Archive for June, 2016

Infographic: The Improving State of the Patient Experience

June 29th, 2016 by Melanie Matthews

Redefining the patient experience is a number one priority for healthcare organizations. Modern technology goes a long way toward improving patient interactions, according to a new infographic by CDW Healthcare.

The infographic highlights some of today’s patient experience improvements.

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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Guest Post: 6 Ways Predictive Analytics Will Move Healthcare Forward in 2016

June 28th, 2016 by Anand Shroff, co-founder and chief technology and product officer, Health Fidelity

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Identifying at-risk patient populations is one way to use predictive analytics to generate rapid returns.

In non-healthcare sectors like retail and manufacturing, ‘predictive analytics’ was arguably the top buzz phrase of 2015. Respected industry analyst Gartner even included predictive analytics in its ‘Top 10 Strategic Technology Trends’ roundup. Predictive analytics have become increasingly important in the healthcare industry, too, as the volume of electronic data grows.

But healthcare organizations have grappled with how to access, analyze and apply their data. Many lack the advanced automated capabilities needed to extract meaning from complex, unstructured data sets from multiple sources. However, it’s crucial to find a way, since the stakes are incredibly high: A McKinsey & Company study estimated that the industry could extract $300 billion in value annually from big data and drive overall healthcare expenditures down by 8 percent.

The key to extracting maximum value from healthcare data sets is to use predictive analytics and cloud-based technologies. By analyzing current and historical data and using the findings to predict future events and trends, healthcare enterprises such as accountable care organizations (ACOs) and others can address the cost-quality equation that is so essential to successful operations in an outcomes-based environment.

The pay-for-performance ecosystem ACOs and other healthcare organizations operate in today demands new strategies to handle bundled payments and population health management challenges, and predictive analytics are tailor-made to produce the insights they need. Using predictive analytics to assess current data sheds new light on the following key metrics:

  • The relationships between cost, quality and patient outcomes;
  • Clinical best practices that drive optimal patient outcomes; and
  • Individual and population-level health risks.
  • By submitting current metrics to predictive analytics, healthcare organizations will gain incredibly valuable insights into how various factors intersect to affect outcomes and which issues they need to address first to drive improvements and value. As they respond to changes in payment models in 2016 and beyond, healthcare organizations will also use predictive analytics to refine their strategies by:

    • Gaining insights into risk factors and how to optimize risk management;
    • Identifying the practices, performers and results that affect organizational performance; and
    • Assessing the impact of ACO reimbursement and bundled payment strategies.
    • Taken together, these are the six ways predictive analytics will move healthcare forward in 2016. By leveraging the power of predictive analytics, healthcare organizations will be able to clearly identify the factors that drive clinical quality and operational expenses. And by applying this information, they can predict and manage clinical and financial performance with greater accuracy. Moreover, they’ll have the opportunity to drive continuous improvement in practices and processes, which will minimize costs while maximizing care quality going forward.

      Healthcare organizations that want to put predictive analytics to work for their operations should consider a two-part strategy that focuses on simple, high-value initiatives first. They’ll need to create an infrastructure that allows them to secure quick wins and then address more complex projects—for example, focusing on revenue improvement by using predictive analytics to proactively manage risk can pay tangible, substantial dividends in the short term.

      Identifying at-risk patient populations in terms of the 30-day readmission window is another way to use predictive analytics to generate rapid returns. Once healthcare organizations have the right processes and practices in place, they can branch out into more complex initiatives like analyzing value-based payment models such as the ACO, episode-based care and patient-centered medical homes. The ability to use discrete and unstructured clinical, financial and operational data to improve performance is the key to success.

      Organizations that embrace predictive analytics in 2016 and beyond will have a key competitive advantage: They will have finally unlocked the value of their data. Predictive analytics have transformed many business sectors in 2015, and 2016 is shaping up to be the breakthrough year for predictive analytics in healthcare, driving better value and outcomes. That’s good news for healthcare organizations and patients alike.

      Anand Shroff

      Anand Shroff, co-founder and chief technology and product officer of Health Fidelity.


