Watch the webinar on youtube: https://youtu.be/rNaU_P2mHXE
The transition to value-based care models has increased pressure to deliver high quality and cost effective care. The medical home concept has gained traction in the primary care setting, and now, the perioperative surgical home has the potential to improve patient satisfaction, outcomes, and cost-effectiveness in the acute setting.
Dr. Zeev Kain, Chancellor’s Professor of Anesthesiology and former Associate Dean of Clinical Operations at University of California at Irvine Health, will share challenges and lessons learned implementing their Joint Replacement Surgical Home to provide more coordinated, standardized care.
What you’ll learn:
– An overview of the Perioperative Surgical Home model, and how it can improve outcomes while reducing cost
– Lessons learned from UC Irvine’s implementation of a Joint Replacement Surgical Home
– Considerations for implementing a Perioperative Surgical Home in your organization
About the Speaker:
Zeev N. Kain is a Chancellor’s Professor of Anesthesiology & Pediatrics & Psychiatry and the Chair of the Department of Anesthesiology & Perioperative Care at UC Irvine Health. Dr. Kain completed residency training in Pediatrics and Anesthesiology, a fellowship in Pediatric Anesthesia and was received an MBA from Columbia University. After 19 years at Yale University he joined UC Irvine Health in 2008. Dr. Kain has had continuous NIH funding since 1996 and had published over 200 publications in the peer-reviewed literature. His main research focus was stress in children undergoing surgery and invasive procedures.
Dr. Kain established the annual summit on the Perioperative Surgical Home and is a member of the steering committee of a 43 hospital collaborative on this topic. His training in Lean Six Sigma and his MBA and his management background have enabled him to embark on the quest to make the Perioperative Surgical Home ubiquitous at UC Irvine Health and to help bring this care model to institutions nationally.
Implementation of a Perioperative Surgical Home (PSH)Wellbe
The PSH is a patient-centered, physician-led system of coordinated care that guides patients through the entire surgical experience. From the decision for surgery to 30-90 days post discharge from a medical facility, the PSH model of care is re-engineered to improve patient care and outcomes while decreasing total cost. Learn how your physicians can earn financial incentives from both the PSH and the new CMS requirements for Alternative Payment Models (APMs).
What does SGR Reform and PSH have in common? Dr. Mike Schweitzer, a national leader in PSH, will show you how physicians can leverage a PSH to meet the new APM requirements. The Medicare Access and CHIP Reauthorization Act (MACRA) replaces SGR with a new performance-based payment system and financial incentives for participation in alternative payment models. The law requires that major changes occur by January 1, 2017 – the measurement year for penalties and rewards in 2019. Dr. Schweitzer will describe how to develop a PSH program in your organization. He will share strategies to engage physician leaders to prepare for MACRA or Value Based Payments through PSH.
This webinar will enable you to:
- Identify the burning platform for a PSH
- Define the elements of a PSH
- Outline the infrastructure needed to implement a PSH
- Build and sustain the metrics to support a PSH
- Learn how to engage physician champions
About the Speaker:
Dr. Mike Schweitzer is the Vice President of Healthcare Delivery Transformation at VHA Southeast in Tampa, FL. Mike is also the Medical Director guiding the ASA-sponsored Perioperative Surgical Home Collaborative involving 44 healthcare organizations across the nation. Dr. Schweitzer is a nationally recognized speaker and has published many articles on the Perioperative Surgical Home.
Dr. Schweitzer previously served as the Chief Medical Officer for Northeast Baptist Hospital in San Antonio, TX where he was involved in the CMS Pilot for Acute Care Episodes, ACO development, and co-management programs.
Three Key Strategies for Healthcare Financial TransformationHealth Catalyst
To succeed in today’s rapidly evolving business environment, healthcare organizations must have accurate financial data. Approximately 50 percent of CMS payments are now tied to a value component; hospital operating margins are at an all-time low; and consumer demands are rising with their costs. In order to meet these new challenges, health systems must shift their strategy or risk being left behind. This article details the operational, organizational, and financial strategies that drive financial transformation, as well as examples of how to obtain and utilize financial data, find waste reduction opportunities, and much more.
As healthcare is a language “all its own,” PYA Principal David McMillan presented “Learning the New Language of Healthcare" at the Georgia Society of CPAs' 2014 Healthcare Conference.
The Latest Regulations, Simplified: MU, PQRS & MIPSathenahealth
Changing governmental regulations for the advancement of healthcare is more than difficult and we have simplified these changes to keep you up to date.
Patient-Centered Medical Home: Navigating through Recognition and Rewardsathenahealth
Join athenahealth as we delve into Patient-Centered Medical Homes and the complications that come with navigating through the regulations to achieve level three recognition status.
Palestra de Rachel David no 3º Fórum Nacional da Saúde Suplementar, realizado pela Federação Nacional de Saúde Suplementar (FenaSaúde), no Sheraton WTC São Paulo Hotel, no dia 6 de outubro de 2017.
Implementation of a Perioperative Surgical Home (PSH)Wellbe
The PSH is a patient-centered, physician-led system of coordinated care that guides patients through the entire surgical experience. From the decision for surgery to 30-90 days post discharge from a medical facility, the PSH model of care is re-engineered to improve patient care and outcomes while decreasing total cost. Learn how your physicians can earn financial incentives from both the PSH and the new CMS requirements for Alternative Payment Models (APMs).
What does SGR Reform and PSH have in common? Dr. Mike Schweitzer, a national leader in PSH, will show you how physicians can leverage a PSH to meet the new APM requirements. The Medicare Access and CHIP Reauthorization Act (MACRA) replaces SGR with a new performance-based payment system and financial incentives for participation in alternative payment models. The law requires that major changes occur by January 1, 2017 – the measurement year for penalties and rewards in 2019. Dr. Schweitzer will describe how to develop a PSH program in your organization. He will share strategies to engage physician leaders to prepare for MACRA or Value Based Payments through PSH.
This webinar will enable you to:
- Identify the burning platform for a PSH
- Define the elements of a PSH
- Outline the infrastructure needed to implement a PSH
- Build and sustain the metrics to support a PSH
- Learn how to engage physician champions
About the Speaker:
Dr. Mike Schweitzer is the Vice President of Healthcare Delivery Transformation at VHA Southeast in Tampa, FL. Mike is also the Medical Director guiding the ASA-sponsored Perioperative Surgical Home Collaborative involving 44 healthcare organizations across the nation. Dr. Schweitzer is a nationally recognized speaker and has published many articles on the Perioperative Surgical Home.
Dr. Schweitzer previously served as the Chief Medical Officer for Northeast Baptist Hospital in San Antonio, TX where he was involved in the CMS Pilot for Acute Care Episodes, ACO development, and co-management programs.
Three Key Strategies for Healthcare Financial TransformationHealth Catalyst
To succeed in today’s rapidly evolving business environment, healthcare organizations must have accurate financial data. Approximately 50 percent of CMS payments are now tied to a value component; hospital operating margins are at an all-time low; and consumer demands are rising with their costs. In order to meet these new challenges, health systems must shift their strategy or risk being left behind. This article details the operational, organizational, and financial strategies that drive financial transformation, as well as examples of how to obtain and utilize financial data, find waste reduction opportunities, and much more.
As healthcare is a language “all its own,” PYA Principal David McMillan presented “Learning the New Language of Healthcare" at the Georgia Society of CPAs' 2014 Healthcare Conference.
The Latest Regulations, Simplified: MU, PQRS & MIPSathenahealth
Changing governmental regulations for the advancement of healthcare is more than difficult and we have simplified these changes to keep you up to date.
Patient-Centered Medical Home: Navigating through Recognition and Rewardsathenahealth
Join athenahealth as we delve into Patient-Centered Medical Homes and the complications that come with navigating through the regulations to achieve level three recognition status.
Palestra de Rachel David no 3º Fórum Nacional da Saúde Suplementar, realizado pela Federação Nacional de Saúde Suplementar (FenaSaúde), no Sheraton WTC São Paulo Hotel, no dia 6 de outubro de 2017.
