Archive for the ‘Accountable Care Organizations’ Category

LVHN Portal Places Healthcare Control in Patients’ Hands, Liberates Staff

November 30th, 2017 by Patricia Donovan

patient portal rolloutConsumers accustomed to communicating, shopping, banking and booking travel online increasingly expect those same conveniences from their healthcare providers.

And as Lehigh Valley Health Network (LVHN) has learned, despite the myriad of benefits a patient portal offers, the most important reason to incorporate this interactive tool into a physician practice is because patients want it.

“As much as we emphasize the marketing aspect of [the portal], having a nice, functional technology that we get in other aspects of our life has really been an enabler,” notes Michael Sheinberg, M.D., medical director, medical informatics, Epic transformation at LVHN. Many LVHN patients found the portal on their own, independent of the tool’s formal introduction, he adds. “Patients really wanted this. Our patients want to be engaged, they want to have access, and they want to own their medical information.”

Dr. Sheinberg and Lindsay Altimare, director of operations for Lehigh Valley Physician Group at LVHN, walked through the rollout of the LVHN portal to its ambulatory care providers during Patient Portal Roll-Out Strategy: Activating and Engaging Patients in Self-Care and Population Health, a November 2017 webinar now available for rebroadcast.

The 2015 launch of LVHN’s patient portal and its continued user growth has earned it the distinction of being the fastest growing patient portal on the Epic® platform.

As Ms. Altimare explained, LVHN first launched its portal with limited functionality in February 2015 as part of the Epic electronic health record that had gone live two years earlier. But even given the portal’s limited feature set, LVHN quickly recognized the tool’s potential to enhance efficiency, education, communication and revenue outside of traditional doctor’s office visits.

At its providers’ request, however, LVHN first piloted the portal within 14 of its 160+ physician practices, using feedback from providers in the two-month trial to further tweak the portal before next rolling it out to its remaining clinicians, and finally to patients.

LVHN supported each rollout phase with targeted marketing and education materials.

Today, LVHN patients and staff embrace the functionality of the portal, which offers an experience similar to that of an online airline check-in. Via the portal, LVHN patients can self-schedule appointments, complete medical questionnaires and forms, even participate in select e-visits with physicians—all in the comfort and privacy of their own homes.

Not only are about 45 percent of LVHN’s 420,000 patients enrolled in the portal, but self-scheduling doubled in the first six months of use. Additionally, upon examining a segment of portal participants over 12 months, LVHN identified a steady rise in portal utilization for common tasks like medication renewals and medical history completion.

The portal “liberates our patients from the need to access our providers in the traditional way,” says Dr. Sheinberg. Appreciation of this freedom is reflected in improved patient experience scores, he adds.

“The portal is a patient satisfier, and certainly a staff satisfier, because it reduces patient ‘no-shows’ and liberates our staff from more manual processes, putting them in the hands of our patients.”


4 Ways CMS 2018 Quality Payment Program Supports ‘Patients Over Paperwork’ Pledge

November 6th, 2017 by Patricia Donovan

“Patients Over Paperwork” is committed to removing regulatory obstacles that get in the way of providers spending time with patients.

Year 2 of the CMS Quality Payment Program promises continued flexibility and reduced provider burden, according to the program’s final rule with comment issued by the Centers for Medicare and Medicaid Services (CMS) last week.

The Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), is a quality payment incentive program for physicians and other eligible clinicians that rewards value and outcomes in one of two ways: through the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

A QPP Year 2 fact sheet issued by CMS highlights 2018 changes for providers under the QPP’s MIPS and APM tracks. The Year 2 fact sheet noted that stakeholder feedback helped to shape policies for QPP Year 2, and that  “CMS is continuing many of its transition year policies while introducing modest changes.”

In keeping with the federal payor’s recently launched “Patients Over Paperwork” initiative, QPP Year 2 reflects the following changes:

    • More options for small practices (groups of 15 or fewer clinicians). Options include exclusions for individual MIPS-eligible clinicians or groups with less than or equal to $90,000 in Part B allowed charges or less than or equal to 200 Part B beneficiaries, opportunities to earn additional points, and the choice to form or join a virtual group.
    • Addresses extreme and uncontrollable circumstances, such as hurricanes and other natural disasters, for both the 2017 transition year and the 2018 MIPS performance period, by offering hardship exception applications and limited exemptions.
    • Includes virtual groups as another participation option for Year 2. A virtual group is a combination of two more taxpayer identification numbers (TINs) made up of solo practitioners and groups of 10 or fewer eligible clinicians who come together ‘virtually’ (no matter specialty or location) to participate in MIPS for a performance period of a year. A CMS Virtual Groups Toolkit provides more information, including the election process to become a virtual group.
    • Makes it easier for clinicians to qualify for incentive payments by participating in Advanced APMs that begin or end in the middle of a year. Updated QPP policies for 2018 further encourage and reward participation in APMs in Medicare.
  • CMS describes its Patients Over Paperwork effort as “a cross-cutting, collaborative process that evaluates and streamlines regulations with a goal to reduce unnecessary burden, increase efficiencies and improve the beneficiary experience. This effort emphasizes a commitment to removing regulatory obstacles that get in the way of providers spending time with patients.”

