The document discusses the American Medical Association's (AMA) work on various issues including: advocating for physicians on regulatory and payment issues; fighting health insurance consolidation; addressing burnout and the burden of electronic health records; priorities under the Medicare Access and CHIP Reauthorization Act (MACRA); confronting chronic disease; efforts to address the opioid epidemic; supporting digital innovation in healthcare; and transforming medical education. The AMA is the largest physician organization in the US and represents physicians through its House of Delegates and Board of Trustees.
PYA Principal J. Michael Keegan, MD, recently presented “Pacing Volume-to-Value Transition” and “The ROI of Avoiding Antibiotic Overuse” at the AlaHA Annual Meeting, June 8-11, 2016. The presentation focused on the importance of antibiotic stewardship programs (ASP) for population health. The presentation explained:
Why the Centers for Medicare & Medicaid Services is proposing a requirement that hospitals implement ASPs to stem the rise of resistant bacteria.
Why PYA is invested in offering hospitals a proven program for improving patient safety while saving costs.
What constitutes a successful ASP.
Pacing Volume-to-Value Transition and The ROI of Avoiding Antibiotic Overuse PYA, P.C.
PYA Principals Scott Clay and J. Michael Keegan, MD, will join forces to present “Hot Topics: Pacing Volume-to-Value Transition” and “The ROI of Avoiding Antibiotic Overuse” at the AlaHA Annual Meeting, June 8-11, 2016. The two-part presentation first will explore volume- to value-based reimbursement, and how the pace of change is unique to each organization. The presentation will introduce a strategic framework to establish and communicate a pace of change befitting various organizations, explaining:
How government policies “set the floor” on the degree of change requested.
How to determine the pace of change in your market.
How to identify your organization’s current position and culture in relation to value-based payment models.
How to set and communicate the pace of transition consistent with your market and your organization’s culture.
The second portion of the presentation will focus on the importance of antibiotic stewardship programs (ASP) for population health. The presentation will explain:
Why the Centers for Medicare & Medicaid Services is proposing a requirement that hospitals implement ASPs to stem the rise of resistant bacteria.
Why PYA is invested in offering hospitals a proven program for improving patient safety while saving costs.
What constitutes a successful ASP.
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.
PYA Principal J. Michael Keegan, MD, recently presented “Pacing Volume-to-Value Transition” and “The ROI of Avoiding Antibiotic Overuse” at the AlaHA Annual Meeting, June 8-11, 2016. The presentation focused on the importance of antibiotic stewardship programs (ASP) for population health. The presentation explained:
Why the Centers for Medicare & Medicaid Services is proposing a requirement that hospitals implement ASPs to stem the rise of resistant bacteria.
Why PYA is invested in offering hospitals a proven program for improving patient safety while saving costs.
What constitutes a successful ASP.
Pacing Volume-to-Value Transition and The ROI of Avoiding Antibiotic Overuse PYA, P.C.
PYA Principals Scott Clay and J. Michael Keegan, MD, will join forces to present “Hot Topics: Pacing Volume-to-Value Transition” and “The ROI of Avoiding Antibiotic Overuse” at the AlaHA Annual Meeting, June 8-11, 2016. The two-part presentation first will explore volume- to value-based reimbursement, and how the pace of change is unique to each organization. The presentation will introduce a strategic framework to establish and communicate a pace of change befitting various organizations, explaining:
How government policies “set the floor” on the degree of change requested.
How to determine the pace of change in your market.
How to identify your organization’s current position and culture in relation to value-based payment models.
How to set and communicate the pace of transition consistent with your market and your organization’s culture.
The second portion of the presentation will focus on the importance of antibiotic stewardship programs (ASP) for population health. The presentation will explain:
Why the Centers for Medicare & Medicaid Services is proposing a requirement that hospitals implement ASPs to stem the rise of resistant bacteria.
Why PYA is invested in offering hospitals a proven program for improving patient safety while saving costs.
What constitutes a successful ASP.
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.
