- The healthcare industry is undergoing major changes driven by the shift from fee-for-service to value-based reimbursement models.
- To succeed under value-based models, healthcare organizations will need to better coordinate care across their networks of providers using health information exchange infrastructure.
- This report defines a new concept called Clinician Network Management, which uses health information exchange platforms to support provider networks through activities like longitudinal patient data viewing, risk scoring, care guidance, and cost of care tracking.
Top Healthcare and Revenue Cycle Trends to watch for in 2019Manish Jain
2017 required healthcare organizations to respond to several new challenges – political change, growing role of technology, shift to value-based care and the increasing role of information security. While we anticipate that these issues will continue to influence through 2018, we will also see new challenges. The blurring lines between providers and payers, a refocusing on care (and more so on the patient), and a changing policy environment will occupy the center stage for 2018.
This whitepaper provides an assessment of the passing of the American Recovery and Reinvestment Act of 2009 (ARRA) which has given “legs” to accelerate physician electronic health record (EHR) adoption via Stark Safe Harbor compliant programs for hospitals.
The combined Stark Safe Harbor and ARRA makes a clear case to move quickly with an EHR initiative.
Cogora in collaboration with NHS England conducted a series of in-depth interviews with the managing directors of 17 commissioning support units (CSUs) and the health leads at 23 independent sector providers of commissioning support services (CSSs).
Top Healthcare and Revenue Cycle Trends to watch for in 2019Manish Jain
2017 required healthcare organizations to respond to several new challenges – political change, growing role of technology, shift to value-based care and the increasing role of information security. While we anticipate that these issues will continue to influence through 2018, we will also see new challenges. The blurring lines between providers and payers, a refocusing on care (and more so on the patient), and a changing policy environment will occupy the center stage for 2018.
This whitepaper provides an assessment of the passing of the American Recovery and Reinvestment Act of 2009 (ARRA) which has given “legs” to accelerate physician electronic health record (EHR) adoption via Stark Safe Harbor compliant programs for hospitals.
The combined Stark Safe Harbor and ARRA makes a clear case to move quickly with an EHR initiative.
Cogora in collaboration with NHS England conducted a series of in-depth interviews with the managing directors of 17 commissioning support units (CSUs) and the health leads at 23 independent sector providers of commissioning support services (CSSs).
Reaching Out, Inviting In: How Medical Call Centers Can Give Hospitals an Edg...TinaMinnick
Certainly the advent of value‐based purchasing attaches a persuasive incentive for improved core measures and HCAHPS performance, but as any hospital that has experienced a negative letter to the editor or defaming remark on a website will attest, the hard and soft costs of patient satisfaction can impact more than just the bottom line. Forward‐thinking organizations not only seek to understand the relationship between patient communications and satisfaction,they are forging it.
Like it or not, the Center for Medicare and Medicaid Services (CMS) has turned from Fee- for -Service (FFS) to Pay-for –Performance (PFP) or a Value Based Purchasing (VBP) model. The question is not whether or not providers, hospitals and systems are ready to let go of those margins, but rather what can they do to mitigate risk today and protect the Revenue Cycle of tomorrow?
In recent years, medical device manufacturers have embarked on an acquisition binge. We’ve seen a series of blockbuster deals as well as numerous smaller transactions. This M&A bonanza has been sparked in part by the belief that absolute scale creates competitive advantage.
But does it? In many other industries, we find a clear correlation between overall scale and profitability. Classic strategy has long focused on building scale because larger companies tend to wield more influence with customers and have a greater ability to maintain pricing discipline. They also benefit from the most accumulated experience with driving down costs and can spread costs over the widest base of business.
Yet in medtech, the correlation between industry scale and profitability is quite weak. Instead, Bain research shows that profitability is more a function of category leadership than overall scale.
The market shift toward value-based care presents unprecedented opportunities and challenges for the US health care system. Instead of rewarding volume, new
value-based payment models reward better results in terms of cost, quality, and outcome measures. These largely untested models have the potential to upend health care stakeholders’ traditional patient care and business models.
PYA Healthcare Consulting Senior Manager Robert Mundy co-presented during, “Valuing Hospitals,” Thursday, July 31, at 1 p.m. EST. This webinar explores the changing world of hospital economics, regulations, and valuations and how appraisers can best prepare themselves for both the opportunities and challenges that lie ahead.
Growth and Dispersion of Accountable Care OrganizationsLeavitt Partners
The Leavitt Partners Center for ACO Intelligence, which tracks national and regional trends related to ACOs and other emerging care delivery systems, published a white paper entitled "Growth and Dispersion of Accountable Care Organizations." This is the first report of its kind regarding the types and locations of ACOs. The report provides data-driven insights into the evolution of ACOs following federal health reform and the recent announcement of the Medicare Shared Savings Program. Data and analysis on the growth and national dispersion trends of more than 160 ACO or ACO-like organizations are highlighted.
