Patient Centered Medical Homes are providing a pathway for healthcare delivery organizations pursuing value-based initiatives. As reimbursement models continue to transition at an accelerated pace, PCMH practices are well-positioned to achieve clinical targets and qualify for the associated financial incentives.
The survey is requesting information from ambulatory care providers about their experiences providing transitional and chronic care management services. It should take around 10 minutes to complete and responses will be reported to CMS. All respondents will receive a report on the survey findings and have a chance to receive a $20 Starbucks gift card for completing the survey.
Think Your Patients Are Loyal? Think Again. It Takes Work!Renown Health
Accenture provides latest insights on patient loyalty. Suzanne Hendery from Baystate Health shares successful best practices on consistently engaging seniors and women to drive loyalty.
Long Beach Gastroenterology Associates relies heavily on Greenway Health technology and tools to help manage their growing practice of 16 providers. As the largest private GI practice in their area, they face challenges from increasing regulations and reimbursement changes. Greenway's EHR, practice management system, and data analytics help the practice improve efficiencies, meet quality measures, and transition to value-based care. Additional Greenway tools like webinars and community forums provide education and support. Through the Phreesia add-on in Greenway Marketplace, the practice increased patient intake efficiency and collected over $60k in payments. Greenway allows the practice to scale effectively as they continue growing.
Build Physician Relationships that Drive Business Results; Part 1Renown Health
This document discusses the need to improve relationships with physicians to drive business and referrals. It notes that physicians today feel overburdened and pessimistic about the profession. The document then outlines Baystate Health's strategy to establish a physician referral program using a 3-pronged approach: 1) A physician relationship database to track referrals and provide analytics. 2) An Office of Physician Referral Management to resolve issues. 3) Physician Relations Liaisons assigned to territories to build engagement with physicians and ensure smooth referrals. The goal is to improve physician well-being, communication, and referrals to grow volumes and the health system's business.
This document discusses the transition from a traditional fee-for-service medical practice model to a direct primary care model in Scotland. It outlines some of the drawbacks of the fee-for-service model like less income, more paperwork, and patient dissatisfaction with out-of-pocket costs. The direct primary care model eliminates insurance billing, allows more time with patients, and improves patient satisfaction and quality of care while decreasing overall costs. The practice in Scotland successfully transitioned 3800 patients to this new direct care model within a few months.
Patient experience has become increasingly important in healthcare. To improve patient experience, healthcare providers need to shift to a patient-centric model that focuses on all touchpoints of a patient's experience, from booking appointments to treatment and follow up. This requires training staff, enhancing technologies, personalizing care, and using data and feedback to continuously monitor and improve the patient experience.
This document provides an overview of the Patient-Centered Medical Home (PCMH) model of healthcare delivery. It describes key aspects of the PCMH including its team-based and patient-centered approach, emphasis on continuous quality improvement, and transformation from a traditional doctor-centered model. It also outlines the recognition process through the National Committee for Quality Assurance, including their standards, elements, factors and requirements for different levels of recognition. Challenges of becoming a PCMH and common myths are also addressed.
This presentation is by Mr.Rajendra P. Gupta at the Putting Patients First Conference on 20th Oct,10. Topic " Role of patients in the healthcare system". HELP is the world's largest the worlds largest free patient education library - www.healthlibrary.com
The survey is requesting information from ambulatory care providers about their experiences providing transitional and chronic care management services. It should take around 10 minutes to complete and responses will be reported to CMS. All respondents will receive a report on the survey findings and have a chance to receive a $20 Starbucks gift card for completing the survey.
Think Your Patients Are Loyal? Think Again. It Takes Work!Renown Health
Accenture provides latest insights on patient loyalty. Suzanne Hendery from Baystate Health shares successful best practices on consistently engaging seniors and women to drive loyalty.
Long Beach Gastroenterology Associates relies heavily on Greenway Health technology and tools to help manage their growing practice of 16 providers. As the largest private GI practice in their area, they face challenges from increasing regulations and reimbursement changes. Greenway's EHR, practice management system, and data analytics help the practice improve efficiencies, meet quality measures, and transition to value-based care. Additional Greenway tools like webinars and community forums provide education and support. Through the Phreesia add-on in Greenway Marketplace, the practice increased patient intake efficiency and collected over $60k in payments. Greenway allows the practice to scale effectively as they continue growing.
Build Physician Relationships that Drive Business Results; Part 1Renown Health
This document discusses the need to improve relationships with physicians to drive business and referrals. It notes that physicians today feel overburdened and pessimistic about the profession. The document then outlines Baystate Health's strategy to establish a physician referral program using a 3-pronged approach: 1) A physician relationship database to track referrals and provide analytics. 2) An Office of Physician Referral Management to resolve issues. 3) Physician Relations Liaisons assigned to territories to build engagement with physicians and ensure smooth referrals. The goal is to improve physician well-being, communication, and referrals to grow volumes and the health system's business.
This document discusses the transition from a traditional fee-for-service medical practice model to a direct primary care model in Scotland. It outlines some of the drawbacks of the fee-for-service model like less income, more paperwork, and patient dissatisfaction with out-of-pocket costs. The direct primary care model eliminates insurance billing, allows more time with patients, and improves patient satisfaction and quality of care while decreasing overall costs. The practice in Scotland successfully transitioned 3800 patients to this new direct care model within a few months.
Patient experience has become increasingly important in healthcare. To improve patient experience, healthcare providers need to shift to a patient-centric model that focuses on all touchpoints of a patient's experience, from booking appointments to treatment and follow up. This requires training staff, enhancing technologies, personalizing care, and using data and feedback to continuously monitor and improve the patient experience.
This document provides an overview of the Patient-Centered Medical Home (PCMH) model of healthcare delivery. It describes key aspects of the PCMH including its team-based and patient-centered approach, emphasis on continuous quality improvement, and transformation from a traditional doctor-centered model. It also outlines the recognition process through the National Committee for Quality Assurance, including their standards, elements, factors and requirements for different levels of recognition. Challenges of becoming a PCMH and common myths are also addressed.
