new clinical information system for pharmacy services at the hospital. The hospital would like to purchase a pharmacy system that will enable physicians to automate orders through Computerized Physician Order Entry (CPOE) in hopes of reducing order delays, improving the legibility of orders, streamlining operations, and ultimately improving patient safety by reducing medication errors. In spite of previous efforts, there has been little movement towards the implementation of the CPOE, and selecting and putting the CPOE into operation are main reasons that you have been hired.
The organization has competent and dedicated hospital leaders who are strongly supportive of the CPOE concept, demonstrating a sound commitment to its implementation. There are also physician champions dedicated to implementing the CPOE and actively involved in influencing other staff physicians to accept the CPOE. These physicians are also ready to facilitate workflow issues involved in using the new system.
This project is comprised of five (5) parts. Refer to the following guidelines, notes, and summaries as you prepare your response. Your Stand-Alone Project responses should be both grammatically and mechanically correct and formatted in the same fashion as the project itself. If there is a Part A, your response should identify a Part A, etc. In addition, you must appropriately cite all resources used in your response and document them in a bibliography using APA style. (300 points) (3 graphical displays, a 15-slide presentation, and an 11–13 page response are required for the combinations of parts A, B, C, D, and E.)
Part A
SWOT Analysis (50 points)
You begin your selection and implementation process by calling a project planning meeting. You take scrupulous notes during the meeting. (A copy of your notes is located at the end of these instructions.)
1.
Based on the discussion during the meeting, perform a SWOT Analysis to define organizational efforts and needs. Create a SWOT matrix using the matrix format located in Lesson 3.
2.
Next, provide a written summary of the SWOT results; be sure to address areas that could pose as risk issues for a successful implementation.
Part B
Request for Proposal (50 points)
The hospital requirements and needs were also discussed during the meeting. Your next step will be to create a generic request for proposal (RFP) that will be sent to all the vendors. Your RFP should consist of the following.
1.
Cover Letter
2.
Proposal Information
3.
A list of questions for vendors. Make sure to include the following topics.
a.
Functional Specifications
b.
Technical Requirements
c.
Implementation Requirements
d.
Systems Costs
Part C
Vendor Comparison (50 points)
You have now received information from several vendors. Y ...
What is the status on ICD-10? In this Infographic I bring you the facts you always wanted to know & 6 foundation blocks for successful ICD-10 implementation
The document discusses using key performance indicators (KPIs) to improve financial performance in dental practices. It recommends measuring important metrics like income per hour, surgery occupancy rates, and numbers of plan patients. These "Tier 1 KPIs" provide insight into how efficiently the practice is operating. Additional "Tier 2 KPIs" like conversion rates, marketing costs, and wait times can also be tracked. Creating a dashboard to monitor KPI trends over 12 months allows practices to identify areas for increased efficiency and profitability.
The document outlines Project LAKSHYA's goals of improving productivity, quality, customer satisfaction and process efficiency at two plants. Key performance indicators are designed for Plant 2 focusing on improved productivity, customer focus, reduced costs, quality improvement, system improvements and innovation. Managers are given objectives in these areas and will form teams to implement action plans. The status review in October 2013 found data collection was in progress. The document also discusses manufacturing system design, strategy, policies, infrastructure and continual improvement initiatives.
This document advertises a study seeking 20 adults aged 35 or older who are at risk of or living with diabetes, have not had formal diabetes education in the past year, regularly use the internet, and can read and speak English, to complete two 20-minute online surveys for $40 total to help improve a diabetes website, with recruitment occurring through November 15, 2014.
This document contains guidelines for the Patient-Centered Medical Home (PCMH) and PCMH-Neighbor programs run by Blue Cross Blue Shield of Michigan (BCBSM). It outlines 14 domains of function that practices must meet capabilities for, such as patient registries, performance reporting, care management, and coordination of care. The document provides details on the required capabilities within each domain, interpretive guidelines, and requirements for verification site visits. It also addresses how specialists can partner with primary care practices through the PCMH-Neighbor program to better coordinate care for shared patients.
