This document discusses a hypothetical case study for a Micro-Health Impact Bond (Micro-HIB) program at Howard University Hospital aimed at reducing readmissions and emergency room visits for patients with cardiovascular diseases. The program would implement low-cost therapies like smile therapy, mindfulness meditation and non-cognitive development training. It provides details on program objectives, structure through a Howard University Non-Cognitive Development Institute and Alliance, financial projections estimating over $445,000 in cost savings over 3 years from reduced readmissions and emergency visits, and an annual budget of $500,000 to fund the program. The goal is to test innovative healthcare financing and achieve improved health outcomes and cost efficiencies.
HAS 20 Virtual: Featuring a World-Class Lineup of Keynote SpeakersHealth Catalyst
The Healthcare Analytics Summit (HAS®) is going virtual this year but will still feature the same world-class experience you expect from HAS–including world-class keynote speakers. HAS 20 Virtual will showcase well-known visionaries and C-level executives from leading healthcare organizations. The summit will feature speakers who’ve battled COVID-19 in the trenches as well as other speakers adjusting to planning for the “new normal” that we all anticipate.
We’re reimagining HAS 20 in a virtual format that will be unlike any other healthcare conference you may have attended, virtual or otherwise. HAS 20 Virtual takes place September 1-3, 2020 and will feature nationally recognized keynote speakers, educational breakout sessions, and much more.
Most population health webinars focus on topics like chronic disease management, closing care gaps, and the role of preventive care. While these are important concerns, we want you to rethink the meaning of population health and why it’s so important right now. After years of saying value-based care is coming, Dr. Will Caldwell, a physician with 19 years of experience and the Senior Vice President for Population Health at Health Catalyst, will make the case that emerging trends are enabling the true shift to population health.
In this webinar, Dr. Caldwell will offer the following:
• Create excitement about your role in helping others live healthier lives.
• Raise awareness of the opportunity facing us.
• Help us understand the role private equity is playing.
• Encourage us to rethink how we source and use data.
• Explain the transition from disease management to population health management.
• Discuss the largest unrealized opportunity in managing the total cost of care and driving better outcomes.
Impact of Health Systems Strengthening on HealthHFG Project
Leaders in low- and middle-income countries (LMICs) require timely and compelling evidence about how to strengthen their health systems to improve the health and well-being of their citizens. Yet, evidence on how to strengthen health system performance to achieve sustainable health improvements at scale, particularly toward Ending Preventable Child and Maternal Deaths (EPCMD), fostering an AIDS-Free Generation (AFG), and Protecting Communities against Infectious Diseases (PCID) is limited. The evidence that does exist is scattered, insufficiently analyzed, and not widely disseminated. Without evidence, decision-makers lack a sound basis for investing scarce health funds in health systems strengthening (HSS) in an environment of competing investment options.
USAID is committed to advancing the evidence base on HSS and this commissioned report clearly demonstrates that HSS can improve health in LMICs.
This report, based on a review of systematic reviews of the effects on health of HSS, presents a significant body of evidence linking HSS interventions to measureable impact on health for vulnerable people in LMICs. Making decisions on who delivers health services and where and how these services are organized is important to achieve priority health goals such as EPCMD, AFG, and PCID. The findings of this report document the value of investing in HSS.
Healthcare Financial Transformation: Five Leading StrategiesHealth Catalyst
Healthcare financial transformation—improving care delivery while lowering costs—has been an ongoing challenge for health systems in the era of value-based care and an even more prominent concern amid COVID-19. While better care and reduced expense to organizations and consumers might seem like opposing goals, by understanding the true cost of services and other drivers of expense, organizations can successfully manage costs while maintaining, and even improving, care delivery. To that end, health systems can use data- and analytics-driven tools and strategies to addresses financial challenges, including uncompensated care, prolonged accounts receivable days, discharged not final billed cases, inefficient resource use, and more.
This document summarizes a presentation on rising health care costs given to the Joint Commission on Health Care. It outlines that health care costs have been increasing at an average rate of 9.8% annually since 1970. The highest costs are concentrated among the sickest 10% of the population. While health insurance premiums continue to rise more slowly than in the past, they still outpace inflation and wage growth. Efforts to control costs include promoting consumer directed health plans, disease management programs, and reducing medical errors through health information technology.
Why Data-Driven Healthcare Is the Best Defense Against COVID-19Health Catalyst
COVID-19 has given data-driven healthcare the opportunity to prove its value on the national and global stages. Health systems, researchers, and policymakers have leveraged data to drive critical decisions from short-term emergency response to long-term recovery planning.
Five areas of pandemic response and recovery stand out for their robust use of data and measurable impact on the course of the outbreak and the individuals and frontline providers at its center:
Scaling the hospital command center to pandemic proportions.
Meeting patient surge demands on hospital capacity.
Controlling disease spread.
Fueling global research.
Responding to financial strain.
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.
HAS 20 Virtual: Featuring a World-Class Lineup of Keynote SpeakersHealth Catalyst
The Healthcare Analytics Summit (HAS®) is going virtual this year but will still feature the same world-class experience you expect from HAS–including world-class keynote speakers. HAS 20 Virtual will showcase well-known visionaries and C-level executives from leading healthcare organizations. The summit will feature speakers who’ve battled COVID-19 in the trenches as well as other speakers adjusting to planning for the “new normal” that we all anticipate.
We’re reimagining HAS 20 in a virtual format that will be unlike any other healthcare conference you may have attended, virtual or otherwise. HAS 20 Virtual takes place September 1-3, 2020 and will feature nationally recognized keynote speakers, educational breakout sessions, and much more.
Most population health webinars focus on topics like chronic disease management, closing care gaps, and the role of preventive care. While these are important concerns, we want you to rethink the meaning of population health and why it’s so important right now. After years of saying value-based care is coming, Dr. Will Caldwell, a physician with 19 years of experience and the Senior Vice President for Population Health at Health Catalyst, will make the case that emerging trends are enabling the true shift to population health.
In this webinar, Dr. Caldwell will offer the following:
• Create excitement about your role in helping others live healthier lives.
• Raise awareness of the opportunity facing us.
• Help us understand the role private equity is playing.
• Encourage us to rethink how we source and use data.
• Explain the transition from disease management to population health management.
• Discuss the largest unrealized opportunity in managing the total cost of care and driving better outcomes.
Impact of Health Systems Strengthening on HealthHFG Project
Leaders in low- and middle-income countries (LMICs) require timely and compelling evidence about how to strengthen their health systems to improve the health and well-being of their citizens. Yet, evidence on how to strengthen health system performance to achieve sustainable health improvements at scale, particularly toward Ending Preventable Child and Maternal Deaths (EPCMD), fostering an AIDS-Free Generation (AFG), and Protecting Communities against Infectious Diseases (PCID) is limited. The evidence that does exist is scattered, insufficiently analyzed, and not widely disseminated. Without evidence, decision-makers lack a sound basis for investing scarce health funds in health systems strengthening (HSS) in an environment of competing investment options.
USAID is committed to advancing the evidence base on HSS and this commissioned report clearly demonstrates that HSS can improve health in LMICs.
This report, based on a review of systematic reviews of the effects on health of HSS, presents a significant body of evidence linking HSS interventions to measureable impact on health for vulnerable people in LMICs. Making decisions on who delivers health services and where and how these services are organized is important to achieve priority health goals such as EPCMD, AFG, and PCID. The findings of this report document the value of investing in HSS.
Healthcare Financial Transformation: Five Leading StrategiesHealth Catalyst
Healthcare financial transformation—improving care delivery while lowering costs—has been an ongoing challenge for health systems in the era of value-based care and an even more prominent concern amid COVID-19. While better care and reduced expense to organizations and consumers might seem like opposing goals, by understanding the true cost of services and other drivers of expense, organizations can successfully manage costs while maintaining, and even improving, care delivery. To that end, health systems can use data- and analytics-driven tools and strategies to addresses financial challenges, including uncompensated care, prolonged accounts receivable days, discharged not final billed cases, inefficient resource use, and more.
This document summarizes a presentation on rising health care costs given to the Joint Commission on Health Care. It outlines that health care costs have been increasing at an average rate of 9.8% annually since 1970. The highest costs are concentrated among the sickest 10% of the population. While health insurance premiums continue to rise more slowly than in the past, they still outpace inflation and wage growth. Efforts to control costs include promoting consumer directed health plans, disease management programs, and reducing medical errors through health information technology.
Why Data-Driven Healthcare Is the Best Defense Against COVID-19Health Catalyst
COVID-19 has given data-driven healthcare the opportunity to prove its value on the national and global stages. Health systems, researchers, and policymakers have leveraged data to drive critical decisions from short-term emergency response to long-term recovery planning.
Five areas of pandemic response and recovery stand out for their robust use of data and measurable impact on the course of the outbreak and the individuals and frontline providers at its center:
Scaling the hospital command center to pandemic proportions.
Meeting patient surge demands on hospital capacity.
Controlling disease spread.
Fueling global research.
Responding to financial strain.
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.
The 2021 Healthcare Financial Forecast: What to Expect, How to PrepareHealth Catalyst
As healthcare financial leaders plan for 2021, they can expect COVID-19 to shape their strategies. Pandemic response and recovery will continue to dominate the industry, inform new perspectives on existing issues (e.g., the shift to value-based care and health equity), and shape priorities. Meanwhile, the Biden administration will start to puts its stamp on U.S. healthcare, further making 2021 a pivotal year for the industry.
Healthcare finance teams can best navigate 2021 by monitoring and preparing to take action in five prominent areas:
Election impact.
Price transparency.
Financial forecasting.
Value-based care.
Health equity.
From Volume to Value: 10 Essential Strategies for Navigating the Healthcare S...Health Catalyst
As the transition of healthcare payment models from volume to value takes longer than expected, healthcare organizations must balance fee for service (FFS) with value-based care (VBC). The transition to VBC will accelerate, but as FFS persists and still generates adequate margins, organizations must also continue to be successful under volume-based reimbursement.
Ten tools can help health systems balance VBC with FFS:
A member perspective.
Cautious investment in hard delivery assets.
Accelerated investment in digital infrastructure.
Innovative digital engagement solutions.
Pricing concessions.
Aligned incentives.
Network management.
Payer-provider trust and collaboration.
Clinician and administrative alignment.
Physician leadership and accountability.
Healthcare Price Transparency: Three Opportunities for TransformationHealth Catalyst
Price transparency has been an ongoing challenge for health systems, and upcoming legislation requiring increased visibility around hospital pricing adds pressure. Meeting the new price transparency requirements means legal compliance, but providing procedure costs, different payment options, and the reasoning behind prices set patients up for an optimal experience, increasing their likelihood to return for future care.
With the right tools, such as robust pricing transparency technology and a defensible price strategy, health systems can use the new mandate to take advantage of three key opportunities:
Satisfy increasing patient interest in cost of care.
Earn patient trust—a short- and long-term imperative.
Create the optimal patient experience.
Artificial Intelligence in Healthcare: A Change Management ProblemHealth Catalyst
The key to successfully leveraging artificial intelligence (AI) in healthcare rests not wholly in the technical aspects of predictive and prescriptive machines but also in change management within healthcare organizations. Better adoption and results with AI rely on a commitment to the challenge of change, the right tools, and a human-centered perspective.
To succeed in change management and get optimal value from predictive and prescriptive models, clinical and operational leaders must use three perspectives:
Functional: Does the model make sense?
Contextual: Does the model fit into the workflow?
Operational: What benefits and risks are traded?