This presentation is by Mr.Rajendra P. Gupta at the Putting Patients First Conference on 20th Oct,10. Topic " Role of patients in the healthcare system". HELP is the world's largest the worlds largest free patient education library - www.healthlibrary.com
Leveraging patient call data to improve your value proposition - Print Articl...Mike Logan
This document discusses how leveraging patient call data after discharge can help post-acute care providers improve their value proposition. It describes a technology called WeCare Connect that makes calls to patients at recovery milestones to track outcomes and patient satisfaction. One organization that implemented this found it helped avert re-hospitalizations by identifying issues early. Acute care partners now look for more than just clinical data and ratings when selecting providers, including how well providers manage patient care after discharge.
M. Samir Qamar PAFP Direct Primary Care DiscussionPAFP
This document discusses direct primary care (DPC), a model of healthcare delivery where patients pay doctors a monthly fee in exchange for basic medical services. It outlines several benefits of DPC including increased efficiency, revenue, and patient satisfaction as well as enhanced work-life balance for doctors. The document also notes that DPC is gaining traction due to factors like the Affordable Care Act and is recognized in the laws of several states either through formal legislation or guidelines.
Healthcare 2014: Realities and Opportunities, MD@UNasir Kamal, MD
This document discusses rising healthcare costs for employers and proposes a telehealth solution. It notes that healthcare premiums per employee rose to $10,475 in 2012 and up to 70% of doctor visits are unnecessary. The proposed solution, MD@U, allows unlimited access to licensed physicians via phone, text, or email for a low flat monthly fee per employee. This solution aims to reduce costs for employers by providing convenient medical care that avoids unnecessary office visits while improving employee satisfaction.
COVID-19 has changed the landscape of long-term care for the foreseeable future for everyone from ownership to admissions. In this webinar, we will help you understand the changing dynamic with managed care and how to properly manage your cash flow. Hear from industry experts on their best practices and tips for financial management for long-term care professionals.
Northwest Counseling Professionals (NWCP) offers various professional consulting services to substance abuse treatment agencies, including assistance with licensing applications, policy development and implementation, identifying appropriate levels of care, navigating regulatory surveys, quality assurance, clinical supervision, staff training, and acting as a liaison between agencies and regulators. NWCP aims to provide quality consultation and support to ensure agencies deliver quality care, training, and regulatory compliance.
There are many missed opportunities for revenue retention in today’s healthcare call centers. Would you like to increase your captured revenue. We highlight a $25M case study.
Digital technology advancements like Internet of Things (IoT)
* Wearable technologies
* Blockchain
* Robotics
* Big data
*Advanced analytics are changing consumer perceptions
Measuring Physician Relations ROI; Tools & TechniquesRenown Health
The document describes a workshop on measuring physician relations return on investment. It discusses how three organizations, including Baystate Health, demonstrate results from their physician relations programs. At Baystate Health, their physician liaison program led to $8 million in new annual revenue, a 25 to 1 return on their $316,000 investment. Their liaisons conduct over 1,400 face-to-face visits annually and help fill new specialist panels 50% faster. The workshop aims to help others learn from these examples on tracking measures that align with goals and demonstrating physician relations program value.
Mason Reiner PAFP Direct Primary Care DiscussionPAFP
This document discusses launching direct primary care in Greater Philadelphia. It notes that US healthcare spending is over 2.5 times the OECD average and employers are seeking innovative solutions to improve quality and control costs. The document proposes that primary care physicians are uniquely positioned to direct 95% of healthcare spending by providing most needed care conveniently and affordably. It outlines a vision for a scalable direct primary care solution for employers through contracting with independent, high-performing primary care practices to empower patient-physician relationships and break down barriers to primary care through accessibility, convenience, technology, and affordability.
The Latest Self-Pay Trends: New Burdens and Opportunitiesathenahealth
Let athenahealth guide you through the burdens of navigating through revenue collections from your patients to make sure your practice has access to all monetary opportunities to ensure financial success.
This document summarizes geriatric care management technology and services offered by My Health Care Manager, a company that provides consulting, training, and software to help agencies enhance their geriatric care management offerings. Their software suite includes tools to assess, plan, implement, and track senior care, provide clinical decision support, and allow family access to client information. Their goal is to help agencies start or expand their geriatric care management lines of business to attract new clients and revenue streams.
Using CRM to Make Physician Referral Networking/Tracking Easier 10 09 ModifiedSuzanne Dewey
What kinds of CRM tools are available to help a physician relations effort with physician tracking? Overview of tools and benefits for physician referral development.
Prophet worked extensively with the marketing and executive leadership teams at IU Health to develop and implement a new, system-wide brand and customer experience strategy to help achieve this vision. Leveraging extensive qualitative and quantitative research across different stakeholders as the foundation, we developed a comprehensive brand strategy for the health system that involved: A new positioning that highlighted the breadth and depth of the entire system, changing the name from Clarian to Indiana University Health, developing a compelling and consistently deliverable patient experience across the system, and developing the key elements that would bring the new brand to life and deliver the desired patient experience.
How Can An Effective Medical Referral Management Increase Revenue up to 65% GaryRichards30
Referral management solution has come as an asset to the healthcare industry to improve care coordination, increase referral volumes and revenue, reduce readmissions and improve outcomes. Secure messaging is a critical aspect of the healthcare industry. Referral Management Solution allows the providers to seamlessly communicate for exchanging patient related data and for improving patient care through a secure network. Watch how an effective medical referral management increase revenue upto 65%
The Agile Approach to Patient Journey Marketing Carl Olsen
Patient journeys are one of the hottest topics in health care marketing and with good reason. They can achieve excellent results by directing engagement tactics to where an individual consumer is on the decision-making continuum for elective health care services. By segmenting consumers along the journey, health systems The Agile Approach to Patient Journey Marketing can attain increased utilization, enhanced patient satisfaction and heightened loyalty.
Within the first three months, 479 visitors responded to the one ad UC Health ran on Facebook. Twenty-five percent of visitors signed up for a seminar, took the quiz or downloaded documents from the microsite; and those 120 prospects provided a name, email address and other information that could be used in future consumer engagement initiatives. Seminar registrations increased 4 percent, and the conversion rate for surgery nearly doubled by month three.
For more information contact: Slideshare@marcusevans.com
Presentation delivered by Donna Medina, Regional Director,OSF Hospice and Homecare Foundation at the marcus evans Home Care Leadership Summit held on July 13 & 14 2015 in Palm Beach FL.
