Archive for October, 2015

Infographic: Top 11 Health Plans in 2015

October 12th, 2015 by Melanie Matthews

Capital District Physicians’ Health Plan (HMO) and Capital District Physicians’ Health Network (HMO), both of New York, were the top rated health plans by NCQA in 2015, according to a new infographic by HIMSS Media, which highlights the NCQA findings.

NCQA used combined HEDIS, CAHPS and NCQA Accreditation standards scores as of June 30, 2015 to develop the ranking. The HIMSS infographic shows the top 11 health plans, based on these scores.

Top 11 Health Plans in 2015

A multi-layer, patient-centered approach to care coordination of Memorial Hermann’s ACO covered lives is designed to cover these members under a population health umbrella spanning the entire continuum of care from wellness services to supportive services for end-of-life care.

During Care Coordination in an ACO: Managing the Population Health Continuum from Wellness to End-of-Life, a September 29th webinar, now available for replay, Mary Folladori, RN, MSN, FACM, CMAC, system director of care management at the Memorial Hermann Physician Network and ACO, provided the inside details on its care coordination strategy and results.

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Infographic: How Do You BYOD?

October 9th, 2015 by Melanie Matthews

“Bring your own device” (BYOD) is a challenging issue for healthcare organizations because it encompasses so many questions related to an organization’s costs, security risks, IT availability, and the varying needs of different groups of staff, according to a new infographic by Spok.

The infographic presents the findings from a June 2015 Spok survey that assessed the current state of BYOD at healthcare organizations across the United States.

How Do You BYOD?

Encouraged by early success in coaching 23 patients to wellness at home via remote monitoring, CHRISTUS Health expanded its remote patient monitoring (RPM) enrollment to 170 high-risk, high-cost patients. At that scaling-up juncture, the challenge for CHRISTUS shifted to balancing its mission of keeping patients healthy and in their homes with maintaining revenue streams sufficient to keep its doors open in a largely fee-for-service environment.

Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System chronicles the evolution of the CHRISTUS RPM pilot, which is framed around a Bluetooth®-enabled monitoring kit sent home with patients at hospital discharge.

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Infographic: Collaboration for Better Care

October 7th, 2015 by Melanie Matthews

Technology can help break down communication barriers and extend more immediate care, according to a new infographic by CDW Healthcare.

The infographic showcases health IT components that support connected care.

Collaboration for Better Care

The rapid evolution of healthcare payment reform requires a sea change of both hospital and physician behavior. As healthcare providers are held more accountable for the quality and cost of care delivered, the physician-hospital organization (PHO) provides an efficient framework for collaboration and resource consolidation.

Physician-Hospital Organizations: Framework for Clinical Integration and Value-Based Reimbursement describes the relevance of the PHO model to today’s healthcare market, offering strategies to leverage the physician-hospital organization for maximum clinical outcomes, competencies and value-based reimbursement.

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The Impact of Patient Engagement: 10 Metrics to Know

October 6th, 2015 by Patricia Donovan

A formal patient engagement program elevates patient satisfaction, care plan adherence and overall quality scores, say three-fifths of healthcare organizations.

While more than 60 percent of healthcare organizations report their patient engagement programs have elevated patient satisfaction, care plan adherence and overall quality metrics, populations with low health literacy or behavioral health conditions are more resistant to efforts to engage them in self-care.

These findings were among the benchmarks identified by an inaugural survey on Patient Engagement by the Healthcare Intelligence Network. The August 2015 survey also determined that 79 percent of respondents are striving to improve patient engagement, employing an arsenal of tactics and e-tools.

Asked to identify some hurdles of engaging patients, half of the survey’s 133 respondents reported that the behavioral health population is the most challenging to engage. And “high utilizers”—individuals with frequent ER visits or hospitalizations—are top candidates for engagement efforts, say 52 percent of respondents.

Today’s value-focused healthcare models theorize that engaged patients not only are healthier and more satisfied but may incur fewer costs than the non-engaged, which is why many programs make patient engagement a priority, such as Medicare’s mandate that accountable care organizations (ACOs) develop processes to promote patient engagement.

Patient and caregiver education is the top strategy deployed to engage patients, say 72 percent of survey respondents. In this area, technology plays a pivotal role, the survey found.

Whether patient engagement translates to good business remains to be seen. In the meantime, the HIN survey found that organizations are testing the impact of health coaching, embedded case management, a team-based approach and telephonic follow-up, among other tactics, on overall population health engagement.

