Archive for May, 2017

Infographic: Anatomy of the ACO Market

May 31st, 2017 by Melanie Matthews

Since the first accountable care organization (ACO) came to market in 2010, the size and shape of the market has changed drastically, according to a new infographic by Oliver Wyman.

There are now 630+ ACOs in the market, plus hundreds of additional pilots being tested. The infographic presents a comprehensive analysis of the ACO market. From overall size of the market to regional differences, “winners” by type, and trends in risk-based models.

The accountable care organization, or ACO, has become a cornerstone of healthcare delivery system and payment reform by raising the bar on healthcare quality and reducing unnecessary costs. There are now more than 700 ACOs in existence today, by a 2017 SK&A estimate.

2017 Healthcare Benchmarks: Accountable Care Organizations, HIN’s fifth compendium of metrics on ACOs, captures ACO operation in today’s value- and quality-focused healthcare environment.

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Infographic: Mobile Communication Leads to Better Outcomes

May 29th, 2017 by Melanie Matthews

Mobile communication is leading to better healthcare outcomes, according to a new infographic by Voalte.

The infographic examines how leading hospitals are using their communication platforms to save time, streamline workflow and improve patient outcomes.

Real-time remote management of high-risk populations curbed hospitalizations, hospital readmissions and ER visits for more than 80 percent of respondents and boosted self-management levels for nearly all remotely monitored patients, according to 2014 market data from the Healthcare Intelligence Network (HIN).

Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management profiles a successful eight-year initiative by New York City Health and Hospitals Corporation’s (NYCHHC) House Calls Telehealth Program that significantly lowered patients’ A1C blood glucose levels.

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Infographic: Futuristic Hospitals

May 26th, 2017 by Melanie Matthews

Hospitals across the globe are bringing together science and technology to improve patient care, according to a new infographic by Gap Medics.

The infographic explores some of the most futuristic hospitals in the world, where state of the art equipment and high tech medical care is advancing 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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Guest Post: 5 Legal Considerations for Maximizing Telehealth Security

May 25th, 2017 by Ammon Fillmore and Mark Swearingen
Patient privacy and data security are key telehealth concerns providers must address.

Patient information privacy and security are key telehealth concerns for healthcare providers.

Telehealth is one of the fastest growing and developing areas of healthcare today. With this rapid growth come many questions and concerns that arise when legal and regulatory schemes are not able to keep up with the pace of development. One such concern is the legal and regulatory issues relating to the privacy and security of telehealth services. Telehealth services can be provided securely, but specific attention must be paid to information and application security in order to protect patient privacy and comply with laws such as the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).

Healthcare provider executives who currently offer, or are considering offering, telehealth services to their patients should give attention and appropriate resources to the following areas in order to maximize the organization’s security posture and operational efficiencies.

Arrangement Structure

One of the primary decisions for a healthcare provider organization to make with any telehealth arrangement is whether the organization will provide the telehealth services itself or in collaboration with a third party. Many considerations will be part of this decision, but information privacy and security should be one of them. An organization should only consider providing telehealth services on its own if it can dedicate sufficient resources and personnel to establishing and maintaining the secure transmission and storage of patient information. Only an organization with a competent and established information technology staff should consider providing telehealth services in this manner.

If an organization chooses instead to collaborate with a third party to provide telehealth services, there are several third parties with whom the organization can collaborate to provide those services securely. Those third parties can provide anything from equipment only to a full range of services, including digital infrastructure and professional physician services. When a third party is involved, the organization must also consider how to structure the arrangement for purposes of HIPAA, including determining whether the third party will be a business associate of the organization or whether the organization and the third party will function as a single Organized Health Care Arrangement (“OHCA”) under HIPAA. These decisions will impact how information flows between the parties and who is responsible for securing that information.

Contractual Protections

Responsibility for securing information where the provider organization collaborates with a third party will be governed by the operative agreements between the parties, including the Business Associate Agreement, where applicable. Provider organizations should be sure that the agreements detail the third party’s security-related obligations and establish the third party’s responsibility for failing to meet those obligations. The operative agreements also should contain sufficient representations and warranties of the third party’s security posture, including the technical specifications that the third party will implement in order to safeguard patient information. Equally important is making sure that the operative agreements include sufficient assurances that patient information will be accessible to the appropriate healthcare provider.

Technical Specifications

Telehealth arrangements will differ in the precise technical specifications that the parties implement to safeguard patient information. However, certain technical specifications are broadly applicable and can significantly reduce security risks. One example of such a specification is the use of encryption technology. Encrypting patient information, both while stored on computer systems and during transmission between systems, is an effective means of safeguarding the information from unauthorized third parties and preventing breaches from occurring. Another such specification is authentication of the participants in a telehealth encounter, the clinicians and patients themselves. It is important that technological measures are implemented to ensure the identity of both the clinicians and patients so that all parties can have confidence that the individuals involved in the encounter are actually who they appear to be. Provider organizations should strongly consider implementing such technologies in any telehealth services arrangement.