Healthcare Consumerism and Cost: Dispelling the Myth of Price TransparencyHealth Catalyst
The world of healthcare costs is confusing and messy for both patients and providers. Many providers don’t fully understand their costs and therefore struggle to meet the increasing pressure for greater price transparency for consumers. With price transparency rules finalized and implementation looming, many providers are racing against the clock to adapt business practices to meet regulations and communicate the implications to consumers. And each organization’s financial health depends on transparency, as uncertainty about costs keeps many patients from seeking care.
Deb Gordon, seasoned healthcare executive and author of the book, “The Health Care Consumer’s Manifesto: How to Get the Most for Your Money,” and Pat Rocap, Director of Cost Management Services at Health Catalyst, examine the relationship between cost and pricing as the path to transparency for consumers. Deb and Pat provide expert analysis and practical advice to help you become a savvier provider and consumer when it comes to healthcare pricing and spending.
- The implications of federal price transparency regulations.
- The connection between healthcare costing and pricing.
- How to start your organization’s journey to understand costs and why it matters.
- Why price transparency is important to both patients and providers.
Alexander Strachan, Jr., MD, MBA, and Asim Usman, MD, of EmCare Hospital Medicine, discuss bundled payments for care improvement (BPCI) and how hospitalists are leading the charge.
Originally presented May 4, 2016, as a webinar in partnership with Becker's Hospital Review.
3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINOCNseg
Palestra de Carmella Bocchino no 3º Fórum Nacional da Saúde Suplementar, realizado pela Federação Nacional de Saúde Suplementar (FenaSaúde), no Sheraton WTC São Paulo Hotel, no dia 5 de outubro de 2017.
Population Health in 2016: Know How to Move Forwardathenahealth
Accountable care organizations (ACOs) present a significant opportunity to reduce health care expenditures and ensure quality care. Successfully managing the transition to an ACO is one of the most difficult challenges facing health organizations today. The key is to focus on the risk contract and approach population health management in a staged, incremental way.
Will the Revenue Ever Return? COVID-19 and the Rise of the Insurers; the Case...Health Catalyst
As healthcare providers face the long-term revenue compression of COVID-19, they’re also navigating significant industry changes. Current challenges include horizontal competition from large insurers and digital disrupters, growing telehealth volumes, headwinds from price transparency, and growth in managed care programs, like Medicare Advantage. Without restored or growing volumes, how do health systems return to profitability?
Health systems will need accurate financial data around service line and procedural profitability, which very few have. Allocations, estimates and averages of cost, and large pools of clinical “overhead” are inaccurate, and these methods have no credibility with physicians and administrators.
Join Rob DeMichiei, Strategic Advisor for Health Catalyst and former Executive Vice President and Chief Financial Officer for UPMC, to learn more.
What You’ll Learn:
- How insurers look at their medical expenses, and their plans to reduce utilization and steer volumes away from traditional providers.
- The implications of price transparency; why a rational pricing strategy is critical to success.
- Using existing EHR data to measure and assess 100 percent of your clinical costs.
- How improved costing enables service-line management and allows for improved clinical care delivery and insight into profitability.
- How activity-based costing can help identify physician and clinical variation.
- Implications of inaccurate RVU/RCC costing on contract negotiations, resource management, and productivity reporting.
- Benefits and simplicity of activity-based (consumption) costing.
The Evolving Role of the Compliance Officer in the Age of Accountable CarePYA, P.C.
Much has been written about new competencies physicians must develop in the face of payment and delivery system reform. But providers are not the only ones seeing their roles change. Compliance officers, who serve as organizations’ internal police officers, will have many new challenges. PYA Principal Martie Ross presented a national Health Care Compliance Association (HCCA) webinar entitled “The Evolving Role of the Compliance Officer In the Age of Accountable Care.”
Physician Payment Reforms: The Future of MIPS and APMs – Value-Based Payments...Epstein Becker Green
Epstein Becker Green Webinar with Attorney Lesley Yeung - Value-Based Payments Crash Course Webinar Series - May 16, 2016.
Topics include:
* An overview of the physician payment reforms included in the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”)
* A summary of the Merit-Based Incentive Payment System (“MIPS”) and Alternative Payment Models (“APMs”) Proposed Rule (publication is expected in the spring of 2016)
* Opportunities for provider engagement with the Centers for Medicare & Medicaid Services to shape physician payment reform efforts
http://www.ebglaw.com/events/physician-payment-reforms-the-future-of-mips-and-apms-value-based-payments-crash-course-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Behavioral Health Industry Insights - 2016Duff & Phelps
This issue of Behavioral Health Insights details the impact of deinstitutionalization and the IMD Exclusion on the behavioral healthcare landscape. On April 25, 2016, the CMS issued a long-awaited official rule meaningfully changing the IMD Exclusion provisions in response to access concerns over inpatient psychiatric and substance use disorder services
ICD-10 Is Really Here: What Does That Mean To Compliance Officers?PYA, P.C.
PYA Principal Denise Hall presented “ICD-10 Is REALLY Here: What Does that Mean to Compliance Officers?” at the THA 2015 Fall Compliance Conference. The presentation helps providers get “in tune” with the latest in ICD-10 compliance:
* A brief discussion of ICD-10 and its impact on healthcare.
* Compliance risks with the transition to the ICD-10 system.
* Mitigation of compliance risk and denial activities during and post-implementation.
* ICD-10’s impact on value-based purchasing and quality-based payment models.
The Future of OB Hospitalist Programs: The Unexpected DeliverablesEmCare
You might expect that with an OB hospitalist onsite 24/7, hospitals are better equipped to manage obstetric and gynecologic care and emergencies, providing the ultimate in patient safety while reducing liability and risk. That’s true. But there are unexpected benefits as well.
Wayne L. Farley, Jr., D.O., FACOG, presents “The Future of OB Hospitalist Programs: The Unexpected Deliverables.” This webinar was September 21, 2016, hosted by Becker’s Hospital Review.
Presentation delivered by Steve Neorr, Chief Administrative Officer, Triad HealthCare Network at the marcus evans National Healthcare CXO Summit 2018 in Orlando FL
Why Clinical Quality Should Be Your Core Business StrategyHealth Catalyst
Over 100 years ago, healing professionals and healthcare itself went through a massive transformation that led us to the models of care delivery that we use today. Dr. Brent James argues that we are now, again, at a once-in-a-century inflection point to change the course of healthcare. Change takes real effort, but provides massive opportunity.
Those changes include a move away from the highly-profitable fee-for-service payment to fee-for-value. An IOM report, published in 2010, substantiated that more than a third of healthcare spending is waste. Pay-for-value aligns financial returns for those who invest in waste elimination. It also requires that clinicians move away from the craft of medicine to the science of medicine, using data and evidence to drive better clinical care.
As the vice president and chief quality officer at Intermountain Healthcare, Dr. James led much of the change that produced Intermountain’s recognized operational and clinical excellence. In this webinar Dr. James educates and inspires all of us to do great work by sharing practical stories of how data has become the critical tool to help healthcare shift from revenue enhancement to clinical quality, which produces the most affordable care.
Learn how to:
- Use data to find variations in both cost and quality of care.
- Standardize care without demotivating underperforming outliers.
- Build a culture of data-driven care providers.
- Develop an improvement strategy that you can start today.
Sought the world over, Dr. James is a recognized expert in this outcomes improvements area. He has championed the standardization of clinical care through data collection and analysis on a wide variety of treatment protocols and complex care processes for more than 20 years.
Healthcare Consumerism and Cost: Dispelling the Myth of Price TransparencyHealth Catalyst
The world of healthcare costs is confusing and messy for both patients and providers. Many providers don’t fully understand their costs and therefore struggle to meet the increasing pressure for greater price transparency for consumers. With price transparency rules finalized and implementation looming, many providers are racing against the clock to adapt business practices to meet regulations and communicate the implications to consumers. And each organization’s financial health depends on transparency, as uncertainty about costs keeps many patients from seeking care.
Deb Gordon, seasoned healthcare executive and author of the book, “The Health Care Consumer’s Manifesto: How to Get the Most for Your Money,” and Pat Rocap, Director of Cost Management Services at Health Catalyst, examine the relationship between cost and pricing as the path to transparency for consumers. Deb and Pat provide expert analysis and practical advice to help you become a savvier provider and consumer when it comes to healthcare pricing and spending.
