This document summarizes a presentation given by Dr. Daniel Hoch on remaining relevant in changing healthcare payment and delivery systems. The presentation discusses new payment models like pay for reporting and pay for performance. It also discusses methods of delivery like accountable care organizations. The goals of the presentation are to help physicians assess readiness for new systems, understand available data, find quality measures, and understand potential roles in medical homes/neighborhoods.
Mgsi -medical billing Company presentationecare India
Welcome to MGSI LLC. We are one of the leading providers of medical billing & coding services. Partner with us to manage your medical bills & revenue cycles.
Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Dr Eileen Pepler, Academic, Researcher and Consultant in the Canadian Healthcare will discuss how NHS England work in chronic disease is being translated into a Canadian context.
Katherine Howell, MBA, BSN, RN, NEA-BC, Senior Vice President and Chief Nurse Executive, Saint Luke's Health System - Presentation delivered at the marcus evans National Healthcare CNO Summit 2016 held in Las Vegas, NV
The Analytic System: Finding Patterns in the DataHealth Catalyst
Dr. Haughom set the stage for this upcoming discussion in his previous webinar, explaining the key components of an effective analytical system that enables self-exploration and learning. In this session Attendees will learn:
How the distinction between random variation and assignable cause variation is critically important to patient care
Creation and application of Statistical Process Control (SPC) charts to:
Monitor process variation over time
Differentiate between assignable cause and random cause variation
Assess effectiveness of change on a given process
Achieve and maintain process stability
How implementing inlier management and creating a collaborative environment will drive continuous improvement
How to identify patterns in data using a live demonstration of advanced analytical tools.
Introducing Health Catalyst University: An Innovative Approach for Accelerati...Health Catalyst
Anyone involved in healthcare knows we need to improve quality and lower costs—but where do you start? And how do you reduce the time it takes to realize improvements after deciding on a course of action? Then there’s the added responsibility of managing the transition to risk-based payment models where the consequences of getting it wrong increase with each passing year.
For these reasons we feel compelled to break from our standard webinar routine and present a new webinar, where we will introduce the Health Catalyst University’s Accelerated Practices (AP) Program, a unique learning experience that has been designed to help you tackle these problems. First, you will hear from Tommy Prewitt, MD, director of the Healthcare Delivery Institute at HORNE LLP. He will share his perspective about the need for change. He will also talk about how programs like ours are critical to surviving and thriving in this new era of healthcare. Then you will hear from Bryan Oshiro, MD, senior vice president and chief medical officer of Health Catalyst. He will explain how the AP Program equips you with the tools and knowledge to mobilize others in accelerating outcomes improvement work and sustaining the gains.
In specific, Tommy Prewitt, MD, will discuss:
The problems the industry is facing
How variations in care delivery impact quality and cost
The value of giving clinicians the right tools to effectively use data to drive outcomes improvement
Sustainable improvements course participants have achieved by attending HORNE’s Advanced Training Program
In specific, Bryan Oshiro, MD, will discuss:
The components required to make a quality improvement training course successful
The need for course participants to apply the science of improvement to course projects in a practical, immersive format
Why leaders need to learn how to understand the nuances of human behavior as a way to affect positive change
The return on investment a quality improvement training program such as Health Catalyst’s Accelerated Practices (AP) Program provides
What attendees of the AP Program will learn
Both presenters are graduates of and proponents for Intermountain’s Advanced Training Program (ATP), a quality improvement program started by Brent James, MD. Their goals with this webinar are to give you greater insight to the problems the industry is facing and a renewed sense of purpose knowing that resources are available to help you through this challenging time.
How To Drive Clinical Improvement Programs That Get Results - HAS Session 20Health Catalyst
Getting accurate data does not improve care unless empowered teams are created with knowledge of how to apply the data. This was the highest-rated breakout session, and the second-highest rated session overall. This was a very hands-on session, using four different “ah ha” experiences to demonstrate key principles for getting clinical improvement results. These experiences included a deal or no deal re-enactment, a popsicle bomb exercise, a water stopping contest, and Paul Revere exercise. Key principles included how to prioritize your clinical improvement programs and cohorts, defining and selecting the most impactful AIM statements, fixing data quality, and defining and rolling out interventions throughout the system.
Mgsi -medical billing Company presentationecare India
Welcome to MGSI LLC. We are one of the leading providers of medical billing & coding services. Partner with us to manage your medical bills & revenue cycles.
Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Dr Eileen Pepler, Academic, Researcher and Consultant in the Canadian Healthcare will discuss how NHS England work in chronic disease is being translated into a Canadian context.
Katherine Howell, MBA, BSN, RN, NEA-BC, Senior Vice President and Chief Nurse Executive, Saint Luke's Health System - Presentation delivered at the marcus evans National Healthcare CNO Summit 2016 held in Las Vegas, NV
The Analytic System: Finding Patterns in the DataHealth Catalyst
Dr. Haughom set the stage for this upcoming discussion in his previous webinar, explaining the key components of an effective analytical system that enables self-exploration and learning. In this session Attendees will learn:
How the distinction between random variation and assignable cause variation is critically important to patient care
Creation and application of Statistical Process Control (SPC) charts to:
Monitor process variation over time
Differentiate between assignable cause and random cause variation
Assess effectiveness of change on a given process
Achieve and maintain process stability
How implementing inlier management and creating a collaborative environment will drive continuous improvement
How to identify patterns in data using a live demonstration of advanced analytical tools.
Introducing Health Catalyst University: An Innovative Approach for Accelerati...Health Catalyst
Anyone involved in healthcare knows we need to improve quality and lower costs—but where do you start? And how do you reduce the time it takes to realize improvements after deciding on a course of action? Then there’s the added responsibility of managing the transition to risk-based payment models where the consequences of getting it wrong increase with each passing year.
For these reasons we feel compelled to break from our standard webinar routine and present a new webinar, where we will introduce the Health Catalyst University’s Accelerated Practices (AP) Program, a unique learning experience that has been designed to help you tackle these problems. First, you will hear from Tommy Prewitt, MD, director of the Healthcare Delivery Institute at HORNE LLP. He will share his perspective about the need for change. He will also talk about how programs like ours are critical to surviving and thriving in this new era of healthcare. Then you will hear from Bryan Oshiro, MD, senior vice president and chief medical officer of Health Catalyst. He will explain how the AP Program equips you with the tools and knowledge to mobilize others in accelerating outcomes improvement work and sustaining the gains.