This document provides an overview and updates from the Michigan Primary Care Transformation Demonstration Project meeting on October 31, 2012. It discusses seeking a nomination for the steering committee, new care management reporting requirements, codes and fees for care management services, new data files for participating practices and physicians, the launch of a dashboard with baseline data, an upcoming care manager training program, documenting success stories, and upcoming practice events.
Interoperability the coming merger of clinical and financial dataMaggieLewis
1. Interoperability between clinical and financial data will increase as meaningful use requirements are implemented and healthcare moves towards value-based reimbursement.
2. Success in managing the transition to new technologies and standards like ICD-10, MU stages 2 and 3, and 5010 will require leadership commitment, choosing the right partners, effective communication, and dedicating time to training.
3. Revenue cycle management performance will be more important than ever given upcoming changes, and data-driven reporting and management will be key to navigating changes to coding, compliance, and reimbursement.
The document discusses the transition to value-based care models and accountable care organizations (ACOs). It outlines five core competencies needed for early success in an ACO program like the Medicare Shared Savings Program (MSSP): 1) physician-centered governance, 2) collection and reporting of quality metrics, 3) data analysis and spend identification, 4) developing a post-acute quality provider network, and 5) population management strategies. It provides examples from Methodist Health System's experience in an MSSP ACO.
This slideshow is about P4P model in health care and how it can transform the health care sector. It also talks about what is P4P it origin, budgeting methods, and how can it transform health care
This document provides an executive summary and analysis of key financial and operational metrics for various hospital peer groups. It analyzes metrics such as total profit margin, operating profit margin, labor costs, staffing levels, and accounts receivable collection rates for over 6 years of data across different hospital types. The metrics are stratified into quartiles to benchmark performance from poor to exceptional. Healthcare Management Partners collected this data to help hospitals assess their financial health and performance relative to peers.
Frontline Nursing Performance and Continuious Improvement 2014iCareQuality.us
This document discusses implementing a Continuous Daily Improvement (CDI) program to improve healthcare quality and reduce costs. It advocates converting unstructured work time for frontline staff into structured quality improvement activities. Key points include:
1) CDI programs allow staff to spend 10-15 minute blocks on quality audits, peer reviews and other activities to earn credits while improving care.
2) Results may include improved clinical outcomes, staff engagement, professional growth, and cost-neutral budgets.
3) By redirecting existing education funds to unit-based quality work, organizations can realize savings while boosting performance.
The document summarizes a presentation on updates related to Medicare Advantage. Key points from the presentation include:
1) Increasing reporting requirements in 2010 for Medicare Advantage plans related to care quality measures, medication therapy management, and data validation.
2) New requirements for Medicare Advantage plans to have a model of care that improves health outcomes and care coordination for enrollees.
3) Potential impacts of proposed health care reform legislation on Medicare Advantage, including changes to payments to plans tied to quality bonus payments and competitive bidding.
HR517-B02 Managerial Accounting
Assignment #2
1
ASSIGNMENT #2: COST SUMMARY FOR TRAINING SESSION & ONGOING
EDUCATION
Miller Clinic is a privately owned Naturopathic Clinic in Winnipeg, Manitoba that specializes in
classic Traditional Chinese Medicine (TCM) treatment. As part of a five-year plan, Miller has
recently completed its expansion into four major areas of Winnipeg. It now offers treatment at
locations in Fort Gary, St. Boniface, Tuxedo and North End. In order to maintain consistency in
its services across all four of its locations and offer high-quality treatment, Dr. Miller has
decided to offer training and ongoing education for its team of 87 staff and practitioners.
Management is trying to decide between two methods of Knowledge-Based training and has
asked for your help.