- The implications of federal price transparency regulations.
- The connection between healthcare costing and pricing.
- How to start your organization’s journey to understand costs and why it matters.
- Why price transparency is important to both patients and providers.
Alexander Strachan, Jr., MD, MBA, and Asim Usman, MD, of EmCare Hospital Medicine, discuss bundled payments for care improvement (BPCI) and how hospitalists are leading the charge.
Originally presented May 4, 2016, as a webinar in partnership with Becker's Hospital Review.
3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINOCNseg
Palestra de Carmella Bocchino no 3º Fórum Nacional da Saúde Suplementar, realizado pela Federação Nacional de Saúde Suplementar (FenaSaúde), no Sheraton WTC São Paulo Hotel, no dia 5 de outubro de 2017.
Population Health in 2016: Know How to Move Forwardathenahealth
Accountable care organizations (ACOs) present a significant opportunity to reduce health care expenditures and ensure quality care. Successfully managing the transition to an ACO is one of the most difficult challenges facing health organizations today. The key is to focus on the risk contract and approach population health management in a staged, incremental way.
Will the Revenue Ever Return? COVID-19 and the Rise of the Insurers; the Case...Health Catalyst
As healthcare providers face the long-term revenue compression of COVID-19, they’re also navigating significant industry changes. Current challenges include horizontal competition from large insurers and digital disrupters, growing telehealth volumes, headwinds from price transparency, and growth in managed care programs, like Medicare Advantage. Without restored or growing volumes, how do health systems return to profitability?
Health systems will need accurate financial data around service line and procedural profitability, which very few have. Allocations, estimates and averages of cost, and large pools of clinical “overhead” are inaccurate, and these methods have no credibility with physicians and administrators.
Join Rob DeMichiei, Strategic Advisor for Health Catalyst and former Executive Vice President and Chief Financial Officer for UPMC, to learn more.
What You’ll Learn:
- How insurers look at their medical expenses, and their plans to reduce utilization and steer volumes away from traditional providers.
- The implications of price transparency; why a rational pricing strategy is critical to success.
- Using existing EHR data to measure and assess 100 percent of your clinical costs.
- How improved costing enables service-line management and allows for improved clinical care delivery and insight into profitability.
- How activity-based costing can help identify physician and clinical variation.
- Implications of inaccurate RVU/RCC costing on contract negotiations, resource management, and productivity reporting.
- Benefits and simplicity of activity-based (consumption) costing.
The Evolving Role of the Compliance Officer in the Age of Accountable CarePYA, P.C.
Much has been written about new competencies physicians must develop in the face of payment and delivery system reform. But providers are not the only ones seeing their roles change. Compliance officers, who serve as organizations’ internal police officers, will have many new challenges. PYA Principal Martie Ross presented a national Health Care Compliance Association (HCCA) webinar entitled “The Evolving Role of the Compliance Officer In the Age of Accountable Care.”
Physician Payment Reforms: The Future of MIPS and APMs – Value-Based Payments...Epstein Becker Green
Epstein Becker Green Webinar with Attorney Lesley Yeung - Value-Based Payments Crash Course Webinar Series - May 16, 2016.
Topics include:
* An overview of the physician payment reforms included in the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”)
* A summary of the Merit-Based Incentive Payment System (“MIPS”) and Alternative Payment Models (“APMs”) Proposed Rule (publication is expected in the spring of 2016)
* Opportunities for provider engagement with the Centers for Medicare & Medicaid Services to shape physician payment reform efforts
http://www.ebglaw.com/events/physician-payment-reforms-the-future-of-mips-and-apms-value-based-payments-crash-course-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Behavioral Health Industry Insights - 2016Duff & Phelps
This issue of Behavioral Health Insights details the impact of deinstitutionalization and the IMD Exclusion on the behavioral healthcare landscape. On April 25, 2016, the CMS issued a long-awaited official rule meaningfully changing the IMD Exclusion provisions in response to access concerns over inpatient psychiatric and substance use disorder services
ICD-10 Is Really Here: What Does That Mean To Compliance Officers?PYA, P.C.
PYA Principal Denise Hall presented “ICD-10 Is REALLY Here: What Does that Mean to Compliance Officers?” at the THA 2015 Fall Compliance Conference. The presentation helps providers get “in tune” with the latest in ICD-10 compliance:
* A brief discussion of ICD-10 and its impact on healthcare.
* Compliance risks with the transition to the ICD-10 system.
* Mitigation of compliance risk and denial activities during and post-implementation.
* ICD-10’s impact on value-based purchasing and quality-based payment models.
The Future of OB Hospitalist Programs: The Unexpected DeliverablesEmCare
You might expect that with an OB hospitalist onsite 24/7, hospitals are better equipped to manage obstetric and gynecologic care and emergencies, providing the ultimate in patient safety while reducing liability and risk. That’s true. But there are unexpected benefits as well.
Wayne L. Farley, Jr., D.O., FACOG, presents “The Future of OB Hospitalist Programs: The Unexpected Deliverables.” This webinar was September 21, 2016, hosted by Becker’s Hospital Review.
Presentation delivered by Steve Neorr, Chief Administrative Officer, Triad HealthCare Network at the marcus evans National Healthcare CXO Summit 2018 in Orlando FL
Why Clinical Quality Should Be Your Core Business StrategyHealth Catalyst
Over 100 years ago, healing professionals and healthcare itself went through a massive transformation that led us to the models of care delivery that we use today. Dr. Brent James argues that we are now, again, at a once-in-a-century inflection point to change the course of healthcare. Change takes real effort, but provides massive opportunity.
Those changes include a move away from the highly-profitable fee-for-service payment to fee-for-value. An IOM report, published in 2010, substantiated that more than a third of healthcare spending is waste. Pay-for-value aligns financial returns for those who invest in waste elimination. It also requires that clinicians move away from the craft of medicine to the science of medicine, using data and evidence to drive better clinical care.
As the vice president and chief quality officer at Intermountain Healthcare, Dr. James led much of the change that produced Intermountain’s recognized operational and clinical excellence. In this webinar Dr. James educates and inspires all of us to do great work by sharing practical stories of how data has become the critical tool to help healthcare shift from revenue enhancement to clinical quality, which produces the most affordable care.
Learn how to:
- Use data to find variations in both cost and quality of care.
- Standardize care without demotivating underperforming outliers.
- Build a culture of data-driven care providers.
- Develop an improvement strategy that you can start today.
Sought the world over, Dr. James is a recognized expert in this outcomes improvements area. He has championed the standardization of clinical care through data collection and analysis on a wide variety of treatment protocols and complex care processes for more than 20 years.
The Changing Landscape: Value-Based Purchasing, Reimbursement and its Impact ...marcus evans Network
Troy Trosclair, HCA MidAmerica Division - Speaker at the marcus evans National Healthcare CNO Summit, held in Hollywood, FL, April 26-28, 2012, delivered his presentation entitled The Changing Landscape: Value-Based Purchasing, Reimbursement and its Impact on Nursing
The Patient Centered Primary Care Collaborative has been working for years to build evidence and knowledge about how to improve healthcare by providing a medical "home" for each of us - a place where all our records reside, where the staff know us, etc. This April 2010 by Executive Director Edwina Rogers shows the phenomenal range of results they've produced.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
The goal of this webinar was to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
Presentation for a Graduate Course in Health Policy at Trinity College, Hartford CT.
In two parts - part 1 presentation on Value-Based Systems. Part 2 is on Health Equity (in progress).
The changing landscape of health care in the US -- drivers and outcomesGregory Travis
The United States has the worst health care outcomes among its OECD peers. It also has the highest health care costs within the OECD. What are the reasons for this and what changes can we anticipate going forward?