The transformation towards more integrated and accountable healthcare delivery systems is aligning physicians, outpatient care, hospitals and ultimately payers in unprecedented numbers. Yet creating a successful clinically integrated network can be a daunting and complicated undertaking.
Yale New Haven Health System (YNHHS), a nonprofit academic medical center, is following a seven-phase plan to achieve a regional, clinically integrated network with the ultimate goal of population health management.
Conifer Health President of Value-Based Care, Megan North and Gayle Capozzalo, FACHE Executive Vice President/Chief Strategy Officer, Yale New Haven Health System (YNHHS), co-presented at the the Becker’s Hospital Review 7th Annual Meeting in Chicago. North and Capozzalo shared “A Seven-Step Approach to a Clinically Integrated Network,” to provide insights into each step of the clinical integration road map.
Transitioning to Value Based Care: Tennessee Oncology, A Case StudyWes Chapman
Transitioning to value based care in medical oncology is a major strategic change in any medical practice. In this presentation to Grand Rounds at the Norris Cotton Cancer Center at Dartmouth, we look at the strategic and operational considerations of making such a transition effective.
March 02, 2018
Value-based health care is one of the most pressing topics in health care finance and policy today. Value-based payment structures are widely touted as critical to controlling runaway health care costs, but are often difficult for health care entities to incorporate into their existing infrastructures. Because value-based health care initiatives have bipartisan support, it is likely that these programs will continue to play a major role in both the public and private health insurance systems. As such, there is a pressing need to evaluate the implementation of these initiatives thus far and to discuss the direction that American health care financing will take in the coming years.
To explore this important issue, the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School collaborated with Ropes & Gray LLP to host a one-day conference on value-based health care. This event brought together scholars, health law practitioners, and health care entities to evaluate the impact of value-based health care on the American health care system.
For more information, visit our website at: http://petrieflom.law.harvard.edu/events/details/will-value-based-care-save-the-health-care-system
Since the launch of the Marketplaces and Medicaid expansion, one out of every 20 Americans has been added to the Medicaid roll. More than 51 million Americans receive physical health benefits from a private Medicaid health plan (or 70% of all beneficiaries) and as of Q3 2015, 41 states had some form of private managed Medicaid. Along with the rapid expansion of Medicaid, comes the push for managed care plans to adopt value-based care approaches that tie provider reimbursement to quality measures and better outcomes. This presentation gives physicians crucial details about Medicaid and CHIP Managed Care Proposed Rule CMS 2390-P, and the five factors for value-based payment success in the era of Managed Medicaid.”
PYA Principal Martie Ross joined University of Kansas Medical Center’s Robert Moser, MD, and CIO Chris Hansen for the keynote presentation at the joint symposium by Heart of America Healthcare Information and Management Systems Society and Missouri Health Information Management Association, September 14, 2016, at Johnson County Community College in Overland Park, Kansas. They discussed insights related to the role of advanced analytics and technology in transforming and transitioning to new payment models.
Current Trends in Data Protection for Integrated Health, Centralized Peer Rev...PYA, P.C.
A webinar hosted by PYA and the Alliance for Quality Improvement (AQIPS) explored “Current Trends in Data Protection for Integrated Health, Centralized Peer Review Systems, and Other Innovative Programs.” PYA Principal Martie Ross participated in the webinar, which focused on how patient safety organization (PSO) protections can bring value to accountable care organizations and other integrated health systems.
In addition, the webinar provided instruction for using:
Patient Safety and Quality Improvement Act (PSQIA) protections in Medicare Shared Savings Programs, centralized peer review programs, and other collaboratives.
PSQIA protections for new types of clinical analysis, clinical quality reports, and performance tools that contain information that may not be protected under existing state peer review privilege or are shared among an integrated network.
Revenue at Risk: Understanding Financial Impacts of Quality ReportingBill Presley
Jodi Frei, Northwestern Medical Center Vermont, and I co-presented at the MUSE Executive Institute on Revenue at Risk: Understanding Financial Impacts of Quality Reporting. The Executive Institute featured many amazing CXO's discussing the changing landscape of revenue cycle management and how finance, quality, and IT departments are converging on revenue cycle.