The Top Three 2020 Healthcare Trends and How to PrepareHealth Catalyst
The document discusses three major healthcare trends for 2020: 1) Continued focus on consumerism and price transparency as consumers demand more affordable and convenient care options like telehealth. 2) Increased mergers and involvement of private companies in healthcare delivery, putting financial pressure on existing providers. 3) Growing emphasis on addressing social determinants of health like housing, employment, transportation, which impact individuals' health outcomes. Health systems will need strategies to meet changing consumer and policy demands while maintaining financial viability.
Healthy Savings. Medical Technology and the Economic Burden of DiseaseRevital (Tali) Hirsch
As America ages and sedentary lifestyles and unhealthy diets become more common, experts agree the nation is suffering a sharp rise in the prevalence of chronic disease. As the 21st century unfolds, technology – in the form of advanced diagnostic and therapeutic devices -- can meet the need for early detection and more effective management of illness. Some researchers, however, have questioned whether the overall benefit of technical advances outweighs the costs -- a question this report definitively answers.
Accordingly, researchers at the Milken Institute undertook a comprehensive, quantitative documentation of medical technology's impact on the economic burden of disease. The study also projects how future innovation in this sector would affect the health care system and the larger economy -- a positive benefit of more than $23 billion a year for the United States.
The study takes a systematic approach to documenting the full costs and broader economic benefits of health care investments by examining innovations pertaining to four prevalent causes of disability and death: heart disease, diabetes, colorectal cancer, and musculoskeletal disease. The report considers therapeutics and diagnostic devices that are widely used and have substantially affected the lives of patients as well as the overall U.S. economy. Among the 10 devices or device-based procedures studied are pacemakers, insulin infusion pumps, colonoscopies, and joint replacement surgery.
The data demonstrate that the use of medical technology brings considerable economic benefits. These are seen in both aggregate savings in treatment expenditures and prevention as well as the reduction of "indirect impact" through larger contributions to the economy.
"You can download this product from SlideTeam.net"
Healthcare Management Powerpoint Presentation Slides is designed especially for the medical industry professionals. Use this PPT slideshow to showcase all the essentials of healthcare administration with a dash of visual brilliance. Demonstrate the key trends and vital stats of the healthcare industry through our content-driven PowerPoint theme. Communicate details about global healthcare economy, and global spending stats. Illustrate the key demand and supply drivers associated with public health management. Employ our audience-friendly medical administration PPT template deck to elucidate stakeholders in the public health system. Cutting-edge graphics and innovative data visualization designs simplify the explanation. Use diagrams featured in this PowerPoint presentation to describe essential public health services. You will also find infographic-style designs to help elaborating concepts like hospital and corporate tie-ups. Utilize the Venn diagram to emphasize the pharma company operating model. Convey the research and development protocol followed in the pharmaceutical industry. Our comprehensive PPT layout contains oodles of other core aspects of hospital management. This includes cost accounting, financial management, data analysis, strategic planning, marketing, and KPI metrics and dashboards. So, hit the download button and captivate your audience. Our Healthcare Management Powerpoint Presentation Slides are topically designed to provide an attractive backdrop to any subject. Use them to look like a presentation pro. https://bit.ly/3oAoykn
Improving Sepsis Care: Three Paths to Better OutcomesHealth Catalyst
Sepsis affects at least 1.7 million U.S. adults per year, making it a pivotal improvement opportunity for healthcare organizations. The condition, however, has proven problematic for health systems. Common challenges including differentiating between sepsis and a patient’s acute illness and data access. In response, organizations must have comprehensive, timely data and advanced analytics capabilities to understand sepsis within their populations and monitor care programs. These tools can help organizations identify sepsis, intervene early, save lives, and sustain improvements over time.
This document provides an overview of new care models and technology-enabled solutions that promote connected and independent living for seniors. It highlights three main sections: an overview of trends in senior care innovation, the current solution landscape, and investment perspectives in the senior care market. The overview section discusses trends like greater technological adoption among seniors, a desire for independent living, and the potential for mass market consumer technologies to help seniors if properly marketed. The solution landscape maps out current categories of solutions like telehealth, medication management, and shared care planning. The investment section profiles the views of venture capitalists on what makes senior care solutions stand out and opportunities in the market.
Dr. Pinto's Presentation at HIN AGM: Collecting Data to address the Social De...HINCoordinator
HIN's Key Speaker for our annual general meeting 2014, Dr. Andrew Pinto, presents his research findings on how data collection is used to address the social determinants of health.
Three Analytics Strategies to Drive Patient-Centered CareHealth Catalyst
The cost of uncoordinated care that fails to prioritize patient needs is estimated to be over $27.2 billion. One of the primary reasons behind these wasted healthcare dollars is a failure to effectively leverage data to understand patient needs—a must-have to deliver patient-centered, value-based care (VBC).
Three analytics strategies enable health systems to focus on patients while also meeting the financial standards for VBC delivery:
Prioritize patient outreach by risk level.
Deploy data tools to combat COVID-19.
Promote data literacy.
Detailed information from comprehensive data sets allows health systems to understand patient needs at a granular level and then use that insight to drive care decisions. More informed care ensures health systems are also meeting the core elements of VBC—managing costs, delivering quality, and ensuring an excellent patient experience.
Employee Engagement During COVID-19: Using Culture to Manage Stress, Maintain...Health Catalyst
As organizations confront a post-COVID-19 world, leaders must balance pandemic-driven practices and environments with team member eagerness to and uncertainty towards returning to business as usual. Even though ongoing fear and stress are inevitable, leaders and managers can use a positive workplace culture to support employees, engage their teams, and foster productivity. Safe, reliable access to health and wellness, remote mental health resources, and consistent communications will help organizations establish and maintain a positive culture that remains a steadfast source of support as the healthcare industry navigates the next phases of COVID-19.
IT Solutions for Fee for Value Reimbursment and Population Health ManagementJohn Squeo
This presentation highlights some key considerations when building or integrating IT solutions for the emergent payment models evolving in Health Care. Population risk stratification, identifying patients to target for high success rate interventions, and tracking physicians adherence to evidence based medicine using key performance indicators are covered at a high level.
Our group selected a recent annual report for WellPoint We assumed they approached our audit firm to hire us as their new auditor. We performed a preliminary analytical review and risk assessment, and wrote a report indicating to the partner-in-charge our recommendation with respect to this potential client. I completed the preliminary risk analytical review.
Behavioral Health Industry Insights - 2016Duff & Phelps
Over the last 50 years, the number of inpatient psychiatric facilities in the US, mostly state-run hospitals, has sharply declined due to deinstitutionalization and Medicaid policies like the IMD Exclusion. Deinstitutionalization reduced state-run psychiatric beds by over 90% from 1955 to 2012. The IMD Exclusion further curtailed Medicaid reimbursement for large facilities, shifting treatment to community-based outpatient care. However, this has left many areas without adequate inpatient beds. Recent policy changes now allow Medicaid reimbursement for some short-term inpatient mental health and addiction services for adults aged 21-64 which could help address gaps.
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.
Six Steps to Managing an Infection Control BreachHealth Catalyst
Despite widespread efforts to improve patient safety, infection control breaches still happen at an alarming rate. In order to improve patient safety and prevent infections, healthcare organizations need to have infection control procedures in place and regularly assess protocols and adherence to these policies. In the case of an infection control breach, organizations need to be prepared to act quickly and follow a six-step evaluation procedure outlined by the CDC:
1. Identify the infection control breach.
2. Gather additional data.
3. Notify and involve key stakeholders.
4. Perform a qualitative assessment.
5. Make decisions about patient notification and testing.
6. Handle communications and logistical issues.
Master Your Value-Based Care Strategy: Introducing Health Catalyst Value Opti...Health Catalyst
The document provides an overview of Health Catalyst's Value Optimizer product, which is a web-based application that aims to help healthcare organizations develop data-informed strategies for value-based care. It describes three key capabilities of Value Optimizer: 1) Creating a comprehensive, benchmarked strategy using complete data, 2) Providing transparent and actionable insights into total cost of care and contracts, and 3) Enabling exploration of various clinical areas to uncover opportunities. The document includes several use cases that demonstrate how Value Optimizer can be used to analyze areas like inpatient utilization, pharmacy spending, imaging utilization, and more. It also discusses the support services that Health Catalyst provides to help customers implement and optimize the Value Optimizer
A Review of Health Financing in NamibiaHFG Project
This document reviews health financing in Namibia. It finds that while Namibia's GDP growth is expected to slow in the short term, limiting additional resources for health, GDP growth is projected to improve after 2017. Currently, Namibia relies heavily on indirect taxes and SACU revenues, though it aims to broaden its tax base. High unemployment and a large informal sector pose challenges. The government provides most health services, while the private sector is financed through medical aid funds. Overall, Namibia's fiscal capacity indicates potential to increase health spending in the medium term by expanding its domestic revenue and improving government efficiencies.
Reasons Why You Need An Experienced Account Managergingin4
The document discusses several key driving forces that will shape the future of the pharmaceutical and biotech industries, including models of change in healthcare, the quest for value over cost and quality, and various political scenarios and their implications. It analyzes trends in healthcare spending, quality, and reform proposals. The main points are that a physician-centric view is no longer sufficient; affordability and third party perspectives must be considered; assumptions about specialty drug models may be overly optimistic; and partnerships with payers are necessary to develop strategically sound plans for new markets and customers.
Design and Development of Cold Chain Monitoring SystemLihguong Jang
This document describes the design and development of a cold chain monitoring system for vaccines. The system was created to ensure vaccine safety by strictly monitoring temperature from production to usage and allowing information sharing between all entities involved. It includes modules for vaccine suppliers, manufacturers, logistics providers, medical facilities, and functions for temperature monitoring, emergency reporting, and inspections. The system establishes authority levels and data access controls. It was tested using scenarios involving temperature deviations and ineffective vaccines to demonstrate how the system could quickly identify issues and improve safety oversight of vaccines. The goal is to implement such a system in Taiwan to better manage vaccine quality and trace any problems.
The document outlines a training program for drilling engineering that includes several modules over multiple months. It lists 27 individual courses covering topics like petroleum exploration, reservoir engineering, drilling, well design, cementing, and completions. The courses range from 1-2 weeks in length and cover basic introductions to more advanced topics. They include both classroom instruction and practical training components. The program takes place in Nigeria and is designed to provide participants with a comprehensive overview of drilling engineering.
The 2021 Healthcare Financial Forecast: What to Expect, How to PrepareHealth Catalyst
As healthcare financial leaders plan for 2021, they can expect COVID-19 to shape their strategies. Pandemic response and recovery will continue to dominate the industry, inform new perspectives on existing issues (e.g., the shift to value-based care and health equity), and shape priorities. Meanwhile, the Biden administration will start to puts its stamp on U.S. healthcare, further making 2021 a pivotal year for the industry.
Healthcare finance teams can best navigate 2021 by monitoring and preparing to take action in five prominent areas:
Election impact.
Price transparency.
Financial forecasting.
Value-based care.
Health equity.
From Volume to Value: 10 Essential Strategies for Navigating the Healthcare S...Health Catalyst
As the transition of healthcare payment models from volume to value takes longer than expected, healthcare organizations must balance fee for service (FFS) with value-based care (VBC). The transition to VBC will accelerate, but as FFS persists and still generates adequate margins, organizations must also continue to be successful under volume-based reimbursement.
Ten tools can help health systems balance VBC with FFS:
A member perspective.
Cautious investment in hard delivery assets.
Accelerated investment in digital infrastructure.
Innovative digital engagement solutions.
Pricing concessions.
Aligned incentives.
Network management.
Payer-provider trust and collaboration.
