Archive for September, 2015

Infographic: Delivering Quality Care Through Remote Patient Monitoring

September 30th, 2015 by Melanie Matthews

With remote patient monitoring, patients can share vital healthcare information using mobile devices at anytime from anywhere.

A new infographic from Vigyanix looks at expected growth in the remote patient monitoring market, the major players in the remote monitoring space, how remote patient monitoring can be used to improve healthcare delivery and the barriers to implementation.

Delivering Quality Care Through Remote Patient Monitoring

Recent market data on telehealth in general and the patient-centered medical home in particular identified home health monitoring as a key care coordination strategy for individuals with complex illnesses as well as a host of vulnerable populations.

2014 Healthcare Benchmarks: Remote Patient Monitoring delivers a comprehensive set of metrics from more than 100 healthcare organizations on current practices in and ramifications of remote monitoring for care management of chronic illness, the frail elderly and remote populations.

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Infographic: Coordinated Care Models Needed for Cancer Care

September 28th, 2015 by Melanie Matthews

Coordinated Care Models Needed for Cancer Care

Overall satisfaction among cancer patients and caregivers with the care they received has improved significantly since the 2012, according to new data from the 2015 Cancer Experience: A National Study of Patients and Caregivers, reflected in a new infographic.

The survey results also mirror the ongoing national healthcare debate and reveal significant gaps between patients' expectations and the quality of care they receive. While having access to advanced oncology therapies is important, survey respondents indicated that healthcare providers need to address their dissatisfaction with the lack of care coordination, confusion and frustration surrounding healthcare terminology (literacy), and the inability to obtain timely information from their care team.

The infographic drills down on these survey results and examines how healthcare providers can respond to these patient concerns.

Anthem's Cancer Care Quality Program: Pathways to Improve Care and Reduce CostsDespite enormous innovations in the field, average costs for oncology drugs are skyrocketing and thousands of people in the U.S. die from cancer each week. Some payers, including Anthem, Inc., have turned to the use of pathways in an effort to make sure patients get the most appropriate evidence-based care that is still cost-effective.

Anthem's Cancer Care Quality Program: Pathways to Improve Care and Reduce Costs discusses the specifics of the insurer's Cancer Care Quality Program, its expectations in terms of outcomes and cost control, lessons it has learned and changes already made in the initial plans.

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Infographic: 4 Key Steps to Increasing Physician Practice Revenue

September 25th, 2015 by Melanie Matthews

There are several key steps physician practices can take to help grow their practice revenue, according to a new infographic by MedLanding News.

4 Key Steps to Increasing Physician Practice Revenue

Lessons from a Leading Pioneer ACO: Value-Based Gains from Physician Engagement, Performance Improvement and Care ManagementFollowing Pioneer ACO Year 3 results released by CMS in August 2015, Steward Health Care Network continues to make good on its Promise to provide coordinated, high-quality and cost-efficient care to its 80,000 Pioneer-aligned Medicare beneficiaries. Promise, Steward's top-performing Pioneer ACO, has generated $30 million of savings in its first three years of participation, according to recently published data.

Lessons from a Leading Pioneer ACO: Value-Based Gains from Physician Engagement, Performance Improvement and Care Management provides veteran advice from Kelly Clements, Pioneer Program Director, Steward Health Care Network. Steward is one of 20 accountable care organizations remaining in the Pioneer program and one of 15 reporting savings for year 3 (2014).

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ACO Trends for Hospitals & Health Systems: 9 Metrics to Know

September 24th, 2015 by Patricia Donovan

Of all healthcare sectors, hospitals and health systems are the most engaged in ACO activity, with 72 percent belonging to an accountable care organization (ACO), versus 50 percent of overall respondents to the 2015 Accountable Care Organizations survey by the Healthcare Intelligence Network.

Hospitals and health systems made a strong showing in HIN's fourth annual ACO activity and trends snapshot.