Here are five more metrics from the 2015 Patient Engagement Survey:

  • Sixty-six percent of respondents have a patient portal, whose top use is education.
  • Almost half of respondents—48 percent—possess an electronic health record (EHR) that helps to identify patients most in need of engagement.
  • Low health literacy is the top barrier to patient engagement, say 20 percent of respondents.
  • The case manager has top responsibility for patient engagement efforts, say 28 percent of respondents.
  • Of those respondents with no formal initiative to foster patient engagement, 65 percent will launch an effort in the coming year.

Download an executive summary of the 2015 Patient Engagement survey results.

Longitudinal Care Plans, Risk Scores Raise Patient Engagement for MSSP ACO’s Complex Population

October 6th, 2015 by Patricia Donovan

A top-performing MSSP in 2014, the Memorial Hermann ACO has successfully engaged its Complex Care population via a collaborative care coordination approach.

The Memorial Hermann ACO may have been one of 2014’s top-performing Medicare Shared Savings Programs (MSSPs), but the health system’s commitment to achieving quality outcomes was solidified more than eight years ago, when its own physicians asked for a clinically integrated physician network.

Memorial Hermann complied, developing a set of tools, training and care models to not only support the physicians but also reflect payors’ needs: chief among them, initiatives that could boost patient engagement.

Today, the Memorial Hermann ACO has a patient-centered care delivery strategy built on teamwork and collaboration. The Texas ACO is proud to point to a patient engagement rate of 74 percent for individuals enrolled in Complex Care, an initiative for individuals with long-term, multiple chronic conditions that has significantly reduced cost and hospital lengths of stay for participants.

This patient engagement measure represents members who consent to participate in the program and remain engaged for 30 days, explained Mary Folladori, RN, MSN, FACM, CMAC, system director of care management at Memorial Hermann Physician Network and ACO, during Care Coordination in an ACO: Managing the Population Health Continuum from Wellness to End-of-Life, a September 2015 webinar from the Healthcare Intelligence Network now available for replay.

Ms. Folladori provided an overview of the ACO’s care coordination strategy that in 2014 generated savings of nearly $53 million in the MSSP program, resulting in a health system payout of almost $23 million. The ACO’s performance earned Memorial Hermann a MSSP quality score of 88 percent.

Some high points from Memorial Hermann’s ACO strategy include the following:

  • Embedding of care coordinators into the ‘micro culture’ of a physician practice, its community and the members served by the practice;
  • Strategic use of a data warehouse to identify vulnerable members early and link them with needed health services;
  • Development of comprehensive risk scores derived from multiple sources for Complex Care patients; and
  • Creation of longitudinal care plans that follow Complex Care patients for up to 18 months and help to transition them back to a baseline level of functioning.

In wrapping up observations on Memorial Hermann’s quality-driven approach, Ms. Folladori quoted its CEO, Chris Lloyd: “The success that has been found within our ACO is deeply based on a collaborative approach to care. It has been cultivated over eight years with our commitment to clinical integration. We all strongly believe that without that strong clinically integrated physician network, without our physicians driving those quality outcomes, we would not have been as successful as we have.”

With so much emphasis on quality and outcomes, it’s no wonder participation today in the Memorial Hermann ACO is by invitation only—and only after a practice has passed an assessment.

Infographic: Using Big Data To Save Lives

October 5th, 2015 by Melanie Matthews

Healthcare organizations are challenged by the large amounts of healthcare data they collect, according to a new infographic by IBM.

The infographic examines the amount of data that healthcare organizations receive and the potential for that data to save lives.

Using Big Data To Save Lives

From 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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Infographic: HIPAA Data Breaches on the Rise

October 2nd, 2015 by Melanie Matthews

HIPAA Data Breaches on the RiseHIPAA data breaches are rising, according to research conducted by Privacy Analytics Inc. for a new infographic, HIPAA Breaches 2009-2015.

Culling data from the Office of Civil Rights, Privacy Analytics found over 1,286 reported incidents affecting 153 million individuals at the time of publication. The largest breach was earlier this year from Anthem Insurance, reporting over 78 million records being breached. According to the Guide to the De-identification of Personal Health Information, the costs incurred for a breach – including notification, legal fines, legal fees, forensics, PR and more – is approximately $208 per person. The average data breach was over 100,000 records and cost $24 million. States with the highest number of individual records breached were Indiana, California and Washington State.

The infographic looks at breaches by type, the need for more HIPAA organizational knowledge and training and new data privacy and security challenges as the use of secondary health data grows.

HIPAA Training for Employees DVD
HIPAA Training for Employees DVD provides training on the following: privacy rule basics; use and disclosures; patient rights; employee behaviors to safeguard patient information; security rules; safeguards to protect patient information electronically; HITECH; breach identification and notification; enforcement; and level of fines.

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