This document discusses patient support programs offered by pharmaceutical companies in 2014. It notes that the patient journey has become more complex, with patients needing to navigate multiple stakeholders and sources of information. It also notes that while pharmaceutical companies traditionally followed a linear promotional model, the patient journey is less linear. The document then analyzes over 200 pharmaceutical websites and identifies 65 patient support programs. It finds that support commonly includes nurse hotlines, educational events, and assistance navigating insurance. However, data tracking remains basic. It concludes that digital health is advancing beyond information seeking to care management, and pharmaceutical companies will need to partner more and help patients navigate the complex system.
The future of primary care and implementing workforce innovations (Wessex AHSN)Robert Varnam Coaching
Presentation at Wessex AHSN event "Lifeline for general practice" event in Southampton. Including updates about the national general practice development programme, and tips on making a success of new ways of working.
Compliatric webinar series 5 enrollment best practices to decrease uninsured ...Compliatric
Join us for a discussion on tools and tips to convert more uninsured patients to covered visits. FQHC enrollment experts will share their insights and strategies on how to maximize approvals with limited resources. This data-driven webinar will include industry statistics and real FQHC outcomes for benchmarking.
Learning Objectives:
- Identify enrollment best practices
- Build strategies for increasing approval rates
- Learn how to collect and interpret enrollment data
- Directly connect your O&E staff to Clinic revenues
Food processing is the transformation of raw ingredients, by physical or chemical means into food, or of food into other forms. Food processing combines raw food ingredients to produce marketable food products that can be easily prepared and served by the consumer.
Leveraging patient call data to improve your value proposition - Print Articl...Mike Logan
This document discusses how leveraging patient call data after discharge can help post-acute care providers improve their value proposition. It describes a technology called WeCare Connect that makes calls to patients at recovery milestones to track outcomes and patient satisfaction. One organization that implemented this found it helped avert re-hospitalizations by identifying issues early. Acute care partners now look for more than just clinical data and ratings when selecting providers, including how well providers manage patient care after discharge.
M. Samir Qamar PAFP Direct Primary Care DiscussionPAFP
This document discusses direct primary care (DPC), a model of healthcare delivery where patients pay doctors a monthly fee in exchange for basic medical services. It outlines several benefits of DPC including increased efficiency, revenue, and patient satisfaction as well as enhanced work-life balance for doctors. The document also notes that DPC is gaining traction due to factors like the Affordable Care Act and is recognized in the laws of several states either through formal legislation or guidelines.
Healthcare 2014: Realities and Opportunities, MD@UNasir Kamal, MD
This document discusses rising healthcare costs for employers and proposes a telehealth solution. It notes that healthcare premiums per employee rose to $10,475 in 2012 and up to 70% of doctor visits are unnecessary. The proposed solution, MD@U, allows unlimited access to licensed physicians via phone, text, or email for a low flat monthly fee per employee. This solution aims to reduce costs for employers by providing convenient medical care that avoids unnecessary office visits while improving employee satisfaction.
COVID-19 has changed the landscape of long-term care for the foreseeable future for everyone from ownership to admissions. In this webinar, we will help you understand the changing dynamic with managed care and how to properly manage your cash flow. Hear from industry experts on their best practices and tips for financial management for long-term care professionals.
Northwest Counseling Professionals (NWCP) offers various professional consulting services to substance abuse treatment agencies, including assistance with licensing applications, policy development and implementation, identifying appropriate levels of care, navigating regulatory surveys, quality assurance, clinical supervision, staff training, and acting as a liaison between agencies and regulators. NWCP aims to provide quality consultation and support to ensure agencies deliver quality care, training, and regulatory compliance.
There are many missed opportunities for revenue retention in today’s healthcare call centers. Would you like to increase your captured revenue. We highlight a $25M case study.
Digital technology advancements like Internet of Things (IoT)
* Wearable technologies
* Blockchain
* Robotics
* Big data
*Advanced analytics are changing consumer perceptions
Measuring Physician Relations ROI; Tools & TechniquesRenown Health
The document describes a workshop on measuring physician relations return on investment. It discusses how three organizations, including Baystate Health, demonstrate results from their physician relations programs. At Baystate Health, their physician liaison program led to $8 million in new annual revenue, a 25 to 1 return on their $316,000 investment. Their liaisons conduct over 1,400 face-to-face visits annually and help fill new specialist panels 50% faster. The workshop aims to help others learn from these examples on tracking measures that align with goals and demonstrating physician relations program value.
Mason Reiner PAFP Direct Primary Care DiscussionPAFP
This document discusses launching direct primary care in Greater Philadelphia. It notes that US healthcare spending is over 2.5 times the OECD average and employers are seeking innovative solutions to improve quality and control costs. The document proposes that primary care physicians are uniquely positioned to direct 95% of healthcare spending by providing most needed care conveniently and affordably. It outlines a vision for a scalable direct primary care solution for employers through contracting with independent, high-performing primary care practices to empower patient-physician relationships and break down barriers to primary care through accessibility, convenience, technology, and affordability.
The Latest Self-Pay Trends: New Burdens and Opportunitiesathenahealth
Let athenahealth guide you through the burdens of navigating through revenue collections from your patients to make sure your practice has access to all monetary opportunities to ensure financial success.
This document summarizes geriatric care management technology and services offered by My Health Care Manager, a company that provides consulting, training, and software to help agencies enhance their geriatric care management offerings. Their software suite includes tools to assess, plan, implement, and track senior care, provide clinical decision support, and allow family access to client information. Their goal is to help agencies start or expand their geriatric care management lines of business to attract new clients and revenue streams.
Using CRM to Make Physician Referral Networking/Tracking Easier 10 09 ModifiedSuzanne Dewey
What kinds of CRM tools are available to help a physician relations effort with physician tracking? Overview of tools and benefits for physician referral development.
Prophet worked extensively with the marketing and executive leadership teams at IU Health to develop and implement a new, system-wide brand and customer experience strategy to help achieve this vision. Leveraging extensive qualitative and quantitative research across different stakeholders as the foundation, we developed a comprehensive brand strategy for the health system that involved: A new positioning that highlighted the breadth and depth of the entire system, changing the name from Clarian to Indiana University Health, developing a compelling and consistently deliverable patient experience across the system, and developing the key elements that would bring the new brand to life and deliver the desired patient experience.