Though pay for performance is the common theme, the logistics of programs including Value Based Purchasing (VBP), Inpatient Quality Reporting (IQR), Hospital Acquired Condition (HAC) Reduction Program, Readmission Reduction, MACRA, MIPS and APMs, are very different. In this session, the specifics of each Quality Program including reporting requirements, scoring methodologies, and associated incentives and penalties will be covered. In addition, tools to track performance and quantify financial risk will be shared.
Reimbursement in this era of health care reform is challenging. We all seek success under this new normal in health care. Optimizing revenue capture in a quality reimbursement model requires acquisition of new knowledge and the use of new tools and strategies. Join us in the conversation; share your strategies; learn from others.
Riding the Rapids of Payment Reform: Downstream Effects of Quality Reporting ...Bill Presley
In this presentation, we highlighted how quality measurement programs impact reimbursement affecting your revenue. The revenue at risk in your organization. We focused on quality programs like Value-Based Purchasing (VBP), Merit-Based Incentive Program (MIPS) and Alternative Payment Models (APM) and their impact on Part A and Part B reimbursements.
It’s no surprise that reimbursement tied to quality performance is quickly becoming a reality for hospitals and physicians. CMS’ aggressive goals aimed at increasing the percentage of Medicare payments associated with quality versus quantity can be achieved through such programs as Value-based Purchasing and MACRA. This session will cover scoring methodologies, reporting requirements, reimbursement impact, infrastructure (and other resource needs), EMR tools and tactics, and workflow modifications.
Modern Physician-Hospital Affiliations in an Era of Increased Fraud and Abuse...PYA, P.C.
PYA Senior Manager Chris Beckham co-presented “Modern Physician-Hospital Affiliations in an Era of Increased Fraud and Abuse Scrutiny” with Ross Burris of Polsinelli at the American Health Lawyer Association’s (AHLA) Physicians and Hospitals Law Institute, February 8-10, 2016.
The Alphabet Soup of Clinical Quality Measures ReportingBill Presley
CMS is transitioning to what the they call "a new and more responsive regulatory framework" for quality reporting and reimbursement. CMS goals are "…electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people". Over the next couple years, we will see a transformation of fee for service into value-based care models driven by the VBP, Quality Payment Program, MACRA, Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Healthcare organizations will no longer be motivated by implementing and meeting Meaningful Use, but instead will be driven by value-based care and risk-based payment models that focus on quality outcomes for reimbursements.
In this Education Session we will review:
• How CMS is aligning clinical quality measures (CQMs) to reduce the reporting burden for healthcare organizations and providers. We will cover the vision and goals for achieving quality alignment for CMS.
• We will dive into the following CMS reporting programs and how they interact with each other: Value-Based Purchasing (VBP), Medicare Access and CHIP Reauthorization Act (MACRA), Merit-based Incentive Payments (MIPS), Hospital Inpatient Quality Reporting (IQR), The Joint Commission (ORYX), Outpatient Quality Reporting (OQR), and Alternative Payment Models (APM).
At the Heart of the Matter: Medical NecessityPYA, P.C.
PYA Principal Denise Hall and Michael Spake, Vice President of External Affairs and Chief Compliance & Integrity Officer at Lakeland Regional Health System, co-presented “At the Heart of the Matter: Medical Necessity,” at the AHLA Institute on Medicare and Medicaid Payment Issues. They discussed:
Recent cases and legal actions
Impact of medical necessity when interpreting the regulations and guidelines for:
-Stents
-Pacemakers
-Automatic Implantable Cardiac Defibrillators (AICD)
-Electrophysiology Studies (EPS) and Ablations
Common areas of risk in applying local coverage determination (LCD)/national coverage determination (NCD) guidance to cardiac procedures: how to identify your risks and avoid vulnerability
Best practices for ensuring compliance with regulations
Achieving population health management through more coordinated care is becoming essential as healthcare organizations move away from fee-for-service models and begin operating in the new value-based care environment. One path to succeeding in this new environment and achieving more coordinated care is through formation of a clinically integrated network.