      About the Author: Anand Shroff is a co-founder and chief technology and product officer of Health Fidelity. He is responsible for the company’s product strategy and execution and marketing initiatives. He has championed the cause of enterprise performance improvement by promoting electronic capture, exchange and analysis of healthcare data. Prior to founding Health Fidelity, Anand was vice president of EHR and HIE products at Optum. Anand has an MBA from the Haas School of Business at the University of California, Berkeley and an MS in Computer Science from the University of California, Santa Barbara. Anand has an undergraduate degree in Computer Engineering from the University of Mumbai. Connect with Anand on LinkedIn and on Twitter.

      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.

HINfographic: Digital Health Connects Complex Comorbid to Care Management

June 27th, 2016 by Melanie Matthews

In evaluating candidates to engage in digital health, those with chronic comorbidities are prime targets, say 58 percent of respondents to the 2016 Digital Health Survey by the Healthcare Intelligence Network. Diabetes tops the list of chronic conditions ripe for connected health interventions, report 58 percent.

A new infographic by HIN examines which populations are targeted by digital health initiatives, the percent of healthcare organizations that have adopted digital health and how digital health programs are staffed.

2016 Healthcare Benchmarks: Digital Health2016 Healthcare Benchmarks: Digital Health assembles hundreds of metrics on digital health strategies from hospitals, health insurers, physician practices and other responding organizations, charting the growth of digital health and its expanding role in population health management.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network. Click here for more information.

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Infographic: Waking up with Healthcare’s Internet of Things in 2040

June 24th, 2016 by Melanie Matthews

By the year 2040, anything and everything that can be tagged with a wireless identifier will probably have one (or more). Tiny, wireless electronic devices that are attached to an object to connect it to the Internet of Things. Wireless identifier may be too restricting of a name…by that time, these devices could do a lot more than just identify an object, they could relay data on size, shape and location or receive instructions on what to do next. These devices might be powered by light, motion, radio waves, biopower or some other means. Bigger devices control the smaller ones, and they all talk together, according to a new infographic by FutureforAll.

The infographic examines what the Internet of Things for healthcare applications might be like in the year 2040.

Relieving the Costs and Consequences of Chronic Pain: A Best Practice Multimodal Approach The financial, physical and emotional toll of pain on the United States is excruciating, but Relieving the Costs and Consequences of Chronic Pain: A Best Practice Multimodal Approach offers an antidote for the 25 percent of Americans suffering daily from chronic or persistent pain and the healthcare organizations that treat them. Featuring contributions from two of pain management’s foremost experts, this special report offers multi-faceted strategies in pain assessment and management to improve quality of life for the chronic pain patient, reducing healthcare utilization in the process.

In this 35-page report, Marilee I. Donovan, Ph.D., R.N., regional pain management coordinator, Kaiser Permanente Northwest, and Cheryl Pacella, D.N.P., R.N., performance improvement advisor at MassPro, describe patient-centric pain management tactics that engage the patient as an active partner and employ creative and alternative therapies and interventions.

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Infographic: Hospitals and Value-Based Care

June 22nd, 2016 by Melanie Matthews

While healthcare organizations broadly support the goals of value-based reimbursement, there are mixed results in achieving those goals, according to a new survey by HealthCatalyst. Many hospitals have embraced value-based initiatives such as accountable care organizations and bundled payments that reward higher quality care while penalizing low quality but few of those surveyed are faring well against Medicare’s goal of tying half its $597 billion in annual payments to value-based care.

A new infographic by HealthCatalyst examines the likelihood of healthcare organizations meeting CMS’ value-based reimbursement goal, the percent of healthcare organizations that are currently engaged in risk-based contracts and the importance of analytics in value-based success.

The New Physician Quality Reporting: Positioning Your Practice for MACRA's Merit-Based Incentive Payment System,A new CMS proposed rule would combine several of its existing physician value-based reimbursement programs, including the meaningful use EHR Incentive Program, the Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier (VBM). This proposal is part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which replaced the Sustainable Growth Rate (SGR) formula for physician reimbursement. Under this current proposal, physicians will be reimbursed by Medicare under either the Merit-based Incentive Payment System (MIPS) or Alternative Payment Models (APMs) starting in January 2017. As this reimbursement shift by CMS moves forward, physician practices are re-examining how they report on physician quality. Most practices will opt for the MIPS program based on their current risk-contracting strategies.