Clinician and administrative alignment.
Physician leadership and accountability.
Healthcare Price Transparency: Three Opportunities for TransformationHealth Catalyst
Price transparency has been an ongoing challenge for health systems, and upcoming legislation requiring increased visibility around hospital pricing adds pressure. Meeting the new price transparency requirements means legal compliance, but providing procedure costs, different payment options, and the reasoning behind prices set patients up for an optimal experience, increasing their likelihood to return for future care.
With the right tools, such as robust pricing transparency technology and a defensible price strategy, health systems can use the new mandate to take advantage of three key opportunities:
Satisfy increasing patient interest in cost of care.
Earn patient trust—a short- and long-term imperative.
Create the optimal patient experience.
Artificial Intelligence in Healthcare: A Change Management ProblemHealth Catalyst
The key to successfully leveraging artificial intelligence (AI) in healthcare rests not wholly in the technical aspects of predictive and prescriptive machines but also in change management within healthcare organizations. Better adoption and results with AI rely on a commitment to the challenge of change, the right tools, and a human-centered perspective.
To succeed in change management and get optimal value from predictive and prescriptive models, clinical and operational leaders must use three perspectives:
Functional: Does the model make sense?
Contextual: Does the model fit into the workflow?
Operational: What benefits and risks are traded?
The Top Three 2020 Healthcare Trends and How to PrepareHealth Catalyst
The document discusses three major healthcare trends for 2020: 1) Continued focus on consumerism and price transparency as consumers demand more affordable and convenient care options like telehealth. 2) Increased mergers and involvement of private companies in healthcare delivery, putting financial pressure on existing providers. 3) Growing emphasis on addressing social determinants of health like housing, employment, transportation, which impact individuals' health outcomes. Health systems will need strategies to meet changing consumer and policy demands while maintaining financial viability.
Healthy Savings. Medical Technology and the Economic Burden of DiseaseRevital (Tali) Hirsch
As America ages and sedentary lifestyles and unhealthy diets become more common, experts agree the nation is suffering a sharp rise in the prevalence of chronic disease. As the 21st century unfolds, technology – in the form of advanced diagnostic and therapeutic devices -- can meet the need for early detection and more effective management of illness. Some researchers, however, have questioned whether the overall benefit of technical advances outweighs the costs -- a question this report definitively answers.
Accordingly, researchers at the Milken Institute undertook a comprehensive, quantitative documentation of medical technology's impact on the economic burden of disease. The study also projects how future innovation in this sector would affect the health care system and the larger economy -- a positive benefit of more than $23 billion a year for the United States.
The study takes a systematic approach to documenting the full costs and broader economic benefits of health care investments by examining innovations pertaining to four prevalent causes of disability and death: heart disease, diabetes, colorectal cancer, and musculoskeletal disease. The report considers therapeutics and diagnostic devices that are widely used and have substantially affected the lives of patients as well as the overall U.S. economy. Among the 10 devices or device-based procedures studied are pacemakers, insulin infusion pumps, colonoscopies, and joint replacement surgery.
The data demonstrate that the use of medical technology brings considerable economic benefits. These are seen in both aggregate savings in treatment expenditures and prevention as well as the reduction of "indirect impact" through larger contributions to the economy.
"You can download this product from SlideTeam.net"
Healthcare Management Powerpoint Presentation Slides is designed especially for the medical industry professionals. Use this PPT slideshow to showcase all the essentials of healthcare administration with a dash of visual brilliance. Demonstrate the key trends and vital stats of the healthcare industry through our content-driven PowerPoint theme. Communicate details about global healthcare economy, and global spending stats. Illustrate the key demand and supply drivers associated with public health management. Employ our audience-friendly medical administration PPT template deck to elucidate stakeholders in the public health system. Cutting-edge graphics and innovative data visualization designs simplify the explanation. Use diagrams featured in this PowerPoint presentation to describe essential public health services. You will also find infographic-style designs to help elaborating concepts like hospital and corporate tie-ups. Utilize the Venn diagram to emphasize the pharma company operating model. Convey the research and development protocol followed in the pharmaceutical industry. Our comprehensive PPT layout contains oodles of other core aspects of hospital management. This includes cost accounting, financial management, data analysis, strategic planning, marketing, and KPI metrics and dashboards. So, hit the download button and captivate your audience. Our Healthcare Management Powerpoint Presentation Slides are topically designed to provide an attractive backdrop to any subject. Use them to look like a presentation pro. https://bit.ly/3oAoykn
Improving Sepsis Care: Three Paths to Better OutcomesHealth Catalyst
Sepsis affects at least 1.7 million U.S. adults per year, making it a pivotal improvement opportunity for healthcare organizations. The condition, however, has proven problematic for health systems. Common challenges including differentiating between sepsis and a patient’s acute illness and data access. In response, organizations must have comprehensive, timely data and advanced analytics capabilities to understand sepsis within their populations and monitor care programs. These tools can help organizations identify sepsis, intervene early, save lives, and sustain improvements over time.
This document provides an overview of new care models and technology-enabled solutions that promote connected and independent living for seniors. It highlights three main sections: an overview of trends in senior care innovation, the current solution landscape, and investment perspectives in the senior care market. The overview section discusses trends like greater technological adoption among seniors, a desire for independent living, and the potential for mass market consumer technologies to help seniors if properly marketed. The solution landscape maps out current categories of solutions like telehealth, medication management, and shared care planning. The investment section profiles the views of venture capitalists on what makes senior care solutions stand out and opportunities in the market.
Dr. Pinto's Presentation at HIN AGM: Collecting Data to address the Social De...HINCoordinator
HIN's Key Speaker for our annual general meeting 2014, Dr. Andrew Pinto, presents his research findings on how data collection is used to address the social determinants of health.
Three Analytics Strategies to Drive Patient-Centered CareHealth Catalyst
The cost of uncoordinated care that fails to prioritize patient needs is estimated to be over $27.2 billion. One of the primary reasons behind these wasted healthcare dollars is a failure to effectively leverage data to understand patient needs—a must-have to deliver patient-centered, value-based care (VBC).
Three analytics strategies enable health systems to focus on patients while also meeting the financial standards for VBC delivery:
Prioritize patient outreach by risk level.
Deploy data tools to combat COVID-19.
Promote data literacy.
Detailed information from comprehensive data sets allows health systems to understand patient needs at a granular level and then use that insight to drive care decisions. More informed care ensures health systems are also meeting the core elements of VBC—managing costs, delivering quality, and ensuring an excellent patient experience.
Employee Engagement During COVID-19: Using Culture to Manage Stress, Maintain...Health Catalyst
As organizations confront a post-COVID-19 world, leaders must balance pandemic-driven practices and environments with team member eagerness to and uncertainty towards returning to business as usual. Even though ongoing fear and stress are inevitable, leaders and managers can use a positive workplace culture to support employees, engage their teams, and foster productivity. Safe, reliable access to health and wellness, remote mental health resources, and consistent communications will help organizations establish and maintain a positive culture that remains a steadfast source of support as the healthcare industry navigates the next phases of COVID-19.
IT Solutions for Fee for Value Reimbursment and Population Health ManagementJohn Squeo
This presentation highlights some key considerations when building or integrating IT solutions for the emergent payment models evolving in Health Care. Population risk stratification, identifying patients to target for high success rate interventions, and tracking physicians adherence to evidence based medicine using key performance indicators are covered at a high level.
Our group selected a recent annual report for WellPoint We assumed they approached our audit firm to hire us as their new auditor. We performed a preliminary analytical review and risk assessment, and wrote a report indicating to the partner-in-charge our recommendation with respect to this potential client. I completed the preliminary risk analytical review.
Behavioral Health Industry Insights - 2016Duff & Phelps
Over the last 50 years, the number of inpatient psychiatric facilities in the US, mostly state-run hospitals, has sharply declined due to deinstitutionalization and Medicaid policies like the IMD Exclusion. Deinstitutionalization reduced state-run psychiatric beds by over 90% from 1955 to 2012. The IMD Exclusion further curtailed Medicaid reimbursement for large facilities, shifting treatment to community-based outpatient care. However, this has left many areas without adequate inpatient beds. Recent policy changes now allow Medicaid reimbursement for some short-term inpatient mental health and addiction services for adults aged 21-64 which could help address gaps.
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.
Six Steps to Managing an Infection Control BreachHealth Catalyst
Despite widespread efforts to improve patient safety, infection control breaches still happen at an alarming rate. In order to improve patient safety and prevent infections, healthcare organizations need to have infection control procedures in place and regularly assess protocols and adherence to these policies. In the case of an infection control breach, organizations need to be prepared to act quickly and follow a six-step evaluation procedure outlined by the CDC:
1. Identify the infection control breach.
2. Gather additional data.
3. Notify and involve key stakeholders.
4. Perform a qualitative assessment.
5. Make decisions about patient notification and testing.
6. Handle communications and logistical issues.
Master Your Value-Based Care Strategy: Introducing Health Catalyst Value Opti...Health Catalyst
The document provides an overview of Health Catalyst's Value Optimizer product, which is a web-based application that aims to help healthcare organizations develop data-informed strategies for value-based care. It describes three key capabilities of Value Optimizer: 1) Creating a comprehensive, benchmarked strategy using complete data, 2) Providing transparent and actionable insights into total cost of care and contracts, and 3) Enabling exploration of various clinical areas to uncover opportunities. The document includes several use cases that demonstrate how Value Optimizer can be used to analyze areas like inpatient utilization, pharmacy spending, imaging utilization, and more. It also discusses the support services that Health Catalyst provides to help customers implement and optimize the Value Optimizer
A Review of Health Financing in NamibiaHFG Project
This document reviews health financing in Namibia. It finds that while Namibia's GDP growth is expected to slow in the short term, limiting additional resources for health, GDP growth is projected to improve after 2017. Currently, Namibia relies heavily on indirect taxes and SACU revenues, though it aims to broaden its tax base. High unemployment and a large informal sector pose challenges. The government provides most health services, while the private sector is financed through medical aid funds. Overall, Namibia's fiscal capacity indicates potential to increase health spending in the medium term by expanding its domestic revenue and improving government efficiencies.
Reasons Why You Need An Experienced Account Managergingin4
The document discusses several key driving forces that will shape the future of the pharmaceutical and biotech industries, including models of change in healthcare, the quest for value over cost and quality, and various political scenarios and their implications. It analyzes trends in healthcare spending, quality, and reform proposals. The main points are that a physician-centric view is no longer sufficient; affordability and third party perspectives must be considered; assumptions about specialty drug models may be overly optimistic; and partnerships with payers are necessary to develop strategically sound plans for new markets and customers.
Design and Development of Cold Chain Monitoring SystemLihguong Jang
This document describes the design and development of a cold chain monitoring system for vaccines. The system was created to ensure vaccine safety by strictly monitoring temperature from production to usage and allowing information sharing between all entities involved. It includes modules for vaccine suppliers, manufacturers, logistics providers, medical facilities, and functions for temperature monitoring, emergency reporting, and inspections. The system establishes authority levels and data access controls. It was tested using scenarios involving temperature deviations and ineffective vaccines to demonstrate how the system could quickly identify issues and improve safety oversight of vaccines. The goal is to implement such a system in Taiwan to better manage vaccine quality and trace any problems.
The document outlines a training program for drilling engineering that includes several modules over multiple months. It lists 27 individual courses covering topics like petroleum exploration, reservoir engineering, drilling, well design, cementing, and completions. The courses range from 1-2 weeks in length and cover basic introductions to more advanced topics. They include both classroom instruction and practical training components. The program takes place in Nigeria and is designed to provide participants with a comprehensive overview of drilling engineering.