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Case Study "Using Real Time Clinical Data To Support Patient Risk Stratification in The Clinical Care Setting"
HealthInfoNet operates the statewide health information exchange in Maine. The exchange currently manages clinical and patient care encounter information on 97 percent of the residents of the State of Maine. The information is gathered in real time, standardized, and aggregated at a patient specific level to support treatment. For the past three years, HealthInfoNet has worked with HBI Solutions, Inc of Palo Alto, CA to utilize this real time clinical and encounter data to support the development of predictive analytic tools that risk stratify patient populations and individual patients for future incidence of disease, cost, and both inpatient and ambulatory care encounters. These real time predictive models have now been used in clinical care settings for a year. The presentation will cover both lessons learned to date from implementing and optimizing real time predictive analytic tools and the early finding of the impact that the use of these tools is having on patient care management, utilization and outcome.
Devore Culver
Executive Director & CEO
HealthInfoNet
An industry-wide survey of the health ecosystem. By looking at leading operating models that are representative of the future health ecosystem, the viewer can get a handle on how the future will look.
In October 2014, INTEGRATED's Bill Jessee presented "Where Is Healthcare Going? And How Will We Get There?" at Iowa Hospital Association's annual meeting. The presentation focuses on the forces shaping healthcare today, the delivery system changing in response to the environment, and what this all means for hospitals and physicians.
Similar to Using the Perioperative Surgical Home as a Model to Implement CJR (20)
Using Enhanced Recovery After Surgery (ERAS) to Enhance Postoperative OutcomesWellbe
Speaker: Francesco Carli, MD, MPhil, senior staff anesthesiologist at the McGill University Health Centre
Cost: Complimentary, sponsored by Wellbe
There is strong evidence that many of aspects of surgical care have little evidence, and therefore the Enhanced Recovery After Surgery (ERAS) program has been set up to accelerate the recovery process and decrease the rate of postoperative complications. There is an opportunity to improve outcomes by using team approach and revision of the standard procedures.
Learn about:
– The elements of ERAS protocols
– How to structure the Team approach
– The role of the patient in ERAS
– How to perform an audit of your program
About the Speaker:
Francesco Carli, MD, MPhil, is Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University and a senior staff anesthesiologist at the McGill University Health Centre. He is currently an Elected Member of the American Academy of Anesthesia and a Board Member of the Enhanced Recovery After Surgery (ERAS) Society. Dr. Carli completed his medical training and anesthesia training in Turin, Italy, Paris, France, and London, England. He completed a Master’s Degree in surgical metabolism at the University of London, England.
His research interests are: metabolic changes associated with surgery and the impact of perioperative interventions (regional analgesia, nutrition, hormones, exercise) on postoperative recovery; evaluation of functional outcome measures during the surgical recovery process; prehabilitation of surgical patients. He is the author of over 250 peer-review scientific articles and has been a recipient of over 50 peer and non peer-review grants.
10-Year Orthopedics and Spine Forecast: Factors Impacting DemandWellbe
Advances in technology and surgical techniques, fluctuations in population, ever-increasing demand for outpatient procedures combined with an array of economic and policy factors will shape our opportunity for growth in Orthopedics and Spine over the next decade. What’s in store for the next 10 years of orthopedics and spine service lines? Mike Graham of Sg2 will review future inpatient and outpatient forecasts for orthopedics and spine services, the key factors impacting their growth, and opportunities to differentiate your orthopedics and spine services to capture additional market share.
About the Speaker:
Mike Graham supports Sg2’s intelligence and analytics in both orthopedics and spine and contributes to the orthopedic and spine forecasts. As an Sg2 thought leader, he writes extensively on the development of orthopedic and spine service line strategy. He also works directly with health care executives and physicians to apply knowledge and strategy to their unique circumstances and environment.
With 20 years of experience in health care management and information systems, Mike has devoted much of his career to sharing best practices in service line development, physician engagement, care redesign and payment reform through publications, webinars, conference presentations and consulting engagements.
Immediately prior to joining Sg2, Mike engaged with hospitals and providers to grow their orthopedic service lines, improve patient outcomes and transition to value-based models of care. Earlier in his career he participated in the creation of groundbreaking approaches in comprehensive spine center development, focusing on innovative methods to improve patient access and employ nurse navigation and outcomes collection throughout the continuum of care.
Mike earned a master in health care administration from Xavier University in Cincinnati and an undergraduate degree in management information systems from the University of Dayton (OH).
Performance and Reimbursement under MIPS for OrthopedicsWellbe
The 2015 MACRA legislation fundamentally changed the way in which providers are paid for their services. It also provides some relief from the “all or nothing” approach used by Meaningful Use.
This session, a review of the Final Rule published on Oct 14, 2016, conveys a practical approach to maximizing reimbursement under MIPS while reducing burden on clinical staff.
After this session, attendees will have a firm grasp of:
– the major components of the Quality Payment Program
– operational strategies for measure selection
– orthopedic-specific quality measures
About the Speaker:
karenclarkKaren R. Clark is chief information officer for OrthoTennessee, where she has worked since 1998. In that role, she serves on national committees for the Healthcare Information Management Systems Society (HIMSS.) A HIMSS Fellow and Certified Professional in Healthcare Information and Management Systems, her current HIMSS committee is the HIT User Experience, which focuses on clinician experience with health information technology.
She has spoken at the AAOE, AAOS and OrthoForum conferences on both information security and the 2015 MACRA legislation, specifically on the Merit Based Incentive Payment System (MIPS.). She is a member of the College of Healthcare Information Management Executives (CHIME) as well as the CIO/CMIO Council with the American Medical Group Association.
After graduating from American University with a degree in marketing in 1979, she joined Brooks Brothers in New York, where she was a buyer. She earned her MBA in finance from Fordham University in 1984. She moved to Knoxville in 1988 and joined Watson’s as director of planning and distribution when her husband, Brooks, was recruited from Sports Illustrated to Whittle Communications. They have two adult daughters, Isabel, and Olivia.
Managing Total Joint Replacement Bundled Payment Models: Keys to SuccessWellbe
Speaker: Andrew Duncan, Executive Director for Orthopaedics and Rehabilitation at University of Florida Health
This webinar will describe bundled payments and episode of care based patient management strategies. Attendees can learn to successfully manage total joint replacement bundled payment programs and what clinical service delivery strategies to use to be positioned for success. The importance of collecting and using data to understand costs for the episode of care and to negotiate will also be a focus.
About the Speaker:
Andrew Duncan has been a licensed physical therapist since 1991, when he graduated from the State University of New York at Buffalo with his Bachelor of Science in Physical Therapy. Upon completion of entry-level training, he worked as a physical therapist for two years and then completed his post professional Master’s degree in Human Movement Science and became certified in Athletic Training at the University of North Carolina at Chapel Hill. He then underwent board certification by the American Board of Physical Therapy Specialties and became a Sports Certified Specialist in 2002. While working as a manager at rehabilitation corporations and later at an academic health care center, he developed a passion for the business of health care and went on to complete his MBA from the Simon School of Business at the University of Rochester and has also earned his DPT from Boston University. Since 2012, Duncan serves as the Executive Director for Orthopaedics and Rehabilitation at the University of Florida College of Medicine, Co-Director of the UF Health Orthopaedic and Sports Medicine Institute, and also serves as the Executive Director for Rehabilitation and Radiology Services at UF Health Shands Hospitals. He holds an adjunct clinical lecturer appointment in the University of Florida Department of Physical Therapy providing instruction in the Patient and Families First and Professional Issues courses of the DPT curriculum.
Regional Anesthesia and Bundled Payments – Opioid-sparing Pain Management for...Wellbe
Speaker: Sonia Szlyk, MD, Director of Regional Anesthesia, Mid-Atlantic Division, North American Partners in Anesthesia
This webinar will:
-Discuss Enhanced Recovery After Surgery (ERAS) protocols for joint replacement
-Review the positive impact of regional anesthesia throughout the episode of care
-Spotlight the key components of successful value-based orthopedic care – length of stay, discharge to home, patient and surgeon satisfaction
About the Speaker:
Sonia Szlyk, MD, is the Director of Regional Anesthesia for North American Partners in Anesthesia’s Mid-Atlantic division. Dr. Szlyk orchestrates an outcomes-based regional anesthesia service focused on patient and surgeon satisfaction, safety, and efficiency. She oversees regional anesthesia quality metrics, billing compliance, strategic growth, and education. Dr. Szlyk specializes in opioid-sparing ERAS protocols for joint replacement, sports medicine, colorectal, general, and cosmetic surgery. Her initiatives highlight the value of regional anesthesia in the evolving era of bundled payments.