Self-Directed Computer-
Based Distance Training
Classroom Training
Development time*
Initial: five months
Yearly updates: one week
Initial: one month
Yearly updates: one week
Internal developers
Three subject matter experts
(Dr. Miller, his wife and
assistant)
Three subject matter experts
(Dr. Miller, his wife and
assistant)
External developers
Web-based training developer
at $200,000
None
Training population
All primary participants
Maximum fifty participants
per session
Frequency
One time per participant
Presented quarterly;
participants attend as needed
Length
Administrative staff: one day
in total; at leisure
Practitioners: four days in
total; at leisure
Administrative staff: one day
Practitioners: four days
Location
In office or at other location
Rental space at $2,500 per
day all expenses included
* The development time estimated here is based on the fact that the owners have subject matter experts with
experience in developing training curricula and that basic modules will be used in each of the population-specific
training packages. If development time exceeds our estimate, training costs will increase.
If the company decides to offer the classroom training, the staff and practitioners will be paid to
attend the training and will be exempt from performing regular duties. The company estimates
that revenue for four days of normal business practices is approximately $40,000 among the four
locations. At each location, Miller employs two full-time administrative staff who make $200 a
HR517-B02 Managerial Accounting
Assignment #2
2
day and two part-time administrative staff that make approximately $80 a day and work 20 hours
per week (exactly half the hours of the full-time staff). The remainder of Miller’s employees are
practitioners. The practitioners’ average salary is $500 per day. The Millers will be providing
lunch if they decide to implement the classroom training which they budgeted $1000 per day.
Write a report to Dr. Miller explaining which training method you recommend he implement for
his employees ...
The document provides an overview of the University of Utah Community Physician Group (CPG). It discusses how CPG hired consultants to evaluate its current compensation plan and provider feedback. The consultants found weaknesses in the existing plan and areas of consensus for a new plan. The new plan aims to be transparent, incentivize productivity and quality, and establish minimum productivity standards. It uses a 3-tiered methodology based on speciality and guarantees compensation for new and established providers.
This document provides an agenda and details for a webinar about the Medical Network One MiPCT project. The webinar will provide updates on communication plans, self-management training, care manager training and onboarding, patient registries, patient portals, transformation payments, and pay for performance. It will also discuss 2012 launch preparedness activities, participating practices and physicians, implementation plan reviews, the performance incentive program, and 2012 6-month performance metrics.
University of Toledo Medical Center Patient Experience Improvement Strategic ...Ioan Duca
The document outlines UTMC's plan to improve service excellence from 2011-2012. It discusses analyzing performance data, aligning leadership to address issues, selecting engaged employees, and developing a patient-centered culture. The goals are to narrow gaps in outcomes vs experience, engage physicians and staff, and prepare for pay-for-performance programs emphasizing quality and satisfaction.
The 2020 Quality Payment Program Final Rule makes several changes including:
1. Increasing the MIPS performance threshold from 30 to 45 points to avoid a penalty and increasing the exceptional performance threshold from 80 to 85 points.
2. CMS will post 2018 MIPS performance scores on Physician Compare in late 2019 and include minimum, maximum, and final scores.
3. Category weights remain the same for 2020 but must be equally weighted between cost and quality by 2022.
4. The data completeness threshold increases to 70% for all quality measures.
The document summarizes Arbitron India's attempt to implement a Balanced Scorecard approach to human resources management. It outlines goals and key performance indicators in financial, customer, internal process, and learning and growth perspectives. Arbitron India aimed to track strategy implementation across functions using this common framework, with monthly review meetings. Next steps included revisiting metrics, effective communication, and evaluating technology enablers to support the Balanced Scorecard rollout.
The document discusses using metrics and analytics to improve physician practice management at ENT and Allergy Associates. It provides examples of key metrics tracked such as cash collections, charges entered, days in accounts receivable. Metrics are reviewed daily, monthly, and quarterly and shared with staff. The practice uses analytics to evaluate processes, set benchmarks and goals. Physician productivity reports aggregate data on procedures, office visits, audio collections and compare individuals to practice averages. Benchmarking and peer grouping allows practices to track growth and identify opportunities.
