Trends Shaping Healthcare in 2017: Employ Technology for Patient Engagement

Steven ValentineThe engagement of patients, particularly those with multiple chronic conditions, continues to challenge healthcare providers.

However, as Steven Valentine, vice president of advisory consulting services for Premier Inc., explains in this podcast, clinicians actually have a host of tools at their fingertips to engage patients—tools they must employ in order to succeed in value-based healthcare.

During Trends Shaping the Healthcare Industry in 2017: A Strategic Planning Session, a November 2016 webinar now available for replay, Steven Valentine provides a roadmap to the key issues, challenges and opportunities for healthcare organizations in 2017.


Length: 2:52 minutes

MACRA Prerequisite: Procure QRUR Performance Data to Maximize MIPS Success

Barry AllisonPrior to enrollment in MACRA’s Merit-Based Incentive Payment System (MIPS), physician practices should request their confidential Quality Use and Resource Report (QRUR) from the Centers for Medicare and Medicaid Services (CMS) for crucial performance feedback, advises Barry Allison, chief information officer, the Center for Primary Care.

In this podcast, Allison explains how to obtain a QRUR report, the origins of QRUR quality and cost data, and the benefits of leveraging QRUR feedback to improve the quality and efficiency of care delivered to attributed Medicare fee-for-service beneficiaries and ultimately prosper under MACRA’s multi-pronged approach.

During Physician Chronic Care Management Reimbursement: Setting MACRA’s MIPS Path for 2017, an October 2016 webinar now available for replay, Mr. Allison shares his organization’s chronic care management reimbursement strategy and how this is guiding their preparation for MIPS in the year ahead.


Length: 3:12 minutes

Novant Health Pharmacist Drug Therapy Management: Ideas to Assure Accurate Medication Lists

Novant HealthAn accurate medication list is square one for clinical pharmacists working to reconcile prescriptions and reduce readmissions among Novant Health’s highest-risk patients, explains Rebecca Bean, director of population health pharmacy for Novant Health. But maintaining a valid list can be problematic when the inventory is accessed by multiple healthcare providers.

Ms. Bean describes the challenges of maintaining an accurate medication list and suggests strategies for ensuring medication list integrity in this audio interview.

During a February 2016 webinar, Medication Management: Using Clinical Pharmacists to Complete Comprehensive Drug Therapy Management Post-Discharge in High-Risk Patients, now available for replay, Rebecca Bean shares her organization’s medication management approach and why a clinical pharmacist is key to the program’s success.


Length: 3:00 minutes

Next Generation Healthcare Nurse Navigators: The Advantages That Won Over ‘Solo Cowboy’ Practitioners

Robert FortiniWhen Bon Secours adapted Geisinger’s case management model six years ago and embedded nurse navigators within physician practices, there was reluctance and even resistance from some “solo cowboy” physician practitioners, recalls Robert Fortini, PNP, chief clinical officer for Bon Secours Medical Group. Today, providers are fiercely protective of the cadre of 70 nurse navigators, who do the “heavy lifting” of chronic care management.

In this audio interview, Fortini offers some lessons learned for organizations considering the embedded case management approach, including budgetary planning, calculations, and “icing-on-the-cake” outcomes for patients and hospitals.

During a January 2016 webinar, Physician Reimbursement in 2016: Workflow Optimization for Chronic Care Management and Advance Care Planning, now available for replay, Fortini offered an inside look at Bon Secours’ experience with CMS’ chronic care management reimbursement in 2015 and how they leverage this experience for CMS’s newest billable event in 2016—advance care planning.


Length: 3:24 minutes

Payoffs from Patient Care Plans and Goal-Setting in Chronic Care Management

Debra BurbaryWhen Arcturus Health Care did the math, CMS’s new Chronic Care Management (CCM) code added up to a potential $100,000 per month in revenue for its four physician practices, or $1 million annually. Having successfully billed Medicare for a half dozen patients enrolled in CCM, Arcturus’s Clinical Quality Assurance Manager Debra Burbary, RN, outlines development of the patient care plan and establishment of patient goals—two CCM requirements facilitated by Arcturus’s electronic health record (EHR).