Yale New Haven Health System (YNHHS), a nonprofit academic medical center, is following a seven-phase plan to achieve a regional, clinically integrated network with the ultimate goal of population health management.
On March 16, 2016, President of Value-Based Care, Megan North and Amanda Skinner, Executive Director of Clinical Integration and Population Health for Yale New Haven Health System (YNHHS), co-presented at the 2016 American College of Healthcare Executives’ Annual Congress on Healthcare Leadership (ACHE Congress). North and Skinner shared “A Step-by-Step Approach to A Clinically Integrated Network,” to provide insights into each step of the clinical integration road map.
The Biggest Healthcare Trends of 2019 and What's to Come in 2020Health Catalyst
In our Healthcare Outlook for 2019 webinar, Stephen Grossbart, PhD, and Bobbi Brown, MBA, shared their predictions for the biggest trends of the year. Which predictions panned out and which didn’t? View this webinar as Stephen takes a look back at 2019 and makes his forecast for 2020.
So, what did happen in 2019? Following the 2018 midterm elections, we predicted a divided Congress would not pass policies to strengthen or weaken the Affordable Care Act (ACA). We were right. Meanwhile, Democratic presidential candidates debated the extent to which they would support Medicare for All. Insurance costs continued to rise, breaking $20,000 annually for families with employer-sponsored coverage, and CMS continued to support payment policies rewarding quality and interoperability as part of their payment policy.
Join Stephen as he looks in the rearview mirror at these important issues and how they impacted the healthcare industry in 2019 and then gazes into the crystal ball to predict the trends that will most impact healthcare in 2020. In this webinar, Stephen discusses the following topics and more:
• The continued focus on price transparency.
• Congress’ efforts to control prescription drug costs.
• Policies that may change the future of ACOs.
• What to expect going into the 2020 election year.
The transformation towards more integrated and accountable healthcare delivery systems is aligning physicians, outpatient care, hospitals and ultimately payers in unprecedented numbers. Yet creating a successful clinically integrated network can be a daunting and complicated undertaking.
Yale New Haven Health System (YNHHS), a nonprofit academic medical center, is following a seven-phase plan to achieve a regional, clinically integrated network with the ultimate goal of population health management.
Conifer Health President of Value-Based Care, Megan North and Gayle Capozzalo, FACHE Executive Vice President/Chief Strategy Officer, Yale New Haven Health System (YNHHS), co-presented at the the Becker’s Hospital Review 7th Annual Meeting in Chicago. North and Capozzalo shared “A Seven-Step Approach to a Clinically Integrated Network,” to provide insights into each step of the clinical integration road map.
Transitioning to Value Based Care: Tennessee Oncology, A Case StudyWes Chapman
Transitioning to value based care in medical oncology is a major strategic change in any medical practice. In this presentation to Grand Rounds at the Norris Cotton Cancer Center at Dartmouth, we look at the strategic and operational considerations of making such a transition effective.
March 02, 2018
Value-based health care is one of the most pressing topics in health care finance and policy today. Value-based payment structures are widely touted as critical to controlling runaway health care costs, but are often difficult for health care entities to incorporate into their existing infrastructures. Because value-based health care initiatives have bipartisan support, it is likely that these programs will continue to play a major role in both the public and private health insurance systems. As such, there is a pressing need to evaluate the implementation of these initiatives thus far and to discuss the direction that American health care financing will take in the coming years.
To explore this important issue, the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School collaborated with Ropes & Gray LLP to host a one-day conference on value-based health care. This event brought together scholars, health law practitioners, and health care entities to evaluate the impact of value-based health care on the American health care system.