In specific, Tommy Prewitt, MD, will discuss:
The problems the industry is facing
How variations in care delivery impact quality and cost
The value of giving clinicians the right tools to effectively use data to drive outcomes improvement
Sustainable improvements course participants have achieved by attending HORNE’s Advanced Training Program
In specific, Bryan Oshiro, MD, will discuss:
The components required to make a quality improvement training course successful
The need for course participants to apply the science of improvement to course projects in a practical, immersive format
Why leaders need to learn how to understand the nuances of human behavior as a way to affect positive change
The return on investment a quality improvement training program such as Health Catalyst’s Accelerated Practices (AP) Program provides
What attendees of the AP Program will learn
Both presenters are graduates of and proponents for Intermountain’s Advanced Training Program (ATP), a quality improvement program started by Brent James, MD. Their goals with this webinar are to give you greater insight to the problems the industry is facing and a renewed sense of purpose knowing that resources are available to help you through this challenging time.
How To Drive Clinical Improvement Programs That Get Results - HAS Session 20Health Catalyst
Getting accurate data does not improve care unless empowered teams are created with knowledge of how to apply the data. This was the highest-rated breakout session, and the second-highest rated session overall. This was a very hands-on session, using four different “ah ha” experiences to demonstrate key principles for getting clinical improvement results. These experiences included a deal or no deal re-enactment, a popsicle bomb exercise, a water stopping contest, and Paul Revere exercise. Key principles included how to prioritize your clinical improvement programs and cohorts, defining and selecting the most impactful AIM statements, fixing data quality, and defining and rolling out interventions throughout the system.
Building Analytic Acumen with Less Classroom "Training" and More LearningHealth Catalyst
Many healthcare organizations understand the value of improved analytic acumen, but analytics and improvement literacy training can be arduous, time-consuming, and costly. Furthermore, learning science demonstrates that a one-size training approach is ineffective and fails to meet individual learners’ needs.
Sheila Luster-Avant, interim chief data and analytics officer, Froedtert and the Medical College of Wisconsin and Health Catalyst team members Tom Burton, co-founder, and Jill Terry, chief learning officer, share how health systems such as Froedtert and the Medical College of Wisconsin are leveraging the latest learning science to significantly improve the analytics and improvement literacy of leaders, analysts, and improvement teams for less time and money.
What You’ll Learn
- Why Froedtert and the Medical College of Wisconsin needed a new approach to improve their analytic acumen.
- How advances in neuroscience make learning more scalable in healthcare organizations.
- How providing direction and autonomy helps individuals succeed in learning and their roles.
- Best practices from Froedtert and the Medical College of Wisconsin’s experience that you can apply at your organization.
Remote Healthcare Work: Best Practices amid COVID-19Health Catalyst
With no known end to the COVID-19 social distancing directives, many healthcare organizations are shifting some team members to remote work arrangements. Clinicians offering telehealth services, case managers, as well as administrative, financial, and IT teams and others contributing away from the frontlines of care are candidates to work from home while continuing to support their organization’s operations. Though a shift in normal processes, research has shown that remote workers can be as or more productive as they are in the office setting and often report high levels of job satisfaction. Following best practices for remote-first work will help team members, managers, and organizations transition to and thrive in a distributed setting.
New Ways to Improve Hospital Flow with Predictive AnalyticsHealth Catalyst
Improving hospitalwide patient flow requires an appreciation of the hospital as an interconnected, interdependent system of care. Michael Thompson explores how Cedars-Sinai Medical Center used supervised machine learning to create predictive models for length of stay, emergency department (ED) arrivals, ED admissions, aggregate discharges, and total bed census and leveraged these models to reduce patient wait times and staff overtime and improve patient outcomes and patient and clinician satisfaction.
Learn more about the following topics:
• How to engage leaders up front with the goal of operationalizing analytics.
• What types of machine learning methods best support operationalizing analytics.
• How to operationalize machine learning-driven results to improve patient flow.
Automated, Standardized Reporting of Patient Safety and Quality Measures to E...Edgewater
Edgewater and UPenn presented on "Moving from Volume to Value Based Care" at The World Congress 10th Annual Healthcare Quality Congress, August 2-3, 2012.
SIMUL8 Director of Healthcare, Claire Cordeaux, discusses her experiences of developing and implementing population health strategies in the UK National Health Service, Canada, and Australia.
How to Eliminate the Burden of Provider Quality Measurement: Able HealthHealth Catalyst
Quality measurement is complicated by incomplete data, calculations, visualizations, and workflows. As a result, quality measurement is a significant burden for medical groups. In fact, research that Health Affairs published in 2016 quantified the burden as 785 hours per provider per year.
That's why Health Catalyst is excited to introduce Able Health, the only quality measures solution that’s truly complete.
In this webinar, you’ll learn how Able Health combines all data, measures, visualizations, and workflows (monitor, improve, and submit) into one complete solution. Eliminating the complexity, and therefore the burden, of provider quality measurement means you spend more time improving performance and less time managing data.
You’ll also learn how each of the three core components of the Able Health solution makes more efficient quality measurement possible:
-Measures engine—calculates performance for all provider quality measures for all payer programs using every available data element.
-Performance dashboard—visualizes all performance metrics for daily tracking, prioritization, and internal reporting for all stakeholders, especially physicians.
-Submission engine—submits compliant data to payers.
Reviewing the Healthcare Analytics Adoption Model: A Roadmap and Recipe for A...Health Catalyst
Dale Sanders provides an update on the Healthcare Analytics Adoption Model. Dale published the first version of this model in 2002, calling it the Analytics Capability Maturity Model. The three intentions at that time are the same as they are today: 1) Provide healthcare leaders with a clear roadmap for the progression of analytic maturity in their organization. 2) Provide vendors with a roadmap to meet the analytic needs of clients. 3) Create a common framework to benchmark the progressive adoption of analytics at the industry level.
In 2012, Dale co-published a new version of the Model with Dr. Denis Protti, rebranding it the Healthcare Analytics Adoption Model and purposely borrowing from the widespread adoption of the EMR Adoption Model (EMRAM) published and supported by HIMSS. In 2015, Dale transferred the model under a creative commons copyright to HIMSS to create a vendor-independent industry standard that is now widely applied to support the original three intentions. He continues to collaborate with HIMSS to progress the Model.
During this webinar, Dale:
-Reviews the current state of the Health Catalyst Model, including recent changes that advocate a ninth level—direct-to-patient analytics and AI.
-Shares his observations of maturity in the market.
-Provides an update on the current state of the HIMSS Adoption Model for Analytic Maturity.