Dr. Szlyk served as the Director of Regional Anesthesia at the Ambulatory Surgery Center of Bethesda, MD where she oversaw the design and implementation of anesthesia services as well as AAAHC accreditation. The center’s comprehensive pain management program included ultrasound-guided peripheral nerve blocks and catheters for outpatient knee and hip replacements, and sports medicine procedures.
Dr. Szlyk is a board-certified anesthesiologist. She completed medical school and anesthesia residency at the George Washington University School of Medicine and was a Clinical Instructor in regional anesthesia at Stanford University Hospital.
NYU Langone Medical Center’s TJA BPCI Experience: Lessons in How to Maximize ...Wellbe
The Bundled Payments for Care Improvement (BPCI) Initiative began generating data in January of 2013. Dr. Iorio will outline the challenges and benefits of implementing BPCI for Total Joint Arthroplasty at an urban, tertiary, academic medical center with a hybrid compensation model. Early results from the implementation of a Medicare BPCI Model 2 primary TJA program demonstrate cost-savings with an improvement in quality of care metrics and continued cost savings through year 3 of our experience. Changes in patient optimization, care coordination, clinical care pathways, and evidence-based protocols are the key to improving the quality metrics and cost effectiveness within the implementation of the Bundled Payment for Care Initiative, thus bringing increased value to our TJA patients.
Maximizing Value in a Bundled Environment – Keys to Success:
• Evidence based, cost effectiveness analysis
• Standardized protocol adoption
• Transparent data
• Perioperative Patient Optimization
• Care management
• Physician-hospital alignment with Gain sharing
• Enhanced pain relief and rehabilitation protocols
• Blood management and rational VTED prophylaxis
About the Speaker:
Richard Iorio, MD, is the William and Susan Jaffe Professor of Orthopaedic Surgery at New York University Langone Medical Center Hospital for Joint Diseases and Chief of Adult Reconstruction at NYU Langone HJD. He co-founded Labrador Healthcare Consulting Services, Responsive Risk Solutions, and the Value Based Healthcare Consortium in 2015. He is a member of the Board of Directors for LIMA, the Lifetime Initiative for the Management of Arthritis. Dr. Iorio is a national expert in physician and hospital quality and safety and a leader in the implementation of alternate payment paradigms in orthopaedic surgery.
The process, people, and tools required to bring total joint replacements to the ambulatory surgery center setting will be presented by members of the team from the Orthopedic & Sports Institute of the Fox Valley (OSI). OSI has been performing total knee & hip replacements in their ASC since 2009.
The Orthopedic & Sports Institute of the Fox Valley (OSI) was created by its independent physician-owners to offer a full spectrum of patient services under one roof. Their unique care model encompasses sports medicine, total joint replacement, spine surgery, and work-related rehabilitation. OSI’s flagship facility in Appleton includes a surgery center, MRI, physical therapy, pain management, orthotics, and a skilled nursing facility. OSI’s commitment to providing industry-leading results has spawned innovations in Direct Contracting, bundled pricing, Work Comp rehabilitation, and recovery facility design.
About the Speakers:
Curt Kubiak, CEO, OSI: Curt has been the guiding force at OSI, an innovative provider of accessible and affordable patient care since 2006. Comprehensive offerings at OSI include orthopedic & spine surgery, imaging/MRI, bundled payments, work comp rehabilitation, physical therapy, and skilled nursing.
Kim Jablonski, Joint Program Director, OSI: Kim coordinates and oversees the entire carepath experience for patients undergoing total joint replacement at the Orthopedic & Sports Surgery Center.
Aaron Bleier, Director of Finance, OSI: A member of the OSI team since its inception, Aaron has been instrumental in the development of OSI’s cost-saving surgical price bundles.
Learn about a model that is applicable to all service lines as healthcare transitions from volume to value. The model concentrates on transforming from services & procedures, to formalized programs, to centers of excellence, while focusing on the four pillars of service line management: Quality/Outcomes; Service/Satisfaction; Volume/Market share Growth; and Cost Containment. Quality and outcomes are particularly stressed as the key to program differentiation and value. Positioning as a regional destination center for managed care and industry is also discussed.
Presentation to cover:
Learn about a model applicable to all service lines
Learn how to transition from performing procedures to becoming a center of excellence
Learn how to transition from volume to value
Learn how to differentiate your centers of excellence
Learn how to create dashboards to maximize quality
Learn some marketing strategies for your service line
Learn how to position yourself as a regional referral destination
About the Speaker:
Bill Munley is a 30-year veteran of the healthcare system and a recognized leader and strategist in Orthopedics, Service Line Development, and Rehabilitation. He currently serves as Vice President of Orthopaedics, General Surgery, and Professional Services at Bon Secours St. Francis Health System in Greenville, SC, where he has served for 27 years. He is responsible for all inpatient and outpatient Orthopedic, General Surgery, and Rehabilitation programs across three campuses. During his tenure there, he has served as a consultant to other healthcare systems, on editorial advisory boards of professional magazines, as a charter board member and officer of multiple state and local organizations, and has developed numerous programs in his specialty areas. Bill has also appeared as a guest speaker at multiple local, state, and national symposiums, presentations and webinars. Bill holds a BA in General Science from the University of Rochester and a MHSA from George Washington University.
Improving Trust Between Physicians and AdministrationWellbe
MidMichigan Health is a four hospital health system located in the Central portion of the Lower Peninsula. I am responsible for operations of both Neuroscience and Surgical Services. As such, I am accountable for the overall contribution of the service lines to the organization. Prior to taking on my current role, I was a Physician Liaison for the Gamma Knife center, which is one of three within the entire State. I was able to increase the referrals from 9 per month to 20 per month. I spent 15 years in the Pharmaceutical Industry in various roles. My entire career has been one requiring the ability to communicate well with physicians as well as with administration. Within our health system, it has been a challenge to move the Neuro and Surgical Service programs forward. This is due to a clear disconnect between Administration and the Providers. Recently, I have begun a process of working with both sides of this equation with some great success. My goal is to share with everyone the ideas that have worked to bring both sides to common ground and ultimately grow the programs.
At the end of this presentation, participants will be able to:
• Identify the key issues that need to be addressed from Administration as well as from the Providers
• Develop a communication strategy that will open discussion
• Begin to build trust through example
• Understand the difference between a “smoke screen” and a true issue
• Become the conduit to facilitate change within the system.
Registry Participation 101: A Step-by-Step Guide to What You Really Need to K...Wellbe
– Is your hospital contemplating joining a registry but you don’t know where to begin?
– Do the acronyms CJR, QCDR, and PROMs cause you angst?
– Have you heard that registry participation can count towards quality programs but you don’t understand the connection?
– Are you a surgeon needing a registry to meet Meaningful Use requirements?
– Are you in one of the 67 geographical areas mandated by the CMS’s Comprehensive Care for Joint Replacement (CJR) program?
– Is your hospital considering a patient-reported outcome measure (PROMs) program and you want to know more about what that entails?
If so, the American Joint Replacement Registry (AJRR) will walk you through everything you need to know about participating in a registry. This session will focus on best practices from over 4,500 surgeons and 675+ hospitals who have successfully implemented and engaged with the data from over 400,000 hip and knee replacement procedures. AJRR will help you to debunk the myth that submitting private health information is complicated, time consuming, and that it takes hundreds of man-hours to participate in a registry.
You’ll also learn how:
• Registry participation can support mandated quality programs – including Meaningful Use, CJR, and PQRS
• To implementing a PROM system in your hospital – what to look out for when starting and helpful tips from current users on what they have learned
• Not all data elements are mandatory – what are the different levels, what does the national registry require, and what is optional
About the Speakers:
Joe Greene is currently the Program Manager of Outreach and Development for the University of Wisconsin Hospital and Clinics in the Department of Orthopedics and Rehabilitation. In this role, Joe coordinates business and philanthropic development activities for the UW Hospital department and University of Wisconsin Department of Orthopedics and Rehabilitation. He represents the needs of all orthopedic subspecialties and has worked for the UW since 1991 when he initiated his career there as an athletic trainer and clinician. He has worked in management and administration across the Department since 1997.