Evaluation of Information Systems in Health Care Must be in APA .docxPOLY33
Evaluation of Information Systems in Health Care
Must be in APA format with references
As the new Director of Information Management, you have been tasked with implementing a new clinical information system for pharmacy services at the hospital. The hospital would like to purchase a pharmacy system that will enable physicians to automate orders through Computerized Physician Order Entry (CPOE) in hopes of reducing order delays, improving the legibility of orders, streamlining operations, and ultimately improving patient safety by reducing medication errors. In spite of previous efforts, there has been little movement towards the implementation of the CPOE, and selecting and putting the CPOE into operation are main reasons that you have been hired.
The organization has competent and dedicated hospital leaders who are strongly supportive of the CPOE concept, demonstrating a sound commitment to its implementation. There are also physician champions dedicated to implementing the CPOE and actively involved in influencing other staff physicians to accept the CPOE. These physicians are also ready to facilitate workflow issues involved in using the new system.
This project is comprised of five (5) parts. Refer to the following guidelines, notes, and summaries as you prepare your response. Your Stand-Alone Project responses should be both grammatically and mechanically correct and formatted in the same fashion as the project itself. If there is a Part A, your response should identify a Part A, etc. In addition, you must appropriately cite all resources used in your response and document them in a bibliography using APA style. (300 points) (3 graphical displays, a 15-slide presentation, and an 11–13 page response are required for the combinations of parts A, B, C, D, and E.)
Part A
SWOT Analysis (50 points)
You begin your selection and implementation process by calling a project planning meeting. You take scrupulous notes during the meeting. (A copy of your notes is located at the end of these instructions.)
1.
Based on the discussion during the meeting, perform a SWOT Analysis to define organizational efforts and needs. Create a SWOT matrix using the matrix format located in Lesson 3.
2.
Next, provide a written summary of the SWOT results; be sure to address areas that could pose as risk issues for a successful implementation.
Part B
Request for Proposal (50 points)
The hospital requirements and needs were also discussed during the meeting. Your next step will be to create a generic request for proposal (RFP) that will be sent to all the vendors. Your RFP should consist of the following.
1.
Cover Letter
2.
Proposal Information
3.
A list of questions for vendors. Make sure to include the following topics.
a.
Functional Specifications
b.
Technical Requirements
c.
Implementation Requirements
d.
Systems Costs
Part C
Vendor Comparison (50 points)
You have now received information from several vendors. Y ...
What is the status on ICD-10? In this Infographic I bring you the facts you always wanted to know & 6 foundation blocks for successful ICD-10 implementation
The document discusses using key performance indicators (KPIs) to improve financial performance in dental practices. It recommends measuring important metrics like income per hour, surgery occupancy rates, and numbers of plan patients. These "Tier 1 KPIs" provide insight into how efficiently the practice is operating. Additional "Tier 2 KPIs" like conversion rates, marketing costs, and wait times can also be tracked. Creating a dashboard to monitor KPI trends over 12 months allows practices to identify areas for increased efficiency and profitability.
The document outlines Project LAKSHYA's goals of improving productivity, quality, customer satisfaction and process efficiency at two plants. Key performance indicators are designed for Plant 2 focusing on improved productivity, customer focus, reduced costs, quality improvement, system improvements and innovation. Managers are given objectives in these areas and will form teams to implement action plans. The status review in October 2013 found data collection was in progress. The document also discusses manufacturing system design, strategy, policies, infrastructure and continual improvement initiatives.
This document advertises a study seeking 20 adults aged 35 or older who are at risk of or living with diabetes, have not had formal diabetes education in the past year, regularly use the internet, and can read and speak English, to complete two 20-minute online surveys for $40 total to help improve a diabetes website, with recruitment occurring through November 15, 2014.