For more information, visit our website at: http://petrieflom.law.harvard.edu/events/details/will-value-based-care-save-the-health-care-system
Since the launch of the Marketplaces and Medicaid expansion, one out of every 20 Americans has been added to the Medicaid roll. More than 51 million Americans receive physical health benefits from a private Medicaid health plan (or 70% of all beneficiaries) and as of Q3 2015, 41 states had some form of private managed Medicaid. Along with the rapid expansion of Medicaid, comes the push for managed care plans to adopt value-based care approaches that tie provider reimbursement to quality measures and better outcomes. This presentation gives physicians crucial details about Medicaid and CHIP Managed Care Proposed Rule CMS 2390-P, and the five factors for value-based payment success in the era of Managed Medicaid.”
PYA Principal Martie Ross joined University of Kansas Medical Center’s Robert Moser, MD, and CIO Chris Hansen for the keynote presentation at the joint symposium by Heart of America Healthcare Information and Management Systems Society and Missouri Health Information Management Association, September 14, 2016, at Johnson County Community College in Overland Park, Kansas. They discussed insights related to the role of advanced analytics and technology in transforming and transitioning to new payment models.
Current Trends in Data Protection for Integrated Health, Centralized Peer Rev...PYA, P.C.
A webinar hosted by PYA and the Alliance for Quality Improvement (AQIPS) explored “Current Trends in Data Protection for Integrated Health, Centralized Peer Review Systems, and Other Innovative Programs.” PYA Principal Martie Ross participated in the webinar, which focused on how patient safety organization (PSO) protections can bring value to accountable care organizations and other integrated health systems.
In addition, the webinar provided instruction for using:
Patient Safety and Quality Improvement Act (PSQIA) protections in Medicare Shared Savings Programs, centralized peer review programs, and other collaboratives.
PSQIA protections for new types of clinical analysis, clinical quality reports, and performance tools that contain information that may not be protected under existing state peer review privilege or are shared among an integrated network.
Revenue at Risk: Understanding Financial Impacts of Quality ReportingBill Presley
Jodi Frei, Northwestern Medical Center Vermont, and I co-presented at the MUSE Executive Institute on Revenue at Risk: Understanding Financial Impacts of Quality Reporting. The Executive Institute featured many amazing CXO's discussing the changing landscape of revenue cycle management and how finance, quality, and IT departments are converging on revenue cycle.
Though pay for performance is the common theme, the logistics of programs including Value Based Purchasing (VBP), Inpatient Quality Reporting (IQR), Hospital Acquired Condition (HAC) Reduction Program, Readmission Reduction, MACRA, MIPS and APMs, are very different. In this session, the specifics of each Quality Program including reporting requirements, scoring methodologies, and associated incentives and penalties will be covered. In addition, tools to track performance and quantify financial risk will be shared.
Reimbursement in this era of health care reform is challenging. We all seek success under this new normal in health care. Optimizing revenue capture in a quality reimbursement model requires acquisition of new knowledge and the use of new tools and strategies. Join us in the conversation; share your strategies; learn from others.
Riding the Rapids of Payment Reform: Downstream Effects of Quality Reporting ...Bill Presley
In this presentation, we highlighted how quality measurement programs impact reimbursement affecting your revenue. The revenue at risk in your organization. We focused on quality programs like Value-Based Purchasing (VBP), Merit-Based Incentive Program (MIPS) and Alternative Payment Models (APM) and their impact on Part A and Part B reimbursements.
It’s no surprise that reimbursement tied to quality performance is quickly becoming a reality for hospitals and physicians. CMS’ aggressive goals aimed at increasing the percentage of Medicare payments associated with quality versus quantity can be achieved through such programs as Value-based Purchasing and MACRA. This session will cover scoring methodologies, reporting requirements, reimbursement impact, infrastructure (and other resource needs), EMR tools and tactics, and workflow modifications.
Modern Physician-Hospital Affiliations in an Era of Increased Fraud and Abuse...PYA, P.C.
PYA Senior Manager Chris Beckham co-presented “Modern Physician-Hospital Affiliations in an Era of Increased Fraud and Abuse Scrutiny” with Ross Burris of Polsinelli at the American Health Lawyer Association’s (AHLA) Physicians and Hospitals Law Institute, February 8-10, 2016.
