Identifying social determinants of health (SDH) requires providers to probe beyond the scope of clinical data. But how can health teams ensure that patients and health plan members provide valid data during SDH assessments? In this audio interview, Dr. Randall Williams, chief executive officer, Pharos Innovations, describes three scenarios to build trust and encourage individuals to share sensitive information during SDH interactions.
During Social Determinants and Population Health: Moving Beyond Clinical Data in a Value-Based Healthcare System, a December 2016 webinar now available for replay, Dr. Williams shares his insight on the opportunity available to providers to impact population health beyond traditional clinical factors.
Whether an ACO is assessing readiness for CMS’s Next Generation ACO model or is already a Medicare Shared Savings Program (MSSP) participant, face-to-face education of non-executive providers living the day-to-day ACO reality is critical to that accountable care organization’s viability, advises Travis Ansel, senior manager of strategic services for Healthcare Strategy Group.
Even within experienced MSSP ACOs, providers often don’t understand MSSP quality goals, the relationship of their actions to cost management or MSSP data requirements, noted Ansel.
In this broadcast, Ansel describes the two biggest barriers to success across all ACO models, and offers two tips to organizations wishing to prosper in the value-based care reimbursement world.
During an April 2016 webinar, Next Generation ACO: An Organizational Readiness Assessment, now available for replay, Ansel and colleague Walter Hankwitz, senior accountable care advisor at Healthcare Strategy Group, provide a value-based risk contract roadmap to determine organizational readiness for participation in the Next Generation ACO Model in particular and in risk-based contracts in general.
Having heard from physicians and payors alike about the challenges of engaging patients, the Memorial Hermann ACO crafted its care management program with the goal of drawing patients more fully into their care, explains Mary Folladori, RN, MSN, FACM, CMAC, system director of care management at the Memorial Hermann Physician Network and ACO.
In this podcast, Ms. Folladori shares some key program design elements from the 2014 top-performing Medicare Shared Savings Program (MSSP) ACO, including immersing care managers into the ‘micro cultures’ of the physician practice, the community and the members that they serve.
During a September 2015 webinar, Care Coordination in an ACO: Managing the Population Health Continuum from Wellness to End-of-Life, now available for replay, Ms. Folladori provided the inside details on its care coordination strategy and results.
As groundwork for participation in CMS’s Bundled Payments for Care Improvement initiative, St. Vincent’s Health Partners (SVHP) formed a cross-functional cross-boundary Transitions Leadership Group to map what happens to patients moving along their care journeys, explains Colleen Swedberg, MSN, RN, CNL, director for care coordination and integration.
In this audio interview, Ms. Swedberg describes the structure and goals of the Transitions Leadership Group and some tools and protocols it developed to set standards for any post-acute provider wishing to join the SVHP network.
During a September 2015 webinar, Post-Acute Care Trends: Aligning Clinical Standards and Provider Demands in the Changing Landscape, now available for replay, Ms. Swedberg and Julia Portale, vice president of community services, Jewish Senior Services, share their organizations’ collaborative approaches to the evolving post-acute care market.
Physician engagement is one of three top challenges of the Medicare Pioneer ACO model, along with performance improvement and care management, explains Kelly Clements, Pioneer program director for Steward Health Care Network, which operates Promise, a top-performer in CMS’s Medicare Pioneer ACO program.
To drive engagement in its accountable care organization at the provider level, Steward offers a range of physician tools and supports, including road shows and report cards, which Ms. Clements describes in this audio interview.
During a June 2015 webinar, Medicare Pioneer ACO: Care Management, Quality Improvement and Data Integration Yields Substantial Performance Gains, now available for replay, Kelly Clements shares her organization’s Pioneer ACO Program experience over the first three Pioneer performance years and how Steward leverages this experience with other risk-based contracts, including the newly announced CMS Next Generation ACO Model.
Given changing reimbursement incentives and collaborative models for physicians and hospitals, Greg Mertz, managing director of Physician Strategies Group, LLC, discusses why the Congressional proposal “Better Care, Lower Cost Act” of 2014 is financially more attractive to providers than ACO models and whether he thinks it will be passed. He also deconstructs CMS’ recently reported financial results for such health reform delivery initiatives as Medicare ACOs, Pioneer ACOs, and the Physician Group Practice demonstration, and weighs in on which, if any, model he considers the most sustainable.
Greg Mertz helped healthcare organizations assess which value-based healthcare delivery model is right for their organization during Physician Alignment: Which Model Is Right for You?, a February 19th, 2014 workshop at 1:30 p.m. Eastern.
There are three key benefits to prudent sharing of performance data among physicians, notes Cynthia Kilroy, senior vice president of provider strategy and business development at Optum, who suggests a four-step systematic approach for data dissemination that moves companies away from simply creating “metrics in a box.” Besides the electronic health record, she recommends three other data sources to mine for provider performance metrics.
Cynthia Kilroy explored the key structure, issues and challenges in these evolving reimbursement models during a January 29, 2014 webinar, Accountable Care Reimbursement Models: Moving from Productivity to Population-Based Incentives, a 45-minute program sponsored by The Healthcare Intelligence Network.