During The New Physician Quality Reporting: Positioning Your Practice for MACRA’s Merit-Based Incentive Payment System, a 45-minute webinar on July 14th, Eric Levin, director of strategic services, McKesson, will provide a brief MACRA overview and outline where practices need to focus for the remainder of 2016 to avoid reimbursement penalties in 2017 based on the proposed rule.

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Infographic: Painkillers and Heroin in the United States

June 20th, 2016 by Melanie Matthews

The abuse of, and addiction to, opioids is a serious problem in the United States that affects the social, health, and economic welfare of the society. It is estimated that opiate abuse/addiction costs Americans approximately $484 billion annually. It is also responsible for 50 percent of serious crimes in the United States, according to a new infographic by the University of New England.

The infographic explores the opiate abuse problem, who is most at-risk of becoming addicted and the role of social workers in treating opiate addiction.

Relieving the Costs and Consequences of Chronic Pain: A Best Practice Multimodal Approach The financial, physical and emotional toll of pain on the United States is excruciating, but Relieving the Costs and Consequences of Chronic Pain: A Best Practice Multimodal Approach offers an antidote for the 25 percent of Americans suffering daily from chronic or persistent pain and the healthcare organizations that treat them. Featuring contributions from two of pain management’s foremost experts, this special report offers multi-faceted strategies in pain assessment and management to improve quality of life for the chronic pain patient, reducing healthcare utilization in the process.

In this 35-page report, Marilee I. Donovan, Ph.D., R.N., regional pain management coordinator, Kaiser Permanente Northwest, and Cheryl Pacella, D.N.P., R.N., performance improvement advisor at MassPro, describe patient-centric pain management tactics that engage the patient as an active partner and employ creative and alternative therapies and interventions.

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CMS to Physicians: 3 Things You Really Need to Know About MACRA

June 20th, 2016 by Patricia Donovan

It is expected that most physician practices will opt for the Merit-based Incentive Payment System (MIPS) under new MACRA-mandated reimbursement strategies.

It is expected that most physician practices will opt for the Merit-based Incentive Payment System (MIPS) under new MACRA-mandated reimbursement strategies.

While digesting the implications of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) can be an understandable distraction for physicians, the goal of the MACRA program is to return the focus to patient care, not spend time learning a new program, emphasized CMS Acting Administrator Andy Slavitt to members of the American Medical Association during the AMA’s annual meeting in Chicago last week.

Early in Slavitt’s comments, available in their entirety in a June 2016 post in the CMS blog, he posed the following two questions to physicians: What do you really need to know about the MACRA program? And what new sets of requirements are there to participate?

At the outset of his explanation, Slavitt emphasized Medicare will still pay for services as it always has, but every physician and other participating clinicians will have the opportunity to be paid more for better care and for making investments that support patients—like having a staff member follow up with patients at home.

As the AMA, AAFP and other physician support organizations have done, CMS will provide comprehensive MACRA documentation, Slavitt assured the association. “We will, of course, provide information in as much or as little detail as is helpful. For those who like to read computer manuals end-to-end, there is of course the 900-page proposed rule complete with every detail about how the regulation and the law is proposed to work. But, for most people, who do not need to see every scenario and how each element of the formula works, there are webinars, in-person meetings, fact sheets, and web portals that will bring all the information to suit various needs.”