How Can An Effective Medical Referral Management Increase Revenue up to 65% GaryRichards30
Referral management solution has come as an asset to the healthcare industry to improve care coordination, increase referral volumes and revenue, reduce readmissions and improve outcomes. Secure messaging is a critical aspect of the healthcare industry. Referral Management Solution allows the providers to seamlessly communicate for exchanging patient related data and for improving patient care through a secure network. Watch how an effective medical referral management increase revenue upto 65%
The Agile Approach to Patient Journey Marketing Carl Olsen
Patient journeys are one of the hottest topics in health care marketing and with good reason. They can achieve excellent results by directing engagement tactics to where an individual consumer is on the decision-making continuum for elective health care services. By segmenting consumers along the journey, health systems The Agile Approach to Patient Journey Marketing can attain increased utilization, enhanced patient satisfaction and heightened loyalty.
Within the first three months, 479 visitors responded to the one ad UC Health ran on Facebook. Twenty-five percent of visitors signed up for a seminar, took the quiz or downloaded documents from the microsite; and those 120 prospects provided a name, email address and other information that could be used in future consumer engagement initiatives. Seminar registrations increased 4 percent, and the conversion rate for surgery nearly doubled by month three.
For more information contact: Slideshare@marcusevans.com
Presentation delivered by Donna Medina, Regional Director,OSF Hospice and Homecare Foundation at the marcus evans Home Care Leadership Summit held on July 13 & 14 2015 in Palm Beach FL.
This document discusses patient support programs offered by pharmaceutical companies in 2014. It notes that the patient journey has become more complex, with patients needing to navigate multiple stakeholders and sources of information. It also notes that while pharmaceutical companies traditionally followed a linear promotional model, the patient journey is less linear. The document then analyzes over 200 pharmaceutical websites and identifies 65 patient support programs. It finds that support commonly includes nurse hotlines, educational events, and assistance navigating insurance. However, data tracking remains basic. It concludes that digital health is advancing beyond information seeking to care management, and pharmaceutical companies will need to partner more and help patients navigate the complex system.
The future of primary care and implementing workforce innovations (Wessex AHSN)Robert Varnam Coaching
Presentation at Wessex AHSN event "Lifeline for general practice" event in Southampton. Including updates about the national general practice development programme, and tips on making a success of new ways of working.
Compliatric webinar series 5 enrollment best practices to decrease uninsured ...Compliatric
Join us for a discussion on tools and tips to convert more uninsured patients to covered visits. FQHC enrollment experts will share their insights and strategies on how to maximize approvals with limited resources. This data-driven webinar will include industry statistics and real FQHC outcomes for benchmarking.
Learning Objectives:
- Identify enrollment best practices
- Build strategies for increasing approval rates
- Learn how to collect and interpret enrollment data
- Directly connect your O&E staff to Clinic revenues
Food processing is the transformation of raw ingredients, by physical or chemical means into food, or of food into other forms. Food processing combines raw food ingredients to produce marketable food products that can be easily prepared and served by the consumer.
This document discusses alternatives to lean manufacturing for companies seeking to differentiate themselves and remain competitive. It outlines five alternate strategies that top manufacturers employ: 1) Partnerships based on information sharing with suppliers, 2) Offering supplementary services, 3) Faster innovation cycles through collaboration, 4) Production flexibility, and 5) Local sourcing. While lean manufacturing provides benefits, these strategies can deliver added value that customers will pay a premium for. Implementing them requires close collaboration between manufacturers and suppliers.
Within three months of deploying TrakSYS™,
Messier-Bugatti was able to identify root causes of the
production problems, prioritize them by their
impact, and focus on measurably improving
production capacity.”
This document is Alejandra Fonseca's nursing portfolio. It outlines her objective of gaining expertise as an entry-level registered nurse and eventually becoming a nurse practitioner. It details her education and certifications, clinical experience in various nursing specialties at different hospitals, community service, and professional development activities like seminars and presentations. Her clinical experiences include roles in medical-surgical, psychiatric, pediatrics, maternity and fundamental nursing units.
Steel India Company is a distributor, manufacturer, supplier, and exporter of metal products based in Mumbai, India. It is certified to work with government contractors and approved by over 1000 multinational companies. Steel India specializes in supplying API 5L pipes for use in the oil and gas industries, including various grades of line pipe that meet API specifications for drilling, production, and transport.
This document contains photo credits from various photographers including byronv2, L'omino con la Canon, thomas lieser, michael pollak, Tanja FÖHR, -Veyron-, Nico-Kaczmarczyk, Vintage Japan-esque, @ADLavinsky, and kjetikor. It encourages the reader to get started creating their own Haiku Deck presentation on SlideShare.
Unemployment can take several forms, including demand deficient, structural, real wage, frictional, and voluntary unemployment. There are many causes of unemployment, such as being between jobs, being laid off, or quitting a previous position. High youth unemployment in Tunisia is due to a surge in the youth population combined with a lack of jobs and mismatch between education and market needs. Unemployment can lead to increased poverty, crime, substance abuse, and even suicide. Solutions proposed include improving education quality and practical skills training, encouraging rural development and industries, and rapid industrialization.
The document provides tips for salespeople on the importance of asking customers for sales. It notes that most sales are closed after the fourth time asking and that the majority of sales meetings end without an ask. It encourages salespeople to ask repeatedly since circumstances may change to allow a yes, and notes that people are often afraid to ask due to fears of looking needy, foolish or stupid or hearing no, but that one should ask with a positive expectation.
Wouter De Geest - Ingénieur dans l'avenir - Ingenieurs in de toekomstGilles Guilmot
"De rol van de ingenieur in de toekomst"
"Le rôle de l’ingénieur dans l’avenir"
Wouter De Geest, CEO BASF
Remise des insignes d'honneurs aux Lauréats du Travail du secteur "Professions et Métiers de l'Ingénieur : Master of Science"
Uitreikingsplechtigheid aan de Laureaten van de Arbeid van de sector "Beroepen & Vakgebieden van de Ingenieur
Master of Science"
Finding a reliable supplier is important for business success. This document provides 19 questions to ask potential suppliers to thoroughly assess them on quality, dependability, costs, speed, and other factors. It discusses questions in each category that evaluate suppliers' performance indicators, certifications, customer service, financial stability, production capacity, and more. Comprehensively answering these questions helps choose suppliers best aligned with business needs.