This document contains guidelines for the Patient-Centered Medical Home (PCMH) and PCMH-Neighbor programs run by Blue Cross Blue Shield of Michigan (BCBSM). It outlines 14 domains of function that practices must meet capabilities for, such as patient registries, performance reporting, care management, and coordination of care. The document provides details on the required capabilities within each domain, interpretive guidelines, and requirements for verification site visits. It also addresses how specialists can partner with primary care practices through the PCMH-Neighbor program to better coordinate care for shared patients.
This document provides updates on quarterly reports that must be submitted to Christine and ensure accuracy. It discusses that MiPCT requested MNO attestation of using the registry, having a quality improvement process, and reviewing data. Finally, it addresses education requirements of three 4-hour sessions on CPT and ICD-9 use, and notes that care management numbers have decreased but the care team remains. An extension of MiPCT is unknown and status quo for now.
This document provides information on various programs and services available for breast and cervical cancer screening, family planning, pregnancy and new mother support, pediatric care, and dental care in Macomb and Oakland counties in Michigan. It lists contact information, eligibility requirements, and services offered for programs like BCCCP, WIC, Medicaid family planning services, food pantries, counseling services, and low-cost dental clinics.
The document describes strategies for developing effective healthcare teams. It discusses establishing care teams with interdisciplinary members and providing training. Key elements of team-based care include protocol-driven processes, care management services, managing care transitions, and engaging patients and families. The document also outlines metrics for measuring utilization, clinical quality, and care processes and explains that implementing a bundle of improvement changes through an interdisciplinary team approach leads to better outcomes.
This document outlines the agenda for a MiPCT Demonstration Project meeting, including: introducing new practice team members, comparing G code billing results between practices, discussing care managers and metrics for 2014. It reviews utilization, clinical quality, and process measures that will be assessed. Learning requirements are outlined for care managers and practice teams, including ICD-10 workshops and a learning collaborative. Participating practice teams are listed and an open discussion is invited.
This document summarizes a focus meeting for PCPs that covered several topics: Medicare risk adjustment, risk scoring, and quality star ratings; the Choosing Wisely campaign; advance care planning; and patient-centered medical homes. It provided details on CMS risk adjustment models, proper medical record documentation for risk adjustment, and ways accurate coding can improve reimbursement and lower member premiums. It also reviewed the STAR bonus program metrics and preventive services. Finally, it discussed introducing advance care planning conversations, documenting patient preferences, and applying advance directives when needed.
This document summarizes a PCP focus meeting that covered several topics: Medicare correct coding initiative, Choosing Wisely campaign, advance care planning, patient-centered medical home designations, organized systems of care, optimizing risk adjustment and stars ratings, and advance directives. It provides details on CMS risk adjustment models, required medical record documentation, acceptable provider types and signatures, case studies, and steps for successful advance care planning.
Behavioral Health Specialist Meeting: Keeping You in the Loopmednetone
The document summarizes key points from a meeting between Medical Network One and behavioral health specialists. It introduced Medical Network One and described its history of collaborating with BCBSM on initiatives like the Physician Group Incentive Program (PGIP), Patient-Centered Medical Home (PCMH), and Organized Systems of Care (OSC). It discussed how collaboration between Medical Network One and behavioral health specialists might work, including developing shared goals and responsibilities. The document also provided an overview of the PCMH, PCMH-Neighborhood, and OSC models, and explained how performance is measured using standards like HEDIS.
This document summarizes a new Medicare Advantage Gain Sharing program offered by Blue Cross Blue Shield of Michigan and Blue Care Network. It provides incentives for providers to improve performance in documentation and coding, utilization, costs, and quality measures. Providers can earn a share of financial gains if they meet education and performance criteria, such as attending training, closing diagnosis code gaps, and improving quality scores and readmission rates. The program compares potential earnings to an alternative diagnosis closure incentive program, paying providers the higher of the two amounts. It includes examples of how earnings are calculated based on members' risk scores and expenses.