Skip Out on the Classroom: How to Transform Learning in the Clinical SettingHealth Catalyst
EHR and data literacy training can be arduous, time-consuming, and costly. Furthermore, learning science demonstrates that a one-size training approach is ineffective and fails to meet individual learners' needs.
Dr. Brent James; Tom Burton, Health Catalyst Co-Founder; Bob Burgin, CEO of Amplifire; and leaders from UCHealth share how they developed an EHR training solution that shortens time to proficiency, significantly reduces costs, and keeps clinicians where they are needed most—on the floor with patients.
During this webinar, you will learn about:
- Advances in learning science that are transforming training and learning in healthcare organizations.
- Evaluating your competency gaps in clinical practices, EHR use, analytics, and improvement literacy.
- Developing a business case for a more effective training approach that could save your organization millions of dollars and deepen analytics, improvement, and clinical learning across your organization.
The Top Five Recommendations for Improving the Patient ExperienceHealth Catalyst
Improving patient satisfaction scores and the overall patient experience of care is a top priority for health systems. It’s a key quality domain in the CMS Hospital Value-Based Purchasing (VBP) Program (25 percent) and it’s an integral part of the IHI Triple Aim. But, despite the fact that health systems realize the importance of improving the patient experience of care, they often use patient satisfaction as a driver for outcomes. This article challenges this notion, instead recommending that they use patient satisfaction as a balance measure; one of five key recommendations for improving the patient experience:
Use patient satisfaction as a balance measure—not a driver for outcomes.
Evaluate entire care teams—not individual providers.
Use healthcare analytics to understand and act on data.
Leverage innovative technology.
Improve employee engagement.
This article also explains why patient experience is so closely tied to quality of care, and why it’s a prime indicator of a healthcare organization’s overall health.
Lean Principles in Healthcare: 2 Important Tools Organizations Must HaveHealth Catalyst
The transition from fee-for-service to value-based reimbursement is driving many healthcare systems to fine-tune processes and work waste out of the system. In the search for quality improvement tools there has been much buzz surrounding lean, touted for its ability to remove waste from processes. Many have tried lean and, failing to achieve any sustainable benefit, are learning that applying lean principles to healthcare can be quite difficult. The lean approach isn’t a magic potion. Sustainable change will never become real without a committed organization dedicated to making it a reality. Lean, or any quality improvement tool, works in healthcare only when it is part of a larger initiative driving real cultural change.
Tap into our integrated system. See how your organization can achieve a new level of care and financial success. Leverage the NextGen Healthcare Ambulatory Ecosystem for your healthcare IT needs.
7 Features of Highly Effective Outcomes Improvement ProjectsHealth Catalyst
There’s a formula for success when putting together outcomes improvement projects and organizing the teams that make them prosper. Too often, critically strategic projects launch without the proper planning, structure, and people in place to ensure viability and long-term sustainability. They never achieve the critical mass required to realize substantial improvements, or they do, but then the project fades away and the former state returns. The formula for enduring success follows seven simple steps:
Take an Accountability Versus Outcomes Focus
Define Your Goal and Aim Statements Early and Stick to Them
Assign an Owner of the Analytics (Report or Application) Up Front
Get End Users Involved In the Process
Design to Make Doing the Right Thing Easy
Don’t Underestimate the Power of 1:1 Training
Get the Champion Involved
Why Healthcare Costing Matters to Enable Strategy and Financial PerformanceHealth Catalyst
According to Moody’s Investment Service Analysis, not-for-profit hospital margins are at an all-time low of 1.6% while the American Hospital Association has found that 30% of all hospitals have negative margins. Financial pressures are continuing to increase in an environment of rising costs, lower payments, an aging population, higher patient responsibility and changing consumer demands. Now more than ever healthcare providers need to have an accurate picture of their costing information to enable precise, strategic decisions that will improve financial performance.
Activity-based costing has the power to do just that. In this webinar Steve Vance, SVP, Professional Services, Health Catalyst explores different costing methodologies and discusses why activity-based costing is the preferable method to manage margins because it directly ties services to their costs. Many healthcare organizations base their costs on generalized drivers such as relative value units (RVUs) through their chargemaster rather than on specific activities associated with their services, leading to inaccurate assumptions and poor decisions.
View this webinar to learn:
- Why activity-based costing should be your core tool for improving financial performance.
- The differences and implications between costing methodologies.
- How to leverage data from an Electronic Data Warehouse (EDW) and automate processes while improving accuracy.
- Ways that you can make strategic decisions using clinical and operational data when tied to costing data.
- Activity-based costing use cases such as contract negotiations, pricing decisions, population health management (PHM), and process improvement efforts
We hope that you will view the webinar and learn from the depth and breadth of Steve’s extensive financial experience.
Building Analytic Acumen with Less Classroom "Training" and More LearningHealth Catalyst
Many healthcare organizations understand the value of improved analytic acumen, but analytics and improvement literacy training can be arduous, time-consuming, and costly. Furthermore, learning science demonstrates that a one-size training approach is ineffective and fails to meet individual learners’ needs.
Sheila Luster-Avant, interim chief data and analytics officer, Froedtert and the Medical College of Wisconsin and Health Catalyst team members Tom Burton, co-founder, and Jill Terry, chief learning officer, share how health systems such as Froedtert and the Medical College of Wisconsin are leveraging the latest learning science to significantly improve the analytics and improvement literacy of leaders, analysts, and improvement teams for less time and money.
What You’ll Learn
- Why Froedtert and the Medical College of Wisconsin needed a new approach to improve their analytic acumen.
- How advances in neuroscience make learning more scalable in healthcare organizations.
- How providing direction and autonomy helps individuals succeed in learning and their roles.
- Best practices from Froedtert and the Medical College of Wisconsin’s experience that you can apply at your organization.
Remote Healthcare Work: Best Practices amid COVID-19Health Catalyst
With no known end to the COVID-19 social distancing directives, many healthcare organizations are shifting some team members to remote work arrangements. Clinicians offering telehealth services, case managers, as well as administrative, financial, and IT teams and others contributing away from the frontlines of care are candidates to work from home while continuing to support their organization’s operations. Though a shift in normal processes, research has shown that remote workers can be as or more productive as they are in the office setting and often report high levels of job satisfaction. Following best practices for remote-first work will help team members, managers, and organizations transition to and thrive in a distributed setting.
New Ways to Improve Hospital Flow with Predictive AnalyticsHealth Catalyst
Improving hospitalwide patient flow requires an appreciation of the hospital as an interconnected, interdependent system of care. Michael Thompson explores how Cedars-Sinai Medical Center used supervised machine learning to create predictive models for length of stay, emergency department (ED) arrivals, ED admissions, aggregate discharges, and total bed census and leveraged these models to reduce patient wait times and staff overtime and improve patient outcomes and patient and clinician satisfaction.
