Archive for December, 2016

Use Annual Wellness Visit to Screen for Social Determinants of Health in High-Risk Medicare Population

December 13th, 2016 by Patricia Donovan

The social determinant of social isolation carries the same health risk as smoking, and double that of obesity.

With about a third of health outcomes determined by human behavior choices, according to a Robert Wood Johnson Foundation study, improving population health should be as straightforward as fostering healthy behaviors in patients and health plan members.

But what’s unstated in that data point is that the remaining 70 percent of health outcomes are determined by social determinants of health—areas that involve an individual’s social and environmental condition as well as experiences that directly impact health and health status.

By addressing social determinants, healthcare organizations can dramatically impact patient outcomes as well as their own financial success under value-based care, advised Dr. Randall Williams, chief executive officer, Pharos Innovations, during Social Determinants and Population Health: Moving Beyond Clinical Data in a Value-Based Healthcare System, a December 2016 webinar now available for replay.

“The challenge is that few healthcare systems are currently equipped to identify individuals within their populations who have social determinant challenges,” said Dr. Williams, “And few are still are structured to coordinate both medical and nonmedical support needs.”

The Medicare annual wellness visit is an ideal opportunity to screen beneficiaries for social determinants—particularly rising and high-risk patients, who frequently face a higher percentage of social determinant challenges.

Primary social determinants include the individual’s access to healthcare, their socio- and economic conditions, and factors related to their living environment such as air or water quality, availability of food, and transportation.

Dr. Williams presented several patient scenarios illustrating key social determinants, including social isolation, in which individuals, particularly the elderly, are lonely, lack companionship and frequently suffer from depression. “Social isolation carries the same health risk as smoking and double that of obesity,” he said.

While technology is useful in reducing social isolation, studies by the Pew Research Center determined that segments of the population with the highest percentage of chronic illness tend to be least connected to the Internet or even to mobile technologies.

“Accountable care organizations (ACOs) and other organizations managing populations must continue to push technology-enhanced care models,” said Dr. Williams, “But they also have to understand and assess technology barriers and inequalities in their populations, especially among those with chronic conditions.”

In another patient scenario, loss of transportation severely hampered an eighty-year-old woman’s ability to complete physical rehabilitation following a knee replacement.

Dr. Williams then described multiple approaches for healthcare organizations to begin to address social determinants in population health, including patients’ cultural biases, which may make them more or less open to specific care options. This fundamental care redesign should include an environmental assessment to catalog available social and community resources, he said, providing several examples.

“This is not the kind of information you’re going to find in a traditional electronic health record or even care management platforms,” he concluded.

Infographic: Is Your Healthcare Data Safe?

December 12th, 2016 by Melanie Matthews

Data loss from U.S. hospitals, urgent care centers, dental practices and clinics is reaching epidemic proportions, according to a new infographic from safetica. Last year the confidential records of one-in-three healthcare patients in the United States were compromised. But what are the costs and causes of data breaches—and how can they be prevented?

The infographic examines the impact of data breaches, the cost of a data breach and a checklist to compare your organization’s data security practices against recent HIPAA case law.

Is Your Patient Data Protected?

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: How Will “Trumpcare” Impact Employers’ Health Benefits?

December 9th, 2016 by Melanie Matthews

More than 800 HR professionals were recently surveyed by Mercer, an Oliver Wyman sister company, on what the Trump administration should prioritize when it comes to health and benefits policy. Respondents also shared their views on what they would like to see replace the ACA.

A new infographic highlights the survey results on these healthcare priorities and an ACA strategy.

How Will

Not in recent history has the outcome of a U.S. presidential election portended so much for the healthcare industry. Will the Trump administration repeal or replace the Affordable Care Act (ACA)? What will be the fate of MACRA? Will Medicare and Medicaid survive?
These and other uncertainties compound an already daunting landscape that is steering healthcare organizations toward value-based care and alternative payment models and challenging them to up their quality game.

Healthcare Trends & Forecasts in 2017: Performance Expectations for the Healthcare Industry, HIN’s 13th annual business forecast, is designed to support healthcare C-suite planning during this historic transition as leaders prepare for both a new year and new presidential leadership.

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Infographic: Using Healthcare Staffing Evidence To Improve Patient Outcomes

December 7th, 2016 by Melanie Matthews

While the healthcare industry’s goal to improve patient outcomes while simultaneously driving down costs, the impact of each health system’s workforce management strategy will be magnified, according to new infographic by API Healthcare.

The infographic details the increasing availability of reliable workforce analytics to empower healthcare organizations to achieve workforce optimization, propelling them to a successful synergy between patient outcomes and cost containment.

Using Healthcare Staffing Evidence To Improve Patient Outcomes

Since the January 2015 rollout by CMS of new chronic care management (CCM) codes, many physician practices have been slow to engage in CCM. Arcturus Healthcare, however, rapidly grasped the potential of CCM to improve patient outcomes while generating care coordination revenue, estimating it could earn up to $100,000 monthly for qualified patients treated in its four physician practices—or $1 million a year.

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 bonus that resulted from CCM code adoption: increased engagement and improved relationships with CCM patients.

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Infographic: Is Your Health System Ready for Virtual Healthcare?

December 5th, 2016 by Melanie Matthews

Consumer preference, increased health system adoption, and health benefit coverage are driving growth in virtual care in the healthcare industry, according to a new infographic by Zipnosis. Health systems need virtual care to compete—both now and in the future.