The Alphabet Soup of Clinical Quality Measures ReportingBill Presley
CMS is transitioning to what the they call "a new and more responsive regulatory framework" for quality reporting and reimbursement. CMS goals are "…electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people". Over the next couple years, we will see a transformation of fee for service into value-based care models driven by the VBP, Quality Payment Program, MACRA, Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Healthcare organizations will no longer be motivated by implementing and meeting Meaningful Use, but instead will be driven by value-based care and risk-based payment models that focus on quality outcomes for reimbursements.
In this Education Session we will review:
• How CMS is aligning clinical quality measures (CQMs) to reduce the reporting burden for healthcare organizations and providers. We will cover the vision and goals for achieving quality alignment for CMS.
• We will dive into the following CMS reporting programs and how they interact with each other: Value-Based Purchasing (VBP), Medicare Access and CHIP Reauthorization Act (MACRA), Merit-based Incentive Payments (MIPS), Hospital Inpatient Quality Reporting (IQR), The Joint Commission (ORYX), Outpatient Quality Reporting (OQR), and Alternative Payment Models (APM).
At the Heart of the Matter: Medical NecessityPYA, P.C.
PYA Principal Denise Hall and Michael Spake, Vice President of External Affairs and Chief Compliance & Integrity Officer at Lakeland Regional Health System, co-presented “At the Heart of the Matter: Medical Necessity,” at the AHLA Institute on Medicare and Medicaid Payment Issues. They discussed:
Recent cases and legal actions
Impact of medical necessity when interpreting the regulations and guidelines for:
-Stents
-Pacemakers
-Automatic Implantable Cardiac Defibrillators (AICD)
-Electrophysiology Studies (EPS) and Ablations
Common areas of risk in applying local coverage determination (LCD)/national coverage determination (NCD) guidance to cardiac procedures: how to identify your risks and avoid vulnerability
Best practices for ensuring compliance with regulations
Achieving population health management through more coordinated care is becoming essential as healthcare organizations move away from fee-for-service models and begin operating in the new value-based care environment. One path to succeeding in this new environment and achieving more coordinated care is through formation of a clinically integrated network.
Yale New Haven Health System (YNHHS), a nonprofit academic medical center, is following a seven-phase plan to achieve a regional, clinically integrated network with the ultimate goal of population health management.
On March 16, 2016, President of Value-Based Care, Megan North and Amanda Skinner, Executive Director of Clinical Integration and Population Health for Yale New Haven Health System (YNHHS), co-presented at the 2016 American College of Healthcare Executives’ Annual Congress on Healthcare Leadership (ACHE Congress). North and Skinner shared “A Step-by-Step Approach to A Clinically Integrated Network,” to provide insights into each step of the clinical integration road map.
The Biggest Healthcare Trends of 2019 and What's to Come in 2020Health Catalyst
In our Healthcare Outlook for 2019 webinar, Stephen Grossbart, PhD, and Bobbi Brown, MBA, shared their predictions for the biggest trends of the year. Which predictions panned out and which didn’t? View this webinar as Stephen takes a look back at 2019 and makes his forecast for 2020.
So, what did happen in 2019? Following the 2018 midterm elections, we predicted a divided Congress would not pass policies to strengthen or weaken the Affordable Care Act (ACA). We were right. Meanwhile, Democratic presidential candidates debated the extent to which they would support Medicare for All. Insurance costs continued to rise, breaking $20,000 annually for families with employer-sponsored coverage, and CMS continued to support payment policies rewarding quality and interoperability as part of their payment policy.
Join Stephen as he looks in the rearview mirror at these important issues and how they impacted the healthcare industry in 2019 and then gazes into the crystal ball to predict the trends that will most impact healthcare in 2020. In this webinar, Stephen discusses the following topics and more:
• The continued focus on price transparency.
• Congress’ efforts to control prescription drug costs.
• Policies that may change the future of ACOs.