Learn more about the following topics:
• How to engage leaders up front with the goal of operationalizing analytics.
• What types of machine learning methods best support operationalizing analytics.
• How to operationalize machine learning-driven results to improve patient flow.
Automated, Standardized Reporting of Patient Safety and Quality Measures to E...Edgewater
Edgewater and UPenn presented on "Moving from Volume to Value Based Care" at The World Congress 10th Annual Healthcare Quality Congress, August 2-3, 2012.
SIMUL8 Director of Healthcare, Claire Cordeaux, discusses her experiences of developing and implementing population health strategies in the UK National Health Service, Canada, and Australia.
How to Eliminate the Burden of Provider Quality Measurement: Able HealthHealth Catalyst
Quality measurement is complicated by incomplete data, calculations, visualizations, and workflows. As a result, quality measurement is a significant burden for medical groups. In fact, research that Health Affairs published in 2016 quantified the burden as 785 hours per provider per year.
That's why Health Catalyst is excited to introduce Able Health, the only quality measures solution that’s truly complete.
In this webinar, you’ll learn how Able Health combines all data, measures, visualizations, and workflows (monitor, improve, and submit) into one complete solution. Eliminating the complexity, and therefore the burden, of provider quality measurement means you spend more time improving performance and less time managing data.
You’ll also learn how each of the three core components of the Able Health solution makes more efficient quality measurement possible:
-Measures engine—calculates performance for all provider quality measures for all payer programs using every available data element.
-Performance dashboard—visualizes all performance metrics for daily tracking, prioritization, and internal reporting for all stakeholders, especially physicians.
-Submission engine—submits compliant data to payers.
Reviewing the Healthcare Analytics Adoption Model: A Roadmap and Recipe for A...Health Catalyst
Dale Sanders provides an update on the Healthcare Analytics Adoption Model. Dale published the first version of this model in 2002, calling it the Analytics Capability Maturity Model. The three intentions at that time are the same as they are today: 1) Provide healthcare leaders with a clear roadmap for the progression of analytic maturity in their organization. 2) Provide vendors with a roadmap to meet the analytic needs of clients. 3) Create a common framework to benchmark the progressive adoption of analytics at the industry level.
In 2012, Dale co-published a new version of the Model with Dr. Denis Protti, rebranding it the Healthcare Analytics Adoption Model and purposely borrowing from the widespread adoption of the EMR Adoption Model (EMRAM) published and supported by HIMSS. In 2015, Dale transferred the model under a creative commons copyright to HIMSS to create a vendor-independent industry standard that is now widely applied to support the original three intentions. He continues to collaborate with HIMSS to progress the Model.
During this webinar, Dale:
-Reviews the current state of the Health Catalyst Model, including recent changes that advocate a ninth level—direct-to-patient analytics and AI.
-Shares his observations of maturity in the market.
-Provides an update on the current state of the HIMSS Adoption Model for Analytic Maturity.
Skip Out on the Classroom: How to Transform Learning in the Clinical SettingHealth Catalyst
EHR and data literacy training can be arduous, time-consuming, and costly. Furthermore, learning science demonstrates that a one-size training approach is ineffective and fails to meet individual learners' needs.
Dr. Brent James; Tom Burton, Health Catalyst Co-Founder; Bob Burgin, CEO of Amplifire; and leaders from UCHealth share how they developed an EHR training solution that shortens time to proficiency, significantly reduces costs, and keeps clinicians where they are needed most—on the floor with patients.
During this webinar, you will learn about:
- Advances in learning science that are transforming training and learning in healthcare organizations.
- Evaluating your competency gaps in clinical practices, EHR use, analytics, and improvement literacy.
- Developing a business case for a more effective training approach that could save your organization millions of dollars and deepen analytics, improvement, and clinical learning across your organization.
The Top Five Recommendations for Improving the Patient ExperienceHealth Catalyst
Improving patient satisfaction scores and the overall patient experience of care is a top priority for health systems. It’s a key quality domain in the CMS Hospital Value-Based Purchasing (VBP) Program (25 percent) and it’s an integral part of the IHI Triple Aim. But, despite the fact that health systems realize the importance of improving the patient experience of care, they often use patient satisfaction as a driver for outcomes. This article challenges this notion, instead recommending that they use patient satisfaction as a balance measure; one of five key recommendations for improving the patient experience:
Use patient satisfaction as a balance measure—not a driver for outcomes.
Evaluate entire care teams—not individual providers.
Use healthcare analytics to understand and act on data.
Leverage innovative technology.
Improve employee engagement.
This article also explains why patient experience is so closely tied to quality of care, and why it’s a prime indicator of a healthcare organization’s overall health.
Lean Principles in Healthcare: 2 Important Tools Organizations Must HaveHealth Catalyst
The transition from fee-for-service to value-based reimbursement is driving many healthcare systems to fine-tune processes and work waste out of the system. In the search for quality improvement tools there has been much buzz surrounding lean, touted for its ability to remove waste from processes. Many have tried lean and, failing to achieve any sustainable benefit, are learning that applying lean principles to healthcare can be quite difficult. The lean approach isn’t a magic potion. Sustainable change will never become real without a committed organization dedicated to making it a reality. Lean, or any quality improvement tool, works in healthcare only when it is part of a larger initiative driving real cultural change.
Tap into our integrated system. See how your organization can achieve a new level of care and financial success. Leverage the NextGen Healthcare Ambulatory Ecosystem for your healthcare IT needs.
7 Features of Highly Effective Outcomes Improvement ProjectsHealth Catalyst
There’s a formula for success when putting together outcomes improvement projects and organizing the teams that make them prosper. Too often, critically strategic projects launch without the proper planning, structure, and people in place to ensure viability and long-term sustainability. They never achieve the critical mass required to realize substantial improvements, or they do, but then the project fades away and the former state returns. The formula for enduring success follows seven simple steps:
Take an Accountability Versus Outcomes Focus
Define Your Goal and Aim Statements Early and Stick to Them
Assign an Owner of the Analytics (Report or Application) Up Front
Get End Users Involved In the Process
Design to Make Doing the Right Thing Easy
Don’t Underestimate the Power of 1:1 Training
Get the Champion Involved
Why Healthcare Costing Matters to Enable Strategy and Financial PerformanceHealth Catalyst
According to Moody’s Investment Service Analysis, not-for-profit hospital margins are at an all-time low of 1.6% while the American Hospital Association has found that 30% of all hospitals have negative margins. Financial pressures are continuing to increase in an environment of rising costs, lower payments, an aging population, higher patient responsibility and changing consumer demands. Now more than ever healthcare providers need to have an accurate picture of their costing information to enable precise, strategic decisions that will improve financial performance.