The document is a corporate presentation for Falco Resources Ltd., a Canadian gold developer. It summarizes Falco's key project, the Horne 5 project located near Rouyn-Noranda, Quebec. The Horne 5 project is a large-scale, high-tonnage underground gold project with indicated resources of over 6 million ounces of gold. A 2016 PEA outlined a 12-year mine life with average annual production of 236,000 ounces of gold at low all-in sustaining costs of US$427 per ounce and an after-tax IRR of 16%. Falco is advancing the project towards feasibility with the goal of production starting in 2020.
Inspiration Lookbook for Financial Servicescolletteseline
We’ve compiled a list of groundbreaking direct mail
campaigns that utilize a cross-channel approach at
different lifecycle stages, all within the financial services space.
Take a look and get inspired.
Logistics information monitoring by means of rfid sensor tagLihguong Jang
This document describes a semi-passive RFID temperature sensing tag that can be used for logistics monitoring. The tag features real-time temperature sensing and data recording capabilities. It uses low-power hardware and firmware designs to extend battery life. Key aspects discussed include the tag's antenna design for improved reading range, hardware prototype including temperature sensing and storage components, and software design for temperature data collection and communication with RFID readers. The tag is presented as a solution for cold-chain logistics to allow remote monitoring of product temperatures during delivery.
El documento habla sobre el correo electrónico y los buscadores web. Explica que el correo electrónico permite enviar mensajes y archivos a través de Internet de forma asincrónica. Describe las ventajas y desventajas del correo electrónico, así como recomendaciones para su uso seguro. También define los buscadores web como programas que recopilan páginas relacionadas con palabras de búsqueda y menciona algunos de los buscadores más importantes como Internet Explorer, Mozilla Firefox y Google Chrome.
El documento habla sobre el correo electrónico y cómo funciona, incluyendo los pasos para ingresar a una cuenta de Hotmail. También define qué es un buscador, mencionando que indexa archivos y datos en la web para facilitar búsquedas a través de palabras clave. Explica diferentes tipos de buscadores como directorios, metabuscadores y multibuscadores, y cómo funcionan motores de búsqueda.
BizViz is a unique BI platform that was built to give users better knowledge and insight into their business. It enables users to assemble data from multiple structured, semi-structured, and unstructured data sources.
BizViz helps analysts provide Descriptive, Diagnostic, Predictive, and Prescriptive analytics in the cloud, on mobile devices, and on-premise. The BizViz platform intersects SMAC (Social Media, Mobility, Analytics, and Cloud). Users can build and interact with dynamic, information-rich dashboards from any device and will be able to enter real-time data from mobile devices.
Are we burying our heads in the sand? Exploring issues around intellectual pr...Jennifer Cham
The threat of patent infringement to businesses is perhaps better known in industries such as pharmaceuticals, engineering and manufacturing. However, in the User Experience (UX) field there are potential issues around patent infringement that, as practitioners, we need to be aware of. This session (originally a discussion held at UX Cambridge 2014) aimed to increase awareness and start a discussion amongst UX professionals regarding intellectual property issues that may impact our work.
The session was an open discussion, where participants shared their experiences and concerns and posed questions for further exploration. The outcome was a sketchnote (https://www.flickr.com/photos/97823772@N02/15058945187/in/set-72157647610886191) which summarised the discussion. This was created by Chris Spalton, https://twitter.com/ChrisSpalton)
[Please note: we are not intellectual property legal experts. Examples are from our own experience in this area, and secondary research sources. The main aim was to start a conversation and to identify the gaps in our knowledge in this potentially important area.]
Presentation (Slide Share) on Mobile Application Development Services and Why We Need It?. Created by a leading enterprise mobile application development company India, which are offering custom mobile app development services across various platforms like iPhone, Windows, Android, Blackberry and iPad.
Tsn investor presentation december 2015investortyson
The document provides forward-looking statements and cautions readers that actual results may differ materially from expectations. It highlights that Tyson Foods is one of the largest food companies in the world with advantaged brands in growing categories. The presentation outlines Tyson's market leadership in protein production, financial trends including sales growth and adjusted EPS growth, and priorities for cash including growing organically, acquisitions, and returning cash to shareholders.
This document discusses ITRI's research into visible light communication (VLC) technology for indoor positioning and communication applications. It provides the following key points:
1. ITRI has developed high-speed VLC transceivers capable of 100Mbps transmission over 3 meters that can enable integrated indoor communication and lighting. VLC provides benefits like high security, accurate indoor positioning under 1 meter, low cost, and no electromagnetic interference.
2. ITRI has conducted field trials of VLC indoor positioning systems in various settings like offices, hospitals, and exhibition rooms. These trials have demonstrated applications like location-based check-ins, automatic information downloading based on doctor position, and navigation within venues.
3. Compared to
IBM Insight 2015 - Accelerator replication scalability and throughput improve...Daniel Martin
The document discusses the results of a study on the effects of exercise on memory and thinking abilities in older adults. The study found that regular exercise can help reduce the decline in thinking abilities that often occurs with age. Specifically, older adults who exercised regularly performed better on tests of memory and decision-making than those who did not exercise regularly.
HealthTech’s Role in Solving Asia’s Healthcare Affordability GapMaria Health
This document discusses capital flow inefficiencies in healthcare financing in Asia and potential solutions using health technology, insurtech, and fintech. It notes a growing healthcare financing gap in Asia estimated to reach $197 billion by 2020. Traditional players like insurers and investors have been conservative, while a lack of data and transparency also create challenges. However, convergence between health, insurance, finance, and digital technologies can help address this through models like: 1) fintech entering health with "fintech for health" subsidiaries or standalone healthtech firms, 2) insurtech distributing insurance through digital channels, 3) partnerships between insurers, distributors, and backed players, and 4) online health platforms providing affordable premiums.
Consumer-Centric Healthcare: 2015--The Tipping Point Has Arrived (Report by William Blair)
Consumers—in tandem with disruptive healthcare technology and healthcare services providers—are the key to solving many of US healthcare's woes, particularly the unsustainably high cost of care.
Public exchanges, private exchanges, and high-deductible health plans are growing quickly. Disruptive forces of competition will create a lower-cost system that promotes the growth of highly efficient, low-cost, and high-quality providers and technologies.
The continued movement of financial and quality risk back to providers (and increasingly to consumers themselves) is encouraging providers and consumers to seek preventive medicine, cost efficiency, clinical efficacy, and overall value in healthcare. In turn, this could drive significant change regarding the primary point of care delivery (rapidly moving outside the hospital), the overall cost of healthcare and investment decisions made by healthcare providers.
Consumer-centric healthcare providers will experience strong top- and bottom-line growth over the coming years. Investors in both the public and private-equity markets will achieve superior long-term returns by identifying and investing in these companies.
Barbados 2012-13 Health Accounts ReportHFG Project
This report presents the findings and policy implications of Barbados’ first Health Accounts estimation, conducted for the year April 2012 to March 2013. It captures spending from all sources: the government, non-governmental organizations, external donors, private employers, private insurance companies and households. The analysis presented breaks down spending to the standard classifications, as defined by the System of Health Accounts 2011 framework, namely sources of financing, financing schemes, type of provider, type of activity and disease/health condition.
Data Science Reveals Patients at Risk for Adverse Outcomes Due to COVID-19 Ca...Health Catalyst
One of the biggest challenges health systems have faced since the onset of COVID-19 is the disruption to routine care. These care disruptions, such as halted routine checkups and primary care visits, place some patients at a higher risk for adverse outcomes. Health systems can rely on data science, based on past care disruption, to identify vulnerable patients and the short- and long-term effects these care disruptions could have on their health. Data science can also inform the care team which care disruptions to address first. With comprehensive information about care disruption on patients, health systems can apply the right interventions before it’s too late.
The document proposes an ontology-based adaptive sustainable healthcare insurance policy system called A-SHIP. A-SHIP aims to create customized healthcare insurance policies for patients based on their health status and needs. It analyzes patient electronic health records and other health data using an ontology and rules engine. The system generates insurance packages tailored to each patient's situation to both meet their needs and reduce costs for insurance companies. It was tested using a real patient dataset and aims to make healthcare more sustainable and personalized through innovative insurance policies and technologies like remote monitoring devices.
This newsletter provides updates on healthcare reform and its costs, workplace wellness programs, and medical clinics. It discusses how the Affordable Care Act will pay for expanding coverage, including new taxes starting in 2011-2018 on drug companies, insurers, and high-cost plans. It also links obesity to higher workers compensation costs and recommends integrating workplace safety with wellness efforts. Finally, it notes the growth of retail medical clinics and their lower costs compared to doctors' offices and emergency rooms.
The document discusses Medicare spending in the United States. It reports that Medicare spending was reduced to 0.2% in 2013 compared to 1.8% between 2009-2012. This decrease may have resulted from the recession limiting spending, delivery system reforms to improve quality while reducing local costs, or a focus on patient-centered care. Statistical data from Medicare budget reports is cited to support the claims around reduced spending.
This document is a research paper analyzing employment and labor trends affecting Hospital Corporation of America (HCA) and the healthcare industry. It provides an overview of the healthcare industry and compares its growth to other industries. It also describes HCA, the largest for-profit healthcare company, and analyzes its employment data. The paper examines recent employment and unemployment trends in healthcare and how government regulations like the Affordable Care Act have impacted demand for healthcare workers.
PEER RESPONSES FOR Patient Outcomes and Sustainable ChangeAssess.docxpauline234567
PEER RESPONSES FOR Patient Outcomes and Sustainable Change
Assessment Description
Reflecting on the "IHI Module QI 202: Addressing Small Problems to Build Safer, More Reliable Systems," describe how your direct practice improvement project achieves clinical improvement. How will you achieve widespread change? How would the widespread change of your DPI Project be affected if it were implemented in a country with universal health care. Describe how the health outcome would be impacted. Provide supporting evidence.
Shabnampreet Kaur
The IHI module QI 202: Addressing Small Problems to Build Safer, More Reliable Systems, reflects on the presence of small problems in healthcare systems and how to overcome these small problems to build safer systems. Steve Spear used various examples to make the readers understand the concept of small loopholes and workarounds which distract the employees resulting in mistakes and sometimes these mistakes become catastrophes(Institute for Healthcare Improvement, 2022b). Also, he suggested ways to address them and make healthcare safer. My DPI project which is fall prevention among older adults achieves clinical improvement by building stronger techniques for addressing the reasons and suggesting ways to improve strength, gait, and balance using tai chi as the intervention. Currently, at the practice site, there is only a shift-to-shift report as the standard criteria for fall reporting. Many times people forget to bring to the provider's notice that they experience a fall in the past 3 months. And sometimes if falls are reported, the shift duty nurses forget to enter them into the EHR system. Also, there is currently no special protocol for fall screening. Screening and assessment can help providers know about the population prone to falling and then they can work towards achieving the aim of fall prevention by devising various patient-centered interventions, My DPI project will streamline the process of screening all the older adults above the age of 65 years with CDC STEADI Stay Independent questionnaire (Centers for Disease Control and Prevention.,2020). Those screened at risk will undergo assessment for fall risk factors using a Timed up and go, 30-second chair rise and balance test, with identification of medicines as per Beers criteria, measurement of orthostatic blood pressure, and asking about potential home hazards. Those having poor balance gait and strength will be enrolled in a 12-week tai chi exercise program as the intervention. In order to achieve widespread change, teamwork and collaboration are needed at the levels of the project. Potential sources of mistakes will be addressed in the first place, the commonest of all being linking the fall risk assessment to the patient's e-chart. If my DPI project were implemented in a country with universal healthcare, the widespread change of the project will be affected in multiple ways. Universal healthcare coverage means all people have full access to hea.
