What are the four conceptual templates for value based care? Is the compensation really worth it? We give you the answers here in this insightful slide-share.
What are the hurdles to overcome in the transition from fee-for-service to value-based reimbursement? Is Value Based Care here to stay? Learn more from this slide-share on the differences between Value Based Care and Fee For Service.
What are the four conceptual templates for value based care? Is the compensation really worth it? We give you the answers here in this insightful slide-share.
What are the hurdles to overcome in the transition from fee-for-service to value-based reimbursement? Is Value Based Care here to stay? Learn more from this slide-share on the differences between Value Based Care and Fee For Service.
Did the Affordable Care Act pave the way for a number of value based purchasing programs? What is the methodology for value based healthcare reform payment? We give you the answers here.
How to propose a model as an alternative payment model (apm) by steven lashSteven Lash
According to noted healthcare consultant Steven Lash the proposed questions seek information on how the proposed APM would improve quality and lower costs, along with some technical details of its operation.
Diabetes And Accountable Care Organizations: A Value-Based Care StrategyNorth Texas CIN (TXCIN)
Studies project that 1 in 3 people will develop type 2 diabetes by 2050. With this information in mind, what is the strategy for ACOs for diabetes care? How do they plan to lower costs? We give you the answers here
This presentation focuses on key elements, graphs, and charts from a CMR Institute white paper written by Anthony D. Slonim, MD, DrPH, Executive Vice President and Chief Medical Officer, Barnabas Health. Executive Director, Barnabas Health ACO-North.
Physician Contracting for Exceptional HospitalsMD Ranger, Inc.
Some hospitals have complexities that require careful consideration while determining a physician contracting compliance process. This video will help you identify potential solutions for academic medical centers, children's hospitals, trauma centers, and small hospitals.
Cost-Quality Aim Analyzer for Ambulatory Carepscisolutions
The PSCI Cost-Quality (Triple Aim) Analyzer for Ambulatory Care module brings together three streams of customer data ― financial, clinical quality, and patient experience. The Cost-Quality Analyzer module analyzes cost in context of quality and patient experience. Optionally, a fourth stream ― State-of-Health (SOH) risk scores ― can be added through the Population SOH Analyzer module.
Did the Affordable Care Act pave the way for a number of value based purchasing programs? What is the methodology for value based healthcare reform payment? We give you the answers here.
How to propose a model as an alternative payment model (apm) by steven lashSteven Lash
According to noted healthcare consultant Steven Lash the proposed questions seek information on how the proposed APM would improve quality and lower costs, along with some technical details of its operation.
Diabetes And Accountable Care Organizations: A Value-Based Care StrategyNorth Texas CIN (TXCIN)
Studies project that 1 in 3 people will develop type 2 diabetes by 2050. With this information in mind, what is the strategy for ACOs for diabetes care? How do they plan to lower costs? We give you the answers here
This presentation focuses on key elements, graphs, and charts from a CMR Institute white paper written by Anthony D. Slonim, MD, DrPH, Executive Vice President and Chief Medical Officer, Barnabas Health. Executive Director, Barnabas Health ACO-North.
Physician Contracting for Exceptional HospitalsMD Ranger, Inc.
Some hospitals have complexities that require careful consideration while determining a physician contracting compliance process. This video will help you identify potential solutions for academic medical centers, children's hospitals, trauma centers, and small hospitals.
Cost-Quality Aim Analyzer for Ambulatory Carepscisolutions
The PSCI Cost-Quality (Triple Aim) Analyzer for Ambulatory Care module brings together three streams of customer data ― financial, clinical quality, and patient experience. The Cost-Quality Analyzer module analyzes cost in context of quality and patient experience. Optionally, a fourth stream ― State-of-Health (SOH) risk scores ― can be added through the Population SOH Analyzer module.
Introduces Value-based Healthcare, an important concept for transforming healthcare making it more cost-effective, sustainable, and patient-centered. Strategically, it makes the healthcare providers accountable to the desired patient and health system "valued" outcomes.
https://youtu.be/-oOuJfpRFpY
The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
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Three Keys to a Successful Margin: Charges, Costs, and LaborHealth Catalyst
How can cost management and complete charge capture protect and enhance the margin?
In this webinar, we will look at 2024 margin pressures likely to impact your organization’s financial resiliency. This presentation will also share how organizations can move from Fee-for-Service to Value; bringing Cost to the forefront.
Population Health Management: Enabling Accountable Care in Collaborative Prov...Salus One Ed
This document provides the reader information about population health management (PMH), how it relates to incentive payments for healthcare providers and their health insurance partners (commercial and government). See details about required transformation of care delivery methods, typical accountable care payment models, how to achieve incentives, partnerships between state government (public health) and community shared services needs and necessary technology and data to achieve it.
