Infographic: What Can a Nurse Practitioner do?

August 31st, 2016 by Melanie Matthews

Nurse practitioners may help to fill staffing needs at hospitals, physician practices and other healthcare organizations, according to a new infographic by Barton Associates.

The infographic looks at how nurse practitioners can practice at the top of their license.

A profitable by-product of CMS's aggressive pursuit of value-based healthcare delivery is a menu of revenue opportunities associated with care management of the Medicare population.

Physician Reimbursement in 2016: 4 Billable Medicare Events to Maximize Care Management Revenue and Results details the ways in which Bon Secours Medical Group (BSMG) leverages a team-based care approach, expanded care access and technology to capitalize on four Medicare billing events: transitional care management, chronic care management, Medicare annual wellness visits and advance care planning.

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Home Visits Validate Predictive Analytics and 10 More 2016 Risk Stratification Trends

August 30th, 2016 by Patricia Donovan

Assuring data integrity is the top challenge to health risk stratification, according to a July 2016 healthcare benchmarks survey.


Two key trends emerging from a July 2016 survey on Stratifying High-Risk Patients highlight the need to occasionally eschew sophisticated tools in favor of basic, face-to-face care coordination.

As one survey respondent noted, “A key element [of stratifying high-risk patients] is building a trusting face-to-face relationship with each patient, knowing what they want to work on, coaching them and activating them.”

The first learning gleaned from the survey's 112 respondents is that, despite the prevalence of high-end risk predictors, algorithms and monitoring tools, clinicians must occasionally step into the patient’s world—that is, literally enter their home—in order to capture the individual’s total health picture.

Fifty-six percent of respondents make home visits to risk-stratified patients; a half dozen identified the home visit as its most successful intervention for risk-stratified populations.

That inside look at the patient environment illuminates data points an electronic health records (EHRs) might never bring to light, including socioeconomic factors like limited mobility that could prevent a patient from keeping a follow-up appointment.

“I never know until the moment I enter the home and actually see what the environment is like whether we correctly predicted the need for high intervention (and get a return on it),” commented one respondent.

The second trend in risk stratification is the emerging laser focus on ‘rising risk’ patients, an activity reported by 72 percent of respondents. This scrutiny of rising risk populations helps to prevention their migration to high-risk status, where complex and costly health episodes prevail.

Other data points identified by the 2016 Stratifying High-Risk Patients survey include the following:

  • Almost four-fifths of 2016 respondents have programs to stratify high-risk patients, and the infrastructures of more than half of these initiatives utilize clinical analytics, predictive algorithms, EHRs and other IT tools to manage care for high-risk patients.
  • The reigning health risk calculator continues to be the LACE tool (Length of stay, Acute admission, Charleston Comorbidity score, ED visits), used by 45 percent in 2016, versus 33 percent two years ago.
  • For more than a quarter of 2016 respondents, assuring data integrity remains a key challenge to risk prediction.
  • A case manager typically has primary responsibility for risk stratification, say 52 percent of respondents.
  • Diabetes is the most prevalent clinical condition among high-risk patients, say 47 percent.
  • At least 70 percent report reductions in hospitalizations and ER visits related to risk stratification efforts.
  • Improvement in the highly desirable metric of patient engagement is reported by 74 percent of respondents.

Click here to download an executive summary of survey results: Stratifying High-Risk Patients in 2016: As Risk Prediction Prevails, Industry Eyes Social Determinants, Rising Risk.

Infographic: Is the Healthcare Industry Digitally Fit?

August 29th, 2016 by Melanie Matthews

A growing number of healthcare consumers are taking charge of their health with digital tools, according to a new infographic by Capgemini Consulting.

The infographic examines how consumers are using these tools and compares healthcare providers by digital maturity.

2016 Healthcare Benchmarks: Digital HealthPerson-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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Infographic: 5 Tips to Empower Medical Practice Staff

August 26th, 2016 by Melanie Matthews

Medical practice staff plays a pivotal role in shaping the patient experience, according to a new infographic by Specialdocs.

The infographic examines five key steps in empowering medical practice staff.

Healthcare Trends & Forecasts in 2016: Performance Expectations for the Healthcare IndustryPatient-centric interventions like population health management, health coaching, home visits and telephonic outreach are designed to engage individuals in health self-management—contributing to healthier clinical and financial results in healthcare's value-based reimbursement climate.
But when organizations consistently rank patient engagement as their most critical care challenge, as hundreds have in response to HIN benchmark surveys, which strategies will help to bring about the desired health behavior change in high-risk populations?

