Archive for January, 2016

Infographic: Virtual Healthcare

January 29th, 2016 by Melanie Matthews

Technologies such as hologram house calls, where a physician “visits” you in your home via a hologram link, and a virtual doctor app for your smartphone or tablet are just of the some of the ways that technology may be used in the future of healthcare. These innovations are projected to dramatically reduce the number of hours that doctors require for each of their patients and could potentially revolutionize the healthcare industry significantly, according to a new infographic by Home Healthcare Adaptations.

The infographic looks at the potential savings of virtual healthcare, benefits to healthcare professionals and patients, and challenges faced by virtual healthcare.

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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Chronic Care Management Revenue Relies on Physician Momentum

January 28th, 2016 by Patricia Donovan

Embedded in CMS’s year-old Chronic Care Management codes is a dramatic potential for revenue—in both reduced costs and enhanced health outcomes for Medicare beneficiaries. But before primary care practices can tap into these opportunities, physician leadership must create momentum for CCM with staff and patients, advises Debra Burbary, RN, clinical quality assurance manager with Arcturus Health.

CMS recognizes that care management is a critical component of the primary care setting and that it can help contribute to the better health of our patients and also reduce spending as well. Our group has looked at this as an opportunity to capture more revenue as well as improve our patients’ health conditions.

However, when we first began to study the Chronic Care Management (CCM) regulations, we found out that it wasn’t going to be quite that easy. CMS has put into place many requirements and guidelines that need to be followed to qualify for this service. We think that one of the biggest messages that came through was the fact that 75 percent of healthcare spending is directly related to chronic conditions. The prevalence of co-morbid conditions also presents a challenge for disease management. Mostly, these patients fall into that category.

The CCM program was going to require a comprehensive effort to reconfigure our clinical workflows and processes to adjust to the needs of these chronically ill patients within a primary care setting. One of the main things we determined we needed was physician leadership. Involvement by our physicians to support this program was going to be a major key to success.

I was very fortunate to work with my physician medical director, who does provide that support for our department, and we were able to move forward. One thing to look at if you’re just starting with this process is the creation within your group of physician buy-in for disease management activities in order to create that culture. Without this supportive culture, you will have a difficult time sustaining a chronic disease management effort.

The cost of disease management continues to drive many of our decisions related to encouraging our patients in self-management activities complementary to the patient-physician relationship—decisions that drive our strategies for supporting patients in becoming informed. Active participants must be extensively developed.

The potential revenue for the CCM code cannot be overlooked. It’s remarkably very, very high, but at the same time very difficult to accomplish.

Source: Medicare Chronic Care Management Billing: Evidence-Based Workflows to Maximize CCM Revenue

http://hin.3dcartstores.com/Framework-for-Patient-Engagement-6-Stages-to-Success-in-a-Value-Based-Health-System_p_5102.html

Medicare Chronic Care Management Billing: Evidence-Based Workflows to Maximize CCM Revenue traces the incorporation of CCM into Arcturus Healthcare’s existing care management efforts for high-risk patients, as well as the unexpected bonus that resulted from CCM code adoption.

Infographic: HIPAA Physical Safeguards

January 27th, 2016 by Melanie Matthews

Physical safeguards are set of rules and guidelines that outline how the physical storage and access to protected health information should be managed under HIPAA security rules, according to a new infographic by Vigyanix.

The infographic details the Physical Safeguard requirements for facility access controls, workstation use and security and device and media control.

Business Associate ManualBusiness Associate Manual is a template-style manual that can be easily adapted to align with your compliance needs as a business associate (BA). All content complies with the Omnibus Rule.

Specifically developed to help BAs meet complex privacy & security compliance requirements. The Business Associate Manual includes: 6 privacy policies; 30 security policies; 6 policies that address common requirements of both the privacy and security rules; 1 breach notification policy; and 4 forms and templates.

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Infographic: Improving Patient Satisfaction

January 25th, 2016 by Melanie Matthews

Provider-led changes can have a significant impact on patient satisfaction rates, according to a new infographic by PatientSafe Solutions.

The infographic outlines how communication is key to unlocking patient satisfaction via face-to-face visits, online touchpoints and provider office interactions.

Intermountain Healthcare’s strategic six-point patient engagement framework not only has transformed patient care delivered by the Salt Lake City-based organization but also has fostered an attitude of shared accountability throughout the not-for-profit health system.