The document discusses the healthcare industry and provides context for analyzing delays in patient discharge processes at a hospital from May to July 2015. It describes the objectives of studying delays, the sample size, tools used, and limitations. It then provides an overview of the global healthcare industry, key segments including hospitals, providers and professionals, models for healthcare delivery, and the market size of the industry in different regions. Porter's five forces model is applied to analyze competition in the healthcare industry.
Legal and Ethical Issues Related to Psychiatric EmergenciesT.docxLaticiaGrissomzz
Legal and Ethical Issues Related to Psychiatric Emergencies
The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare.
In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments.
To Prepare
· Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.
The Assignment
In 2–3 pages, address the following:
· Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.
· Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
· Explain the difference between capacity and competency in mental health contexts.
· Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.
· Identify one evidence-based suicide risk assessment that you could use to screen patients.
· Identify one evidence-based violence risk assessment that you could use to screen patients.
Attach copies of or links to the suicide and violence risk assessments you selected.
NOTE: MY STATE IS ILLINOIS
2
Final Project : Policy Research and Organizational Analysis Report
Precious Teasley
Southern New Hampshire University
IHP-620-Q1591 Economic Principles- healthcare 22TW1
Dr. Scott
October 20, 2022
Introduction
The purpose of this report is to focus on economic principles and how they apply to the field of healthcare. Healthcare facilities need to make economic decisions because they need financial resources to run. They need economic consultants that will help in making strategic economic decisions that will guide healthcare facilities on where and how to spend their money (Hicks, 2020). This ensures that they are wise in their undertakings. This report focuses on Jackson Memorial Hospital, a facility that has more than 1,500 li.
This document discusses several common payment mechanisms used in the US healthcare system, including Medicaid/Medicare, out-of-pocket expenses, and preferred provider organizations (PPOs). Medicaid/Medicare accounts for a large portion of US healthcare spending and debt. Patients are also responsible for out-of-pocket costs like co-payments that are rising faster than incomes. PPOs allow patients to choose providers both in and out of their insurance network, and these plans are becoming more popular for Medicare recipients. Billing and payment collection are essential to fund the entire healthcare system.
Improving Efficiency to Achieve Health System Goals in Botswana: Background P...HFG Project
Health outcomes have improved in Botswana over the last few decades. These successes have come at the same time as overall macroeconomic growth, with annual Gross Domestic Product (GDP) growth averaging around 6 percent between 2010 and 2015 (IMF 2015), and Human Development Index ranking above the regional average. These improvements originate in a strong health service delivery system. In 2008, Botswana’s public health system included 338 health posts and 277 health clinics, sufficient to ensure that at least 80 percent of the population has coverage of essential, high-impact services. Management of these services was initially done by the Ministry of Local Government but has been transferred to district health teams under the Ministry of Health (MOH). As of 2008, Botswana’s public health system also had 17 primary hospitals, 14 district hospitals, two referral hospitals, and one mental health hospital; these hospitals are managed by the central government.
Accenture Transformative Power of Healthcare Technology M&A in Life Science 2015Arda Ural, MSc, MBA, PhD
Explosive advances in healthcare technology are enabling new opportunities for technology mergers and acquisitions (M&A) that focus on improving patient outcomes. Digital technologies allow for enhanced patient services and care. Pharmaceutical companies are increasingly engaging in M&A deals and partnerships with medical device and technology companies to develop new business models and position themselves for future growth. Healthcare is undergoing a fundamental shift that is forcing new collaborations across industries to leverage technology for managing health.
Capital Investment in Health Systems: What is the latest thinking?HFG Project
Capital investment in health typically refers to large expenditures in construction of hospitals and other facilities, investment in diagnostic and treatment technologies, and information technology platforms. These investments are characterized by their longevity and they are critical to efforts to improve healthcare quality and efficiency. Contrary to developed countries where there is well documented experience on capital investment in the health sector, including use of public private partnerships for the investment; there is little evidence on capital investment in health from low and middle income countries.
This work was undertaken to add to the HFG’s knowledge and learning strategy by clarifying what good practice guidance exists in capital benchmark in LMICs health sectors, as well as the HFG project’s experience in the area. This brief will be of value to all those interested in the planning and financing the capital investment in the health sector. This includes politicians, planners, managers, health professionals, architects, designers, and researchers in both the public and private sectors.
1Running Head CRITICAL THINKING NEW HOSPITAL PROPOSALCR.docxfelicidaddinwoodie
1
Running Head: CRITICAL THINKING: NEW HOSPITAL PROPOSAL
CRITICAL THINKING: NEW HOSPITAL PROPOSAL 2
Introduction
The system of healthcare in most of the countries is national based healthcare system whereby the government offers health care services to the public using governmental agencies. In Saudi Arabia for example, there are some growing private healthcare facilities. The government of many nations remains the full controller of the healthcare sectors both private and public. The private hospitals are both non-profit and profit for example in Saudi Arabia, most of these private hospital attracts several expats. Both the standards of both private and government hospitals are of more similarity. Some of the private healthcare facilities are of the world class but with poor health service delivery (Penm,2015).
Comparing and Contrasting the Legal Structure and Governance of the Profit and Non-profit international entities
Differences
The selected international entities include the Joint Commission International (non-profit), International Hospital Federation (non-profit) and the Kaiser Permanente (non-profit and profit). The legal structure of the Joint Commission International (JCI) follows the certification and accreditation of the hospital. The hospital must be evaluated first to see if the hospital complies with the standards and meets the activities needed by this entity. There are accreditation programs that any hospital must go through. This is then followed by the certification which can either be based on associated health care organization (Joint Commission, 2016). On the other hand, the International Hospital Federation requires a formal and documented request addressed to the Chief Executive Officer for one to be a member. The legal structure of Kaiser Permanente is consisting of two or three independent legal entities in each region of California (Finz, 2012). The applying employee must have been hired as a new Kaiser Permanente for an award-eligible post.
The governance of the International Hospital Federation is consisting of three organs i.e. the general assembly, governing council, and the executive committee. There are also the designated positions which consist of the president, chairman designate, immediate past president, treasurer, and the chief executive officer (International Hospital Federation, 2015). On the other hand, Kaiser Permanente is consisting of entities with each entity having its management and governance structure. There are regional entities and twelve Permanente Medical groups which were created by the Permanente Federation. The role of the Permanente is to standardized patient care as well as the performance (Finz, 2012). The governing of JCI is under the leadership of the President and the chief executive officer (Matt, 2011).
Advantages of the Entities
Join Commission International provides a wide variety of health care programs l ...
The document discusses the need for health insurance in India to move beyond only covering hospitalization and toward financing primary care and chronic conditions. Currently about half the population lacks access to any health financing. As India's disease burden shifts to non-communicable diseases, outpatient funding becomes increasingly important. The rising prevalence of chronic conditions also calls for insurance that provides long-term coverage rather than excluding pre-existing illnesses. The paper focuses on developing insurance frameworks for chronic disease management and elderly care.
A Roadmap for Optimizing Clinical Decision SupportHealth Catalyst
Compared to industries such as aerospace and automotive, healthcare lags behind in decision support innovation. Following the aerospace and automotive arenas, healthcare can learn critical lessons about improving its clinical decision support capabilities to help clinicians make more efficient, data-informed decisions:
Achieve widespread digitization: Healthcare must digitize its assets and operations (patient registration, scheduling, encounters, diagnosis, orders, billings, and claims) for effective CDS similarly to how aerospace digitized the aircraft, air traffic control, baggage handling, ticketing, maintenance, and manufacturing.
Build data volume and scope: Healthcare must collect socioeconomic, genomic, patient-reported outcomes, claims data, and more to truly understand the patient at the center of the human health data ecosystem.
A Roadmap for Optimizing Clinical Decision Support
TheMicroHIBWhitePaper1.0
1.
2. Infinite8 Institute, L3C
The design and finance of social impact systems
Sheik Khalifa Medical City, Abu Dhabi, U.A.E.
3. Ean Garrett, J.D. is the Chief InnovationOfficer of
Infinite 8 Institute, L3C, a low-profit limited liability
company.
Acknowledgements:
We would like to thank global staffand administrationwithin the medical field for their hard
work and dedicationin such a demandingand intricate field.
4.
5. CONTENTS
INTRODUCTION………………………………………………………………………………………………....i
WHAT IS A HEALTH IMPACT BOND……………………………………………………………………….1
RISING HEALTHCARE COSTS………………………………………………………………………………...1
A HYPOTHETICAL CASE STUDY: HOWARD UNIVERSITY HOSPITAL ……….…………………....2
Summary…………………………………………………………………………………………………………………………..3
Objectives…………………………………………………………………………………………………………………………3
Program Plan…………………………………………………………………………………………..................................3
Financials………………………………………………………………………………………………...................................4
Recruitment……………………………………………………………………………………………………………………...5
ROLE OF MAJOR DEPRESSIVE DISORDER (MDD) in PATIENTS WITH CARDIOVASCULAR
DISEASE…………………………………………………………………………………………………………….5
Heart Disease & Myocardial Infarctions……………………………..…………………………………………….5
Pneumonia………………………………………………………………………………………………………………….…….5
LOW COST STRESS-REDUCTION THERAPIES…………………………………………………………….7
Smile Therapy…………………………………………………………………………………………………………………...7
Mindfulness Meditation……………………………….…………………………………………………………………...7
Non-cognitive Development Therapy………………………………….………………………………………...…8
FEASIBILITY………………………………………………………………………………………………………..8
DATA COLLECTION & ANALYSIS……………………………………………………………………………8
WEARABLE TECHNOLOGY…………………………………………………………………………………….9
CONTRACT FORMATION………………………………………………………………………………………9
STANDARD vs. COMMUNITY-BASED METRICS…………………………………………………………9
RELEVANT LEGISLATION………………………………..…………………………………………....……....9
U.S. FEDERAL TAX INCENTIVES……………………………….……………………………………….......10
6. i.
INTRODUCTION BY EAN GARRETT, J.D.
ChiefExecutiveOfficer, Infinite 8 Institute, L3C
There are often many formalities and procedures as well as other hierarchy of thought that the
medical field has traditionally followed as a business model. With a new century, arrives an
urgent need to transform the way we thinkabout providingservices in the healthcare sector.In
a field full of specialists,the heavyintegration ofcross-sector disciplines in collectiveimpact
efforts, must also lead to the adoptionofexternal viewpoints bythe medical field and constant
adaptation and learning.
The Micro-Health Impact Bond (Micro-HIB) is not the sole answer but it is a tool that has the
potential to help get us there. There is a huge burden on the healthcare system from
widespread issues,such as Depression,Heart Disease, and Pneumonia,which form a large sum
of healthcare related costs. As a result there is a larger pressure on the healthcare system with
a smaller set of resources. In such an environment, continuedexistence relies on the ability to
navigate the current healthcare landscape, which is plush with uncertainty.
However, the strategic implementation ofinitiatives and the efficient utilizationofresources in
the form of Social Impact Bonds (SIBs), provides a unique opportunityto pilot innovative
healthcare products and services that may provide potentialsystematicsolutions.The Micro-
Health Impact Bond (Micro-HIB), is a further step in that direction. The aim of the model is to
provide creativefinancingfor the design and implementation ofinnovativeand prototypical
global healthcare initiatives.The model brings outcomes to the forefront of the healthcare
paradigm, and the consequence is puttingthe patient backat the center of everything.