Due to popular demand, the Comprehensive Primary Care Plus (CPC+) team hosted a repeat of the webinar that was originally held on Thursday, April 21, 2016. During this webinar Model team members provided an overview of the model specifically for health IT vendors.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The document discusses different approaches to financing healthcare:
1. Fee for service rewards volume over quality and does not incentivize care coordination.
2. Capitation rewards cost reduction but not outcomes and limits patient choice.
3. Diagnosis related groups does not cover all services or incentivize innovation.
4. Bundled payments incentivize integrated care across settings but specialist coordination can be difficult.
5. Payment when healthy incentivizes preventative care but is not discussed in detail.
All approaches face challenges in properly balancing cost, quality, and access. Bundled payments and payment for health show most promise by linking reimbursement to outcomes and prevention.
On May 23, Conifer Health Solutions hosted a lecture at the ACHE Fellows Seminar in San Antonio, TX. The lecture, “Planning for Success with Clinical Integration,” focused on the steps associated with building a clinically integrated network; the power of strategic alignment with partners in the care community; and sustainable governance and incentive structures for the clinically integrated network.
- Parkview Medical Group participated in the Maryland Multi-Payer Plan (MMPP), a program that provided financial incentives for practices that improved care coordination and achieved savings through reduced hospital admissions and specialist referrals. For the first time in 2014, Parkview received shared savings payments through the MMPP.
- Parkview worked to achieve NCQA Patient-Centered Medical Home Level 3 recognition, requiring collaboration between administration, providers, and staff. After over a year of preparation, Parkview received Level 3 recognition in 2015.
- Parkview has enhanced access for patients by adding services and expanded hours. They launched an online patient portal in 2014 and are working to integrate behavioral health services and move towards more integrated "whole patient
Patient engagement is evolving to include a composite of practices that impact patient behaviors and health. Contemporary models of patient engagement include the HIMSS 5 phases of patient engagement and the Regional Primary Care Coalition's 6 dimensions of patient engagement. Meaningful Use Phase 3 identifies key priorities around patient access to health records and secure messaging. Barriers to patient engagement include defining engagement and integrating diverse engagement tools and technologies.
The document summarizes key information about the Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). It discusses how MIPS combines previous quality reporting programs and the shift toward value-based payments. It provides an overview of MIPS, noting it has four performance categories: quality, resource use, clinical practice improvement activities, and meaningful use of technology. It also addresses concerns for small practices and steps they can take to prepare for MACRA implementation, including using the Quality and Resource Use Reports.
The Center for Medicare & Medicaid Services hosted a webinar on Thursday, April 14, 2016. During this webinar staff provided an overview of the model. A repeat of the webinar was held on Tuesday, April 19.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The FMBHP is a collaboration among frontier/rural healthcare communities; Mineral Community Hospital’s Interdisciplinary Medical Education Center; iVantage, an industry leader providing comprehensive hospital evaluation tools; Mayo Clinic’s Practice-Based Research Network (PBRN); and the Appalachian Osteopathic Postgraduate Training Institute Consortium (A-OPTIC). The FMBHP will partner with CMS, IHS, Veteran Administration and other private insurers to develop a seamless and sustainable model of patient-centered and community-based healthcare that produces better outcomes cost-effectively.
The document outlines a seven-step approach to building a clinically integrated network (CIN). The steps include: 1) gathering interested stakeholders; 2) creating a value proposition; 3) developing governance and participation agreements; 4) selecting quality measures; 5) recruiting physicians; 6) measuring and improving programs; and 7) engaging payers. The goal is to improve access, health outcomes, and value through clinical integration and care coordination across providers.
Care Coordination - Northwest Medical Partnerspedenton
This document discusses care coordination in the medical home. It defines care coordination as organizing patient care activities between multiple participants to facilitate appropriate healthcare delivery. Effective care coordination involves numerous participants exchanging information and integrating care activities. The care coordination model aims to deliver the right services, in the right order and setting. Key elements of the model include assuming accountability for coordination, providing patient support, developing relationships and agreements with other providers, and improving connectivity through information sharing.
This document discusses strategies for increasing patient enrollment and use of patient portals. It begins by outlining the benefits of patient portals such as providing secure access to health records and communication with providers. It then discusses challenges to enrollment and use, such as patient motivation, staff education and physician buy-in. The document proposes strategies like explaining portal benefits to patients, training staff, and streamlining the enrollment process during visits. Ensuring access for low-income and elderly patients is also discussed.
Keynote Presentation delivered by Marvin O’Quinn, Executive Vice President and Chief Operating Officer, Dignity Health at the marcus evans National Healthcare CXO Summit Spring 2018 held in Orlando FL
The document discusses key strategies for hospital success, including establishing the business case for health information technology, redesigning processes around new technologies, and using technology to extend patient-centered care beyond hospital walls. It also covers best practices like incorporating evidence-based design principles in construction, including stakeholders in the design process, and designing flexibility into buildings. Additional topics include promoting economic viability, the benefits of electronic medical records, achieving patient-centered care, comprehensive care planning, and using social media and marketing.
Learn how Hahnemann University Hospital reduced readmissions at the Center for Advanced Heart Failure Care by over 20%. This is a follow up to our Fall 2014 webinar with more data and outcomes to reveal. During this discussion, you’ll learn the positive impact a Readmissions Reduction program can have for a hospital including financial, care delivery, and care team collaboration improvements.
A Seven Step Approach to a Clinically Integrated Network.pdfPatWilson13
This document outlines a seven-step approach to building a clinically integrated network (CIN). The steps include: 1) gathering interested stakeholders; 2) creating a value proposition; 3) developing governance and participation agreements; 4) selecting quality measures; 5) recruiting physicians; 6) measuring and improving programs; and 7) engaging payers. The presentation emphasizes using data to benchmark quality, utilization, and costs in order to develop a sustainable incentive structure for the CIN. Yale New Haven Health System's experience in establishing its CIN, called the Total Health Network, is discussed as a case study.