• What to expect going into the 2020 election year.
Lean Healthcare: 6 Methodologies for Improvement from Dr. Brent JamesHealth Catalyst
The survival of healthcare organizations depends on applying lean principles. Organizations that adopt lean principles can reduce waste while improving the quality of care. By applying stringent clinical data measurement approaches to routine care delivery, healthcare systems identify best practice protocols and incorporate those into the clinical workflow. Data from these best practices are applied through continuous-learning loop that enables teams across the organization to update and improve protocols–ultimately reducing waste, lowering costs, and improving access to care.
This executive report based on a presentation by Dr. Brent James at a regional medical center, covers the following:
1. How lean healthcare principles can help improve the quality of care.
2. The steps healthcare organizations need to take to create a continuous-learning loop.
3. How a lean approach creates financial leverage by eliminating waste and improving net operating margins and ROI.
Presentation in the framework of the International Conference "10th anniversary of the Spanish Network of Health Technology Assessment Agencies. Towads patient and public engagement in HTA" Zaragoza 27-28 April 2017
The Next Revolution in Healthcare: Why the New MSSP Revisions Matter Now More...Health Catalyst
Now more than ever, we are entering a period of rapid change catalyzed by the power of data. On December 21, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for the Medicare Shared Savings Program (MSSP), strengthening the financial incentives for ACOs to drive improved outcomes. The health systems that embrace data to achieve financial success will grow while the rest will struggle to compete. View this webinar for a discussion on how to prepare.
The US healthcare system didn’t develop overnight, rather, it is the culmination of a series of revolutions within wealthy parts of the world. In this webinar, we explore the high points of history that have led us to our current challenges. While care has steadily improved over time, the cost of that care has risen at a much more dramatic rate. CMS created the MSSP to help mitigate the growth of these costs while providing better care for individuals and populations. On a larger scale, the program serves to shift the healthcare industry towards fee-for-value.
Despite general frustration related to legislative involvement, history has proven that regulatory changes precede attitudinal changes and the MSSP (combined with accurate, timely data) may be just the piece of legislation to help make value-based care a reality. By viewing this webinar you will learn:
- How the US healthcare industry reached its current state.
- Why financial imperatives drive cultural change in our economic model.
- Ways that the MSSP can help your organization achieve financial success.
- Ideas for how to utilize data to develop better healthcare delivery systems.
Dr. Will Caldwell is a strong proponent of the use of data analytics to promote good health and save lives. His area of expertise rests in technology-enabled health care delivery models and value-based care platforms. We hope that you will view this webinar and learn from his 17-years of work as a data-informed clinician.
3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINOCNseg
Palestra de Carmella Bocchino no 3º Fórum Nacional da Saúde Suplementar, realizado pela Federação Nacional de Saúde Suplementar (FenaSaúde), no Sheraton WTC São Paulo Hotel, no dia 5 de outubro de 2017.
Online Conference Takes “Deep Dive” into Affordable Care ActPYA, P.C.
PYA’s Martie Ross, Principal, joined three other panelists in a full-day, online conference sponsored by the American Institute of Certified Public Accountants to offer an in-depth look at healthcare reform under the Affordable Care Act (ACA).
During the 2018 mid-term elections, candidates faced off making big claims that they would be the ones to fix healthcare. Now that they are back to work, what can we anticipate with a new Congress? Will we finally see improvements or gridlock? Join Bobbi Brown, MBA and Stephen Grossbart, PhD as they tackle these questions along with a 2018 lookback of what went right and 2019 predictions of the most important trends that will impact our daily work.
Beyond political maneuvering, in 2018 we saw material changes in the business of healthcare. The pace of mergers, acquisitions and partnerships was strong and deals like the pending acquisition of Aetna by CVS, could dramatically impact patient behavior and revenue streams. In addition, the Center for Medicare & Medicaid Services (CMS) continues to support existing programs while adding new measures to support transparency, interoperability and a continued shift to value-based payments. What does this mean for your organization in 2019? View this webinar to learn more across these areas:
- The business of healthcare including new market entrants, business models and shifting strategies to stay competitive.