Activity-based costing has the power to do just that. In this webinar Steve Vance, SVP, Professional Services, Health Catalyst explores different costing methodologies and discusses why activity-based costing is the preferable method to manage margins because it directly ties services to their costs. Many healthcare organizations base their costs on generalized drivers such as relative value units (RVUs) through their chargemaster rather than on specific activities associated with their services, leading to inaccurate assumptions and poor decisions.
View this webinar to learn:
- Why activity-based costing should be your core tool for improving financial performance.
- The differences and implications between costing methodologies.
- How to leverage data from an Electronic Data Warehouse (EDW) and automate processes while improving accuracy.
- Ways that you can make strategic decisions using clinical and operational data when tied to costing data.
- Activity-based costing use cases such as contract negotiations, pricing decisions, population health management (PHM), and process improvement efforts
We hope that you will view the webinar and learn from the depth and breadth of Steve’s extensive financial experience.
Industry Perspectives and Future Trends in Population HealthRohan DSouza
Presentation on industry perspectives on the future of population health management. This is a talk I gave at the eClinicalWorks National Users Conference in Nashville, TN (2015). With a lot of buzz surrounding pop health programs, I wanted to provide a roadmap on making the switch and succeeding.
Netta Hollings (Programme Manager - Mental Health and Community Care) discusses how you can get the most out of the Maternity Services Data Set (MSDS) and the Child Health Data Sets.
The data sets provide comparative, mother and child-centric data that will be used to improve clinical quality and service efficiency; and to commission services in a way that improves health and reduce inequalities.
Paying health care providers: Getting the incentives right - Divya Srivastava...OECD Governance
This presentation was made by Divya Srivastava, OECD, at the 4th meeting of the Joint DELSA/GOV-SBO Network on Fiscal Sustainability of Health Systems, held in Paris on 16-17 February 2015.
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.
Health IT Summit Houston 2014 - Case Study "EHR Optimization for Organizational Value in a Changing Healthcare Environment"
Luis Saldana, MD, MBA, FACEP
CMIO
Texas Health Resources
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
Three Keys to a Successful Margin: Charges, Costs, and LaborHealth Catalyst
How can cost management and complete charge capture protect and enhance the margin?
In this webinar, we will look at 2024 margin pressures likely to impact your organization’s financial resiliency. This presentation will also share how organizations can move from Fee-for-Service to Value; bringing Cost to the forefront.
Edifecs CJR: don't fumble with your bundle ssEdifecs Inc
Comprehensive Care for Joint Replacement (CJR) opens the door to opportunity for improved joint replacement patient care delivery. With full accountability for both cost and quality for the joint replacement episode, hospitals must share critical data in near real time to align and coordinate the full continuum of post-acute providers. The top complexities Jay Sultan addressed include:
The top complexities Jay Sultan addressed include:
Considerations for entering into contracts with your orthopedic surgeons and other collaborating episode providers
Episode bundle administration and monitoring; gain sharing administration
Real-time data acquisition from collaborating providers
Analytics and reporting, focused care delivery management, and preparation for CMS audits
Whatever burning issues and questions are on your mind
How Northwestern Medicine is Leveraging Epic to Enable Value-Based CarePerficient, Inc.
Value-based care and payment reform are prompting hospitals and healthcare providers to more closely manage population health. Hospitals and health systems rely on technology and data to outline the characteristics of their population and identify high-risk patients in order to manage chronic diseases and deliver enhanced preventative care.
Our webinar covered how Cadence Health, now part of Northwestern Medicine, is leveraging the native capabilities of Epic to manage their population health initiatives and value-based care relationships across the continuum of care.
Our speakers:
-Analyzed how Epic’s Healthy Planet and Cogito platforms can be used to manage value-based care initiatives.
-Examined the three steps for effective population health management: Collect data, analyze data and engage with patients.
-Covered how access to analytics allows physicians at Northwestern Medicine to deliver enhanced preventive care and better manage chronic diseases.
-Discussed Northwestern Medicine’s strategy to integrate data from Epic and other data sources.
Costing for Hospitals - How to arrive at service level cost ?Manivannan S
Costing hospital Services poses serious challenges in identifying the basis of allocation of costs and the allocation itself. This PPT gives you the entire methodology
Webinar: “While You Were Sleeping…Proposed Rule Positioned to Significantly I...PYA, P.C.
You likely know from the headlines that the 2021 Medicare Physician Fee Schedule (MPFS) Proposed Rule slashes payments for surgical specialists. But the impact of the Proposed Rule is far broader, reflecting a fundamental realignment driven by the transition to value-based payments. In our webinar, “While You Were Sleeping…Proposed Rule Positioned to Significantly Impact Physician Compensation,” PYA experts addressed these proposals, helping you understand and prepare for the changes ahead.
Following this presentation, attendees were able to:
Understand how a handful of wRVU changes would alter Medicare reimbursement for nearly all physicians.
Appreciate the operational impact of these changes.
Recognize the challenges to existing physician compensation models.
Identify strategies and tactics to prepare for and manage these impacts.
Presenters include PYA Principals Angie Caldwell, Martie Ross, and Valerie Rock. The webinar took place Thursday, September 10 and was hosted in conjunction with the Florida Hospital Association.
If you have additional questions about the MPFS Proposed Rule and its impact on physician compensation or need assistance with any matter involving physician compensation, valuation, strategy and integration, or compliance, contact a PYA executive below at (800) 270-9629.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
Presentation to Mass Neurologic Association
1. Remaining
Relevant
in
the
Changing
Health
Care
Payment
and
Care
Delivery
Systems
Daniel
Hoch,
Ph.D.,
MD,
FAAN
OutpaAent
Medical
Director
Department
of
Neurology
MassachuseCs
General
Hospital
MassachuseCs
Neurologic
AssociaAon
November
7,
2013
5. How
do
you
squeeze
$
800
billion
out
of
a
system
where
labor
is
the
main
cost?
hronic
condiAons
• Coordinated
care
for
c
• Enhance
horizontal
integraAon
• EMR
adopAon
(as
decision
support
and
for
communicaAon)
• Reduce
hospital
readmissions
• IncenAves
to
reduce
cost,
increase
quality
through
sharing
• Cap
the
rate
of
medical
inflaAon
(1%
over
CPI)
6. Other
Reasons
to
Care?