The document summarizes key points from a PCP cluster meeting held on November 13, 2013 in Monroe, Michigan. The meeting focused on several topics: Medicare correct coding initiative, Choosing Wisely campaign, advance care planning, patient-centered medical home designations, organized systems of care, and risk adjustment. The risk adjustment portion provided details on CMS risk scoring, hierarchical condition categories, documentation requirements, and a case study example. It also discussed the Medicare Advantage STAR bonus program and its quality measures. Finally, the document covered advance care planning and POLST (Physician Orders for Life-Sustaining Treatment) forms.
This document outlines guidelines for collaboration between primary care and specialty care providers to improve patient care. It defines key terms like patient-centered medical home and discusses different types of care transitions including pre-consultation, formal consultation, complete transfer of care, and co-management. The guidelines establish mutual agreements around maintaining accurate records, safe transfers of care, and adopting a referral system. It provides templates for primary care and specialty care expectations in areas like maintaining records, ordering tests, informing patients, and timely communication. The overall goal is to enhance communication and collaboration between providers through coordinated, patient-centered care.
This document outlines a webinar for the Michigan Primary Care Transformation Demonstration Project. It lists the practices in attendance at the webinar and their scheduled dates for best practice showcases. It also details the learning requirements for care managers and practice units in 2014, including required hours and acceptable training activities. Finally, it lists the practices that participated in a learning event in 2013 and those that were absent.
This document outlines details from a webinar on the Michigan Primary Care Transformation Demonstration Project that took place on October 23, 2013. It lists the practices in attendance and their scheduled dates to present their best practices. It also discusses funding, learning requirements, practice visits, the Choosing Wisely campaign, and the State Innovation Model initiative. The webinar covered key details about the project for the participating primary care practices.
This document outlines a webinar for the Michigan Primary Care Transformation Demonstration Project. It lists the practices in attendance at the webinar and their scheduled dates for best practice visits. It also details the learning requirements for care managers and practice units in 2014. Finally, it notes which practices attended a learning event in 2013 and which were absent.
This document provides information about the Michigan Primary Care Transformation Demonstration Project webinar that took place on September 25, 2013. It lists the practices that attended the webinar and announces an upcoming learning event on September 28th to provide updates to practice teams on new billing codes, advance care planning, and quality improvement processes. It then outlines the schedule for best practice showcases at different practices between September 2013 and April 2014. The document concludes by defining key terms related to the Multi-payer Advanced Primary Care Practice Demonstration, including the purpose and goals of evaluating the demonstration and defining care management.
This document summarizes a webinar for the Michigan Primary Care Transformation Demonstration Project. It lists the attendees of the webinar and recognizes practices that have achieved URAC accreditation or provided appreciation. It outlines quality metrics and goals for care managers, such as engaging patients in care management. It also announces upcoming training events for care managers and practices in July and a challenge to enroll new patients. Time is allotted at the end for open discussion.
The document describes several healthcare organizations' Performance Recognition Programs (PRP) for 2013. It outlines changes made to the programs, including increasing budgets, eliminating pay-as-you-go components, and scoring providers individually on quality measures. Providers can earn payments by meeting quality goals or improving scores by a certain percentage. The programs include measures related to preventative screenings, disease management, and controlling conditions like diabetes and cardiovascular disease. Bonus payments are available for measures like adult BMI tracking and annual medication monitoring.
This referral form provides patient and physician information for referral to Medical Nutrition Therapy and Diabetes Self Management Education. It includes the patient's name, date of birth, contact information, insurance information, and health details like blood pressure, height, and weight. The form indicates a need for either initial or follow-up Medical Nutrition Therapy, and lists possible reasons for referral to Diabetes Self Management Training. Relevant medical details and lab results are requested to better assess the patient's needs. The referring physician's signature and contact information is included.
