Archive for March, 2016

CMS Postpones LOI Deadline to May 2, Readies for Next Wave of ‘Next Generation ACO’ Participants

March 10th, 2016 by Patricia Donovan

Update: On March 11, 2016, the Centers for Medicare and Medicaid Services (CMS) pushed back the deadline for letters of intent for 2017 Next Generation ACO participation to May 2, 2016.

ACO

April 1 is the deadline to submit a letter of intent to participate in the Next Generation ACO Model in 2017.

Letters of intent from healthcare organizations interested in applying to the Next Generation ACO Model for the January 1, 2017 start date must be submitted by April 1, 2016, according to an update from the Centers for Medicare and Medicaid Services.

The letter of intent (LOI) as well as more information about CMS’s newest accountable care organization model, including dates and times for Application Open Door Forums, can be found on the Next Generation ACO Model web page.

Only organizations that submit an LOI will be able to complete an application. Even applicants that submitted an application previously but are not participating in the Next Generation ACO Model for 2016 must complete and submit an LOI if they wish to apply to participate in the Next Generation ACO Model beginning in 2017, CMS stated.

Subsequent to the organization’s LOI, applications for 2017 Next Generation ACOs will be due in two parts:

  • The narrative portion is due May 25, 2016; and
  • The Participating Provider list is due June 3, 2016.

If an organization plans to submit more than one LOI, it should use a different email address for the primary contact listed on each LOI submission, CMS said in its Next Generation ACO LOI and application FAQs.

In 2016, there are currently 21 ACOs participating in the Next Generation ACO Model, an initiative for ACOs that are experienced in coordinating care for populations of patients. The Next Generation ACO model allows these provider groups to assume higher levels of financial risk and reward than are available under the current Pioneer and Shared Savings Program (MSSP) models. The goal of the Next Generation ACO model is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries.

2015 metrics from the Healthcare Intelligence Network (HIN) found that one-fifth of healthcare organizations expect to participate in CMS’ new ‘Next Generation’ ACO Model in the future.

View an infographic on the Next Generation ACO model.

An April 5th webinar hosted by the Healthcare Intelligence Network will provide a value-based, risk contract roadmap to determine organizational readiness for participation in the Next Generation ACO Model in particular and in risk-based contracts in general. Click here for more details.

Infographic: From Volume to Value: Designing a Patient-Centered Health System

March 9th, 2016 by Melanie Matthews

Healthcare payment and delivery models have come a long way, according to a new infographic by Astellas Pharma US, Inc.

But are they truly patient-centered? The infographic lays out a timeline of the move toward a value-based system and the key to making the system truly patient-centered.

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.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Infographic: A Journey Through Post-Acute Care

March 7th, 2016 by Melanie Matthews

With steeper penalties from the Centers for Medicare and Medicaid Services for hospital readmissions, healthcare organizations are not only looking at internal factors that impact readmissions, but are also partnering with post-acute care providers to shore up issues across the post-acute continuum that could lead to a readmission.

A new infographic by ECG Management Consultants looks at the expected path through the continuum for a high-risk, congestive heart failure patient and how this patient might be better supported in a high-functioning post-acute care model.

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.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Infographic: TRICARE’s Potential for Value-based Insurance Design

March 4th, 2016 by Melanie Matthews

With TRICARE costs on the rise and increased cost-sharing leading to reduced use of high-value clinical services, TRICARE would benefit from a value-based insurance design (VBID) approach, according to a new infographic by the University of Michigan V-BID Center.

The infographic looks at the impact of VBID and compares the current TRICARE plans to VBID plans.

Healthcare’s inevitable shift from volume to value-based reimbursement is reflected not only in Medicare’s alternative payment timeline but also in the waves of commercial payors now evaluating and rewarding providers on the basis of quality of care delivered rather than number of services provided. Adding to its roster of quality-centered payment models, CMS announced in 2015 plans to explore value-based reimbursement for Medicare Advantage and home health.

2015 Healthcare Benchmarks: Value-Based Reimbursement captures the healthcare industry’s reaction to payment formulas for value-added care, and how this shift away from fee-for-service is transforming care delivery and quality.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

11 Healthcare Data Analytics Trends to Know

March 3rd, 2016 by Patricia Donovan

Population health management is the driving force behind healthcare's data analytics explosion, according to new market metrics from the Healthcare Intelligence Network.

What’s driving healthcare’s data analytics delirium? Increasingly, it’s population health management.

A passion to enhance population health has motivated 25 percent of healthcare organizations to dive into data analytics, according to the latest Data Analytics and Integration metrics from the Healthcare Intelligence Network (HIN).

With reimbursement for services increasingly riding on readings from clinical outcomes, patient experience and cost of care, the desire to slice and dice patient and population data in order to provide value-based healthcare has never been stronger.

The healthcare publisher’s January 2016 survey identified a number of factors behind widespread analytics adoption. More than three-quarters of responding organizations—77 percent—already have delineated data analytics and integration strategies, the survey found.

Additionally, having applied the actionable information these programs yield to craft population-based interventions, 41 percent already report declines in total spend they attribute to data analytics. Hand in hand with these savings are appreciable spikes in quality ratings, report 58 percent of respondents.

Given their potential cost, risk and utilization patterns, it’s not surprising high-utilizers or hot-spotters—patients with frequent ER visits and hospital stays—are the key target of data analytics programs for 74 percent of responders.

But hot-spotters are by no means the only data analytics targets. A majority of adopters—60 percent—collect data on upwards of 75 percent of patient and member populations served.

“As the path to value-based purchasing becomes clearer, care management platforms without a vast warehouse of clinical, claims and cost data that they can draw upon in order to measure provider and organizational performance will flounder,” noted Melanie Matthews, HIN executive vice president and chief operating officer. “To survive in healthcare’s new ‘fee for quality’ world, organizations must be ready to back up their claims with hard data.”

Here are some other highlights from HIN’s inaugural Data Analytics and Integration survey conducted in January 2016:

  • Clinical and operational dashboards lead the list of data analytics tools for 62 percent of respondents.
  • Diabetes is the top clinical condition targeted by data analytics, say 58 percent of respondents;
  • „„The collection of healthcare data is the top challenge of analytics and integration efforts for 28 percent of respondents;
  • „„Beyond population management, predictive analytics and cost savings are key goals of data analytics efforts for 15 percent of respondents; and
  • Almost two-thirds of respondents experienced a drop in ER utilization that they attribute to data analytics.

Download a complimentary executive summary of HIN’s 2016 Healthcare Data Analytics and Integration trends to learn why data analytics is the framework for population health management.

Infographic: 5 Tips for Effective Patient Engagement

March 2nd, 2016 by Melanie Matthews

Patient engagement programs can elevate patient satisfaction, care plan adherence and overall quality metrics, important factors in an increasingly value-based healthcare system.

A new infographic by Emmi provides five tips you need to know for effective patient engagement.

Transformational patient-centered models emerging post-ACA are designed to succeed with a core of engaged, activated patients, yet enlistment of individuals in chronic care management, telehealth and other health enhancement interventions continues to challenge the healthcare industry.

2015 Healthcare Benchmarks: Patient Engagement documents strategies, program components, successes and challenges of engaging patients and health plan members in self-care from 133 organizations responding to the 2015 Patient Engagement survey by the Healthcare Intelligence Network.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.