As pharmaceutical manufacturers look for ways to build
stronger relationships with their Integrated Delivery Network
(IDN) clients, RWE is emerging as a desired infrastructure
capability, presenting a window of opportunity to support and
collaborate on IDN efforts. If done well, these RWE-related
partnerships should provide value for both parties involved
but require pharma to expand its mindset beyond
product-specific approaches.
E healthcare. Medical Cross-Enterprise Collaborative Platform.Vassily Buzuyev
Medical Cross-Enterprise Collaborative Platform is a modern solution enabling independent physicians to become more efficient and competitive. The platform enhances quality of the medical services rendered by the independent physicians and small medical clinics by reducing their operating expenses.
Healthcare reform: Five trends to watch as the Affordable Care Act turns fivePwC
In its first five years, the Affordable Care Act (ACA) has had a profound, and likely irreversible, impact on the business of healthcare. Industry leaders must rethink strategies to remain relevant in a post-ACA world.
Web Page: http://www.pwc.com/us/acahealthreform
Historically, the medical device industry has been highly attractive and relatively stable. As a consequence, established players have been able to compete successfully across the device spectrum, applying common business models and processes without much need for differentiation.
The future, however, is very different as disruptive change is underway. Companies will need to look at new segments and offer end-to-end solutions to secure additional revenue and maintain their profit margins.
CFO Strategies for Balancing Fee-for-Service and ValuePhytel
Moving from fee-for-service to value-based care is not easy. However, leading health systems are all following a similar blueprint that enables the move to value-based care.
Download this whitepaper to learn how:
- Bon Secours Richmond - Closed 75,801 gaps in care within 12 months, generating $7 million in revenue for chronic & preventive care, while improving quality.
- Northeast Georgia Medical Center - Decreased HbA1C levels across uncontrolled diabetes by an average of 1.6 points within 120 days.
- Riverside Medical Center - Reduced unnecessary readmissions by 40% by using automation to reach and assess patients post discharge.
- Prevea Health - Increased care management productivity by 150% by automatically identifying high risk patients, and automating patient engagement.
Reaching Out, Inviting In: How Medical Call Centers Can Give Hospitals an Edg...TinaMinnick
Certainly the advent of value‐based purchasing attaches a persuasive incentive for improved core measures and HCAHPS performance, but as any hospital that has experienced a negative letter to the editor or defaming remark on a website will attest, the hard and soft costs of patient satisfaction can impact more than just the bottom line. Forward‐thinking organizations not only seek to understand the relationship between patient communications and satisfaction,they are forging it.
Like it or not, the Center for Medicare and Medicaid Services (CMS) has turned from Fee- for -Service (FFS) to Pay-for –Performance (PFP) or a Value Based Purchasing (VBP) model. The question is not whether or not providers, hospitals and systems are ready to let go of those margins, but rather what can they do to mitigate risk today and protect the Revenue Cycle of tomorrow?
In recent years, medical device manufacturers have embarked on an acquisition binge. We’ve seen a series of blockbuster deals as well as numerous smaller transactions. This M&A bonanza has been sparked in part by the belief that absolute scale creates competitive advantage.
But does it? In many other industries, we find a clear correlation between overall scale and profitability. Classic strategy has long focused on building scale because larger companies tend to wield more influence with customers and have a greater ability to maintain pricing discipline. They also benefit from the most accumulated experience with driving down costs and can spread costs over the widest base of business.
Yet in medtech, the correlation between industry scale and profitability is quite weak. Instead, Bain research shows that profitability is more a function of category leadership than overall scale.
The market shift toward value-based care presents unprecedented opportunities and challenges for the US health care system. Instead of rewarding volume, new
value-based payment models reward better results in terms of cost, quality, and outcome measures. These largely untested models have the potential to upend health care stakeholders’ traditional patient care and business models.
PYA Healthcare Consulting Senior Manager Robert Mundy co-presented during, “Valuing Hospitals,” Thursday, July 31, at 1 p.m. EST. This webinar explores the changing world of hospital economics, regulations, and valuations and how appraisers can best prepare themselves for both the opportunities and challenges that lie ahead.
Growth and Dispersion of Accountable Care OrganizationsLeavitt Partners
The Leavitt Partners Center for ACO Intelligence, which tracks national and regional trends related to ACOs and other emerging care delivery systems, published a white paper entitled "Growth and Dispersion of Accountable Care Organizations." This is the first report of its kind regarding the types and locations of ACOs. The report provides data-driven insights into the evolution of ACOs following federal health reform and the recent announcement of the Medicare Shared Savings Program. Data and analysis on the growth and national dispersion trends of more than 160 ACO or ACO-like organizations are highlighted.
As pharmaceutical manufacturers look for ways to build
stronger relationships with their Integrated Delivery Network
(IDN) clients, RWE is emerging as a desired infrastructure
capability, presenting a window of opportunity to support and
collaborate on IDN efforts. If done well, these RWE-related
partnerships should provide value for both parties involved
but require pharma to expand its mindset beyond
product-specific approaches.