A Clinically Integrated Network (CIN) is a selective partnership of physicians collaborating with
hospital(s) and other providers to deliver evidence-based care, improve quality and efficiency,
manage populations and demonstrate value to the market. Once these objectives are met, the network may contract on behalf of participants
Network physicians, hospitals, and other care continuum providers work collaboratively in active clinical process improvement programs across service lines and specialties to define, establish, implement, monitor, evaluate and periodically update the processes of:
- Evidence-based medicine
- Beneficiary engagement
- Care coordination
- Conservation of healthcare resources
- Clinical data reporting
ACOs and CINs — Where Did They Start, How Have They Evolved, and Where Are Th...Health Catalyst
As the types and structures of Accountable Care Organizations (ACOs) and Clinically Integrated Networks (CINs) continue to evolve, organizations moving into value-based care face an ever-changing landscape. Alternative payment model arrangements have driven provider organizations to hone in on specific tactics to meet their contractual and strategic objectives.
Please join Health Catalyst Senior Vice President Dr. Amy Flaster and Population Health Management Consultant Jonas Varnum as they discuss the evolution of the ACO and CIN models, what new tools ACOs employ today to promote success, and lessons learned from organizations that have succeeded in alternative payment models. They will dive deep into lessons learned in addition to providing a primer on what has always been and continues to be vitally important to success in value based care. Specifics they will cover include:
- Approaches to simplify quality metric reporting
- Enhanced methodology that zeroes in on identifying high-value opportunities to improve patient populations
- Key tips to expand your business with new contracts
Dr. Flaster and Mr. Varnum’s combined experience make them uniquely qualified to guide you in your ACO or CIN journey. Dr. Flaster comes from a clinical background where she worked as Associate Medical Director at Partners HealthCare - one of the largest ACOs in the country. Mr. Varnum is a professional services strategy leader with demonstrated expertise delivering payment model transformation and helping providers and payers to strategically adjust their operations.
Modern Relationships Between Physicians, Hospitals, and Long-Term Care Provid...PYA, P.C.
PYA Consulting Manager Aaron Elias co-presented “Modern Relationships Between Physicians, Hospitals, and Long-Term Care Providers in a Time of Risk-Based Contracting,” along with Jeanna Palmer Gunville, a shareholder at Polsinelli.
Similar to Positioning FQHCs for Value-Based Payment (20)
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.
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.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
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.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
2. Outline
• Understanding the “New World”
• An Introduction to Health Reform and Payment
Arrangements
• The World of Payers
• A Framework for Building Value-Based Care
• Patient-Centered Access
• Team-Based Care
• Population Health Management
• Care Management and Support
• Care Coordination and Care Transitions
• Performance Measurement/QI
• Tying it all together for value-based care
3. Objectives
• Attendees will be able to identify and define key terminology
commonly utilized in value-based payment arrangements.
• Attendees will learn the details of common value-based
payment arrangements and the challenges and opportunities
associated with the payment design.
• Attendees will learn operational strategies for positioning
facilities for value-based payment arrangements.
4. So What Is Value-Based Payment?
• It is a payment model that rewards providers
for meeting certain performance measures for
quality and efficiency. It often penalizes
caregivers for poor outcomes or increased costs.
• Also known as “pay-for-performance“ (P4P) or
“value-based purchasing”.
• Contrasted with “fee-for-service” (FFS) or
“volume-based payment”.
• ACA pushing towards VBP: ACOs and quality
links to payment.
5. Intro to Health/Payment Reform
• The Department of Health and Human Services (HHS)
focus areas:
• Payment Incentives: Tying payment to value through
alternative payment models;
• Care Coordination: Care delivery changes through greater
teamwork, integration, coordination of providers across
settings, and a focus on population health;
• Data and Technology: Harnessing the power of information to
improve care for patients (Burwell, 2015).
http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-3.html
6. Intro to Health/Payment Reform
• CMS Goals: (Announced 1/26/2015)
• 85% of all Medicare fee-for-service
payments tied to quality or value
by 2016 (90% by 2018).
• 30% of Medicare payments tied to
quality or value through
alternative payment models by the
end of 2016 (50% by the end of
2018).
• First time in history!
80
60
37.5
15 12.5 10
15
20
37
55
47
40
2.5
10
12.5
15
20
25
2.5
10 12.5 15 20 25
2011 2014 2015 2016 2017 2018
Medicare Payment Goals
Category 4 Population-based payment
Category 3 Alternative payment models built on fee-for-
service architecture
Category 2 Fee-for-service with a link of payment to quality
Category 1 Fee-for-service with no link of payment to quality
http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-3.html
7. Väth Consulting, LLC
For complete presentation, please contact Väth Consulting
at
vathconsulting.com or kyle@vathconsulting.com