Even when employing sophisticated predictive analytics to zero in on population health risk, healthcare organizations shouldn’t discount providers’ intuition, advises Luke Hansen, MD, vice president and chief medical officer, population health for AMITA Health.
With a future plan to adopt a risk prediction tool, AMITA currently creates chronic illness registries to track its high-cost patients. Listen as Dr. Hansen discusses the tradeoffs of mathematically intense risk predictors versus physicians’ guts.
During an August 2016 webinar, Reducing Readmissions and Avoidable Emergency Department Visits Through a Connected Care Management Strategy, now available for replay, Dr. Hansen and Susan Wickey, AMITA Health vice president, quality and care management, share the key components of AMITA Health’s care management process, how the various care management teams work together and the impact the program is having on healthcare costs and utilization.
By focusing chiefly on moving high-risk patients down to the low-risk band, population health management programs are in danger of missing the “natural inertia” driving low-risk patients right back into that high-risk stratum, cautions Dr. Adrian Zai, clinical director of population informatics at Massachusetts General Hospital (MGH).
Dr. Zai describes why MGH, ranked the number one hospital in the nation by U.S. News & World Report,® advocates a multi-pronged approach addressing both low-risk and rising risk patients—a strategy that has improved MGH care quality and provider performance while reducing high-cost healthcare utilization.
During an August 2016 webinar, Targeting High-Risk and Rising-Risk Patients: A Multi-Pronged Strategy, now available for replay, Dr. Zai shares the key details behind his organization’s strategy and the results it has achieved.
Increasingly in motivational interviewing (MI) research, change talk—anything a patient or client says that counts as an argument for change—is a reliable sign they’re ready to make a change, notes Mia Croyle with the University of Wisconsin School of Medicine and Public Health.
Here, Ms. Croyle shares some of the latest thinking regarding change talk: how motivational interviewing practitioners might interpret change talk in interactions with clients, particularly those with behavioral health diagnoses, as well as how to elicit more change talk during an MI session.
During a June 2016 webinar, Behavioral Health Patient Engagement: Using Motivational Interviewing Techniques and Strategies To Improve Outcomes, now available for replay, Ms. Croyle shares key learnings from patient engagement initiatives targeted at patients with behavioral health conditions.
The future for health plans is not so much in plan design or call centers but in how they leverage their storehouses of healthcare data, advises Paul Keckley, managing director of Navigant. In this audio interview, Keckley talks about infomediation—the mining of membership data to determine factors influencing population health—and its influence on payor valuation, its role in shared risk arrangements, and why health plans’ ’embedded Intel’ uniquely positions them for success.
During a November 2015 webinar, Trends Shaping the Healthcare Industry in 2016: A Strategic Planning Session, now available for replay, Keckley and Laura Jacobs, executive vice president of GE Healthcare Camden Group, provided a roadmap to the key issues, challenges and opportunities for healthcare providers and payors in 2016.
The use of a care coordinator boosts the quality of care a physician practice provides and thus its potential for earning incentives in Humana’s Physician Quality Rewards program, explains Chip Howard, Humana’s vice president of payment innovation in the provider development center of excellence.
Here, Howard describes the value Humana places on the care coordination function, and describes the support and training available to physician practices at each level of the three-tiered rewards program, a hallmark of Humana’s Accountable Care Continuum.
Chip Howard will share how Humana’s program supports physicians’ transition from volume to value and helps them become successful population health managers during a December 16, 2014 webinar, Physician Quality Rewards for Population Health Management, a 45-minute program sponsored by The Healthcare Intelligence Network.
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.
Adventist Health’s successful use of incentives to engage employees in population health sets a high bar for the program’s imminent rollout to patients at Adventist-owned White Memorial Medical Center, notes Elizabeth Miller, Adventist’s vice president of care management. In this interview, Ms. Miller describes the program’s target population as well as the incentive that engaged 95 percent of its employees in health management.
Elizabeth Miller shared the key features of the population health management program at White Memorial, the program’s impact on Adventist’s 27,000 employees and program rollout to its patient population during a January 22, 2014 webinar, Managing Risk in Population Health Management, a 45-minute program sponsored by The Healthcare Intelligence Network.
There’s education, there’s experience, and then there’s the ‘right stuff’ the indefinable personality traits that earmark an individual as a change agent, collaborator and ambassador of case management, says Annette Watson, senior vice president of community transformation for Taconic IPA (TIPA), of TIPA’s requirements for the RN case managers it hires for its advanced patient-centered medical homes.
Then there are the not insignificant contributions of the RN case manager to accountable and patient-centered care, which Ms. Watson describes in this interview.
While staff-buy-in and communication continue to challenge the embedded case manager model, the participant in CMS Innovation Center’s Comprehensive Primary Care (CPC) initiative says reimbursement for embedded case management is less of an obstacle today than in the past, due to funding-friendly care models and pilots descending from healthcare reform.
Ms. Watson shared how TIPA has successfully embedded case managers in an open, multi-payor community during an October 9, 2013 webinar, Improving Population Health with Embedded Case Managers in an Open, Multi-Payor Community.
A patient might expect a reminder about a missed colonoscopy during a primary care visit, but during a trip to the dermatologist? Providing health plan members with “consistent and ubiquitous reminders” via multiple touchpoints in their healthcare journey is one of Kaiser Permanente’s key population health management strategies, reports Jim Bellows, PhD, senior director of evaluation and analytics for Kaiser Permanente.
Another is the vigorous use of registries more than 50 in all, at last count even for relatively rare diseases. Dr. Bellows defines the criteria for registry creation, expands on the choice and availability of patient touchpoints and explains the evolution of other Web-based PHM tools in use by Kaiser Permanente.
Dr. Bellows shared his organization’s approach to population care and population health management during a July 31, 2013 webinar, Managing Population Health with Integrated Registries and Effective Patient Touchpoints.
When health coaches employ motivational interviewing during patient encounters, expect upticks in medication adherence, weight loss, HbA1c levels and overall engagement, notes Alicia Vail, RN health coach for Ochsner Health System. Ochsner’s eight health coaches focus on patients with diabetes, hypertension and obesity who have come to their attention by way of physician referrals, health screenings and pre-chart reviews.
In this podcast, Ms. Vail describes how Ochsner Health System incorporates health coaches in its clinic structure and describes the benefits that result from the coaching intervention.
Alicia Vail and Bill Appelgate, executive director of the Iowa Chronic Care Consortium, shared how an evidence-based health coaching focus drives returns in a value-based payment delivery system during a June 19, 2013 webinar, Health Coaching’s Value in Accountable Care and Medical Homes.