The
SGR
Fix
(Senate
Finance,
House
Ways
and
Means)
• permanently
repeal
the
SGR
update
• Reform
fee-‐for-‐service
(FFS)
through
– focus
on
value
over
volume
– encourage
parAcipaAon
in
alternaAve
payment
models
(APM)
A
new
“value-‐based
performance
(VBP)
payment
program”
would
be
used
to
adjust
payments
beginning
in
2017.
This
new
VBP
program
essenAally
combines
all
the
current
incenAve
and
penalty
programs
(e.g.,
value-‐based
modifier,
meaningful
use,
PQRS)
into
one
budget-‐neutral
program.
Payments
could
be
increased
or
decreased
significantly,
depending
on
how
well
a
physician
scores
relaAve
to
others
on
a
composite
performance
score
7. SGR
Fix-‐
ConAnued
• Physicians
parAcipaAng
in
certain
alternaAve
payment
models,
including
the
paAent-‐
centered
medical
home,
would
be
exempt
from
the
VBP
program
• HHS
would
publish
uAlizaAon
and
payment
data
for
physicians
on
the
Physician
Compare
web
site
8. Goals
of
this
presentaAon:
• Be
able
to
assess
your
readiness
to
take
part
in
new
payment
and
delivery
systems
• Know
where
to
find
resources
that
can
help
with
this
transiAon
• Understand
the
data
that
is
available
as
part
of
new
care
delivery
systems
• Know
where
to
find
quality
measures,
their
role,
and
how
you
can
use
them
• Understand
potenAal
roles
for
your
pracAce
in
medical
homes/neighborhoods,
and
how
to
add
value
to
that
collaboraAon
• Understand
the
role
of
paAent
engagement
in
these
new
processes
of
care
9. New
Payment
Models
Pay
for
reporAng
Pay
for
performance
Method
of
Delivery
ACOs
• Hospital
Created
• Physician
Created
• Insurer
Founded
• CMS
inspired
Shared
Savings
ACO-‐like
Bundled
payments
CapitaAon
New
PracAce
Models
• PCMH
• PCMH-‐N
10. Gemng
Ready-‐
Look
Around
At
What
Is
Happening
In
Your
Area
• There
are
almost
certainly
novel
pracAce
and
payment
efforts
in
your
area.
Find
out
about
them.
– How
many
faciliAes
– How
many
clinicians
– Primary
Care
vs.
specialists
• Governance
– Are
specialists,
specifically
neurologists,
engaged
in
leadership
– Has
the
organizaAon
or
pracAce
reached
out
to
neurologists
• What
is
the
role
of
payers
– Are
there
exisAng
collaboraAve
care
models
with
payers
• Are
other
Neurologists
in
the
area
taking
part
in
the
new
models
11. Consider
Your
Role
In
New
Models
• What
are
the
proposed
or
exisAng
new
roles.
–
–
–
–
How
will
the
neurologist
be
integrated
into
the
new
model
Will
the
processes
of
care
be
a
big
change
Is
there
an
expected
Ame
table
Are
some
neurologists
already
changing
pracAce
processes
• Possible
roles
• Curbside
consultaAon/Pre-‐consultaAon
(telephone,
email,
other)
• Teleneurology
• On
or
off
site
collaboraAve
care
• Do
you
have
to
work
with
a
hospital?
If
not,
how
will
your
pracAce
change?
12. Assess
Your
Value
to
the
Community
Consider
paAent
and
physician
surveys.
Determine
your
market
share.
Do
you
have
outcome
measurements?
What
is
your
relaAonship
to
the
hospital
(s)
What
is
your
primary
care
group
referral
base?
• What
is
the
exisAng
technology
infrastructure
that
you
contribute?
•
•
•
•
•
13. Value
=
Cost/Quality
New
models
will
be
Value
based.
• You
can
reduce
costs
without
reducing
quality
• You
can
increase
quality
without
increasing
costs
It
will
be
excepAonally
difficult
to
integrate,
collaborate
and
increase
value
without
shared
data
• EHR,
outcomes
measurement
and
cost
accounAng
systems
must
support
the
new
mode
relaAonship
between
providers.
14. You
Have
An
Impact
On
Value
• Tests
–
guidance
to
care
team
on
appropriateness
of
studies
• UAlizaAon-‐
Is
a
given
test
or
intervenAon
necessary
• PopulaAon
management:
– PotenAal
model
in
the
way
generalists
have
worked
together
with
endocrinologists
on
diabetes
management
– Registries
15. Quality
Will
be
Measured
and
Used
to
Determine
Value
• NaAonal
push
for
meaningful
outcomes
measures,
not
process
measures
•
AAN
must
idenAfy
meaningful
paAent
outcomes
•
Neurologists
must
take
accountability
for
helping
paAents
reach
meaningful
outcomes
16. Payment
will
be
Modified
Based
on
Value
Quality
Score
§ Payment
adjustment
to
begin
in
2017
for
all
providers
(based
on
2015
reporAng
data)
– Certain
ACOs
excepted
• Quality
of
care
is
a
composite
score
– CombinaAon
of
quality
measures
•
•
•
•
•
•
Clinical
care
PaAent
experience
PaAent
safety
Care
coordinaAon
Efficiency
PopulaAon/Community
Health
• Assigned
a
level
of
high,
average,
or
low
quality
• Measured
against
naAonal
mean
Modified
From
J.
Fritz
and
D.
Evans,
2012
17. Payment
will
be
Modified
Based
on
Value
Cost
Score
• Total
costs
• Total
costs
for
beneficiaries
with
specific
condiAons
(COPD,
heart
failure,
coronary
artery
disease,
diabetes)
• Assigned
a
level
of
high,
average,
or
low
• Measured
against
naAonal
mean
Modified
From
J.
Fritz
and
D.