Care Management - Critical Component Of Effective Population HealthHealth Catalyst
In this first webinar, of a two-part series, Dr. Kathleen Clary will share how analytics can be used to answer these questions to ensure delivery of a well-organized and effective care management program.
Dr. Clary will discuss how analytics can enable:
Data integration from multiple EMRs and data sources
Patient stratification and intake
Care coordination
Patient engagement
Performance measurement
We look forward to you joining us!
Transforming Clinical Practice InitiativeCitiusTech
The Transforming Clinical Practice Initiative (TCPI) is designed to help small practices and clinicians achieve large-scale health transformation. The initiative is designed to support more than 140,000 clinician practices over four years duration in sharing, adapting and further developing their comprehensive quality improvement strategies. The TCPI is one part of a unique strategy advanced by the Affordable Care Act to strengthen the quality of patient care and manage health care expenditures, ultimately saving the taxpayer from substantial costs. This document describes the initiative in detail with the type of participants, eligibility and reporting requirements of the participants. Understanding the implementation of this initiative not only helps clinicians, but opens up a huge market for Healthcare IT companies offering the products and services like EHR implementation, Integration, EHR/ Data Migration, Implementation of HIE etc.
The Patient Centered Primary Care Collaborative has been working for years to build evidence and knowledge about how to improve healthcare by providing a medical "home" for each of us - a place where all our records reside, where the staff know us, etc. This April 2010 by Executive Director Edwina Rogers shows the phenomenal range of results they've produced.
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Patient Centered Medical Home, A Pathway to Value-Based Reimbursement?
1. Confidential 2/17/2016Slide 1
Patient Centered Medical Home,
A Pathway to Value-Based Reimbursement?
Industry Webcast
February 3, 2016
11:00 PT / 2:00 ET
2. Confidential 2/17/2016Slide 2
Today’s discussion
○ Introduction and overview
○ PCMH clinical and financial
performance
○ The alternative payment landscape,
and its link to PCMH
○ Core competencies,
today and tomorrow
○ The Christ Hospital: PCMH’s role in
practice transformation
○ Q&A
3. Confidential 2/17/2016Slide 3
Speaker introductions
David Rowe
SVP, Marketing & Business Development
Joe Siemienczuk, MD
Chief Medical Officer
Jacquelyn Hunt, PharmD, MS
Chief Population Health Officer
Amy Mechley, MD
Medical Director – Wellness Division,
The Christ Hospital Health Network
4. Confidential 2/17/2016Slide 4
Enli Health Intelligence
Top-Performing Population Health Management Solution
- KLAS Research. December 2015. Population Health Management 2015: How Far Can Your Vendor Take You?
Enli
6. Confidential 2/17/2016Slide 6
What is PCMH, practically?
The medical home is best described as a model or
philosophy of primary care that is patient-centered,
comprehensive, team-based, coordinated,
accessible, and focused on quality and safety [ … ]
Above all, the medical home is not a final destination
instead, it is a model for achieving primary care
excellence…Source: Patient-Centered Primary Care Collaborative
7. Confidential 2/17/2016Slide 7
PCMH provides roadmap to advanced primary care practice
○ 7K+ practices recognized by NCQA1
○ 500%+ growth in PCMH incentive
programs—from 26 (2009) to 160 (2016)2
○ Fastest growing NCQA service
PCMH certification also offered by URAC, The Joint Commission, AAAHC
1. Journal of the American Board of Family Medicine. Jan – Feb, 2016. Rosenthal. Are We Learning More
About Patient-Centered Medical Homes (PCMHs), or Learning About Primary Care?
2. Health Leaders Media. January 2016. Letourneau. PCMH Model Soaring, Despite Funding Challenges
8. Confidential 2/17/2016Slide 8
Enli customers are pursuing PCMH more aggressively than industry at-
large
33%
50%
9%
0%
10%
20%
30%
40%
50%
60%
70%
US PCP's Enli Customers
PCMH Program Participation
Live Planning
1. Enli Health Intelligence and PYA Consultants. National CCM Provider Survey 2015
2. Enli Health Intelligence. Alternative Payment Model Participation, December 2015
○ Enli customer
participation in
PCMH networks is
>50% greater than
the national average
○ Providers
participating in
PCMH are early
adopters of
government and
commercial APMs
9. Confidential 2/17/2016Slide 9
Evidence supports the efficacy of the PCMH model
14 peer-reviewed studies
› 10 reported on cost, 6 found
improvements
› 13 reported on utilization, 12
found improvements
› 3 reported on quality, 2 found
improvements
› 4 reported on access, 4 found
improvements
› 4 reported on satisfaction, 4
found improvements
Source: Patient-Centered Primary Care Collaborative.
January 2015. The Patient-Centered Medical Home’s
Impact on Cost and Quality
10. Confidential 2/17/2016Slide 10
PCMH requires investment, but economics scale
○ $147,573, median annual cost1
○ $64,768 per clinician, $30 per patient1
○ 30% more, incremental short-term
impact to primary care costs2
1. Health IT Analytics. January 2016. RAND: Patient-Centered Medical Home May Cost $147K Per Year
2. JABFM. Jan – Feb, 2016. Rosenthal. Are We Learning More About Patient-Centered Medical Homes (PCMHs), or Learning About Primary Care?