The infographic examines the drivers of this shift to virtual care and what the future holds.

Is Your Health System Ready for Virtual Healthcare?

Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System 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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Trump Taps Orthopedic Surgeon, Medicaid Architect to Helm U.S. Healthcare Posts; Industry Reacts

December 5th, 2016 by Patricia Donovan

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Healthcare industry reaction to President-elect Donald J. Trump’s choices to head the HHS and CMS was largely positive.

Calling his nominees “the dream team that will transform our healthcare system for the benefit of all Americans,” President-elect Donald J. Trump last week announced his plan to nominate Chairman of the House Budget Committee Congressman Tom Price, M.D. (GA-06) as secretary of the U.S. Department of Health and Human Services (HHS) and Seema Verma as administrator of the Centers for Medicare and Medicaid Services (CMS).

“Chairman Price, a renowned physician, has earned a reputation for being a tireless problem solver and the go-to expert on healthcare policy,” said President-elect Trump in a news release. “He is exceptionally qualified to shepherd our commitment to repeal and replace Obamacare and bring affordable and accessible healthcare to every American.”

Prior to serving in Washington, Rep. Price worked in private practice as an orthopedic surgeon for nearly 20 years.

In the same announcement, the President-elect called Seema Verma, his nominee for CMS administrator, one of the leading experts in the country on Medicare and Medicaid. “She has decades of experience advising on Medicare and Medicaid policy and helping states navigate our complicated systems,” he said.

Seema Verma is the president, CEO and founder of SVC, Inc., a national health policy consulting company. For more than 20 years, Ms. Verma has worked extensively on a variety of policy and strategic projects involving Medicaid, insurance, and public health, working with governors’ offices, state Medicaid agencies, state health departments, state insurance departments, as well as the federal government, private companies and foundations.

Ms. Verma has extensive experience redesigning Medicaid programs in several states. Ms. Verma is the architect of the Healthy Indiana Plan (HIP), the nation’s first consumer-directed Medicaid program, and served as the State of Indiana’s health reform lead following the ACA’s passage in 2010.

Responding to the announcement, the American Medical Association (AMA) said it supports the nomination of Dr. Tom Price, who would be the first physician to serve as HHS secretary since President George H.W. Bush appointed Louis W. Sullivan, MD, in 1989, and only the third doctor in the HHS’s 63-year history.

In a statement, Patrice A. Harris, MD, MA, AMA Board Chair, cited decades of interactions with Dr. Price as a member of the AMA House of Delegates, Georgia state senator and House of Representatives. “Over these years, there have been important policy issues on which we agreed (medical liability reform) and others on which we disagreed (passage of the Affordable Care Act). Two things that have been consistent are [Dr. Price’s] understanding of the many challenges facing patients and physicians today, and his willingness to listen directly to concerns expressed by the AMA and other physician organizations.”

On the payor side, America’s Health Insurance Plans (AHIP), the national trade association representing the health insurance community, said in a statement that it anticipates cooperative, collaborative relationships with the new leaders of HHS and CMS.

“For many years, Dr. Price has been committed to ensuring that patients and consumers are well-served,” said Marilyn Tavenner, AHIP president and CEO. “He will bring a balanced and thoughtful perspective to his role as Secretary of HHS. We look forward to working with him to promote competition, increase choice, and lower costs for every consumer.

“Likewise, we look forward to working with Seema Verma to strengthen our nation’s healthcare system and empower Americans to improve their health and financial well-being, particularly those who depend on the valuable support and services provided through Medicare and Medicaid.”

Related Resource: MACRA Physician Quality Reporting: Positioning Your Practice for the MIPS Merit-Based Incentive Payment System

MACRA MIPS

MACRA Physician Quality Reporting: Positioning Your Practice for the MIPS Merit-Based Incentive Payment System delivers a veritable MACRA toolkit for physician practices, with dozens of tips and strategies that lay the groundwork for reimbursement under Medicare’s Merit-based Incentive Payment System (MIPS), one of two payment paths Medicare will offer to practices beginning January 1, 2017.

Infographic: Health Outcomes Analytics: Opportunities and Gaps

December 2nd, 2016 by Melanie Matthews

Analyzing patients’ health outcomes is a major step on the way to improving them. A variety of equally reputable sources provides different views, angles and approaches to both measurement and analysis, according to a new infographic by ScienceSoft.

The infographic examines the opportunities and gaps in healthcare data analytics on patients’ outcomes.

Health Outcomes Analytics: Opportunities and Gaps

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results Between Medicare’s aggressive migration to value-based payment models and MACRA’s 2017 Quality Payment Program rollout, healthcare providers must accept the inevitability of participation in fee-for-quality reimbursement design—as well as cultivating a grounding in health data analytics to enhance success.

As an early adopter of the Medicare Shared Savings Program (MSSP) and the largest sponsor of MSSP accountable care organizations (ACOs), Collaborative Health Systems (CHS) is uniquely positioned to advise providers on the benefits of data analytics and technology, which CHS views as a major driver in its achievements in the MSSP arena. In performance year 2014, nine of CHS’s 24 MSSP ACOs generated savings and received payments of almost $27 million.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results documents the accomplishments of CHS’s 24 ACOs under the MSSP program, the crucial role of data analytics in CHS operations, and the many lessons learned as an early trailblazer in value-based care delivery.

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.