Archive for November, 2014

Infographic: Healthcare Quality Reporting

November 14th, 2014 by Melanie Matthews

Healthcare quality reporting initiatives have revealed the state of healthcare quality in the United States, according to a new infographic by Caradigm.

In the infographic, Caradigm explores the impact of quality on patients and providers.

Healthcare Quality Reporting

Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care While widespread adoption of electronic health records has generated new streams of actionable patient data, John C. Lincoln has taken data mining to new levels to enhance performance of its accountable care organization (ACO).

Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care reviews the concentrated data dig undertaken by John C. Lincoln to prepare for participation in the CMS Medicare Shared Savings Program (MSSP).

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Sentara Home Visits for High-Risk ‘VIPs’ Drive Hybrid Case Management Outcomes

November 13th, 2014 by Cheryl Miller

When the Sentara Medical Group evolved to a hybrid embedded case management model in 2012, case managers spent time in the practice, but also managed care through other touch points, including home visits, explains Mary M. Morin, RN, NEA-BC, RN-BC, vice president, nurse executive with Sentara Medical Group. How to identify high-risk patients for case management, and home visits in particular? Here, Ms. Morin addresses that question posed by The Healthcare Intelligence Network during a recent webinar.

Question: How does Sentara identify high-risk patients for case management in general and for home visits in particular? Do all patients in the case management program receive home visits?

Response: (Mary M. Morin) This program started as a pilot in 2012. It was targeted at patients that we called very important patients — high-cost, high-utilizers, the top of the pyramid. There are about 2,300 patients within 11 of our primary care sites. We kept it small, with five RN care managers. That population included all payors, most importantly our health plan patients. Because of our health plan, we were able to really study whether RN care management had an impact on the total cost of care — not unlike other organizations, if you can find a cost savings and justify the expense of having RN care managers, it makes the case much more solid moving forward with formalizing the program.

We sorted those patients by high-risk, high-cost or high-cost, high-utilizers because of chronic diseases. We looked at patient with congestive heart failure (CHF), chronic obstructive pulmonary disorder (COPD), asthma, renal failure and diabetes. We excluded patients that had any traumatic event like a car accident or something that led to high-cost, or they had cancer or they were a transplant patient.

The purpose was to engage that population. It is voluntary. We studied that population for three years. It allowed us to measure our outcomes over time because we weren’t sure if there was seasonality to the patients with chronic disease: did they just not use services because of seasonal issues or because it’s a cycle issue within the chronic disease phase? After three years of data, we determined there is definitely a difference in the outcomes of this patient population and their utilization.

Home visits was one of the big differences in the model. The main reason to do home visits is not to do patient care, but to do an assessment of the patient’s environment. A lot of times, patients don’t share with us their actual living situation. They tell you that they’re walking, and then you find out they walk within a five-foot radius. The real emphasis for home visits was to get in and meet the patient in their environment.

We found that RN care managers in the home facilitated advance care planning. That is best done in the patient’s home with a family member present, not in the doctor’s office or waiting until the patient is admitted to the hospital. We found that patients appreciated the visits. The RN care managers who went in really cleaned up the medications. Patients will hold on to medications.

value-based reimbursement
Mary M. Morin, RN, NEA-BC, RN-BC, is a nurse executive with Sentara Medical Group, where she is responsible and accountable for non-physician clinical practice within the Sentara Medical Group (160 clinics/practices) to ensure integration and alignment with Sentara Healthcare, regulatory compliance, standardization of nursing practice/care, and patient safety.

Source: Hybrid Embedded Case Management: New Model for Cross-Continuum Care Coordination

Infographic: Medication Non-Adherence’s Impact

November 12th, 2014 by Melanie Matthews

Medication Adherence

Medication Adherence

Medication non-adherence negatively impacts patient health and drives increases in healthcare costs, according to an infographic by NextIT.

The infographic examines one of the top reasons for medication non-adherence, eliminating health risk factors, and the role of virtual health assistants in helping patient manage chronic conditions.

What’s the cost of medication non-adherence? As high as $290 billion annually, according to one frequently cited estimate. An equally bitter pill to swallow is the dismal C+ grade in medication adherence earned in 2013 by Americans with chronic medical conditions, according to the first National Report Card on Adherence from the National Community Pharmacists Association (NCPA). Fortunately, the healthcare industry is striving to improve performance in this area.