During a May 2015 webinar, Medicare Chronic Care Management Billing: Leveraging Population Health Management for Successful Claim Submission, now available for replay, Ms. Burbary shares her organization’s approach to care management of high-risk patients and billing for chronic care management.


Length: 4:04 minutes

7 Metrics to Build a Business Case for a Multidisciplinary Care Coordination Team

Shameka ColesBecause care management and coordination often defy traditional return on investment formulas, come budget time, AltaMed Health Services Corporation had to take a hard look at contributions of its multidisciplinary care team to the organizational bottom line.

Shameka Coles, AltaMed’s associate vice president of medical management, outlines seven key metrics presented to AltaMed’s CFO tying the coordinated care team to Altamed’s financial goals—data that ultimately secured funding for phase four of the coordinated care management initiative.

During a May 2015 webinar, A Comprehensive Care Management Model: Care Coordination for Complex Patients, now available for replay, Ms. Coles shared the key steps in development, rollout and evaluation of this care management model for AltaMed’s highest risk patients, a population that includes dual eligibles.


Length: 3:48 minutes

Billable Chronic Care Management Services: What Counts as Care Coordination, and What Doesn’t?

Paul RudolfWhat constitutes care coordination under the new Chronic Care Management (CCM) codes?

While CMS has identified a long list of CCM activities that can be counted toward the 20-minutes-per-month requirement, physician practices must also keep in mind certain services that cannot be billed when CCM is billed.

During a February 12, 2015 webinar, Chronic Care Management Reimbursement Compliance: Overcoming Obstacles and Meeting Requirements, Paul Rudolf, MD, a partner with Arnold & Porter LLC, outlined exceptions to and examples of billable CCM tasks.

During the 45-minute program, now available as on on-demand replay, Dr. Rudolfe and Nicole Liffrig Molife, counsel, Arnold & Porter, delve into CMS requirements and discuss approaches and challenges to meeting the CCM requirements. The program was sponsored by the Healthcare Intelligence Network.


Length: 3:43 minutes

Chronic Care Management Medicare Reimbursement Could Boost Patient Portal Use

Rick HindmandProvisions for separate payments for chronic care management (CCM) services included in the 2015 Medicare Physician Fee schedule support more flexibility in communications between healthcare provider and patient, notes Rick Hindmand, attorney with McDonald Hopkins, including the use of patient portals.

Hindmand, whose law firm advises a nationwide client base extensively on healthcare reimbursement, outlines communication scenarios expected to qualify for CCM service payments as well as suggestions for segmenting care transition management services provided under CCM and a second CMS initiative.

Rick Hindmand advised physician practices on how to best structure their organizations to optimize CCM reimbursement during a November 19, 2014 webinar, Chronic Care Management Medicare Reimbursement: New Revenue Opportunities for Care Coordination, a 45-minute program sponsored by The Healthcare Intelligence Network.


Length: 5:16 minutes

Humana Remote Monitoring Pilots Engage Member’s Circle of Care

Humana’s remote monitoring pilots go beyond traditional targets of heart failure, diabetes and COPD to observe functionally challenged members, explains Gail Miller. This novel approach uses a Personal Emergency Response System (PERS) with a built-in accelerometer to monitor members challenged by activities of daily living (ADL), says the VP of telephonic clinical operations in Humana’s care management organization, Humana Cares/SeniorBridge. Another pilot, a collaboration with HealthSense, places sensors around the member’s home to study algorithms of normal movement so Humana can detect changes and intervene before a member’s crisis.

All Humana remote monitoring pilots engage the circle of care surrounding the member — be it home health, a family member, or a spouse.

Gail Miller shared more details of Humana’s telephonic care management and how remote monitoring pilots will enhance care coordination during a March 19, 2014 webinar, Integrating Mobile Health Remote Patient Monitoring with Telephonic Care Management for Improved Care Coordination Results, a 45-minute program sponsored by The Healthcare Intelligence Network.


Length: 4:26 minutes