In addition to his role with the UW Hospital, Joe also is the CEO and Owner of OrthoVise. OrthoVise is an Orthopedic advisory firm that assists orthopedic practices of all types with operational and business development needs. His experiences have allowed him and his advisors the opportunity to consult formally with orthopedic practices since 2010. He has particular areas of interest that include Orthopedic and Sports Medicine Program Business Development, Service Line Development, Health Information Technology and EMR Operational Optimization for Orthopedics, Innovative Service Delivery Implementation, Smart Staffing, and Workflow Enhancement.
Joe will be joined by AJRR staff who are experts in guiding individual surgeons and hospital orthopaedic service line directors through the process.
Using Patient Navigation in an Orthopedic Service Line to Drive Outcomes and ...Wellbe
Preparing for joint replacement surgery can be overwhelming for many patients; they often feel inundated with the number of tasks that need to be completed prior to surgery such as medical appointments, preadmission testing, and preparing for their recovery. Learn how one health system used technology and nurse navigation to guide their patients through the joint replacement journey.
About the Speakers:
KateG100Kate Gillespie is the AVP of the Orthopedic Service Line at Virtua in Southern New Jersey. Kate received her BSN from the College of New Jersey and her MBA in Health Care Administration from Eastern University, she is certified in Nursing Administration. As the Orthopedic service line leader her responsibilities include driving efficiency through standardization, cost containment and quality outcomes. Kate is a certified Six Sigma Black Belt with expertise in operation efficiency and lean methodology. As a Six Sigma Black Belt, Kate has led quality and financial projects, and co-led multiple Kaizen projects. She is also active in New Jersey State Nurse Association and chairwoman for the NJ INPAC.
J Smith100Jennifer Smith is the Director of Clinical Outcomes for the Orthopedic Service at Virtua in Southern NJ. Jennifer received her BSN from Thomas Jefferson University and her MSN in Nursing from Villanova University. As the Director of Clinical Outcomes her responsibilities include driving standardization and quality outcomes for the service line. Jennifer is certified as both a Clinical Nurse Specialist in Adult health and Professional in Health Care Quality.
Developing and Operating Post-Acute Networks in Value-Based ProgramsWellbe
Today’s value-based programs (ACOs, bundled payments, etc.) are shifting the responsibility for total spend from the payer to the provider. As the primary contractor under many of these programs, hospitals take on the responsibility for post-acute spend while generally having little experience in that area. This creates a significant challenge to create a successful and profitable programs.
This session will focus on the design and development of an effective post-acute provider network through implementation and ongoing operation. Specific areas to be covered include:
– The role of post-acute care in value-based programs
– Identifying post-acute opportunity for your partnerships
– Designing a post-acute network
– Developing your network
– Operational issues
– Monitoring performance
Learning Objectives:
1. Establish an effective post-acute network
2. Understand performance drivers for post-acute partners
3. Create incentives for post-acute partners to participate
4. Evaluate partner performance within your program
5. Communicate network value to patients
About the Speaker:
Sheldon Hamburger is an alternative payment model advisor for hospitals and healthcare firms nationally. With a focus on program implementation, he brings extensive knowledge and experience gained from more than 25 years of healthcare financial consulting, technology design and development, and sales & marketing strategy for Fortune 1000 clients. He is a frequent speaker and writer on regulatory and technology trends affecting hospital operations, provider reimbursement issues, BPCI and CJR, programs and regulations, medical expense strategies and payer-provider dynamics.
Residing in Raleigh, he is an Executive-In-Residence at North Carolina State University – Poole School of Management and an investor at RTP Capital Associates. He continues to be an active member of national and regional HIMSS and HFMA.
He holds a degree in Computer Engineering from the University of Michigan.
Making CJR Work for You: A Roadmap for Successful Implementation of Medicare ...Wellbe
This presentation will describe a structured approach to successfully launching a program for the Comprehensive Care for Joint Replacement (CJR) Model. Based on years of experience with bundled programs, this roadmap provides the basis for developing a targeted plan for your organization as the April 1, 2016 deadline for CJR rapidly approaches.
Key topics to be addressed include:
• Overview of CJR rules and program requirements
• CJR implications for your organization
• Bundle evaluation – financial and clinical issues
• Gainsharing considerations with program collaborators
• Designing an effective post-acute care network
• Using analytics to develop and monitor your program
• Key “must-dos” for an April 1, 2016 launch
Learning Objectives:
1. Describe the rules and requirements of CJR
2. Assess the key success drivers in bundle performance
3. Evaluate where and why organizations fail in bundles
4. Develop strategies and tactics to create a post-acute partnership
5. Illustrate risk stratification factors in bundle design
About the Speaker:
Sheldon Hamburger is an Alternative Payment Model advisor for hospitals and healthcare firms nationally. With a focus on program implementation, he brings extensive knowledge and experience gained from more than 25 years of healthcare financial consulting, technology design and development, and sales & marketing strategy for Fortune 1000 clients. He is a frequently sought-after speaker and writer on regulatory and technology trends affecting hospital operations, provider reimbursement issues, BPCI / CJR, programs and regulations, medical expense strategies and payer-provider dynamics. Residing in Raleigh, he is an active member of HIMSS, HFMA, & ACHE. He earned his B.S.E. in Computer Engineering from the University of Michigan.
How to Engage Physicians in Quality/Safety Improvement Using MetricsWellbe
The unsustainable rising cost of medical care is creating financial pressures that will critically alter the way that health care is both paid for and delivered. Limited resources dictate that we become more efficient at providing high quality care. In an effort to provide financial incentive for delivering quality care the Federal government instituted Value Based Purchasing (VBP) and Bundled Payments. In order to maximize reimbursement under these programs, providers of health care must follow to the basic tenants of the quality principles.
Lorraine Hutzler, Associate Director of the Center for Quality and Patient Safety at NYU Hospital for Joint Diseases at the NYU Langone Medical Center, will discuss:
• How to build a quality infrastructure for your orthopedic program
• What quality metrics to measure and how to engage surgeons using them
• Lean and Six Sigma principles to use to accelerate improvement
About the Speaker:
Lorraine100Lorraine Hutzler is the Associate Director of the Center for Quality and Patient Safety at NYU Hospital for Joint Diseases at the NYU Langone Medical Center and a Principal of Labrador Healthcare Consulting. She designed, built and maintains a robust quality infrastructure for the Department of Orthopaedic Surgery. Lorraine has extensive expertise in quality metrics management and reporting as well as Lean and Six Sigma Certification.
Fundamentals of Bundles for Joint Replacement – Creating the Competitive EdgeWellbe
Medicare is expected to issue the final rule for the Comprehensive Care for Joint Replacement (CJR) initiative soon. As proposed, hospitals in chosen MSAs must be ready to take on this new challenge by January 1, 2016.
The Connecticut Joint Replacement Institute (CJRI) at Saint Francis Hospital has performed more than 20,000 procedures since opening in 2007. CJRI has been on the forefront of bundled payments for joint replacements since implementing their first bundle agreement in 2010. CJRI will share the essential elements to developing a bundle program and the challenges of evolving towards a value-driven, risk bearing model in today’s healthcare environment.
Attendee Takeaways:
– Learn the essential ingredients to develop a successful bundle payment program
– Understand the fundamentals of value-based healthcare
– Learn how to create sustainable bundled payments and maintain a competitive edge in the marketplace
About The Speaker:
Maureen Geary is the Program Director at the Connecticut Joint Replacement Institute in Hartford, Connecticut. Maureen been involved with bundle payments since 2009. CJRI signed their first commercial contract in 2010. She leads strategic initiatives and new product development for the company. Maureen also provides consultative services for orthopedic organizations seeking to develop a bundled product or expand their service line.
