Archive for June, 2016

Infographic: Connected Technology Improves Medication Adherence

June 10th, 2016 by Melanie Matthews

The use of a connected medication dispensing technology can greatly benefit patients with chronic conditions, helping them better comply with long-term therapy, according to a new study from Philips. Over the span of one year, user data from more than 1,300 patients in the Netherlands was analyzed, showing 96 percent of patients using Philips Medido, a connected medication dispensing solution, were adherent to their medication schedule.

A new infographic by Philips looks at the impact of medication non-adherence, demographic data of the study’s patients and the impact on medication adherence and cost savings from the intervention.

What’s the cost of medication non-adherence? As high as $290 billion annually, according to one frequently cited estimate. An equally bitter pill to swallow is the dismal C+ grade in medication adherence earned in 2013 by Americans with chronic medical conditions, according to the first National Report Card on Adherence from the National Community Pharmacists Association (NCPA).

Fortunately, the healthcare industry is striving to improve performance in this area. 42 Metrics for Improving Medication Adherence: Interventions, Impacts and Technologies provides convincing evidence of the impact of nine key interventions on medication non-adherence—from the presence of pharmacists in patient-centered medical homes to medication reconciliation conducted during home visits.

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Infographic: Provider Risk Readiness

June 8th, 2016 by Melanie Matthews

The Medicare Access and CHIP Reauthorization Act (MACRA) dramatically changes Medicare physician reimbursement.

A new infographic by AMGA examines the MACRA timetable, groups affected, tools that physician groups will need for effective implementation and the biggest impediment to physician groups taking on downside risk.

With the nation’s leading accountable care organizations already testing the waters with CMS’ newest value-based reimbursement opportunity, the Next Generation Accountable Care Organization Model, healthcare organizations are evaluating how this new opportunity aligns with their value-based contracting strategy.

During Next Generation ACO: An Organizational Readiness Assessment, a 60-minute webinar on April 5, 2016, now available for replay, Healthcare Strategy Group’s Travis Ansel, senior manager of strategic services, and Walter Hankwitz, senior accountable care advisor, 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.

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Infographic: Big Data Tools Fight Medicare Fraud & Abuse

June 6th, 2016 by Melanie Matthews

Over the past five years, the Centers for Medicare & Medicaid Services has successfully implemented a Fraud Prevention System using “big data” and predictive analytics approaches to fight fraud, waste and abuse in the Medicare fee-for-service program.

Taking “big data” mainstream has given the CMS the ability to better connect with public and private predictive analytics experts and data scientists, as well as collaborate more closely with law enforcement.

A new infographic by CMS looks at how many claims have been analyzed, the return on investment of the program and the national savings growth.

2016 Healthcare Benchmarks: Data Analytics and IntegrationThe 2016 Healthcare Benchmarks: Data Analytics and Integration assembles hundreds of metrics on data analytics and integration from hospitals, health plans, physician practices and other responding organizations, charting the impact of data analytics on population health management, health outcomes, utilization and cost.

2016 Healthcare Benchmarks: Data Analytics and Integration examines the goals, data types, collection processes, program elements, challenges and successes shared by healthcare organizations responding to the January 2016 Data Analytics survey by the Healthcare Intelligence Network. Click here for more information.

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Infographic: 18 Million Non-Urgent ED Visits

June 3rd, 2016 by Melanie Matthews

Many states are moving toward co-payments for Medicaid patients who visit emergency departments for reasons classified as “non-urgent,” according to a new infographic by Policy Prescriptions.

The infographic examines key characteristics of these non-urgent ED visits.

Industry reforms, expanded coverage under insurance exchanges, Medicaid expansion, and shifting healthcare delivery models continue to influence emergency room utilization. In response, healthcare organizations employ a variety of strategies to reduce avoidable ER use.

2014 Healthcare Benchmarks: Reducing Avoidable ER Visits delivers actionable metrics from 125 healthcare organizations on their efforts to foster appropriate use of hospital emergency departments.

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ACOs: MSSP Commitment Hinges on MACRA Advanced APM Bonus Eligibility

June 2nd, 2016 by Patricia Donovan

ACO

A new NAACOS report polls ACOs on operating costs, MACRA and risk readiness.

More than half—56 percent—of accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) indicated they would leave the MSSP program if their ACOs were not eligible for the 5 percent Advanced Alternative Payment Model (APM) bonus under MACRA, according to a May 2016 survey by the National Association of ACOs (NAACOS).

A third of ACOs said they would stay in the MSSP program even if deemed ineligible for the bonus, the NAACOS survey found.

The Alternative Payment Model is one of two paths for participation in the quality improvement programs included in the MACRA legislation for eligible professionals; the other is the Merit-Based Incentive Payment System (MIPS).

Currently, MSSP Track 1, a one-sided payment model, is not among the models that would qualify for the APM track—which CMS calls “Advanced APMs”—under the proposed MACRA rule; however, the MSSP Tracks 2 and 3, Next Generation, and Pioneer ACO programs, which all require downside risk, would qualify as APMs.

Approximately 411 MSSP ACOs, or 95 percent, participate in Track 1 of the program, according to April 2016 data from CMS.

All APM qualifying participants will receive a 5 percent lump sum bonus on their Medicare payments for 2019 through 2024. This bonus will be in addition to the incentive paid through existing contracts with the qualified APM (e.g., MSSP) demonstration program, etc.

Beginning in 2026, these ACOs will qualify for a 0.75 percent increase in their payments each year.

In other findings, the NAACOS survey also determined the following:

  • More than half of respondents (51 percent) describe their ongoing ACO operational costs as very significant;
  • The average total ACO operating costs for all respondents is $1.6 million per year, but the cost difference is significant between single or multi-ACOs, with single ACOs averaging just under $2 million and multi-ACOs averaging almost $1 million per year.
  • If required by CMS to take on downside risk, 43 percent said they would leave the MSSP program and about a third would stay (33 percent).
  • Over three quarters of the ACO respondents (84 percent) said they would be ready for downside risk within the next six years, with 44 percent of those even ready as soon as one to three years.

Infographic: The Power of the First Call in the Patient Experience

June 1st, 2016 by Melanie Matthews

There are several distinct elements of a phone call that will determine a patient’s experience, according to the Baird Group, which conducts mystery-shopping assessments via the phone. The Baird Group has collected data from thousands of mystery shopping phone calls to healthcare organizations throughout the country, and found the good, the bad and the downright ugly.

The Baird Group created an infographic that gives a visual summary of the findings—one of the most startling findings is that 35 percent of first time callers are not likely to return.

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.

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