Framework for Patient Engagement: 6 Stages to Success in a Value-Based Health System details Intermountain’s multilayered approach and how it supports its corporate mission: Helping people live the healthiest lives possible.

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Infographic: New Models of Care

January 22nd, 2016 by Melanie Matthews

In response to healthcare industry trends, healthcare organizations are turning to social media, mobility, analytics and cloud computing to stay relevant in the digital landscape, according to a new infographic by CSC.

The infographic examines the industry trends driving these changes and how healthcare organizations are responding.

2015 Healthcare Benchmarks: Chronic Care ManagementThe desire to improve health outcomes for individuals with serious illness coupled with opportunities to generate additional revenue have prompted healthcare providers to step up chronic care management initiatives. The Centers for Medicare and Medicaid Services now reimburses physician practices for select chronic care management (CCM) services for Medicare beneficiaries, with more private payors likely to follow suit.

2015 Healthcare Benchmarks: Chronic Care Management captures tools, practices and lessons learned by the healthcare industry related to the management of chronic disease. Click here for more information.

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The Care Plan Process: 15 Trends to Know

January 21st, 2016 by Patricia Donovan

Care planning begins with a needs assessment, say the majority of respondents to HIN's 2015 survey on Care Plans.

The use of care plans increases medication adherence, patient self-management and clinical quality ratings, say 70 percent of healthcare organizations engaged in care planning, according to newly published market metrics from the Healthcare Intelligence Network (HIN).

A majority of respondents—83 percent—incorporate care plans into value-based healthcare delivery systems, according to HIN’s December 2015 survey, with more than half of remaining organizations planning to do so in the coming year.

High-risk health indicators derived from health risk assessments or the imminent transition of a patient from one care site to another are the chief triggers of the care planning process, said survey respondents.

Survey Highlights:

Other findings from HIN’s Care Plans survey include the following:

  • First and foremost in a care plan strategy is an assessment of needs, say 87 percent of respondents.
  • The electronic health record is the care plan maintenance and distribution tool of choice for almost two-thirds of respondents, although the retention of paper records is reported by nearly half of responding companies.
  • The principal criterion for classifying patients in need of care plans is the data derived from health risk assessments (HRAs), say nearly two-thirds of respondents, but patients transitioning between care sites also are prioritized for care planning, note 61 percent.
  • The presence of a behavioral health condition poses the greatest challenge to care planning by a large margin, said 39 percent of respondents, as compared to diagnosis of physical health problems.
  • The typical tracking time for care plans ranged from one to two months, said 24 percent, while adherence to care plans is checked monthly by 37 percent of respondents.
  • Patient engagement is the most significant barrier to care plan success, say 44 percent of respondents.
  • Patients’ healthcare utilization patterns are the most reliable indicators of care plan adherence, say 29 percent.
  • About 13 percent report ROI from care planning efforts as between 2:1 and 3:1.

Download a complimentary executive summary of 2016 Care Plan metrics to learn the value of evidence-based care plans in following high-risk patients through health episodes and transitions of care.

HINfographic: Telehealth and Telemedicine Technologies Foster Access, Power Population Health

January 20th, 2016 by Melanie Matthews

With millennials to Medicare beneficiaries strapping on fitness trackers, visiting specialists via video, and monitoring chronic conditions at home, telehealth and telemedicine services are redefining the boundaries of healthcare delivery. A 2015 Telehealth & Telemedicine survey by the Healthcare Intelligence Network captured trends powering this burgeoning market, whose global value is expected to surpass $34 billion by 2020.

A new infographic by HIN examines the top clinical telehealth applications, the greatest barrier to telehealth implementation and details on telehealth adoption and ROI.

The world of digitally enabled care is exploding: the number of patients using telehealth services will rise to 7 million in 2018, according to IHS Technology; healthcare apps and ‘wearables’ are trending in technology circles and healthcare providers’ offices; and CMS’s new ‘Next Generation ACO’ model is expected to favor expanded telehealth coverage.

2015 Healthcare Benchmarks: Telehealth & Telemedicine delivers actionable new telehealth metrics on technologies, program components, successes and ROI from 115 healthcare organizations. This 60-page report, now in its fourth year, documents benchmarks on current and planned telehealth and telemedicine initiatives, with historical perspective from 2009 to present.