3. Health IT Analytics. July 2014. CMSA Study: Patient Navigators Pay for Themselves in Two Months
○ 4%, reduction in the 30-day
readmission rate3
○ $156,000, combined savings per
navigator over six month period3
○ 2 months, average pay back period
for navigator (based upon $35K annual
salary)
3
11. Confidential 2/17/2016Slide 11
○ HHS publishes clear objectives and goals to guide payment reform. The
proliferation of commercial and government reimbursement programs to
complement team-based delivery creates sustainable models
○ PCMH certification criteria developed and updated, providing discrete
measures and offering an onramp to other programs or models
(e.g. ACO certification)
○ The Health Care Payment Learning and Action Network launches, bringing
together public and private stakeholders to accelerate the transition to
alternative payment models
Catalyzing the transition from volume to value
12. Confidential 2/17/2016Slide 12
Alternative Payment Model Framework
Source: Health Care Payment Learning & Action Network,
https://hcp-lan.org/workproducts/apm-whitepaper-onepager.pdf
13. Confidential 2/17/2016Slide 13
Medical homes well-positioned to pursue more aggressive payment
models
Payments in Category 3 are structured to
encourage providers to deliver effective and efficient
care
○ Primary care PCMHs are recognized within
Category 3 of HCP-LAN’s framework
○ PCMH practices have the flexibility to participate
in FFS reimbursement programs linked to quality
and value
○ PCMH practices accepting downside risk are
building competencies for population-based
payment programs
14. Confidential 2/17/2016Slide 14
…PCMH figures prominently in the Merit-Based
Incentive Payment System (MIPS), which aims to
accelerate the nation’s shift to pay-for-performance
reimbursement and financial bonuses based on quality
achievements using the PCMH as one of the most
promising foundations for systemic improvements.
Source: Health IT Analytics. January 2016. RAND: Patient-Centered Medical Home May Cost $147K Per Year
16. Confidential 2/17/2016Slide 16
PCMH standards & requirements
Standard Summary of Requirements
PCMH 1: Patient-Centered Access
The practice provides 24/7 access to team-based care for both routine and urgent needs of
patients/families/caregivers.
PCMH 2: Team-Based Care
The practice provides continuity of care using culturally and linguistically appropriate, team-
based approaches.
PCMH 3: Population Health
Management
The practice provides evidence-based decision support and proactive care reminders
based on complete patient information, health assessment and clinical data.
PCMH 4: Care Management and
Support
The practice systematically identifies individual patients and plans, manages and
coordinates care, based on need.
PCMH 5: Care Coordination and
Care Transitions
The practice systematically tracks tests and coordinates care across specialty care, facility-
based care and community organizations.
PCMH 6: Performance Measurement
and Quality Improvement
The practice uses performance data to identify opportunities for improvement and acts to
improve clinical quality, efficiency and patient experience.
17. Confidential 2/17/2016Slide 17
Team-based approach to clinical care delivery
○ Clinic culture consistent with the medical home
○ Team-based training program
○ Central care team that provides support across
provider panels
○ Case management support for high-risk patients
○ Patient recognized as part of the care team
18. Confidential 2/17/2016Slide 18
Process to proactively engage & cost-efficiently operate
Continuous loop, grounded in ongoing
operational improvement
○ Mechanisms to identify high-risk patients
○ Communication forums and information sharing
○ Escalation procedures and triggers
○ Community connections
○ Integration of behavioral health
○ Patient access
19. Confidential 2/17/2016Slide 19
Technology platform to scale delivery model
○ Risk Stratification
● Tap clinical, claims, socioeconomic, health behavior data
● Build a population risk profile
● Define population goals consistent with contract requirements
○ Care Coordination
● Assign cohorts to programs
● Standardize workflows to minimize variation
● Assign tasks to team members according to licensure
● Forecast workload to align demand and capacity
○ Care Delivery
● Monitor, curate, and codify medical guidelines in the software
● Individualize care plans for patients
● Display opportunities complementary views across the enterprise
● Monitor and enhance patient health and engagement
22. Confidential 2/17/2016Slide 22
Step 2:
Rapid review of the Care Plan to
support pre-visit chart prep and
morning huddle. Use Memo for
communication and tasking
35. Confidential 2/17/2016Slide 35
CareManager addresses key PCMH certification standards
Standard Factors
Degree of Coverage
Product 360° Program EHR
PCMH 1: Patient-Centered
Access
A. Patient-Centered Appointment Access X
B. 24/7 Access to Clinical Advise X
C. Electronic Access X
PCMH 2: Team-Based Care
A. Continuity X
B. Medical Home Responsibilities X X
C. Culturally & Linguistically Appropriate Services X
D. The Practice Team X X
PCMH 3: Population Health
Management
A. Patient Information X
B. Clinical Data X
C. Comprehensive Health Assessment X X
D. Use Data for Population Management X X
E. Implement Evidence-Based Decision Support X X
36. Confidential 2/17/2016Slide 36
CareManager addresses key PCMH certification standards (cont.)
Standard Factors
Degree of Coverage
Product 360° Program EHR
PCMH 4: Care Management
& Support
A. Identify Patients for Care Management X X
B. Care Planning & Self-Care Support X X
C. Medication Management X X X
D. Use Electronic Prescribing X
PCMH 5: Care Coordination
& Care Transitions
A. Test Tracking & Follow-Up X X X
B. Referral Tracking & Follow-Up
C. Coordinate Care Transitions X X X
PCMH 6: Performance
Measurement & Quality
Improvement
A. Measure Clinical Quality Performance X
B. Measure Reporting Use & Care Coordination X X
C. Measure Patient & Family Experience
D. Implement Continuous Quality Improvement X X
E. Demonstrate Continuous Quality Improvement X
F. Report Performance X
G. Use Certified EHR Technology X
39. Confidential 2/17/2016Slide 39
The Christ Hospital Health Network
○ Integrated delivery system based in
Cincinnati, OH with a 555 bed acute care
hospital, 41 primary care locations, and
100+ ambulatory sites
○ Recognized national leader in clinical
excellence and patient experience
○ Focused on improving the health of the
TCH community and creating patient value
by providing exceptional outcomes,
affordable care, and the finest experiences
42. Confidential 2/17/2016Slide 42
○ PCMH provides a framework to
evaluate clinical effectiveness and
supports our drive for better outcomes
○ PCMH standardizes best practices
across a broad network
○ PCMH aligns delivery with emerging
reimbursement models
● Commercial payers consider PCMH network
adoption in contracts
● State of Ohio has published 5-year roadmap
for payment reform on PCMH principles
● CMS is funding payment innovation
• MDs: 200+
• Staff: 1,000+
• Clinical specialties: 25
• Locations: 100+
• EHR platform: Epic