Prepping for CCJR: Lessons Learned in Physician Alignment and Bundled PaymentsWellbe
With CMS’ recent announcement of its Comprehensive Care for Joint Replacement (CCJR) payment model and its plan to implement in seventy-five geographic areas, hospitals must be prepared to manage the entire episode of care from the time of surgery through ninety days after discharge. CCJR presents both opportunities and challenges for hospitals. In order to achieve success, organizations must manage their system of care delivery, ensure they are aligned with their physicians and post acute providers, and master the analytics necessary for driving high quality, low cost care.
MedAssets has worked with numerous providers to implement alignment models that bring hospitals and their physicians together, evaluate, identify, and implement changes to the care delivery system to improve quality and decrease cost across the continuum, and employ meaningful analytics for managing an episode of care.
Kevin Lieb, Senior Director for MedAssets’ Physician Alignment Solutions division, will share examples demonstrating how organizations have successfully implemented Episodes of Care. Mr. Lieb will also share examples from both hospital led and specialist led programs and provide lessons learned from these experiences.
This webinar will enable attendees to do the following:
• Identify alignment models within bundled payments and understand their applicability to your organization
• Understand the analytic capabilities necessary for success in a bundled payment environment
• Identify opportunities and strategies for cost reduction and quality improvement
About the Speaker:
Mr. Lieb has more than 20 years of healthcare-related experience focusing on quality improvement, market development and cost reduction initiatives for the hospital provider market. Mr. Lieb has worked for a number of well-known healthcare companies including GE Medical Systems, HCIA and LBA in Denver, Colorado. His responsibilities included healthcare consulting with a focus on process improvement and quality initiatives.
Disease-Specific Care Certification for Hip and Knee Replacement ProgramsWellbe
The Joint Commission Disclaimer: This presentation is current as of June 30, 2015. The Joint Commission reserves the right to change the content of the information as appropriate.
The Joint Commission’s Disease-Specific Care (DSC) certification program is designed to evaluate clinical programs across the continuum of care. Orthopedic joint replacement programs (hip, knee and shoulder) are certified under the standards for DSC programs.
Joint replacement programs seek certification because it:
Demonstrates commitment to a higher standard of service
Provides a framework for organizational structure and management
Provides a competitive edge in the marketplace
Enhances staff recruitment and development
Is recognized by insurers and other third parties
In this webinar, David Eickemeyer, MBA, Associate Director of Certification for The Joint Commission, will:
Define the main components of certification
Provide examples of performance measures
Provide tips on assessing readiness and preparation timelines
Discuss how and when to apply
About the Speaker:
David Eickemeyer is Associate Director for The Joint Commission’s certification programs. In this role, he manages all of the marketing efforts for Disease-Specific Care certification, Palliative Care certification and Health Care Staffing certification.
In his 18 years at The Joint Commission, Eickemeyer has conducted marketing efforts for most of The Joint Commission’s various accreditation programs, as well as marketing for publications and educational offerings from Joint Commission Resources.
Before joining The Joint Commission in 1993, Eickemeyer marketed health care consulting services and third-party administrative services for Price Waterhouse and Unum Insurance Company.
Eickemeyer holds a bachelor’s degree and master’s degree in business administration from the University of Illinois, Urbana, Illinois.
90 Days to Bundled Payments: Roadmap and Methodology for Implementing Your Bu...Wellbe
CMS’ recent announcement to “double down” on value-based models including bundled payments demonstrates their commitment to this paradigm. Providers need to respond in kind and launch their programs ASAP.
The complexities and time associated with changing focus, care design, and operations can be daunting and this has caused many organizations to delay or reject implementation. But it doesn’t have to be this way.
This session will describe a structured approach that was successfully used to launch a BPCI Model 2 program in 90 days. This particular case study involved an organization that needed to change conveners making the challenge even more difficult. Nevertheless, the program moved along on schedule.
Key topics to be addressed include:
Organization, planning, project management, and priorities
Selecting (or changing) the convener
Bundle selection (even in the absence of data)
Expediting the CMS application process
Keys to establishing/launching an effective post-acute care network
Organizational alignment and change management
Performance metrics – another approach
Leveraging success to expand the program
Learning Objectives
Learn how to prioritize objectives to simplify the bundled payment project plan
Understand the key drivers in bundle selection to avoid analysis paralysis
Learn how to measure real-time progress of the plan and the bundle
Develop strategies and tactics to create a post-acute partnership
Understand the role of change management in a complex project
About the Speaker:
Sheldon Hamburger serves as a Principal of The Aristone Group, a healthcare consulting group. With focus on helping healthcare enterprise organizations address emerging trends, Aristone provides expertise in strategy, process, and technology. With over 30 years of experience in developing and marketing healthcare technology products and services, Mr. Hamburger’s career includes various “firsts” in medical and pharmaceutical financial processing systems.
Evaluating the Effectiveness of Current Pain Management StrategiesWellbe
Pain management of orthopedic surgery patients is being impacted by the changes in health care regulation and reimbursement. There is a need for safer, more effective pain management pathways that can provide opportunities for early discharge without increasing the risk of readmissions or compromising outcomes.
Current pain management strategies for joint replacements, spine surgery and outpatient knee and shoulder procedures will be examined from clinical, safety, satisfaction and cost perspectives. The process of implementing and evaluating these pathways will also be discussed.
Nina Whalen will demonstrate how she evaluated, developed and improved pain management pathways for patients. These pathways include:
– Multimodal pain management for total joint and spine
– Peripheral nerve block utilization for inpatients and outpatients
– Customized pain pathways for special populations
– The use of intraoperative tissue infiltration with medications as a primary pain management strategy in joint replacement surgery
About The Speaker:
Nina Whalen, RN, APN-C, has over 30 years of experience as a nurse practitioner in orthopedic medicine. She has been involved in every phase of patient care at both the clinic and tertiary care levels. In the 1990’s she created and worked in a nurse practitioner hospital program at Presbyterian St Luke’s hospital that provided 24 hour coverage for the needs of hospitalized orthopedic surgery patients. She has worked in research and has co-authored publications in the areas of sports medicine and total joint. She is currently the manager of clinical outcomes at OrthoIndy Hospital (formerly Indiana Orthopaedic Hospital) which is a 38 bed, physician owned, orthopedic specialty hospital in Indianapolis.
The external healthcare environment is changing rapidly and providers are under increasing pressure to innovate with increasing speed and efficiency.
Be it experimenting with new care delivery models to improve care coordination, redesigning workflows to enhance efficiency, or developing new products that improve clinical outcomes, hospitals and their service lines are looking for effective ways to harness the creative power of physicians and employees to solve problems that matter. However, few organizations innovate in an orderly, reliable way.
Great ideas remain captive in the heads of physicians and employees and one-off attempts to spur innovation through “hack-a-thons” and “pitch days” prove disappointing. As an academic medical center and a world leader in orthopedics, Hospital for Special Surgery has a long history of results-oriented innovation.
In this webinar, we will share:
– HSS’ systematic approach for driving innovation
– strategies for generating new insights and developing novel solutions
– processes for piloting and testing new ideas
– guiding principles for creating a culture of innovation
– advice on how to build your very own innovation infrastructure
About the Speaker:
Mark Angelo is Vice President, Innovation & Business Development for Hospital for Special Surgery. Mark joined HSS in 2009 and has held various senior management positions at the Hospital across operations, strategy and business development. As Vice President, Innovation & Business Development, Mark is responsible for advancing hospital strategic priorities related to quality and efficiency, innovation, growth and diversification. One of his key responsibilities includes leading the Operational Excellence program, a hospital-wide initiative that leverages industrial engineering principles to maximize quality and efficiency. Mark also leads the HSS Innovation Center whose mission is to support the development and commercialization of early-stage technologies and solutions.