- Continuous quality and cost control monitoring across populations.
- CMS proposals to push ACOs into two-sided risk models.
- Historic changes to Merit-based Incentive Payment System (MIPS).
- Fewer process measures but more quality outcomes scrutiny for providers.
- Increased consumer demand for more transparency.
There are many challenges and opportunities for all of us in healthcare. Join Bobbi and Stephen as they draw upon their decades of experience to make sense of the past year and look ahead to give you guidance for the new year. This is the fourth year running that Bobbi has presented her predictions at the turn of the new year and past attendees will remember that her knack for predicting is uncanny and her stories are unforgettable. This time was no different.
Why Clinical Quality Should Be Your Core Business StrategyHealth Catalyst
Over 100 years ago, healing professionals and healthcare itself went through a massive transformation that led us to the models of care delivery that we use today. Dr. Brent James argues that we are now, again, at a once-in-a-century inflection point to change the course of healthcare. Change takes real effort, but provides massive opportunity.
Those changes include a move away from the highly-profitable fee-for-service payment to fee-for-value. An IOM report, published in 2010, substantiated that more than a third of healthcare spending is waste. Pay-for-value aligns financial returns for those who invest in waste elimination. It also requires that clinicians move away from the craft of medicine to the science of medicine, using data and evidence to drive better clinical care.
As the vice president and chief quality officer at Intermountain Healthcare, Dr. James led much of the change that produced Intermountain’s recognized operational and clinical excellence. In this webinar Dr. James educates and inspires all of us to do great work by sharing practical stories of how data has become the critical tool to help healthcare shift from revenue enhancement to clinical quality, which produces the most affordable care.
Learn how to:
- Use data to find variations in both cost and quality of care.
- Standardize care without demotivating underperforming outliers.
- Build a culture of data-driven care providers.
- Develop an improvement strategy that you can start today.
Sought the world over, Dr. James is a recognized expert in this outcomes improvements area. He has championed the standardization of clinical care through data collection and analysis on a wide variety of treatment protocols and complex care processes for more than 20 years.
Why Payers, Providers and Life Science/Pharma Must Join Forces to Achieve Tru...Health Catalyst
Is value-based care (VBC) the path to reducing the 18% of GDP that is spent on healthcare? It just may be, but all parties must play their part. Iya Khalil, chief commercial officer & co-founder at GNS Healthcare argues that in order for VBC to reach peak levels of performance and adoption, there must be a convergence of understanding between three key players: payers, providers and the life science industry.
These three parties have developed lifesaving innovations, tech-enabled new procedures, and advanced medical training that have all contributed over the last half century to push the US economy to spend an unsustainable amount on healthcare. Data and analytics are key to fixing this problem and are transforming the way that healthcare is delivered, however, VBC implementation remains complex. In this webinar Iya and Elia Stupka, SVP and general manager, life sciences business at Health Catalyst discuss how the healthcare industry reached this tipping point, why the move to VBC is so important, and how these parties can jointly work together to make healthcare sustainable.
View the webinar and learn:
- How you can make the move to VBC
- The importance of AI and data to drive VBC
VBC will happen and presents an unprecedented moment for payers, providers and life science groups to work together.
mHealth Israel_US Health Insurance Overview- An Insider's PerspectiveLevi Shapiro
Presentation about the US Health Insurance Sector by Lori Rund, VP, Product Management and Market Intelligence at Health Alliance Plan, a managed care organization owned by the Henry Ford Health System, with 650,000 lives. Lori is responsible for the identification, concept building, researching and business case developments for new products, services and markets. She develops and leads comprehensive market intelligence functions to help the organization better understand industry trends and identify business opportunities.
Prior to joining Health Alliance Plan, Lori was Director of Product Development and Market Intelligence at Health Alliance Medical Plans in Illinois and Director of Market Research and Strategy at Carle Clinic Association, also in Illinois.
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Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