The Micro-HIB, was created specificallyto address the ailingissues at the forefront of hefty
costs associated with patient readmissions and emergency admissions.However, we expect the
model to widelyexpand in the coming years to include many other health subjects. In the
private sector, if a client base continuallyreturned with a similar problem unsolved there would
be a strong effort to address the issue. When a person’s very existence and well-beingare the
issue, an even more valiant effort should be made to effectively and efficientlyaddress a
customer’s needs.
Over the past year we have communicated with healthcare professionals and researched the
finest healthcare systems in the world. Every communityand population is faced with a unique
set of challenges,both measurable and immeasurable.The role and potential ofvarious
technologies in the future of medical science cannot be denied,such as wearable technologies.
The Micro-SIB provides a replicable frameworkfor healthcare professionals from which to
launch the next life-savingtechnologyor methodology. We hope that this will be the start of a
much larger conversation concerningwhere we can go from here.
Ean Garrett,J.D.
ChiefInnovation Officer,Infinite 8 Institute, L3C
Infinite8 Institute, L3C
The design and finance of social impact systems
7. pg. 1
WHAT IS A HEALTH IMPACT BOND?
Social Impact Bond’s or (SIBs), which are debt or
equity instruments – sometimes referred to as
“pay-for-success,” “social innovation financing”
or “outcome-based financing arrangements” –
through which third-party investors take on the
financial risk associated with expanding social
programs.1
The first Health Impact Bond (HIB),
was implemented on May 2013, in Fresno,
California, a city with one of the nation’s
highest asthma rates (20%).2
The California Endowment awarded Social
Finance and Collective Health $660,000 in grant
funding to launch an HIB aimed at improving
the health of low-income children with asthma.
Savings accrued to the state, who benefit from
the reduced costs associated with the
emergency treatment of childhood asthma.
RISING HEALTHCARE COSTS
In the first quarter of 2015, health spending was
7.3% higher in the previous year, and hospital
spending increased 9.2%. Many of the gains are
credited to increase healthcare system usage as
a result of the Affordable Care Act (ACA).
Likewise, the number of days people spent in
the hospital also rose as well.3 Also, by 2022,
1
The Center for American Progress describes SIBs as:
an innovativefinancial arrangement between oneor
moregovernment agencies and an external
organization—sometimes called an “intermediary” –
that can either bea nonprofit or for-profit entity.
See, e.g., Kristina Costa et al., Frequently Asked
Questions: Social ImpactBonds, CTR. FOR AM.
PROGRESS, 3 http//:www.americanprogress.org/wp-
content/uploads/2012/12/FAQSocialImpactBonds-
1.pdf (last visited on Aug. 7, 2015).
2
Kennedy, K. (2013). Social Finance: The California
Endowment Awards Grantto Social Finance and
Collective Health. Retrieved from
http://tcenews.calendow.org/releases/social-
finance-the-california-endowment-awards-grant-to-
social-finance-and-collective-health
the ACA is projected to reduce the number of
uninsured people by 30 million, add
approximately 0.1 percentage-point to average
annual health spending growth over the full
projection period, and increase cumulative
health spending by roughly $621 billion.
Furthermore, health spending is also projected
to be 19.9% of the DGP by 2022.4
With the steady increase in healthcare
expenditures over the next decade, costs must
be curbed in order to relieve pressure on the
system. The area where costs have been
admitted to be the highest among the Federal
government, as well as the industry at-large,
concerns cardiovascular diseases, more
specifically heart disease, myocardial
infarctions, and pneumonia. In 2013, 2,225
hospitals were fined up to 1% Medicare
reimbursements for too many readmissions
related to heart attacks, heart failure
(myocardial infarctions), and pneumonia. The
maximum penalty will reach up to 3% in 2015
for non-compliant health institutions.5
3
Altman, Drew (2015). TheNew York Times. New
Evidence Healthcare Spendingis Growing Faster
Again. Retrieved from
http://blogs.wsj.com/washwire/2015/06/11/new-
evidence-health-spending-is-growing-faster-again/
4
Centers for Medicare& Medicaid Services. Office of
theActuary, National Statistics Group(2012).
National Health Expenditures Projections2012-2022.
Retrieved from https://www.cms.gov/research-
statistics-data-and-systems/statistics-trends-and-
reports/nationalhealthexpenddata/downloads/proj2
012.pdf
5
Daily Briefing (2013). CMS: The 2,225hospitalsthat
will pay readmissions penalties next year. The
Advisory Board Company. Retrieved from
https://www.advisory.com/daily-
briefing/2013/08/05/cms-2225-hospitals-will-pay-
readmissions-penalties-next-year
8. pg. 2
A HYPOTHETICAL CASE STUDY:
HOWARD UNIVERSITY HOSPITAL
The purpose of the following hypothetical is to
stimulate conversation and scholarly debate
relating to the pressing needs of the healthcare
industry across the globe, especially institutions
servicing dynamic populations and communities
with unique needs, similar to a metropolitan
hospital, such as Howard University Hospital.
Founded in 1862, the century-old hospital
services the largest population of impoverished
patients in the District of Columbia.6
The
scenario and programmatic model, while
fictitious, utilize existing scientific
methodologies and publicly available
quantitative data with real cost-savings. The
6
Kaiser Health News (2013). Panel says Medicare
unfairly penalizes hospitalsserving thepoor.
Retrieved from
hypothetical provides healthcare practitioners,
government, and the private sector a tangible
look into creative financing in the healthcare
sector, in hopes of spurring action and further
creative innovation.
Summary
The world’s first Micro-Health Impact Bond
(Micro-HIB) is aimed at reducing readmissions
of patients suffering from cardiovascular
diseases, as well as a reduction of overall
emergency room (ER) visits. The Howard
University Hospital (HUH) Non-cognitive
Development Institute (HU-NDI) and the
Howard Non-cognitive Development Institute-
Alliance (HU-NDIA), will form a group of
community businesses, organizations, and
http://www.medicalpracticeinsider.com/news/comp
liance/panel-says-medicare-unfairly-penalizes-
hospitals-serving-poor
THE MICRO-HEALTH IMPACT BOND
9. pg. 3
healthcare patients coming together to ensure
quality affordable healthcare and innovative
research initiatives. The Alliance will collectively
achieve a higher level of efficiency and
productivity in the development of a patient
centered paradigm. Its purpose will be achieved
by the implementation of a globally competitive
health impact structure.
The Micro-HIB, will serve a total of 100
residents annually for three years in the target
areas of Northeast Washington, DC. The area
was chosen because of its immense need and
opportunity to yield substantial results. After
completion of the readmission program,
participants will demonstrate a proficiency in a
set of low-cost therapies, including smile
therapy, non-cognitive development therapy,
and mindfulness meditation to enhance health
outcomes related to Major Depressive Disorder
(MDD), while achieving and maintaining a high
level of patient satisfaction. Partnering with
relevant local organizations, the HUH Micro-HIB
will accomplish significant cost-savings by
decreasing patient readmissions for
cardiovascular diseases and lowering the
number of daily ER admissions.
Objectives
The Micro-HIB will meet the goals of reducing
cardiovascular patient readmissions and daily
ER admission through the implementation of
leading international health and management
strategies. The Micro-HIB will achieve the
following five measurable objectives by Year 3
of the pilot program:
1) Decrease daily emergency admissions
by 1% in YR-1, and 2% in YR-2 & YR-3;
2) Decrease in-patient readmissions for
cardiovascular diseases by 8%;
3) Decrease MDD by 5% among program
participants admitted for cardiovascular
diseases (i.e., Heart Disease, Myocardial
Infarctions, and Pneumonia) and/or
prevent episodes of MDD as a result of
low-cost therapies;
4) Increase patient non-cognitive
development by 20% in at least one
non-cognitive development area (i.e.,
self-discipline, self-responsibility,
persistence, fearlessness, excellence,
foresight, character, and humility);
5) Achieve a 3-star rating on the Hospital
Consumer Assessment of Healthcare
Providers and Systems (HCAHPS) for
patient satisfaction (the current rating
is 2-stars).
Program Plan
The HU-NDIA will be placed within the existing
framework of HUH, who will coordinate and
house the programming, while I8I will provide
consulting, project management, technical
assistance, leaderships, and resources for the
life of the 3-year Micro-HIB. A collaboration of
organizations will form the HU-NDIA, who will
serve as a university, community, and city-wide
research, best-practices, and innovation
network. The HU-NDIA will share best-practices
and accelerate innovation through the
voluntary production of presentations, panel
sessions, and a single annual white paper
concerning project discoveries by members of
the board. The HU-NDIA will also serve as an
advisory body to the NDI, comprised of eight
voting board positions. The HU-NDIA will
initially consist of the following organizations
and/or organization types: Howard University &
Howard University Hospital, Quality
Improvement Organizations, University Hospital
Consortium, District of Columbia Hospital
Association, District of Columbia Healthcare
Finance Administration, Managed Care
Organizations, Long-term Acute Care Hospitals
and Skilled Nursing Facilities, Home Health
Agencies, Walgreens Pharmacy, CVS Pharmacy,
and Uber & other transportation companies.
Additionally, the HU-NDI will coordinate the
following internal programs to achieve program
objectives: Community Health & Family
Medicine, Dietary, Finance, Pediatrics,
Environmental Services, Information Desk,
10. pg. 4
Medical Records, Nursing Patient
Transportation, Physical Therapy, Printing and
Duplicating, Radiology, Multicultural Affairs,
Occupational Therapy, Anesthesiology,
Emergency Medicine, Internal Medicine,
Psychiatry & Behavioral Sciences, Howard
University Heart Center, Howard University
Diabetes Center, and Center for Sickle-Cell
Disease.
I8I and HUH will collaborate to form a hiring
committee to determine qualified candidates
for the position of NDI Executive Director,
Patient Experience Manager, and
Administrative Assistant. The NDI will also
independently contract with in-home
healthcare providers to provide patient follow-
up within 3 days, in addition to status
monitoring, wellness counseling, educational
development, and specialized therapies for 3-
months following patient readmission. Patients
will also be retro-fit with wearable technology
(i.e., Smartwatches), in order to better manage
their heart rate, exercise, and emergency
communication. Independent contractors will
receive 16 hours of training to deliver the
following specialized therapies, which include:
Smile Therapy, Mindfulness Meditation, and
Non-cognitive Development. Oxygen and
Exercise Therapy Training will be provided to
patients upon need. Independent contractors
will also carry a caseload of 10 voluntary of
physician recommended program participants.
A waiting list will immediately fill program slots
as they become available. The Community Clinic
will also be extended for one hour during week
days in YR-1 and two hours in YR-2 to curb
unnecessary ER visits.
Financials
The Micro-SIB will be a private contractual
agreement between multiple interested parties.
I8I seeks to create a 3-year Micro-SIB with an
annual budget of $500,000, utilizing national
and international best healthcare practices to
accomplish the project objectives. The
outcomes will be assessed by an independent
third party intermediary. I8I will also conduct a
feasibility study to quantify cost-savings and
assess potential quantitative impact as a result
of Socially Responsible Investments (SRI). I8I will
collaborate with HUH to solidify investors for
up-front costs as well as philanthropic and/or
financial sector support to pay for successful
outcomes. The outcomes will be assessed by an
independent third party assessor.
