Ochsner Health System C3: Protocols in Transition Care Management Codes Scalable for All Panel Sizes

Although Ochsner Health System’s Care Coordination Center (C3) applies consistent methodologies across nine hospitals, one protocol—C3’s attention to two new transition care management (TCM) codes—is scalable for most care coordination efforts, regardless of panel size, suggests Mark Green, system AVP, transition management, at Ochsner Health System.

In this podcast, Green offers more care coordination lessons adaptable to any size player in the healthcare market, and describes the “tipping point” in terms of patient population and assumed financial risk that triggered the creation of C3.

Mark Green will share why Ochsner took this approach, how it assigns a severity index to its patients and the financial returns and quality metrics it has achieved from its C3 approach during an October 8, 2014 webinar, Moving the Metrics: Financial and Quality Returns from System-wide Care Coordination and Risk Stratification, a 45-minute program sponsored by The Healthcare Intelligence Network.

Length: 7:59 minutes

PHO Provides Framework for Physician Success in Value-Based Payment Models

The physician-hospital organization (PHO) model provides two key components that until now have kept many physicians from healthcare’s value-based initiatives, maintains Travis Ansel, senior manager with the Healthcare Strategy Group: a relationship with other providers and health systems in their market, and the infrastructure to support success under a population model.

In this audio interview, Ansel anticipates the direction health systems—especially those with a large number of independent physicians—will take to flourish in value-based initiatives, and shares other essential benefits of the PHO model.

Travis Ansel will share critical insight into the PHO development process and walk participants through required competencies and implications of these payment models on physicians and hospitals during an October 1, 2014 webinar, Preparing for Value-Based Reimbursement Models: PHO Development for ACOs, Bundled Payments and Direct Contracting, a 45-minute program sponsored by The Healthcare Intelligence Network.

Length: 8:08 minutes

Case Management Focus on Care Transitions Helps to Halve 30-Day Medicare Rehospitalizations

Caldwell UNC Health Care case managers embedded in primary care practices take patient follow-up seriously, calling 90 percent of individuals who visit the ED and almost all discharged from a hospital stay, explains Melanie Fox, director of the Caldwell Physician Network Embedded Case Management program at Caldwell UNC Health Care. In particular, connecting with the recently discharged has helped her organization to reduce 30-day rehospitalizations from 19.16 percent in 2012 to 9.69 percent in 2013. If that crucial transition of care is well managed, all other goals for the patient should fall in line, she notes.

In this audio interview, Ms. Fox describes the 12-point checklist for the recently discharged and offers advice on engaging providers and staff before the case manager even settles in at physician practice.

Melanie Fox will describe how Caldwell UNC Health Care’s managers embedded in primary care practices and work sites are improving the quality of care and reducing healthcare costs during a September 25, 2014 webinar, Embedded Case Management in Primary Care and Work Sites: Referral, Stratification and Protocols, a 45-minute program sponsored by The Healthcare Intelligence Network.

Length: 12:00 minutes