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Infographic: 12 Physician Practice Models

January 18th, 2016 by Melanie Matthews

Healthcare industry challenges and government mandates are changing the way some physician practices operate, according to a new infographic by BillingParadise.

The infographic outlines how 12 different physician practice models work to help physicians understand and choose a model best suited for them.

One year after the Centers for Medicare and Medicaid Services began reimbursing physician practices for chronic care management services, Bon Secours Medical Group is now comfortable with the CCM reimbursement requirements and is reporting that it’s unique approach to this revenue opportunity is ramping up nicely. And, the organization’s approach to chronic care management reimbursement is helping to position itself for advance care planning as a new billable CMS event in the upcoming year.

During Physician Reimbursement in 2016: Workflow Optimization for Chronic Care Management and Advance Care Planning, a January 26th webinar at 1:30 p.m. Eastern, Robert Fortini, PNP, chief clinical officer for Bon Secours Medical Group, will provide an inside look at his organization’s experience with CMS’ chronic care management reimbursement this year and how they are leveraging this experience for CMS’ newest billable event in 2016—advance care planning.

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Infographic: Trends in Employer-Sponsored Health Insurance

January 15th, 2016 by Melanie Matthews

Between 1999 and 2015, employer-sponsored health insurance premiums increased by 203 percent, outpacing both inflation and workers’ earnings. However, growth of premiums for family coverage slowed toward the end of that time period, from an average of 11 percent a year between 1999 and 2005, to 5 percent between 2005 and 2015, according to a new Visualizing Health Policy infographic by the Henry J. Kaiser Family Foundation.

The infographic also looks at the average annual premium for family coverage and how employers are responding to high-cost health plans.

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.

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Yale New Haven’s High-Risk Care Management Commences with Its Employees

January 14th, 2016 by Patricia Donovan

A care management pilot by YNHHS for employees and their dependents with diabetes was a template for future embedded care management efforts.

Disenchanted with vendors it engaged to provide care management for its workforce, Yale New Haven Health System (YNHHS) launched an initial care management pilot for its high-risk employee populations. The pilot went on to become a very robust program and served as a training ground for two more embedded on-site care management initiatives. Here, Amanda Skinner, YNHHS’s executive director for clinical integration and population health, provides details from on-site face-to-face care management for YNHHS employees and their dependents.

We have an RN care coordinator based on each of the four main hospital campuses of our health system: one in Greenwich, one in Bridgeport and two in New Haven. All of the RN care coordinators in this program are trained in motivational interviewing. The intent is for them to work with our high-risk, high-cost employees who have chronic diseases, and with their adult dependents that also fall into that population.

The care coordinators work with these employees across the entire system to help them access the care they need, identify their goals of care, get under the surface a little to determine barriers to their being as healthy as they can be, and manage them over time. We did create some incentives for employee participation in this program, including waived co-pays on a number of medications (for example, any oral anti-diabetics).

When we initially launched the program, we limited it to employees and dependents that had diabetes, because that was the population for which we had very robust data. We also knew that diabetes was generally a condition that lent itself well to the benefit of care coordination; that there were a lot of gaps in care. When we looked at our data, we saw that ED utilization was very high for this population; that their past trend was rising, that utilization of their primary care provider was actually below what you would expect. This meant that they were under-utilizing primary care, over-utilizing hospital services, and were not particularly compliant with care.

With that population, we saw a lot of opportunity that a care management program could help address. In general, diabetes is a condition that lends itself to accepting a helping hand, to help people understand their condition and address the medical and social issues so they can manage that condition more effectively.

The program has been tremendously successful. We expanded it this year to include wellness coaches based at all of our delivery networks’ main campuses as well. These coaches work with a lower risk population and are available to any health system employee that wants to work with a coach to set care goals and then meet with the coach monthly or quarterly to track improvements against those goals. This expansion is because we’ve seen such positive results from this program.

Source: 3 Embedded Care Coordination Models to Manage Diverse High-Risk, High-Cost Patients across the Continuum examines YNHHS’s three models of embedded care coordination that deliver value while managing care across time, across people, and across the entire continuum of care. In this 30-page resource, Amanda Skinner, executive director for clinical integration and population health at Yale New Haven Health System, and Dr. Vivian Argento, executive director for geriatric and palliative care services at Bridgeport Hospital, present a trio of on-site care models crafted by YNHHS to manage three distinct populations.