A. Initial Estimate of HUH Cost-savings
a. AnnualIn-patient Readmission Cost-savings
(Heart Disease, MCI, & Pneumonia)
i. 5% reduction in YR-1
1. YR-1 Cost-savings = $117,553
ii. 6% reduction in YR-2
1. YR-2 Cost-savings = $142,301
iii. 8% reduction in YR-3
1. YR-3 Cost-savings = $185,610
iv. 3-YR Subtotal Cost-savings = $445,
464
b. AnnualER Admission Reduction Cost-savings
i. 1% reduction in YR-1 (ER hours
extended +1)
1. Annual Cost-savings =
$2,562,090.125
ii. 2% reduction in YR-2 (Clinic hours
extended +2)
1. Annual Cost-savings =
$5,124,180.125
iii. 2% reduction in YR-3 (Clinic hours
extended +2)
iv. 3-YR Subtotal Cost-savings =
$12,080,450
B. TOTAL AnnualEstimated HUH Cost-savings
a. Annual Subtotal YR-1 =
$3,007,554.125
b. Annual Subtotal YR-2 = $5,569,644.25
c. Annual Subtotal YR-3 = $5,569,644.25
d. ANNUAL TOTAL COST-SAVINGS YR-1
= $2, 305,054.125
e. ANNUAL TOTAL COST-SAVINGS YR-2
= $4,867,144.25
11. pg. 5
f. ANNUAL TOTAL COST-SAVINGS YR-3 =
$4,867,144.25
g. (Subtracted) Annual Programmatic
Costs YR-1, YR-2, YR-3 = $500,000
h. (Subtracted) Annual Investor 13.5%
Interest Rate YR-1, YR-2, & YR-3 = $202,
500
i. 3-YR TOTAL PROJECTED COST-
SAVINGS = $12,039,342.63
Recruitment
HU-NDI will collaborate with HUH staff to
recruit up to 100 newly admitted candidates to
participate in the HU-NDI programming.
Candidates will then be interviewed while
admitted, and selected upon June 22, 2015
evaluation and joint recommendation by HU-
NDI and HUH Staff. HU-NDI will also recruit
candidates for the program on a referral basis.
Candidates will then be interviewed, and
selected by a joint committee of HU-NDI and
HUH staff.
A. Target population of NDI program
participants:
1. District of Columbia (DC) residents;
and
2. Medicare/Medicaid patients
admitted for complications related to
Heart Disease, Myocardial Infarctions,
and Pneumonia.
Role of Major Depressive Disorder
(MDD) in Patients with Cardiovascular
Diseases
Heart Disease & Myocardial Infarctions
7
Jiang W, Davidson JRT. Antidepressant therapy
in patients with chemic heart disease. American
Heart Journal, November 2005. 871-881
8
Frasure-Smith N, et al. Depression following
myocardial infarction: Impact on 6-month
Heart Disease & Myocardial Infarctions are
among the leading causes of patient
readmission in America. Up to 15 percent of
patients with cardiovascular disease and up to
20 percent of patients who have undergone
coronary artery bypass graft (CABG) surgery
experience major depression.7
Unmanaged
stress can lead to high blood pressure, arterial
damage, irregular heart rhythms and a
weakened immune system. Patients with
depression have been shown to have increased
pro-inflammatory markers (such as C-reactive
protein or CRP), which are all risk-factors for
cardiovascular disease. For people with heart
disease, depression can increase the risk of an
adverse cardiac event such as a heart attack or
blood clots.8
For people who do not have heart disease,
depression can increase the risk of a heart
attack and development of coronary artery
disease. In one landmark study, the continued
presence of depression after recovery increased
the risk of death (mortality to 17 percent within
six months after a heart attack versus 3 percent
mortality in heart attack patients who didn’t
have depression).9
During recovery from cardiac surgery,
depression can intensify pain, worsen fatigue
and sluggishness, or cause a person to withdraw
into social isolation. Patients who have had
coronary artery bypass graft and have
untreated depression after surgery also have
increased morbidity and mortality. Patients
with heart failure and depression, have an
increased risk of being readmitted to the
hospital, and also have an increased mortality
risk. Early research findings have indicated that
Survival. JAMA, October 20, 1994. 270(15):
1819-1825.
9
Frasure-Smith N, et al. Depression following
myocardial infarction: Impact on 6-month
Survival. JAMA, October 20, 1994. 270(15):
1819-1825.
12. pg. 6
there may be genetic factors that increase a
patient’s risk of depression and risk of recurrent
events after a heart attack.10
Patients with heart disease and depression also
perceive a poorer health status, as manifested
by Quality of Life (QoL) Studies. Furthermore,
heart disease patients with depression have
worse treadmill exercise and medication
adherence than that of patients with heart
disease, who do not have depression.11 1213
Negative lifestyle habits with depression, such
as smoking, excessive alcohol consumption, lack
of exercise, poor diet and lack of social support
– interfere with the treatment of heart disease.
Depression has been proven to be such a risk
factor in cardiac disease that the American
Heart Association (AHA) has recommended that
10
Nakatani D, et al. Influence of Serotonin
transportation gene polymorphism on
depression symptoms and new cardiac events
after acute myocardial infarction. American
Heart Journal, October 2005. 150 (4): 652-658
11
Ruo B, et al. Depressive Symptoms and heart-
related quality of life: the Heart and Soul Study.
JAMA, July 9, 2003. 290(2): 215-221.
12
Geh, AK, et al. Self-reported medication
adherence and cardiovascular events in patients
with stable coronary heart disease: the Heart
and Soul study. The American Journal of
Cardiology, September 15, 2003. 922(6) 705-
707.
13
Gehi AK, et al. Relations of Sel-reported
angina pector is to inducible myordial ischemia
in patients with known coronary artery disease:
the Heart and Soul Study Archives of Internal
Medicine, November 2005. 165(2): 2508-2513.
14
Litchman JH, et al. Depression an coronary
heart disease: Recommendation for screening,
referral and treatment. A science advisory firm
from the American Heart Association
Prevention Committee of the Council on
Cardiovascular Nursery, Council on Clinical
all cardiac patients be screened for depression
using simple screening questions and an easy-
to-administer survey called the PATIENT
HEALTH QUESTIONNAIRE (PHQ-2).14
Patients
with MDD had a significantly higher probability
of an intensive care unit admission, need for
mechanical ventilation, and in-hospital death
than patients without MDD.15
Pneumonia
Depression was associated with 1.28-times
greater odds of pneumonia hospitalization.16
After treatment for pneumonia, patients also
had nearly double the risk of substantial
depressive symptoms.17 After adjusting for
demographic characteristics, clinical factors, and
health-risk behaviors, depression was
independently associated with increased odds of
hospitalization for pneumonia.18
Cardiology, Council on Epidamology and
Prevention, and Interdisciplinary Council on
Quality of Care and Outcome Research:
endorsed by the American Psychiatric
Association. Circulation, Oct 21 2008. 118(17);
1768-1775.
15
Kao L-T, Liu S-P, Lin H-C, Lee H-C, Tsai M-C,
Chung S-D (2014) Poor Clinical Outcomes
among Pneumonia Patients with Depressive
Disorder. PLoS ONE 9(12): e116436.
doi:10.1371/journal.pone.0116436
16
Kao Li-Ting, Poor Clinical Outcomes among
Depression Patients with Pneumonia. 2014 Dec
31; 9(12): e116436.
http://www.jpsychores.com/article/S0022-
3999(14)00286-4/abstract.
17
Catherine L. Hough, M.D., M.Sc., U-W;
Deborah A. Levine, M.D., M.P.H., U-M and VA;
Kenneth M. Langa, M.D., Ph.D., U-M and VA.
Functional Disability, Cognitive Impairment, and
Depression After Hospitalization for
Pneumonia,” American Journal of Medicine,
doi:10.1016/j.amjmed.2012.12.006.
18
Davydow DS, Hough CL, Zivin K, Langa KM,
Katon WJ. Depression and Risk of
Hospitalization for Older Americans. J
13. pg. 7
LOW-COST STRESS REDUCTION
THERAPIES
Smile Therapy
Holding a smile on one’s face during periods of
stress may help the heart. Muscle problems
brew in a core of the body with the shoulders at
its base and the forehead at its peak – the
tension triangle. Muscles in this area react
dramatically to psychological pressure: the
brow furrows, the jaw clenches, the neck
tightens and the shoulders rise. Corrugator
muscles, the ones the knit the brow into a
frown, tighten in response to emotional
tension. A study at the Massachusetts General
Hospital in Boston shows that depressed people
have chronically tensed corrugators, even when
they do not look as if they are frowning.
Furthermore, tension in the corrugators, along
with the nearby frontalis muscle is such a good
gauge of muscle tension throughout the body
that the forehead muscles are used in bio
feedback training to monitor overall tension. As
muscles throughout the body relax, tension
leaves the forehead.19 Researchers say their
findings suggest smiling during brief periods of
stress may help reduce the body’s response to
stress, regardless of whether or not the person
actually feels happy or not.20
According to Mark
Stibich, Ph.D., at Columbia University, smiling:
a. Relieves stress – Stress does express
itself right in our faces. When we smile,
Psychosom Res. 2014 Dec;77(6):528-34. doi:
10.1016/j.jpsychores.2014.08.002. Epub 2014
Aug 11.
19
Goleman, Daniel, and Tara Goleman.
"Relieving Stress: Mind Over Muscle." New York
Times 28 Sept. 1986: n. pag. Print.
20
Kraft, Tara L.; Pressman, Sara D.; “Grin and
Bear It: The Influence of Manipulated Facial
Expression on the Stress Response.”
it can help us look better, less tired, less
worn down.
b. Boosts Immune System – Smiling can
actually stimulate your immune
response by helping you relax.
c. Lowers Blood Pressure – When you
smile, there is evidence that your blood
pressure can decrease.
d. Releases Endorphins and Serotonin
– Research has reported that smiling
releases endorphins, which are natural
pain relievers, along with serotonin,
which is also associated with feel good
properties.
e. Duchenne (full) – Smiles are the only
types of smiles that create this positive
effect. These smiles engage the muscles
in the mouth, cheeks, and eyes and are
considered to be genuine smiles.21
Mindfulness Meditation
We conclude that an intensive but time-limited
group stress reduction intervention based on
mindfulness meditation can have long-term
beneficial effects in the treatment of people
diagnosed with anxiety disorders.22
Psychological risk factors such as anxiety and
depression have been associated with Coronary
Heart Disease (CHD). Stress can have an impact
on the risk factors for the disease, such as high
blood pressure (BP), physical activity, and being
overweight. The economic and social burden on
the healthcare system due to CHD, is increasing
21
Stibich, Mark, Ph.D. "Top Reasons to Smile."
Web log post. About Health. N.p., 7 Mar. 2015.
Web. 7 June 2015.
<http://longevity.about.com/od/lifelongbeauty
/tp/smiling.htm>.
22
Miller, John J; Fletcher, Ken; Kabat-Zinn, Jon.
Three-Year Follow-up and Clinical Implications
of a Mindfulness Meditation-based Stress
Reduction Intervention in the Treatment of
Anxiety Disorders. General Hospital Psychiatry
17, 192-200, 1995.
14. pg. 8
medical costs of heart disease, including
surgeries and cardiac rehabilitation programs.
The present study provides evidence for the
effectiveness of Mindfulness Meditation-based
Stress Reduction programs in reducing
symptoms of anxiety and depression, perceived
stress, BP and BMI in patients with CHD, and
offers new insights in the management of
patients with CHD.23
Non-cognitive Development Therapy
Non-cognitive skills represent personality traits
and socio-economic skills…including
extraversion, conscientiousness, openness to
experience, agreeability, and emotional
stability.24 The strongest correlation…are among
non-cognitive skill measures, such as between
internalizing and externalizing behavior (i.e.,
and between these two indicators and the
depressive symptoms scale.25
Higher health
outcomes at age 42 were observed among
clinical adolescent participants who scored
higher on non-cognitive assessments and self-
reports.26
The Macro-SIB is a public transaction, where
government either pays investors for successful
outcomes, or government serves as the
financial administrator of funds, using the full
faith of the government to add legitimacy to the
transaction and mitigate investor risk.