Slavitt then outlined three immediate features of the program designed as improvements over Medicare’s existing payment system:

  • First, MACRA sunsets three disjointed programs. If you participate in the Physician Quality Reporting System, the Value Modifier, and the Meaningful Use program, your life just got simpler, as they are replaced with a single, aligned Quality Payment Program, which will reduce reporting requirements, eliminate duplication, and reduce the number of measures. For those who participate in MACRA Alternative Payment Models, those requirements are reduced further or eliminated.
  • Second, it also reduces the combined possible downward adjustment of 9 percent that is occurring today from the three programs to a maximum of 4 percent in the first year of the Quality Payment Program. The program is designed to build up over the course of several years, with more modest financial impacts in the first year when the vast majority of physicians are expected to be in the MIPS part of the program.
  • Third, while the Merit-Based Incentive portion of the law is designed to be budget neutral in general, there are new opportunities for additional bonuses. In MIPS, in addition to the 4 percent positive payment adjustment, there is the potential for much higher payments through $500 million in funding over six years. Physicians earn a 5 percent lump sum bonus for participating in an Advanced Alternative Payment Model.

Under the current proposed timing, the first physician reporting isn’t due until early 2018 for the first performance period in 2017, Slavitt said. Off-the-shelf tools like Certified EHRs and clinical data registries can provide complete capabilities, but other options exist as well, including most types of reporting that a physician is doing today.

If CMS can get data automatically or through another source, it will do so, he stated, before moving on to MACRA implementation and priorities.

Editor’s Note: To briefly outline MACRA and advise on physician practice focus for the remainder of 2016 to avoid reimbursement penalties in 2017 based on the MACRA proposed rule, the Healthcare Intelligence Network will hold a 45-minute webinar on July 14, 2016: The New Physician Quality Reporting: Positioning Your Practice for MACRA’s Merit-Based Incentive Payment System.

Infographic: The Impact of mHealth on the Future of Healthcare

June 17th, 2016 by Melanie Matthews

Mobile health applications, internet of things (IOT), wearables, kiosks, are part of an ever growing mobile ecosystem that aims to improve population health and clinical outcomes and reduce healthcare costs. With over 165,000 mHealth applications available on mobile devices, patients are taking their health into their hands, according to a new infographic by Vigyanix.

The infographic explores how these emerging mobile health trends are shaping the present and the future of healthcare.

2016 Healthcare Benchmarks: Digital HealthPerson-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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Infographic: Population Health and Children’s Hospitals

June 15th, 2016 by Melanie Matthews

More than two-thirds of children’s hospitals consider population health a top priority, according to a new survey by the Children’s Hospital Association (CHA).

A new infographic by CHA examines the defined populations for which hospitals have aligned payment models for population health management, funding sources for population health programs, the percent of organizations with risk-based contracts and the need for reliable data for population health management.

2016 Healthcare Benchmarks: Population Health ManagementPopulation health management remains a top-ranked healthcare development opportunity, according to 2016 industry trends data from The Healthcare Intelligence Network, with many organizations deriving clinical and financial gains from population health’s data-driven, risk-stratified care management approach.

2016 Healthcare Benchmarks: Population Health Management drills down on the latest population health management (PHM) trends, including the prevalence of PHM initiatives, program components, targeted conditions, PHM care team members, challenges and ROI.

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Infographic: The Forced March to Value-Based Healthcare

June 13th, 2016 by Melanie Matthews

The Centers for Medicare and Medicaid Services (CMS) is accelerating the transition to value-based care by engaging physicians and providers with a battery of new value-based programs and quality incentives. With commercial insurers following CMS’s lead, the government is setting a rapid pace of change.

A new infographic by Oliver Wyman provides a history of CMS’s value-based initiatives, pilots, and targets.

11 Profitable Value-Based Reimbursement Models: Lessons from Early AdoptersCMS’s ambitious agenda for moving Medicare into alternative payment models is driving the U.S. healthcare system toward greater value-based purchasing at a furious rate. Private payors also have pledged to continue to shift payments away from fee for service and into alternative payment models such as accountable care organizations (ACOs). Fortunately, many healthcare organizations are already exploring value-based payments—often a single innovation at a time—testing models that reward providers for meeting Triple Aim goals of improving patient experience and population health while reducing healthcare’s per capita cost.

11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters encapsulates nearly a dozen such approaches, from Bon Secours’ building of a business case for its multidisciplinary care team to the John C. Lincoln ACO’s deep dive into data analytics to identify and manage the care of high-risk, high-cost ‘VIP’ patients to ‘beat the benchmark’ to WellPoint’s engagement of specialists in care coordination.

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