E healthcare. Medical Cross-Enterprise Collaborative Platform.Vassily Buzuyev
Medical Cross-Enterprise Collaborative Platform is a modern solution enabling independent physicians to become more efficient and competitive. The platform enhances quality of the medical services rendered by the independent physicians and small medical clinics by reducing their operating expenses.
Healthcare reform: Five trends to watch as the Affordable Care Act turns fivePwC
In its first five years, the Affordable Care Act (ACA) has had a profound, and likely irreversible, impact on the business of healthcare. Industry leaders must rethink strategies to remain relevant in a post-ACA world.
Web Page: http://www.pwc.com/us/acahealthreform
Historically, the medical device industry has been highly attractive and relatively stable. As a consequence, established players have been able to compete successfully across the device spectrum, applying common business models and processes without much need for differentiation.
The future, however, is very different as disruptive change is underway. Companies will need to look at new segments and offer end-to-end solutions to secure additional revenue and maintain their profit margins.
CFO Strategies for Balancing Fee-for-Service and ValuePhytel
Moving from fee-for-service to value-based care is not easy. However, leading health systems are all following a similar blueprint that enables the move to value-based care.
Download this whitepaper to learn how:
- Bon Secours Richmond - Closed 75,801 gaps in care within 12 months, generating $7 million in revenue for chronic & preventive care, while improving quality.
- Northeast Georgia Medical Center - Decreased HbA1C levels across uncontrolled diabetes by an average of 1.6 points within 120 days.
- Riverside Medical Center - Reduced unnecessary readmissions by 40% by using automation to reach and assess patients post discharge.
- Prevea Health - Increased care management productivity by 150% by automatically identifying high risk patients, and automating patient engagement.
A look at the trends, populations and products at play.
More questions than answers face a health industry in flux grappling with new meanings of cost, value, compliance and care delivery. Different stakeholder groups offer up different answers as they accelerate to keep pace with medical innovation. Providers, payers and businesses serving healthcare are being asked to incorporate and act on new data, integrate with new platforms and pioneer new offerings to create an increasingly accessible, connected experience. What’s driving the adaptation, and what trends are worth acting on?
White Paper - Building Your ACO and Healthcare IT’s RoleNextGen Healthcare
The tools needed to capture, organize, and share healthcare data are truly evolving at the speed of light. Patient Centered Medical Homes play a vital role in the path toward accountable care and technology, staff, and workflow transformation are necessary to achieve PCMH recognition. This transformation allows healthcare providers to deliver higher quality coordinated care by streamlining and rationalizing the patient experience.
Healthcare Payer Digital Transformation | Health Plan Services | Healthcare B...RNayak3
Transform your healthcare payer operations with our digital transformation services. As the #1 outsourcing and consulting company, we're your premier provider for BPO/BPM solutions in the healthcare payer industry.
As healthcare reform and transformation advances, providers will seek new ways to engage patients and influence behavior using connected health and will increasingly look for more advanced solutions that are proven to consistently motivate sustained behavioral change. These solutions are referred to as “Patient Portal 2.0.”
The Patient Portal 2.0 that the market requires relies on a host of functions that think outside the confines of Meaningful Use. In order to develop a portal that reaches into a population and makes a difference it is important to understand the purpose of the portal. Taking the necessary time to identify what motivates the intended audience and developing tools that deliver that experience is key to successfully engaging patients.
This paper looks at seven portal features that the market is currently pushing towards.
Key Takeaways from the first IDC Pan European Healthcare Summit . Post event ...Silvia Piai
This slide deck summarizes the key takeaways from the first Pan European Healthcare Executive Event. Focused on the three themes of the Summit ( Personalization,Integration and Industrialization), the Summit has explored the different dimensions in which ICT is an enabler of a new business model for sustainable healthcare in Europe
Placing Customer Centricity at the Heart of Healthcare1to1 Media
A look at how healthcare providers, pharmaceuticals, and health insurers are adapting to the changing customer landscape and evolving their patient experiences. www.1to1media.com
Healthcare IT Services Insights - January 2016Duff & Phelps
This issue of Healthcare IT Insights details the increased use of predictive analytics in the healthcare industry to reduce costs and improve outcomes for patients and populations. Predictive analytics can address three categories that unnecessarily cost the healthcare delivery system in the U.S. approximately $350 billion annually: overtreatment, care delivery failure and lack of care coordination.
Payers are being challenged as the industry shifts from volume-based care to a value-based reimbursement structure that would benefit the patient, the healthcare provider and the payer. New payment models including fee-for-service only and pay-for performance creates impetus for payers to acquire, aggregate, and analyze data.
Similar to The Migration to Clinician Network Management - Chilmark Research (20)
28. THE MIGRATION TO CLINICIAN NETWORK MANAGEMENT
Contact
For more information please feel free to contact the authors:
John Moore
john@chilmarkresearch.com
Brian Murphy
brian@chilmarkresearch.com
Chilmark Research LLC
5 JFK St., Suite 404
Cambridge, MA 02138
www.ChilmarkResearch.com
info@chilmarkresearch.com
Ph. 617.615.9344