FEASIBILITY
23
Parswani, Manish J; Shama Mahendra P; and
Hyengar, SS. Mindfulness-based Stress
Reduction Program in Coronary heart disease: A
randomized control trial. International Journal
of Yoga 6(2), 2013 June 13; 75, 111-117.
24
Mohamed Ihsan Ajwad, Joost de Laat, Stegan
Hut, Jennica Larrison, Ilhom Adbulloev, Robin
Audy, Zlatko Nikoloski, and Federico Torrachi
25
Glewwe, Paul, Qiuqiong Huang, and Albert
Park. "Cognitive Skills, Non-Cognitive Skills, and
As a part of the service provision of the Micro-
SIB, a full feasibility study will be conducted by
I8I in order to formalize and assess the overall
economic impact, qualitative impact, costs, as
well as cost-savings concerning the HUH Micro-
HIB for Cardiovascular Diseases.
DATA COLLECTION & ANALYSIS
Data collection and analysis will be
implemented by the Patient Experience
Manager, who will report bi-monthly to the
Executive Director concerning project updates.
Data will be input and kept current by the
Administrative Assistant and Executive Director.
The Executive Director will be responsible for
meeting quarterly and reporting annually to the
HU-NDIA, who will provide recommendations
and assessment. The Executive Director will
publish the HU-NDI’s annual report, making the
results and progress available to the public and
academic community. The NDI will follow a
three-pronged plan: Communication,
Education, and Follow-up in accordance with
National best-practices (Cleveland Clinic). This
will include information continuity,
management continuity, and relational
continuity. The Cleveland Clinic is among the
15% of hospitals that achieved an overall three-
star rating from the Society of Thoracic
Surgeons (STS) FOR CABG Survey. The ratings
reflect the highest quality of cardiac surgery.
The HU-NDI will measure the following metrics
among project participants:
1. Patient Satisfaction Survey
2. Discharge Rx Correct Capture rate
the Employment and Wages of Young Adults in
Rural China." 2011 Annual Meetings, July. 2011;
17.
26
Carneiro, Pedro; Crawford, Claire; Goodman,
Alissa. The Impact of Early Cognitive and Non-
cognitive Skills on Later Outcomes. Centre for
the Economics of Education. 1 January 2007.
15. pg. 9
3. 30-day readmission rates
4. Patient Loyalty Scores
5. MDD Survey
6. Hospital Anxiety and Depression
Scale, Perceived Stress Scale, Blood
Pressure, and Body Mass Index (BMI).
7. Exercise Stress Test27
WEARABLE TECHNOLOGY
The program will also integrate affordable
wearable technology with the patient
experience for the duration of the 3-month
program, specifically the Pebble Smartwatch,
providing a discrete and modern device with
heartrate monitoring and exercise focused
applications that will be customized to the
specifications of HUH and the needs of the NDI
program. The device will also be simple to use,
further allowing for a one-touch emergency
response feature to contact all designated
parties, such as caretakers, family, physicians,
and 911 emergency support. The device will be
returned to the HU-NDI upon patients exiting
the program.
CONTRACT FORMATION
The University of Georgetown’s Social
Enterprise & Non-profit Law Clinic, a division of
Georgetown Law, has agreed to partner with
I8I, and author a standard contractual
agreement for the Micro-SIB, providing a
framework for Micro-HIB’s.
STANDARD VS. COMMUNITY-BASED
METRICS?
The Micro-HIB will utilize the IRIS Metrics as a
bare framework, providing standard metrics for
a variety of fields to build off of, while also
27
Haggerty, J.L.,R.J. Reid, G.K. Freeman, B.H.
Starfield, C.E. Adair, R. McKendry, “Continuity of
Care: A Multi-disciplinary Review,” BMJ 327
(7425)(2003): 1219-1221
encouraging stakeholders to exercise freedom
of discretion regarding the customization and
implementation of community-based
standards. Therefore, the local negotiating table
will have the final say concerning the ultimate
determination of project metrics.
RELEVANT LEGISLATION
Federal Legislation
Social Impact Partnership Act (H.R. 1336) – On
March 4, 205, U.S. Representatives Todd Young
(R-IN) and John Delaney (D-MD) – along with
eight other bipartisan cosponsors reintroduced
H.R. 1336, which would create a one-time
$300M fund at the Office of Management and
Budget to support the development of new
social impact bond deals at the state and local
level over the next 10 years.28
Social Impact Partnership Act (S. 1089) – On
April 27, 2015, U.S. Senators Orrin Hatch (R-UT)
and Michael Bennet (D-CO) reintroduced a
companion bill to H.R. 1336, the Social Impact
Bond Partnership Act (S. 1089), which would
create a $300M fund at the U.S. Treasury to
support PFS at the state and local level.29
Every Child Achieves Act (S. 1177) – On July 16,
2015, the U.S Senate passed legislation that
would reauthorize the Elementary and
Secondary Education Act (ESEA), (1) which
would allow states and local school districts to
invest in their Title I, Part D funds (Programs for
Neglected, Delinquent, and At Risk Children and
Youth, $47.6M in FY15) in PFS initiatives; (2)
allow local school districts to invest their Title
IV, Part A funds (Safe and Drug Free Schools and
Communities, $70 million in FY15) in PFS
initiatives; and (3) allow states to invest their
early childhood coordination funds (Early
28
H.R. 1336, 114th
Cong. (2015).
29
S. 1089, 114th
Cong. (2015).
16. pg. 10
Learning Alignment and Improvement Grants,
newly authorized program) in PFS initiatives.30
The Student Success Act (H.R. 5) – On July 8,
2015, the U.S. House passed its ESEA
reauthorization bill – H.R. 5, the Student
Success Act, which would (1) allow states and
local school districts to invest their Title II, Part
A funds (Teacher Preparation and Effectiveness,
approximately $2.3 billion in FY15) in Pay for
Success initiatives; and (2) would allow states
and local school districts to invest their Teacher
and School Leader Flexible Grant Funds (a new
program authorized at $697 million) in PFS
initiatives.31
Workforce Innovation and Opportunity Act
(WIOA) – On July 22, 2014, President Obama
signed the WIOA into law. This bipartisan
legislation, authorizes the three largest federal
workforce development programs (Youth
Workforce Investment program, Adult
Employment and Training program, and
Dislocated Workers Employment and Training
program), which includes new provisions which:
(1) increase the amount of WIOA funds can set
aside and distribute directly from 5-10% and
authorize them to invest these funds in Pay for
Performance initiatives; (2) authorize states to
invest their own workforce development funds,
as well as non-federal resources, in Pay for
Performance initiatives (3) authorize local
workforce investment boards to invest up to
10% of their WIOA funds in Pay for Performance
initiatives; and (4) authorize states and local
workforce investment boards to award Pay for
Performance contracts to intermediaries,
community based organizations, and
community colleges.32
30
S. 1177, 114th
Cong. (2015).
31
H.R. 5, 114th
Cong. (2015).
32
H.R. 803, 113TH
Cong. (2014).
33
H.R. 1493, 110th
Cong. (2008).
Second Chance Act – Through the U.S.
Department of Justice’ Second Chance Act,
whose program goals are to “reduce recidivism,
provide reentry services, conduct research, and
evaluate the impact of reentry programs.” The
FY14 and FY15 federal appropriations bills also
authorized the Department to invest up to
$7.5M of its Second Chance Act funds in Pay for
Success efforts, including $5M to implement
projects using the Permanent Supportive
Housing model.33
Corporation for National and Community
Service – FY16 and FY15 Federal appropriations
bills authorized the Corporation for National
and Community Service (CNCS) to invest up to
20% of the Social Innovation Fund (SIF) (up to
$14 million) in Pay for Success initiatives. Key
focus areas include: economic opportunity,
healthy futures, and youth development.
Federal grant dollars must be matched by the
grantee with nonfederal dollars and services.34
U.S. Dept. of Housing & Urban Development –
The Obama Administration’s FY16 Budget
request seeks demonstration authority allowing
the U.S. Department of Housing & Urban
Development (HUD) to use PFS deals to finance
energy efficiency retrofits in HUD-assisted
housing through reduction in utility costs.35
FY16 Total Proposed Exec. Budget = $364M
U.S. FEDERAL TAX INCENTIVES
New Market Tax Credits (NMTC) – The New
Market Tax Credit program stems from the
Community Renewal Tax Relief Act of 2000,
which to date has allocated $29.5B in
investments to privately management
investment institutions. Through the creation of
34
“National ServiceAgency Announces $12M to
Support Pay for Success Projects. NCS. NCS, 1
October 2014. Web. 7 September 2015.
35
“Improving Outcomes through Pay for Success.”
White House. WhiteHouse, 13 April 2015. Web. 7
September 2015.
17. pg. 11
Community Development Financial Institutions
(CDFIs), who privately administer raised capital
for Micro-SIBs, investors are able to recoup tax
credits of up to 39% of their cash equity
investment over a period of seven years (5% in
years 1-3, and 6% in years 1-3).36
Low-income Housing Tax Credits (LIHTC) – The
LIHTC program was created in 1986 to
encourage private investment in the
development and rehabilitation of rental
housing for low to moderate-income families,
seniors, and persons with special needs. LIHTCs
are governed by Section 42 of the Internal
Revenue Code and corresponding Federal
Regulations. Tax credits under the LIHTC
program are transferrable and able to be sold to
investors for capital or equity. The aim of the
legislation is to provide lower rents that are
affordable for low-income and moderate-
income households, while giving investors’ tax
breaks that exceed their total investment in the
real estate.37
Consumer Energy Efficiency Tax Credits –
Under the Tax Increase Prevention Act of 2014,
eligible consumer items, such as Geothermal
Heat Pumps, Small Residential Wind Turbines,
and Solar Energy Systems, provide tax credits
for up to 30% of the cost, up to $500 per .5 KW
of power capacity. Existing homes and new
construction do qualify. Rental homes and
second homes do not qualify.38
Losses on Sale of Small Business Equity – Under
IRS 1244, investors’ who invest in a company
with less than $1M in assets – and lose their
investment, may be able to write off the loss as
an ordinary loss rather than a capital loss, which
allows investors to write off up to $50,000 in
36
”New Markets Tax IncentiveProgram.” CDFI. CDFI.
3 September 2015. Web. 7 September 2015.
http://www.cdfifund.gov/what_we_do/programs_id
.asp?programID=5.
37
National Associationof HomeBuilders, The local
Economies Impact of Typical HousingTax Credit
Developments (March2010).
losses on a qualified domestic corporation. This
in turn can be used to reduce an investor’s
ordinary income, which otherwise would be
taxed at a maximum rate as high as $39.6%.39
For more information on Micro-HIB’s, please
contact us at info@infinite8institute.com and
www.infinite8institute.com.
38
“Federal Tax Credits for Consumer Energy
Efficiecy.” Energy Star. Energy Star, 30 October 2013.
Web. 7 September 2015.
https://www.energystar.gov/about/federal_tax_cre
dits.
39
26 U.S.C. Sec. 1224 (1958).
https://www.law.cornell.edu/uscode/text/26/1244,
18. Infinite8 Institute, L3C
The design and finance of social impact systems
Mount Avernia Hospital & Medical Centre, Singapore