Evans,
2012
18. Value-‐Based
Payment
Modifier
• For
Groups
of
25
or
more
• Quality
Aers
– 9
combinaAons
– VBPM
ranges
from
2%
to
-‐1%
Low
cost
Average
cost
High
cost
High
quality
+2.0x*
+1.0x*
+0.0%
Average
quality
+1.0x*
+0.0%
-‐0.5%
Low
quality
+0.0%
-‐0.5%
-‐1.0%
19. The
AAN
has
an
Aggressive
Program
to
IdenAfy
Quality
Measures
• AAN
has
embarked
on
an
intensive
program
to
develop
quality
measures
– Measures
available
now:
DemenAa,
Parkinson’s
Disease,
Epilepsy,
Stroke
– Measures
available
in
2013
-‐
ALS,
Distal
Symmetric
Neuropathy
– Measures
available
in
2014-‐
Headache,
Muscular
Dystrophies,
update
to
PD
– Measures
available
in
2015
–
MS,
update
to
Epilepsy
• See
hCp://www.aan.com/go/pracAce/quality/
measurements
20. Federal
Programs
Encourage
Quality
Measurement
The
AAN
has
requested,
and
views
as
criAcal,
the
inclusion
of
neurologist
developed
measures
• Meaningful
Use
Stage
2
– DemenAa
CogniAve
Assessment
Physician
Quality
ReporAng
System
(PQRS)
Applicable
neurology
measures
for
2013
reporAng:
• Epilepsy
–
3
individual
measures
for
claims
or
registry
reporAng
• DemenAa
–
9
measures
in
group
for
claims
or
registry
reporAng
• Parkinson’s
disease
–
6
measures
in
group
for
registry
only
reporAng
• Sleep
–
4
measures
in
group
for
registry
only
reporAng
• Stroke
–
5
InpaAent
measures
for
claims
or
registry
reporAng
• Low
back
pain
–
4
measures
in
group
for
claims
or
registry
reporAng
21. ReporAng
is
Being
Simplified
UnAl
this
year,
quality
reporAng
as
part
of
Meaningful
Use
and
under
PQRS
were
not
well
coordinated.
BUT
• StarAng
in
2013,
you
may
saAsfy
the
meaningful
use
Clinical
Quality
Measures
by
parAcipaAng
in
the
PQRS
–Medicare
EHR
incenAves
pilot.
• In
2014
the
two
quality
reporAng
systems
will
have
essenAally
merged,
– MU
and
PQRS
will
have
overlapping
measures
– PQRS
and
MU
will
share
a
reporAng
mechanism.
22. Quality
ReporAng
Is
Local
as
Well
AAN
has
a
partnership
with
CE
City
to
report
measures
through
a
registry
– The
2013
sets
were
live
in
late
May
– CE
City
-‐
hCp://info.cecity.com/about.html
– Registry
info
hCps://aan.pqriwizard.com/default.aspx
• All
payers
have
quality
reporAng
programs
that
feed
into
their
pay-‐for-‐performance
or
value-‐based
contracAng
programs.
– AAN
Staff
are
reviewing
the
cost
and
quality
measures
being
used
in
private
payer
programs,
– MeeAng
with
private
payers
to
understand
their
programs
– AAN
will
have
a
resource
for
members
that
outlines
the
cost
and
quality
metrics
used
in
programs
by
Fall
2013.
Based
on
the
latest
reports
available,
in
2011,
only
20.8%
of
eligible
neurologists
parAcipated
in
PQRS.
23. The
Choosing
Wisely
Campaign
Engages
PaAents
in
Quality
• A
campaign
to
make
paAents
AND
physicians
aware
of
some
common
procedures
that
are
clearly
of
liCle
value
• The
AAN
suggesAons
for
neurologic
care
– EEGs
are
not
helpful
in
headache
– CaroAd
US
should
not
be
done
in
simple
syncope
(no
other
associated
signs
or
symptoms)
– Do
not
use
bubalbital
or
opioids
in
migraine
except
as
a
last
resort
– Don’t
prescribe
interferon-‐beta
or
glaAramer
acetate
to
paAents
with
disability
from
progressive,
non-‐relapsing
forms
of
mulAple
sclerosis.
– Don’t
recommend
CEA
for
asymptomaAc
caroAd
stenosis
unless
the
complicaAon
rate
is
low
(<3%)
24. You
Should
be
Engaged
in
ReporAng
AND
CreaAng
Metrics
• There
will
be
opportuniAes
to
shape
local
efforts
to
improve
quality
– Payers
want
to
know
that
efforts
are
underway
to
measure
and
improve
quality
– Internal
efforts
in
large
groups
may
rely
on
unique
process
or
outcome
measures
and
reporAng
Examples-‐
– Timely
communicaAon
to
referring
physicians
– Wait
Ames
for
an
appointment
– Average
wait
once
in
the
doctors
office
– And
many
more…
25. These
Changes
in
Healthcare
Require
New
PracAce
RelaAonships
• The
PaAent
Centered
Medical
Home
(PCMH)
exemplifies
many
of
the
ideas
that
will
guide
new
relaAonships
criAcal
to
the
future
payment
and
delivery
systems
– Pa:ent
Centered-‐
RelaAonship
based,
with
aCenAon
to
the
whole
person
– Comprehensive
care-‐
The
Primary
care
home
will
meet
a
majority
of
the
paAents
medical
and
mental
health
needs
– Coordinated
care-‐
engaging
with
all
parts
of
the
health
care
system
from
specialists
to
hospitals
and
nursing
homes
– Accessible
services-‐
shorter
wait
Ames,
in-‐person
and
electronic
availability.
– Quality
and
Safety-‐
commitment
to
measurement
of
quality
and
process
improvement,
use
of
decision
support
and
evidence-‐based
pracAce.
26. Specialists
Will
Be
Part
Of
The
Medical
Home
Neighborhood
• Specialists
can
work
together
with
the
PCMH
in
many
possible
ways.
– TradiAonal
ConsultaAon
– Off-‐site
collaboraAve
care
– On-‐site
collaboraAve
care
– Principle
care
– The
NCQA
has
developed
a
set
of
principles
for
the
PCMH
neighbor
hCp://ow.ly/kYHlx
27. Greater
CommunicaAon
and
CollaboraAon
Off-‐Site
• Neurologist
is
available
by
phone,
email,
specialized
IT
portal.
– Curbside
or
“pre
consultaAon”
may
be
all
that
is
needed
– PCP/team
ozen
managed
meds,
intervenAon
– Complexity
and
comfort
zone
of
PCPs
drive
process.
On-‐site
• Embedded
with
the
PCMH
– More
real-‐Ame
interacAons
– Great
opportunity
for
educaAon
– Co-‐management
A
“stepped
approach”
may
dictate
who
manages
the
paAent
in
either
model.
28. “Principle
Care”
May
Be
a
Model
for
Some
PaAents/Neurologists
Neurologist/Team
serve
as
the
principle
care
providers
• Response
to
the
younger,
otherwise
healthy
paAent
who
feels
they
only
need
a
neurologist.
– MS,
Epilepsy,
etc.