This document summarizes a webinar for the Michigan Primary Care Transformation Demonstration Project. It recognizes several practices that have received URAC accreditation or will be undergoing upcoming audits. It discusses care manager training programs and liability insurance coverage for care managers. It also outlines various pilot programs and initiatives around topics like shared medical visits, billing and coding seminars, metrics tracking, and increasing physician engagement in transformation efforts.
2. Agenda
Year One metrics
What’s being measured in Year Two
Training
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3. Committee Composition
David Livingston, UnitedHealthcare Community Plan of Michigan
Dr. Paul Ponstein, POM ACO and MCCSI
Carol Callaghan, Michigan Department of Community Health
Ruth Clark, Integrated Health Partners
Dr. Jim Forshee, Molina Healthcare of Michigan
Margaret Mason BCBSM
Betsy Wasilevich, BCBSM alternate
Ewa Matuszewski, Medical Network One
Dr. Kimberlee Coleman, United Physicians (N)
Christina Hildreth, Metro Health PHO (N)
Susan Dolby, MSU Health Team (N)
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4. Goals
Year One (2012): Develop primary care practice
infrastructure including enhanced access, all patient
registry system and embedding care managers within the
primary care practices.
Year Two (2013): Optimize care management, improve
quality metrics and avoid high cost care.
Year Three (2014): Achieve the “Triple Aim” of improved
quality of care, improved patient and primary healthcare
team experience of care and reduced /stabilized costs of
care.
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5. Data Sources
Claims Data: All participating health plans will
submit claims data to the Michigan Data
Collaborative which can be used to calculate
utilization and cost metrics. Claims data will be
calculated for each Health Plan and aggregated
across all contracted plans. Confidence intervals at
95% will be provided.
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6. Data Sources
MiPCT Quarterly Reports: The report will
document updates to the MiPCT Implementation
Plan and progress to date in developing PCMH
infrastructure capabilities and carrying out MiPCT
clinical initiatives.
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7. Data Sources
Self-Reported Data (SRD): PGIP POs currently
report to BCBSM twice a year on their practice’s
PCMH capabilities. BCBSM applies accuracy,
validity and inter-rater reliability checks and
balances to the reports. Financial penalties are
imposed on POs for inaccurate reporting of
capabilities and are reflected proportionally on the
distribution of funds to the PO.
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8. Data Sources
Registry/EHR data: PO’s/practices will submit
requested clinical data from EHR or registry
systems in a specified format to the Michigan Data
Collaborative for calculation of clinical quality
metrics.
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9. 6 Month Ranking
After
PO # MiPCT 30% SD hours Registry MCM MCM CCM CCM
Total Rank
ID Practices appoint appoint. Function hired trained hired trained
8 hr/wk
A 7 10 10 10 5 5 5 5 50.00 1
B >25 10 10 10 5 5 5 5 50.00 1
C <5 10 10 10 5 5 5 5 50.00 1
D <5 10 10 10 5 5 5 5 50.00 1
E 6 10 10 9.3 5 5 5 5 49.30 5
F 15 9.3 10 9.7 5 5 5 5 48.70 6
G 5 10 10 8.8 5 5 5 5 47.80 7
H 6 10 10 8.7 5 5 5 5 47.50 8
I 18 10 9.4 9.2 5 5 5 5 46.50 9
J 11 9.1 9.1 9.8 5 5 5 5 46.73 10
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10. Care Managers Six Month
Moderate MiPCT 1. Number of MCM 1. Number of
care Quarterly hired/ contracted required MCM per
managers report by practices and/or PO
(MCM) PO 2. Number of MCM
trained and 2. Number of MCM hired/ contracted 10 points
working within PO that have
completed the
required training
Complex care MiPCT 1. Number of CCM 1. Number of
managers Quarterly hired/ contracted required CCM per
(CCM) trained report by practices and/or PO
and working PO 10 points
2. Number of CCM
2. Number of CCM in hired/ contracted
PO that have
completed the
required training
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11. Complex Care Manager
12 Months
Complex care MiPCT IM/FP: Number of Number of 15
managers (CCM) Quarterly CMC trained and attributed MiPCT
trained and report providing services to members in PO as
working* and Care practices in PO of June 30, 2012
Manager Plus divided by 5000
Resource (may be a lower
Peds: Number of
Center ratio for pediatric
CMC trained and
Verificati practices
providing services
on compared to
within PO
internal and
family medicine
practices)
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12. Moderate Care Manager
12 Months
Moderate care MiPCT Internal Medicine & Number of attributed 15
managers (MCM) Quarterly Family Practice (IM/FP): MiPCT members as
trained and report Number of MCM of June 30, 2012 in
working trained and providing PO divided by 5000
services to practices in (may be a higher
PO ratio for pediatric
practices compared
Pediatrics (Peds.): to internal and family
Number of MCM medicine practices)
trained and providing
services within PO
(Trained means
completed MiPCT
approved Moderate
Care Manager course
and will be self-reported
by the PO.)