Security Awareness

Even the best technical safeguards can be compromised by human error, so it is imperative that effective security awareness training be provided both to workforce members as well as patients. Workforce members who participate in telehealth services arrangements must be made aware of their obligations to protect the privacy and security of patient information under their organization’s policies and procedures and be sanctioned when a violation occurs. Likewise, patients should be provided with information about the security risks present in telehealth arrangements and advised of the steps they can take to mitigate those risks.

Security Risk Analysis

Provider organizations are required under HIPAA to periodically perform an enterprise-wide security risk analysis and to take steps to remediate any risks that are identified. The failure to do so can result in substantial fines and penalties to a provider organization. An enterprise-wide risk analysis considers not only the electronic health record but also any system or equipment that contains electronic patient information, which would include equipment and systems utilized in providing telehealth services. Accordingly, provider organizations should be sure to include telehealth systems in their risk analysis, including those utilized by a third party service and to address any identified risks and vulnerabilities in a timely fashion.

This article is educational in nature and is not intended as legal advice. Always consult your legal counsel with specific legal matters. If you have any questions or would like additional information about this topic, please contact Ammon Fillmore at (317) 977-1492 or afillmore@hallrender.com or Mark Swearingen at (317) 977-1458 or mswearingen@hallrender.com.

About the Authors: Ammon Fillmore and Mark Swearingen are attorneys with Hall, Render, Killian, Heath & Lyman, P.C., the largest healthcare-focused law firm in the country. Please visit the Hall Render Blog for more information on topics related to healthcare law.

Mark Swearingen

Mark Swearingen

Ammon Fillmore

Ammon Fillmore















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.

Infographic: The Battle for Medication Adherence

May 24th, 2017 by Melanie Matthews

Patient adherence to a prescription regimen can reduce costs and improve the quality of life, according to a new infographic by Medical Marketing & Media.

However, healthcare providers and pharmaceutical companies struggle to find the best tools, words and technologies that will improve adherence rates among patients with chronic conditions.

The infographic examines the impact of non-adherence and how text messaging and “polypills” can impact adherence.

Leveraging Pharmacists to Reduce Cost and Improve Medication Adherence in High-Risk PopulationsWhen it comes to medication management for Medicare beneficiaries, there are more than 25 different factors that can complicate proper use of prescribed medicines—from affordability issues, even among the insured, to fear of a drug’s side effects to potential dangers from high-risk medications or health conditions.

Leveraging Pharmacists to Reduce Cost and Improve Medication Adherence in High-Risk Populations examines Novant Health’s deployment of pharmacists as part of its five-pronged strategy to deliver healthcare value through medication management services.

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Reducing SNF Readmissions: Clinical Targets, Quality Scorecards Elevate Performance

May 23rd, 2017 by Patricia Donovan

reducing SNF readmissions

Michigan’s Tri-County Collaborative holds the line on hospital readmissions from 130 participating SNFs.

Three geographically close Michigan health systems shared more than a concern over escalating readmissions from skilled nursing facilities (SNFs).

As Henry Ford Health System (HFHS), the Detroit Medical Center and St. John’s Providence Health System ultimately discovered from Michigan Quality Improvement Organization (MPRO) data in 2013, they also shared about 30 percent of their patient population.

This revelation, combined with the pinch of new hospital readmission penalties from the Centers for Medicare and Medicaid Services (CMS), prompted the three to set aside competition and siloed strategies and forge a coordinated approach to reducing readmissions from SNFs.

Today, the resulting Tri-County SNF Collaborative operates with a set of clinical and quality targets and metrics created in tandem with more than 130 member SNFs. Tri-County’s dozen participation requirements for SNFs range from regular reporting through a dedicated SNF portal to achievement of specified performance metrics.

“We developed collaborative relationships,” explained Susan Craft, director of care coordination for the family caregiver program in HFHS’s Office of Clinical Quality & Safety. “We wanted to have very open, honest conversations to review issues that were identified and find ways to resolve those.”

Ms. Craft shared the roots, framework and results of the SNF collaborative, which launched in the first quarter of 2015, during Reducing SNF Readmissions: Quality Reporting Metrics Drive Improvements, a May 2017 webcast now available for replay.

Once admitted to the collaborative, member SNFs must report on 14 metrics in four key areas: acuity, care transitions, quality and readmissions. In return, SNFs receive a 13-point unblinded quarterly scorecard with metrics on readmissions and patient acceptance response times, among many others.