PCP
is
the
“neighbor”
• The
neurology
pracAce
will
need
addiAonal
resources
to
help
with
tasks
that
PCMH
teams
may
normally
do
• Neurologist
will
want
to
have
experience
with
populaAon
management
concepts
As
paAent
ages,
and
health
issues
expand,
PCP
becomes
the
“home”,
Neurologist
the
“Neighbor”
29. Providing
Principle
Care
as
a
“Medical
Home”
Will
Not
Be
Easy
•
Access
and
ConAnuity
–
– Azer
hours
and
electronic
access
– Provide
culturally
and
linguisAcally
appropriate
services
•
IdenAfy
and
Manage
PaAent
PopulaAons
–
•
Plan
and
Manage
Care
–
– Registries
to
proacAvely
remind
paAents
of
overdue
care
– Implement
evidence-‐based
guidelines
using
point-‐of-‐care
reminders
– IdenAfy
high
risk
paAents
– Manage
medicaAons
•
Provide
Self-‐Care
Support
–
–
–
–
–
Provide
educaAonal
resources
IdenAfy
and
refer
to
community
resources
Provide
self-‐management
tools
and
plans
Include
paAents
and
their
families
•
Track
and
Coordinate
Care
–
•
Measure
and
Improve
Performance
–
– tesAng
and
referral
tracking
– managing
care
transiAons
– Quality
metrics
and
reporAng
– Include
the
paAent
experience
of
care
30. The
Way
You
Work
With
Pateints
Will
Change
• In
addiAon
to
new
professional
relaAonships
and
payment
models,
there
will
be
new
relaAonships
with
paAents
• “Engagement”
– Partnering
with
paAents
so
that
they
are
drivers
of
their
care,
rather
than
passive
passengers
• There
are
many
organizaAons
that
can
help
– Consumers
Advancing
PaAent
Safety
• hCp://www.paAentsafety.org/
– Informed
Medical
Decisions
FoundaAon
• hCp://informedmedicaldecisions.org/
– InsAtute
for
PaAent
and
Family
Centered
Care
• hCp://www.ipfcc.org/
– Society
for
ParAcipatory
Medicine
• hCp://parAcipatorymedicine.org/
31. Most
Medical
Care
Occurs
Outside
the
Office
or
Hospital
Ferguson’s
inverted
pyramid
32. Why
You
Should
Collaborate
with
PaAents
• PaAents
are
already
collaboraAng
with
each
other,
and
doctors!
– They
are
online
in
vast
numbers
– They
talk
to
each
other
online
– They
do
research
online
– They
include
medical
professionals
in
their
social
networks
(even
if
we
don’t
know
it)
– Some
rate
doctors
and
hospitals.
– Almost
70%
feel
that
coordinaAon
of
care
is
a
problem,
30%
feel
it
is
a
major
problem.
33. The
Pew
Internet
Project
Finds:
• 34%
of
Internet
users
have
read
descripAons
of
other
people’s
experience
with
health
• 25%
of
Internet
users
have
watched
health
related
videos
online.
• 24%
of
Internet
users
have
looked
up
informaAon
about
drugs
online
• 18%
of
Internet
users
have
looked
for
other
paAents
with
their
concerns
• 16%
of
Internet
users
have
consulted
doctor
raAngs.
• 15%
of
Internet
users
have
consulted
raAngs
for
hospitals
or
faciliAes.
34. PaAents
Can
Be
Integrated
Into
The
Workflow:
Experience
At
Kaiser
Compared
Provider–PaAent
e-‐mail
users
and
nonusers
(
>35,000
paAents)
Found
improved
HEDIS
measures
in
those
with
hypertension
and
diabetes
BeCer
HA1C
values
BeCer
screening
Lower
BP
Zhou,
Y.
Y.,
et.
Al
(2010).
Improved
quality
at
Kaiser
Permanente
through
e-‐mail
between
physicians
and
paAents.
Health
affairs
(Project
Hope),
29(7),
1370-‐5.
doi:10.1377/hlthaff.2010.0048
35. There
Are
Many
Other
Examples
Of
Impact
Of
PaAent
Engagement
• Bedside
presentaAons
reduce
apprehension
in
paAents
and
may
increase
accuracy
of
data
• Sharing
of
notes
with
paAents
is
rare,
but
when
it
is
promoted,
paAents
express
“considerable
enthusiasm
and
few
fears”
about
sharing
notes.
• Walker
et
al.
AIM
2011
• Why
is
this
important?
We
know
coordinaAon
of
care
is
a
problem,
but
paAents
also
see
it..
36. There
are
Many
Tools
You
Can
Use
to
Increase
Engagement
• Shared
decision
aids-‐
– Informed
Medical
Decisions
FoundaAon
– Programs
to
aid
paAents
in
understanding
risks,
outcomes
and
the
views
of
other
paAents
• Portals,
and
other
IT
– MeeAng
MU
– “Engaging”
paAents
in
your
pracAce
• Behavioral
Health/Behavior
Change
– MoAvaAonal
interviewing
• Style
of
interacAng
helps
paAent
take
control
of
their
health
on
their
terms
37. Summary
Points
• Health
care
reform
will
include
major
changes
in
how
neurologists
are
paid
and
the
way
they
provide
care
• CoordinaAon
of
care,
use
of
teams,
and
new
processes
of
care
will
proliferate
• You
can
make
the
transiAon
by
understanding
your
present
processes,
costs
and
outcomes.
• Focus
on
the
value
you
bring
to
the
paAent’s
care.
• Do
not
be
afraid
to
jump
in
and
work
with
our
colleagues
who
are
pioneering
these
changes.
38. Resources
for
Assessing
the
Delivery
Models
• Overview
– hCp://www.aan.com/go/pracAce/models
– hCp://cp.neurology.org/content/2/3/224.full
• Accountable
Care
OrganizaAons
– hCp://www.aan.com/go/pracAce/models/aco
– hCp://ow.ly/kOdQH
• PaAent
Centered
Medical
Homes
– hCp://www.aan.com/go/pracAce/models/pcmh
– hCp://cp.neurology.org/content/3/2/134.full
• Webinars
from
AMA
– hCp://ow.ly/kOe35
The
AAN
will
launch
a
new
website
to
help
keep
many
resources
in
one
place,
someAme
in
June.
39. Resources
for
Assessing
Payment
Models
• Overview
from
the
AMA
– hCp://www.ama-‐assn.org/resources/doc/psa/
payment-‐opAons.pdf
• Bundled
Payments
– hCp://www.aan.com/go/pracAce/models/bundled
• Global
Payments
– hCp://www.aan.com/go/pracAce/models/
comprehensive
• Pay
for
Performance
– www.aan.com/go/pracAce/models/performance
• Pay
for
ReporAng
– hCp://www.aan.com/go/pracAce/pay