Moreover, respondents in this sector are united on many ACO fronts, reporting 100 percent commitment to the following: use of electronic health records (EHRs); inclusion of population health management and care coordination in their ACOs; adoption of NCQA guidelines for ACO recognition; review of clinical outcomes, health claims and health utilization data to measure ACO success; and designation of program rollout as the chief challenge of ACO creation.

And while not unanimous, hospital ACOs are almost twice as likely to be administered by a physician-hospital organization (60 percent, versus 28 percent overall); and to incorporate telehealth into their ACO framework (60 percent versus 34 percent overall).

This fourth comprehensive accountable care snapshot by the Healthcare Intelligence Network also found that ACOs within the hospital/health system sector, which comprised 11 percent of 2015 survey respondents, are twice as likely to employ 100 to 500 physicians (a metric reported by 60 percent of hospitals and health systems, versus 29 percent overall).

Also, hospitals have the largest number of pending ACOs, with half of those not already in an ACO expecting to be part of an ACO launch in the next twelve months, as compared to 25 percent overall.

Additionally, 40 percent of hospital-reported ACOs say they will participate in the Next Generation ACO Model, the latest Medicare Accountable Care Organization introduced by CMS, as compared to 21 percent of overall respondents, the survey found.

On the payment front, the hospital sector reports the highest use of a “fee for service + care coordination + shared savings” reimbursement model within their ACOs (60 percent versus 45 percent overall), the survey found.

Return on investment for hospital ACOs also tended to be healthier, with responding hospitals almost four times more likely to report ACO ROI between 3:1 and 4:1 (20 percent of hospitals versus 5 percent overall).

Finally, despite robust value-based activity, this sector expressed the most skepticism over CMS’s ability to shift half of Medicare payments to value-based models, with 71 percent doubting Medicare would meet this 2018 goal, versus 46 percent of responding healthcare organizations overall.

Source: 2015 Healthcare Benchmarks: Accountable Care Organizations

Infographic: The Growing Demand for Case Management

September 23rd, 2015 by Melanie Matthews

The Growing Demand for Case ManagementThe increase in insured populations combined with a growing number of Medicare beneficiaries underscores the need for inpatient case management services, according to a new infographic by McBee Associates.

The infographic outlines the four key reasons why an adequately staffed case management department is important for hospitals.

Care Coordination of Highest-Risk Patients: Business Case for Managing Complex Populations Asked 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.

The 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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Guest Post: 7 Ideas to Improve Communication and Coordination between Care Sites

September 22nd, 2015 by Richard A. Royer, CEO, Primaris

With access to some of the most highly educated and trained medical professionals in the world, providing Americans with the best patient care possible should be simple. Unfortunately, that’s not often the case. Poor communication between specialists, duplicate tests and unnecessary procedures are frequently the norm rather than the exception, leading to costly, dangerous and sometimes deadly consequences. With so many specialists and resources readily on hand, how is this happening?

The problem is a lack of care coordination. Simply put, care coordination is the idea that all specialists treating a patient should communicate and share information to ensure that everyone acts as a team to meet patient needs. This includes reporting all results back to a primary care practice or to someone coordinating patient care, and ensuring that labs, specialists, hospitals, and long-term care facilities work together to communicate information quickly and appropriately. It’s about primary care physicians, nurses, technicians, specialists, and caregivers collaborating on patient care rather than working as separate entities.

The average Medicare beneficiary interacts with seven physicians in four different practices during a single year, according to the New England Journal of Medicine. For those with chronic conditions, the numbers can be even higher. And, nearly one-fifth of Medicare patients who are hospitalized are readmitted within 30 days of discharge, and 75 percent of these readmissions could have been prevented by improved care coordination.

Too often, patients discharged from hospitals don’t get the support and encouragement they need to take their medicine, follow their diets, and adhere to the regimens doctors have prescribed during their stay. Many of these problems can be solved by improving care coordination, and that starts with communication between care sites.