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13. 12 Month Transitions and ED
Notification of MiPCT Number of Number of 15
admissions and Quarterly practices Practices in PO
discharges for at report reporting
least 50% of MiPCT capability
beneficiaries
Primary care Change in PO PCS PO Baseline Rate 10
sensitive ED visits Claims ED visits/1000 (Mean of 2010 &
(NYU algorithm) Data (Baseline Rate – 2011
2012 rate ED visits/1000)
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14. Patient Registry
Electronic patient a. MDC Number of Total number of 5
registry attestation practices with practices in PO
functionality: ability to
Tracking chronic b. Electronic transmit clinical
illness care and report of the data to the Total number of 20
preventive clinical metrics MDC practices in PO
services PLUS
Sum of the
points practices
received for
summary report
of clinical
measures
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15. Access
30% same day SRD Number of Number of 10
appointments report practices in PO practices in PO
(5.7) with capability
Access outside SRD Number of Number of 10
regular hours: report practices in PO practices in PO
12 hr/week (5.5) with capability
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16. Outcome Measures
Utilization (Improvement over baseline) 55
Primary care sensitive ED visits (NYU algorithm) 30
Ambulatory Care Sensitive Hospitalizations 15
Readmissions 10
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17. Outcome Measures
Clinical Quality Metrics - Claims Based ( Improvement over baseline) 15
Diabetes: AIC tests completed
Diabetes: Annual retinal eye exams
Breast Cancer Screening
Cervical Cancer Screening
Well Child Visits - 15 months
Well Child Visits - 3-6 years
Adolescent immunizations
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18. Process Measures
Clinical Quality Metrics – EHR or registry (Pay for Reporting) 15
Diabetes Control (adults): a. AIC < 8
1. Diabetes Poor Control (adults): AIC > 9
1. Diabetes (adults): Blood Pressure < 140/90
1. Cardiovascular Disease (adults): Blood Pressure < 140/90
1. Hypertension (adults): Blood Pressure < 140/90
1. Asthma (ages 5-64): Asthma Action Plan or self-management plan
for
a. all asthma and b. persistent asthma
1. Tobacco Use ( 13 years and older): Percent smokers
1. Obesity - children: BMI Percentile
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19. Process Measures
Notification of hospital admissions & discharges 3
Tracking referrals of high-risk patients to community resources. 3
(10.7)
Follow-up of high-risk with community referrals for next steps. 3
(10.8)
At least one member of PO or practice unit has completed formal 3
training in a nationally or internationally-accredited self-
management support program and works with/educates practice
unit staff members to actively use self-management support
concepts and techniques. (11.8)
Self-management support is offered to all patients with the 3
chronic condition selected for initial focus (based on need,
suitability, and patient interest. (11.2)
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21. One Year Refresher Workshop
Each PU team participates 5 hour training
• Three Sessions: Saturday and weekdays
Each Care Manager participates in training
• Ten Sessions: Saturday and weekdays
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