PCMH certification vs. PCMH methodology
43. Confidential 2/17/2016Slide 43
Value-based programs offer new revenue streams
○ Comprehensive Primary Care Initiative (CPCI)
● Multi-payer program providing primary care practices with monthly care
management payments to support practice transformation
● 4-year project: Yr. 1-2, limited risk; Yr. 3-4, base payment reduced 25% with gain
share
● Represents $10M over 4 years
● 16 of 34+ practices chosen for CPCI
○ Chronic Care Management (CCM)
● CMS-sponsored program that allows providers to bill ~$42 PMPM for non-face-to-
face care management services delivered to eligible Medicare beneficiaries
● Non-CPCI practices eligible to bill for service
● Represents $2M - $3M annually
44. Confidential 2/17/2016Slide 44
Team-based care was not designed into the EHR
○ The EHR user experience is
transactional, not actionable
○ EHRs are designed for data
capture, not visualization or
knowledge transfer
○ Epic ill-equipped to address more
rigorous 2014 NCQA PCMH
certification requirements, or
value-based programs like
CPCI and CCM
46. Confidential 2/17/2016Slide 46
Financial impact > Commercial Medicare Results
Intentional investment on focused resources leads to significant improvements
Actual Earned Potential Available Actual Earned Potential Available
3%, of
$153,160
55%, of
$236,877
Q4 2014, MA Products
Q1 2015, MA Products
47. Confidential 2/17/2016Slide 47
Work effort > Commercial Medicare Advantage
CPCi and Non-CPCi Offices
366
118
53
93
33
417
17 12 4 7 12 12
0
50
100
150
200
250
300
350
400
450
Calls Made LMTCB Referral Placed Refused Called for
Report/Waiting
Gap Closed
CPCi Offices Non-CPCi Offices
48. Confidential 2/17/2016Slide 48
YTD Performance > Clinical Quality Measures
Clinical Quality Measure
TCHHN
Performance
All CPC Region
Performance
Influenza Immunization 24% 37%
Tobacco Use Assessment and Cessation Intervention 94.04% 70%
Colorectal Screening 59.71% 42%
Breast Cancer Screening 63.53% 41%
Diabetes Hemoglobin A1c Poor Control (low % desirable) 11.47% 12%
Diabetes LDL Control (Patients screened for LDL test) 80.07% 62%
Diabetes LDL Control (Patients LDL < 100) 45.69% 42%
Blood Pressure Control 72.93% 68%
Ischemic Vascular Disease (Patients Screened for LDL test) 74.83% 58%
Ischemic Vascular Disease (LDL controlled) 49.74% 42%
52. Confidential 2/17/2016Slide 52
Looking forward, what’s next?
○ TCHHN has committed to invest further in CareManager,
upgrading to incorporate additional clinical evidence to address
at-risk populations
Deployment within 6 weeks
○ TCHHN is installing CareManager Central Worklist to help with
the efficiency and effectiveness of our care teams engaged in
PCMH outreach
○ TCHHN is augmenting its technology platform and delivery
model with creative strategies focused on patient engagement!
53. Confidential 2/17/2016Slide 53
collaborate@enli.net
CareManager supports PCMH & can help put you on the path to VBR
“Enli stand outs due to its 'Knowledge to Action,' which
introduces real-time clinical decision support at the
point of care by synthesizing the latest evidence-based
guidelines and codifying them in the software”
Matt Guldin,
Chilmark Research
Clinical
decisions
informed by
evidence
HHS has set a goal of tying 30% of Medicare fee-for-service payments to quality or value through alternative payment models by 2016 and 50% by 2018
HHS has also set a goal of tying 85% of all Medicare fee-for-service to quality or value by 2016 and 90% by 2018
Because advanced primary care models call for more care to be delivered outside of traditional face-to-face office visits, FFS is not a sufficient mode of payment if health system transformation is the goal
The APM Framework was developed by HCP-LAN (LAN), and is meant to be a critical first step toward achieving the goal of smarter spending, better quality, and better patient-centered care
The LAN believes that driving the health system toward more transformational models of Categories 3 and 4 will improve care coordination and the patient experience
Two types:
Primary care PCMHs with shared savings only (upside gainsharing)
Primary care PCMHs with shared savings/losses (gainsharing + downside risk)
The implementation of the bipartisan MACRA legislation is a major item squarely on our punch list that has everyone’s attention. At its most basic level it is a program that brings pay for value into the mainstream through something called the Merit-based incentive program, which compels us to measure physicians on four categories: quality, cost, the use of technology, and practice improvement.
- Andy Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services
JP Morgan Annual Healthcare Conference – January 11, 2016
MACRA establishes a pathway for physicians to participate in alternative payment models, including the patient-centered medical home
Navigating the corridor
We are challenged to succeed under multiple payment models with different incentives
We must be proactive, ready and propelling ourselves toward accountable, value-based arrangements
We must ensure the PCMH, our foundational strategy, is affordable and financially sustainable
Support top-of-license teamwork
Staff filter registry to identify patients coming in today
Team reviews Control Panel of patients coming in today to clarify shared activities
Front desk gives patients DSP to gather patient data
MA reviews the Control Panel to identify standing orders
Test tracking and follow up
Filter registry to identify patients overdue for cancer screening
Use registry to send patient message
Track test results
Closed loop follow up for abnormal cancer screening results
ED Follow Up
Filter CM Risk Profile to identify patients in the ED in the previous day
Contact patient using CW workflow
Set Patient Goals using CM Control Panel Patient Goals
Use CM to send patient individualized Asthma Action Plan
The Medical Home is not a checklist—it requires transformational change in the culture
Although clinics have individual needs, some things can be standardized across all clinics
Most effective if groundwork and buy-in are established
Need effective work teams and team leaders
None of these are static, needs to be revisited and revised (unintended consequences)
Transformation of FFS to value based outcomes care. We need to engage differently.
CPCI is a product of the Centers for Medicare and Medicaid Innovation center.
2014: $4,852 earned of potential $153,160 (3%)
2015: $129,330 earned of potential $236,877 (55%)
Red bars are above average risk practices compared to region, green bars are below average risk practices for region.
Comparison of TCHHN Primary Care CPCI Results
Data provided by CMS -- tracked and reported quarterly
Bar graphs for each TCHHN primary care practice
Black line represents regional averages
Blue line represents TCHHN averages
Bar graphs in red – Above average mix of high risk patients as compared to other practices
Bar graphs in green -- Below average mix of high risk patients as compared to other practices
Red bars are above average risk practices compared to region, green bars are below average risk practices for region.