Here are seven suggestions for improving communication between care sites—as well as across the care continuum:

  • Start the dialog: As a rule of thumb, improving communication between care sites begins with healthcare providers asking themselves what they know that others need to know, and sharing that information with the patient’s care team. What do patients need to know when they’re referred to a specialist? What do the specialists that patients are being referred to need to be aware of, e.g. what tests have already been completed? Has the primary care physician been informed?
  • Create a team and make it accountable: Organizations should start by assigning a team of people to be accountable for managing patient care. Define the extent of their responsibilities for key activities such as following up on test results and communicating information to other physicians. Establish when specific responsibilities should be transferred to other care providers—whether that means specialty physicians, long-term care facilities, or home care providers.
  • Designate care coordinators: Designate staff that will act specifically as care coordinators can help to reduce hospital readmissions. Before patients leave the hospital, care coordinators should meet with them to make sure they understand the treatment plans they need to follow at home as well as any changes to their medication regimens. The hospital care coordinators also must follow up on any pending labs and imaging studies and contact primary care physicians to communicate updated medications, treatment plans, and test results for their patients. The likelihood of readmission drops significantly when patients leave with a clear understanding of their treatment plans and when their primary care physicians know what is necessary during follow-up care.

    This same communication protocol should also apply to patients who leave the hospital for long-term care facilities. In this instance, the hospital care coordinator should communicate discharge instructions to the long-term care staff. As soon as residents return to the long-term care facility, staff there should meet with residents to review their discharge instructions, answer their questions, and communicate with the hospital if any further clarification is needed. Long-term care staff should also follow up regularly with these residents to ensure they continue to comply with instructions the doctor has recommended and intervene if any problems arise.

  • Standardize communication processes: Create a protocol for filling out patient charts in a standard way so they are easy to interpret and key elements aren’t overlooked. You also should standardize communication by using structured forms to ensure primary care providers, specialists, and long-term care providers all have the same and necessary information.
  • Develop a referral tracking system: Creating a system to internally track and manage referrals and transitions— including consultations with specialists, hospitalizations and ER visits, and referrals to community agencies—can go a long way towards improving communication between care sites. It will help to ensure patients are well prepared for their referral visit and know what to expect afterwards. And, it simplifies follow-up with referral providers about findings, next steps and treatment plans.
  • Follow up on referrals: When a primary care physician refers a patient to a specialist, for example, office staff should follow up to make sure the appointment was made and completed. In addition, office staff needs to ensure the specialist shares his findings with the primary care physician so he can be well versed on the patient's progress and any additional steps to be taken.
  • Notify providers in the patient's medical neighborhood: Similarly, when patients visit the emergency room or are admitted to the hospital, communication should be a priority. In this instance, hospital staff should notify the primary care practice so the primary care doctor can follow the patient’s progress through discharge and institute a care plan to prevent future admissions. In addition, the practice can reach out to patients when they leave the hospital to make sure they understand discharge instructions and schedule follow-up appointments. When the patient comes in for follow-up care, the primary care physician should have a complete history of specialists seen during the hospital admission, their recommendations, and tests performed, along with the results.

The healthcare industry can no longer simply “discharge” patients. Providers must now work collaboratively with all others across the continuum of care to transition and coordinate the ongoing care of every patient. That’s what care coordination is all about.


Richard Royer

About the Author: Richard A. Royer has served as the chief executive officer of Primaris since 2001. He has extensive administrative healthcare experience and is actively involved in several statewide healthcare initiatives. In 2006 he was appointed by the Missouri governor to the Missouri Healthcare Information Technology Task Force and chaired the resources workgroup. He also serves on the board of directors as treasurer for the Excellence in Missouri Foundation. In his over 35 years of medical business experience he has held positions as chief executive officer at Cuyahoga Falls, Ohio, General Hospital; executive director of Columbia Regional Hospital in Missouri; and founder and president of Avalon Enterprises, a medical financial consulting firm.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

Infographic: Value-Based Payor Provider Partnerships

September 21st, 2015 by Melanie Matthews

The number of payer-provider partnerships built around value-based compensation has quadrupled since 2012, when Oliver Wyman began monitoring these types of health insurance products.