Prior to joining HSS, Mark worked as a management consultant for Monitor Group where he specialized in operations strategy and organizational design. Mark holds a Bachelor of Applied Science in Biomedical Engineering from the University of Toronto and a Master of Business Administration from Harvard Business School.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
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CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
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Using the Perioperative Surgical Home as a Model to Implement CJR
1. 8/26/16
1
The Perioperative
Surgical Home
Chancellor’s Professor ofAnesthesiology & Pediatrics & Psychiatry
Department ofAnesthesiology & PerioperativeCare
ExecutiveDirector, Center for Stress & Health
UC IrvineSchool ofMedicine
President, American CollegeofPerioperativeMedicine
DISCLOSURE: I serve as a health care consultant to a variety of entities including: hospitals, health
systems, clinicians, states and the US government. This presentation does not contain information or
services for which I could derive a financial benefit.
8 /2 6 /1 6
“The Americanhealthcaresystemis a dysfunctionalmess.” (Ezekiel
Emanuel, MD, Chair oftheDepartment ofBioethicsat the ClinicalCenter of the NationalInstitutesof
Health)
60
70
80
90
100
110
65
71 71
74 74
77
80
82 82
84 84
90
93
96
101
103 103 104
110
Preventable Deaths* per 100,000 Population
in 2002-2003 (19 Industrialized Nations,
Commonwealth Fund)
(* by conditions such as diabetes, epilepsy, stroke, influenza,
ulcers, pneumonia, infant mortality and appendicitis)
As muchas 30% of healthcarecosts (over $700billion per year)couldbeeliminated
without reducingquality
Moody's US not-for-profit healthcare outlook: 2016
Ø Moody's cautioned that uplift while likely to persist over next 12-18 mos:
Ø Hospitals are investing heavily in population health management,
Ø Spending large amounts of capital to build lower-acuity care settings,
Ø Buy physician practices
Ø Upgrade their health information technology systems.
Ø Goals of population health are to decrease utilization, particularly for higher-
cost services
Ø Healthcare providers also are becoming more reliant on government
insurers. Medicaid now represents 15% of revenue, up from 11.9% in 2009,
according to Moody's. Commercial health plans, in contrast, account for
30.5% of revenue, down from 35.8% in 2009.
7. 8/26/16
7
PHYSICIANS
PAT IENT
EXPERIENCE
HUMAN
RESOURCES ANEST HESIOL OGY
PERIOPERATIVE
SERVICES
HOSPIT AL
L EADERSHIP
NURSING CRIT ICAL CARE
CASE
MANAGEMENT
DECISION
SUPPORT /
F INANCE
IT / INFORMATICS PHARMACY
QUAL IT Y/ SAFETY BL OOD BANK ER
PHYSICAL
T HERAPY NUT RITION
BUSINESS
PL ANNING
25
PERIOP
NURSING
QUAL IT Y
Step II: Build a Guiding Team & Choose a Project
Ran
Schwarzkopf
Laur a
Br uzzone
Alice IssaiRanjan Gupta Zeev Kain
Choose the right Project:
Increasing Threat to Joint Replacement Profitability
Depart m ent of Anest hesiology & Perioperat ive Care, UC I rvine | May 1, 2015
200
300
400
500
600
700
800
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Thousands
Knee Replac ements
Sour ce: HCUP Nat ionwide I npat ient Sam ple ( NI S) ; 1
Obr em skey, W. T. , et al. , “Value- based Pur chasing of Medical
Devices”
Orthopedic Procedures GrowingRapidly
88%
34%
Hip Replacem ent s
132%
27%
Cos t of Total
Hip Implant
Medic are
Reimburs ement
Procedure Costs Outpace
Medicare Reimbursement Rates
Volume(thosansds)
Year $215,600
$218,500
$226,500
$229,100
$234,900
$236,900
$241,000
$278,200
$333,400
$355,000
$455,600
$756,800
$770,100
$1,168,000
Major Small & LargeBowelProcedures (221)
Other Vascular Procedures(173)
COPD (140)
Other Pneumonia (139)
Rehabilitation(860)
PercutaneousCardioProceduresw/o AMI(175)
Cervical SpinalFusion(321)
Heart Failure (194)
Normal Newborn or Neonate(640)
Hip Joint Replacement(301)
Sepsis (720)
Knee Joint Replacement (302)
Dorsal & Lumbar Fusion Procedure(304)
Vaginal andCesareanDelivery (540& 560)
Prioritizing Care Variation in Joint Replacement
Depart m ent of Anest hesiology & Perioperat ive Care, UC I rvine | May 1, 2015
PotentialHospital-wideChargeSavingsbyReducingVariationinCommonDRGs1
2
Sour ce: Cr im son Cont inuum of Car e dat a and analysis;
Physician Execut ive Council int er views and analysis.
9. 8/26/16
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• Lean Six Sigmastarts with thecustomers and Patients View ofservicevalue.
• Reducingprocess variationwith SixSigma,combinedwith
• Eliminatingwaste andimprovingspeed withLean Techniques canhelp
achievemajor goals of processimprovementin healthcare:
• Quality(outcomes),
• Efficiency(costs),and
• Patient Satisfaction.
Improve Projectand Program Effectiveness
RapidCycle Projects
• GB Project Completion90 – 120 Days
• Expand use of KaizenEvents
De fine
Me asure
Analyze
Improve
Control
120
Da
ys
34
35
Working as a TEAM
Depart m ent of Anest hesiology & Perioperat ive Care| August 26, 2016
Kick Off Meeting
uMeeting objective
uAgenda-Planned topics and speakers
§ Sponsor –commitment to the project
§ Champion and project manager-
Communicate the vision
uDocumenting action items
uDate of next meeting
uPost minutes within 24 hours
10. 8/26/16
10
Stakeholder
uCreate a stakeholder roster- usually not published
uStakeholder analysis using a authority-interest grid to determine the level of
involvement in the project
Low interest
high power
High interest
high power
Low interest
high power
Low interest
low power
Interest
Power
High
High
Low
Low
Keep Satisfied Manage Closely
Monitor Keep Informed
38
Build a Business Plan
Table of Contents
Staffing
Workflow/Training
Communication/Edu
cation
Sustainability
Accountability
Risks/Challenges
Implementation
Timeline
Conclusion
References
Table of Contents
Executive Summary
Service/Program
Description
Goals/Benefits
Situation Analysis..
Current State vsFuture
StakeholderAnalysis
Pilot Assessment Results
ExternalAnalysis
Financial
Considerations.
Patient Volume
Cost Savings
39
Plan: Joint Surgical Home Implementation Team…
Depart m ent of Anest hesiology & Perioperat ive Care, UC I rvine | May 1, 2015
Six WorkingGroups
Joint Surgical Home Steering
Committee
• Anes thes iologis ts, Orthopedic
Surgeons
• Nurs es , Pharmac ists, Phys ic al
Therapis t
• Cas e Manager,
Soc ial Work er
• IT Ex perts
• Proc es s Champions : Chairs of
Anes thes ia,Orthopedic s, and
COO
Preoperativ e
Admis s ions
Intraoperative
Immediate
Pos toperative
Pos toperativ e
Dis c harge
Quality
As s uranc e and
Performanc e
Improv ement
Res earc h
All team leaders receive LEAN
Six Sigma training
12. 8/26/16
12
Aligning Disparate Data Sources to Improve Patient Care
Information Technology is Critical for Success
How Metrics Are Collected Example Metrics
Clinical Proce ss Me asure s
• Cancellation within 2 4 hours
of planned procedure
• Lowest post-op hemoglobin
level
Safe ty Outcome Me asure s
• Calculation of frailty index
• Incidence of surgical
infection
Nurs ing Flow
Sheets
Patient
Feedbac k Forms
Monthly/Quarterly
Progress Metrics
Allow PSH leaders to
unders tand progres s,
identify potentialquality
improv ement opportunities
Daily Patient Progress
Metrics
Enables team totrack
patients as they progres s
through the PSH and
ens ure adherence to
protoc ols
Preoperativ e
Tes ting
Perioperative Surgical Home
Data Mart
Order Sets
Ac c es s a full list of
metric s from the UC
Irv ine HealthJ oint
Replac ement Home at
adv is ory .com
Depart m ent of Anest hesiology & Perioperat ive Care, UC I rvine | May 1, 2015
Post-Operative Care
Depar t m ent of Anest hesiology & Per ioper at ive Car e, UC I r vine | May 1, 2015
Total Joint PSH: A Cost Analysis