9 Protocols to Promote Patient Engagement in High-Risk, High-Cost Populations presents a collection of tactics that are successfully activating the most resistant, hard-to-engage patients and health plan members in chronic condition management. Whether an organization refers to this population segment as high-risk, high-cost, clinically complex, high-utilizer or simply top-of-the-pyramid 'VIPs,' the touch points and technologies in this resource will recharge their care coordination approach.

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Infographic: Healthcare Cyber Security Threat Prognosis

August 24th, 2016 by Melanie Matthews

The 10 largest healthcare cyber attacks of 2015 affected over 100 million records, valued at up to $154 per record breached, according to a new infographic by FireEye.

The infographic examines the depth of the healthcare cyber security threat, why the healthcare industry is a top target for cyber crime and the potential cost to healthcare organizations of a security breach.

Healthcare Trends & Forecasts in 2016: Performance Expectations for the Healthcare IndustryFrom cost pressures, consumerism and consolidation to a proliferation of patient-centered, value-based delivery and payment models, the state of healthcare continues to challenge organizations in the industry.

Healthcare Trends & Forecasts in 2016: Performance Expectations for the Healthcare Industry, HIN's 12th annual business forecast, pins down the trends destined to impact the industry in the year to come and proposes tactics C-suite executives can employ to distinguish their operations in a dynamic marketplace. Click here for more information.

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AMITA Health Connected Care Management: Patients Transitioned But Never Really Discharged

August 23rd, 2016 by Patricia Donovan

Connected care includes AMITA Health front line staff, administrators, physicians, hospital executives and community partners.


Does a health system really need four types of care managers?

When AMITA Health set out to craft an ambulatory care coordination team for its highest-risk Medicare beneficiaries, it realized it didn't.

As part of its thirteen-point plan to revamp care management across its continuum, the newly minted Medicare Shared Savings Program (MSSP) accountable care organization (ACO) reexamined the roles of its navigators, case managers, patient-centered home care managers and ACO care managers, ultimately abandoning its siloed approach in favor of a more human-centric model of care.

"We really needed a better way to care for our patients across the continuum," explained Susan Wickey, vice president, quality and care management at AMITA Health, during Reducing Readmissions and Avoidable Emergency Department Visits Through a Connected Care Management Strategy, an August 2016 webinar now available for replay. "We had to identify and remove those silos, and break down those barriers."

AMITA Health's decision to remake care management was a response to its MSSP program goal of fulfilling the Triple Aim: improving population health and experience of care while fostering appropriate utilization and cost. The initiative in no way devalued care managers' contributions. "Our care coordinators across the continuum serve as our first responders when high risk patients need intervention," said Ms. Wickey.

In the process of improving efficiencies, the nine-hospital system discovered that often, one could be more effective than four.

With help from Phillips Healthcare Consulting Division, AMITA inventoried its care management resources, then created a single centralized care management hub. Communication would occur via a single universal transfer form for each patient, for whom a single care plan would be developed. This power of one echoed throughout the transformation as AMITA restructured processes and programs.

AMITA rolled out the program initially with one unit of patients; today, all nine of AMITA Health's hospitals operate with some component of this enterprise-wide redesign.

"We wanted to be a health system where our patients were transitioned but never really discharged from our healthcare system," explained Ms. Wickey's co-presenter, Dr. Luke Hansen, vice president and chief medical officer, population health for AMITA Health. "We never discharge a patient from our system; rather we transition our patients to the most appropriate setting."

"This collaborative vision of connected care includes all of the front line staff, key administrators, physicians, hospital executives, along with AMITA's community partners," added Ms. Wickey.

In assessing its MSSP experience, Dr. Hansen said access to Medicare claims data enabled AMITA Health to track utilization, a first for the organization. Trends toward lower all-cause readmissions, lower admissions for ambulatory-sensitive conditions and emergency department visits were recorded, he said. And while he can't definitely credit the MSSP for his organization's improved quality scores in recent years, he takes pride in AMITA's achievements of strengthening quality while holding costs relatively stable.

However, improvements have leveled off since 2013, its first MSSP performance year, which frustrates the population health CMO. "As those of you participating in MSSP know, year-over-year improvement is what you need to do to succeed."

"We live that tension between our old models of care delivery, which were very successful for our organization, and new models, which we will have to adopt in a timely way to be successful in the future," concluded Dr. Hansen.

Click here for an audio interview with Dr. Hansen.