A new infographic by Oliver Wyman examines the geographic distribution of these partnerships.

Value-Based Payor Provider Partnerships

6 Value-Based Physician Reimbursement Models: Action Plans for Alignment, Analytics and Profitability In today's value-based healthcare sphere, providers must not only shoulder more responsibility for healthcare outcomes, cost and quality but also align with emerging compensation models rewarding these efforts—models that often seem confusing or contradictory. The challenges for payors and partners in creating a common value-based vision are sizing the reimbursement model to the provider organization and engaging physicians' skills, knowledge and behaviors to foster program success.

6 Value-Based Physician Reimbursement Models: Action Plans for Alignment, Analytics and Profitability examines a set of provider compensation models across the collaboration continuum, advising adopters on potential pitfalls and suggesting strategies to survive implementation bumps.

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Infographic: Healthcare Security Breaches in 2015

September 18th, 2015 by Melanie Matthews

In 2015, the healthcare sector has had more security breaches than any other sector but one, according to a new infographic by Netsurion.

The infographic examines security breaches by market sector, along with specific details on healthcare security breaches.

Healthcare Security Breaches in 2015

HIPAA Compliance ManualThe customized HIPAA Compliance Manual contains the policy and procedure documentation required by the HIPAA privacy and security rules and HITECH. Operating forms are included in the manual for ease of customization for your office. The manual also includes state laws and regulations that interface with HIPAA and state identity theft laws.

The HIPAA Compliance Manual also includes as a bonus: The Advisor, a monthly newsletter to help you stay current on new regulations and interpretations throughout the year. You will receive The Advisor each month by email as a part of your manual purchase.

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HINfographic: 2015 Post-Acute Care Challenge: How to Foster Warm Handoffs

September 16th, 2015 by Melanie Matthews

With patient transitions between care sites a top post-acute care (PAC) challenge for 25 percent of healthcare organizations, discharge planning, hiring of care transition navigators and data exchange are helping to facilitate 'warm handoffs'—full-circle communication between hospital and post-acute care clinicians regarding a patient's care—according to 2015 Healthcare Intelligence Network metrics.

A new infographic by HIN examines the top strategies to improve post-acute care and reduce costs and the percentage of healthcare organizations that include post-acute care in value-based reimbursement methodologies.

2015 Healthcare Benchmarks: Post-Acute Care TrendsHealthcare is exploring new post-acute care (PAC) delivery and payment models to support high-quality, coordinated and cost-effective care across the continuum—a direction that ultimately will hold PAC organizations more accountable for the care they provide. For example: two of four CMS Bundled Payments for Care Improvement (BPCI) models include PAC services; and beginning in 2018, skilled nursing facilities (SNFs) will be subject to Medicare readmissions penalties.

2015 Healthcare Benchmarks: Post-Acute Care Trends captures efforts by 92 healthcare organizations to enhance care coordination for individuals receiving post-acute services following a hospitalization—initiatives like the creation of a preferred PAC network or collaborative. Click here for more information.

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Infographic: Smart Watches & Healthcare

September 14th, 2015 by Melanie Matthews

Healthcare apps currently account for 4 percent of all apps on the market, according to a new infographic by Watches2U. This percentage is set to explode with the advent of wearable technologies and, in particular, smart watches.

The infographic examines what your watch will be able to monitor by 2020, how your watch could help medical research, the smart watches with some of these functionalities now and the top health and fitness apps.

Smart Watches & Healthcare

Remote Patient Monitoring for Enhanced Care Coordination: Technology to Manage an Aging PopulationFrom home sensors that track daily motion and sleep abnormalities to video visits via teleconferencing, Humana's nine pilots of remote patient monitoring test technologies to keep the frail elderly at home as long as possible. When integrated with telephonic care management, remote monitoring has helped to 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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