42 Metrics for Improving Medication Adherence42 Metrics for Improving Medication Adherence provides convincing evidence of the impact of nine key interventions on medication non-adherence— from the presence of pharmacists in patient-centered medical homes to medication reconciliation conducted during home visits.

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Infographic: Optimizing Employers’ Health Program Performance

November 10th, 2014 by Melanie Matthews

Employers are rethinking their healthcare strategies to achieve a high-performance benefit portfolio by making sure their health plans are aligned, affordable, efficient and engaging, according to new research by Towers Watson.

In a new infographic, Towers Watson explores how employers are aligning health plans with broader goals and needs, making plans affordable for both the business and the employee, leveraging efficient strategies and tactics, and engaging employees in accountability for their own health.

 Optimizing Employers Health Program Performance

Population Health Framework: 27 Strategies to Drive Engagement, Access & Risk Stratification Faith-based integrated delivery system Adventist Health is on a mission to improve population health status with a wellness-based approach it estimates will eventually net $49 million in savings.

In Population Health Framework: 27 Strategies to Drive Engagement, Access & Risk Stratification walks through the elements of Adventist’s population health management program that engages individuals to modify behaviors and prevent illness in the future.

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Infographic: Optimizing the Home Healthcare System

November 7th, 2014 by Melanie Matthews

Optimizing the Home Healthcare SystemWhile today’s hospital CEO is told to fill beds, tomorrow’s will be told to empty them, driving an increase in home healthcare, according to a new infographic by ClickSoftware.

The infographic also looks at how patients can best be served in their home and the typical characteristics of home healthcare patients.

Remote Patient Monitoring for Enhanced Care Coordination: Technology to Manage an Aging Population When integrated with telephonic care management, remote patient monitoring can help avert medical emergencies and preventable hospitalizations among individuals with serious medical and functional challenges.

In Remote Patient Monitoring for Enhanced Care Coordination: Technology to Manage an Aging Population Gail Miller, vice president of telephonic clinical operations in Humana’s care management organization, Humana Cares/SeniorBridge, reviews Humana’s expanded continuum of care aimed at improving health outcomes, increasing satisfaction and reducing overall healthcare costs with a more holistic approach.

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Infographic: The Connected Hospital

November 5th, 2014 by Melanie Matthews

New advances in technology are radically transforming the way healthcare is delivered and managed, from the point of care to payment and reimbursement. Delivering this type of care requires providers to connect with their patients and across healthcare systems in new ways.

An infographic by MuleSoft looks at how healthcare organizations are connecting with patients and other providers to share clinical and non-clinical data.

The Connected Hospital

Transforming Health Care: The Financial Impact of Technology, Electronic Tools and Data Mining The healthcare technology revolution is just around the corner. And when it arrives, it will change and enrich our lives in ways we can only begin to imagine. Doctors will perform blood pressure readings via video chat and nutritionists will analyze diet based on photos taken with cell phone cameras.

Transforming Health Care: The Financial Impact of Technology, Electronic Tools and Data Mining combines healthcare, technology, and finance in an innovative new way that explains the future of healthcare and its effects on patient care, exploring the emergence of electronic tools that will transform the medical industry.

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Infographic: CMS’ Value-Based Modifier Program

November 3rd, 2014 by Melanie Matthews

CMS’ new Value-Based Modifier program is designed to assess both quality of care and the cost of that care under the Medicare Physician Fee Schedule. Starting in 2015, all providers who participate in fee-for-service Medicare need to prepare for VBM because their 2017 Medicare payments will be adjusted based on their 2015 performance.

In a new infographic, Health Fusion examines how the value-based modifier is calculated, how physician practices might measure up and what practices will need to do in 2015.

CMS' Value-Based Modifier Program

Value-Based Reimbursement Answer Book: 97 FAQs on Healthcare Models, Measures and MethodologyIf one trend has transformed the healthcare industry post-ACA more than any other, it is the market’s new business model rewarding value over volume.

Value-Based Reimbursement Answer Book: 97 FAQs on Healthcare Models, Measures and Methodology provides a framework for healthcare’s new value proposition, with advice from thought leaders steeped in the delivery and reimbursement of value-based care.

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