Infographic: Path Toward Value-Based Care

August 22nd, 2016 by Melanie Matthews

UnitedHealthcare recently recognized more than 1,900 care providers who earned more than $148 million in quality of care bonus payments for achieving performance metrics in the UnitedHealthcare PATH Excellence in Patient Service Awards for their commitment to improving health outcomes for people enrolled in its Medicare Advantage plans, according to a new infographic by UnitedHealthcare.

The infographic examines the components of the PATH program and some of the quality performance measurements and their impact.

A profitable by-product of CMS's aggressive pursuit of value-based healthcare delivery is a menu of revenue opportunities associated with care management of the Medicare population.

Physician Reimbursement in 2016: 4 Billable Medicare Events to Maximize Care Management Revenue and Results details the ways in which Bon Secours Medical Group (BSMG) leverages a team-based care approach, expanded care access and technology to capitalize on four Medicare billing events: transitional care management, chronic care management, Medicare annual wellness visits and advance care planning.

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Infographic: Medicaid Expansion in Pennsylvania

August 19th, 2016 by Melanie Matthews

The Medicaid expansion has made it possible for more Pennsylvanians to access healthcare than ever before, according to a new infographic released the by Pennsylvania Department of Human Services. As of April 2016, the expansion had reached 625,970 newly eligible Pennsylvanians, ages 18 to 64.

The infographic provides a demographic snapshot of the newly insured.

Care Coordination of Highest-Risk Patients: Business Case for Managing Complex PopulationsAsked by its C-suite to quantify contributions of its multidisciplinary care team for its highest-risk patients, AltaMed Health Services Corporation readily identified seven key performance metrics associated with the team.

Having demonstrated the team's bottom line impact on specialty costs, emergency room visits, and HEDIS® measures, among other areas, the largest independent federally qualified community health center (FQHC) was granted additional staff to expand care management for its safety net population.

Care Coordination of Highest-Risk Patients: Business Case for Managing Complex Populations chronicles AltaMed's four-phase rollout of care coordination for dual eligibles—a population with higher hospitalization and utilization and care costs twice those of any other population served by AltaMed.

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Infographic: Connecting the Triple Aim and Supply Chain Management

August 17th, 2016 by Melanie Matthews

Supply chain processes that support caregivers as well as the products that are selected and sourced directly and indirectly impact patient safety and patient satisfaction, according to a new infographic by the Association for Healthcare Resource and Materials Management.

The infographic examines how supply chain management aligns with the Institute of Healthcare Improvement's Triple Aim.

Pursuing the Triple Aim: Seven Innovators Show the Way to Better Care, Better Health, and Lower CostsWritten by the President and CEO of the Institute for Healthcare Improvement (IHI) and a leading healthcare journalist, this groundbreaking book examines how leading organizations in the United States are pursuing the "Triple Aim": improving the individual experience of care, improving the health of populations, and reducing the per capita cost of care.

Pursuing the Triple Aim: Seven Innovators Show the Way to Better Care, Better Health, and Lower Costs shares compelling stories that are emerging in locations ranging from Pittsburgh to Seattle, from Boston to Oakland, focused on topics including improving quality and lowering costs in primary care; setting challenging goals to control chronic disease with notable outcomes; leveraging employer buying power to improve quality, reduce waste, and drive down cost; paying for care under an innovative contract that compensates for quality rather than quantity; and much more. The authors describe these innovations in detail, and show the way toward a healthcare system for the nation that improves the experience and quality of care while at the same time controlling costs.

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Infographic: 4 Ways Ambulatory Surgery Centers Control Costs

August 15th, 2016 by Melanie Matthews

Ambulatory Surgery Centers (ASCs) are helping to keep healthcare costs down—reducing the cost of outpatient surgery by over $38 billion per year in the United States by providing a lower cost site of care compared to hospital outpatient departments, according to a new infographic by SourceMed.

The infographic looks at the four ways that ASCs reduce costs.

Bundled Payments for Post-Acute Care: Profiting from Alternative Payments and Clinical Redesign A desire to position itself at the forefront of healthcare payment reform and be a catalyst for clinical redesign are two factors driving Brooks Rehabilitation's participation in Model 3 of CMS's Bundled Payments for Care Improvement (BPCI) initiative.

Today, having completed more than 1,000 bundled episodes for total hip replacements, total knee replacements and hip fractures, Brooks has reduced cost by 19 percent per episode, lowered readmissions to about 15 percent across its 60-day time frame, registered a patient satisfaction level of 94 percent and documented significant functional improvement.

Bundled Payments for Post-Acute Care: Profiting from Alternative Payments and Clinical Redesign examines the four domains of success of Brooks' Complete Care program supporting the organization's bundled payment clinical outcomes and financial results.

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