A multidisciplinary team within Tri-County Collaborative reviews all SNF metrics bi-annually to determine each facility’s continued participation.

As for the collaborative’s impact since its launch, Henry Ford Health System achieved a nearly 20 percent drop in Medicare SNF readmissions as well as a 28 percent reduction in SNF lengths of stay. The initiative also identified opportunities for improvement, resulting in enhanced outpatient scheduling and nurse-to-nurse handoffs and interventions focused on SNF-specific issues like sepsis, Ms. Craft explained.

Despite these advancements, the collaborative still faces the inherent challenges of competition and transparency, as well as SNFs’ hesitancy to adopt value-based practices. “Our SNFs are still entirely dependent on fee for service [payment models],” said Craft. “They haven’t been impacted by penalties and value-based purchasing, although that is coming for them next year.”

Although not yet referring to participating SNFs as “preferred providers,” the collaboratives hopes to one day equip patients with complete data pictures to guide them in SNF selection. Also on Tri-County Collaborative’s radar are home care agencies, concluded Ms. Craft.

“We know there needs to be a lot of coordination across all post-acute care settings.”

Listen to Susan Craft describe how Michigan’s SNF Collaborative set aside competition to improve quality and readmission rates.

Infographic: The Future of Connected Health

May 22nd, 2017 by Melanie Matthews

Many physicians believe that personal connected health devices are helping health outcomes but there is still more convincing to be done, according to a new infographic by the Personal Connected Health Alliance.

The infographic examines physicians’ views on patient-generated data, concerns related to patient-generated data and how patient-generated data can be harnessed.

2016 Healthcare Benchmarks: Digital HealthDigital health, also referred to as ‘connected health,’ leverages technology to help identify, track and manage health problems and challenges faced by patients. Person-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 more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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Infographic: Medicaid’s Role in Behavioral Healthcare

May 19th, 2017 by Melanie Matthews

Medicaid restructuring as proposed in the American Health Care Act could limit states’ ability to care for people with behavioral health conditions, according to a new infographic by the Kaiser Family Foundation.

The infographic details how Medicaid currently enables people with behavioral health needs to access care and how reduced federal spending could limit behavioral health coverage and services.

Behavioral Health Patient Engagement: Using Motivational Interviewing Techniques and Strategies To Improve OutcomesAs the critical role of an engaged, activated healthcare consumer becomes more apparent in a value-based healthcare system, healthcare organizations are focusing on patient engagement and activation programs.

In a recent industry survey on trends in patient engagement, healthcare organizations reported that behavioral health conditions presented a particular challenge to patient engagement initiatives. However, there is robust evidence that motivational interviewing is a powerful approach for treating substance abuse, anxiety and depression.

Behavioral Health Patient Engagement: Using Motivational Interviewing Techniques and Strategies To Improve Outcomes, a 45-minute webinar now available for replay, Mia Croyle with the University of Wisconsin School of Medicine and Public Health shares key learnings from patient engagement initiatives targeted at patients with behavioral health conditions.

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HINfographic: Care Coordination Trends: Oversight of Complex Comorbid Spans Continuum

May 17th, 2017 by Melanie Matthews

Care coordinators organize patient care activities and share information among vested participants to achieve safer and more effective care, per the Agency for Healthcare Research and Quality (AHRQ). And for 86 percent of respondents to the 2016 Care Coordination survey by the Healthcare Intelligence Network, care coordination takes place across all care settings, including the patient’s home.

A new infographic by HIN examines patient care coordination touchpoints, patients by diagnoses prioritized for care coordination and care coordination touchpoint frequency and reimbursement models.

2016 Healthcare Benchmarks: Care CoordinationCare coordination involves deliberately organizing patient care activities and sharing information among all participants concerned with a patient’s care to achieve safer and more effective care, as defined by the Agency for Healthcare Research and Quality (AHRQ).

2016 Healthcare Benchmarks: Care Coordination examines care coordination settings, strategies, targeted populations, supporting technologies, results and ROI, based on responses from 114 healthcare organizations to the September 2016 Care Coordination survey by the Healthcare Intelligence Network.

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Infographic: A Look Back at Healthcare Steps in Trump’s First 100 Days

May 15th, 2017 by Melanie Matthews

In the first 100 days of his administration, President Donald J. Trump has taken a number of actions that could impact healthcare, including filling a Supreme Court seat and taking steps to repeal the Affordable Care Act, according to a new infographic by AJMC.

The infographic examines some of the most notable healthcare-related happenings in Trump’s first 100 days in office.

Healthcare Trends & Forecasts in 2017: Performance Expectations for the Healthcare Industry 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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