    Healthcare Hotwire: Social Determinants of Health

    October 25th, 2017 by Melanie Matthews

    Healthcare risk sharing requires a new focus on the whole patient…addressing all of the factors that could impact the health of accountable populations.

    Evidence is mounting that social determinants of health—social, economic and environmental factors that impact quality of life—significantly influence population health.

    Initiatives such as CMS’ Accountable Health Communities Model and other population health platforms encourage healthcare organizations to tackle the broad range of social, economic and environmental factors that shape an individual’s health. Mission Health recently attributed its success in CMS’ Medicare Shared Savings Program to its care coordination model that addresses the whole person.

    And 2015 research by Brigham Young University found that the social determinants of loneliness and social isolation are just as much a threat to longevity as obesity.

    In the new edition of Healthcare Hotwire, you’ll get details on how social health determinants impact patient populations and what healthcare organizations are doing to address these factors.

    HIN’s newly launched Healthcare Hotwire tracks trending topics in the industry for strategic planning. Subscribe today.

    2016 ACO Results: Majority of Next Generation and Pioneer ACOs Earn Shared Savings

    October 20th, 2017 by Patricia Donovan

    Six of eight Pioneer ACOs and eleven of eighteen Next Generation ACOs earned shared savings in separate initiatives in 2016, according to newly released quality and financial data from the Centers for Medicare and Medicaid Services (CMS).

    In 2016 Performance Year Five of the Pioneer ACO program, one of several new accountable care organization (ACO) payment and service delivery models introduced by CMS to serve a range of provider organizations, only Monarch HealthCare and Partners HealthCare were not among shared savings earners.

    Banner Health Network emerged as the top 2016 Pioneer ACO performer, earning nearly $11 million in shared savings based on care provided to its more than 42,000 beneficiaries.

    In order to receive savings or owe losses in a given year, Pioneer ACO expenditures must be outside a minimum corridor set by the ACO’s minimum savings rate (MSR) and minimum loss rate (MLR).

    The Pioneer ACO model is designed for healthcare organizations and providers already experienced in coordinating care for patients across care settings. It allowed these provider groups to move more rapidly from a shared savings payment model to a population-based payment model on a track consistent with but separate from the Medicare Shared Savings Program (MSSP).

    The Pioneer ACO Model began with 32 ACOs in 2012 and concluded December 31, 2016 with eight ACOs participating.

    Meanwhile, at the conclusion of 2016 Performance Year One of the Next Generation ACO model, Baroma, Triad and Iowa Health topped the list of ACO earners in this program, with each organization accumulating more than $10 million shared savings.

    Building upon experience from the Pioneer ACO Model and the Medicare Shared Savings Program, CMS’s Next Generation ACO Model sets predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care, and aims to attain the highest quality standards of care.

    According to a CMS fact sheet, 18 ACOs participated in the Next Generation ACO Model for the 2016 performance year, and 28 ACOs are joining the Model for 2017, bringing the total number of Next Generation ACOs to 45. The Next Generation ACO Model will consist of three initial performance years and two optional one-year extensions.

    CMS’s ACO models are one of seven Innovation categories designed to incentivize healthcare providers to become accountable for a patient population and to invest in infrastructure and redesigned care processes that provide for coordinated care, high quality and efficient service delivery.

    Infographic: Industry Perspectives on Value-Based Payment

    October 4th, 2017 by Melanie Matthews

    The shift to value-based payment is a slow one, with most health plans not yet making the transition to risk, according to a new infographic by HealthScape Advisors.

    The infographic examines the percentage of plans in upside and downside risk contracts, the impact of health plan sponsor on risk contracts, cost and quality impacts for risk contracts, value-based payment enablers and recommendations for success in value-based contracts.

    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.

    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.

    Empathy Interviewing Elicits Patient’s ‘Story,’ Uncovers Social Determinants of Health

    September 26th, 2017 by Patricia Donovan

    social determinants of health

    Healthcare must mitigate patient risk factors outside of the hospital, referred to as social determinants of health (SDOH).

    If healthcare hopes to move the needle on runaway expenses and improve the health of its communities, it must first focus on patients’ social and environmental circumstances, also known as social determinants of health (SDOH).

    That’s the advice of Cindy Buckels, director of population health for TAV Health, which helps healthcare organizations navigate the challenges of SDOHs.

    “When we don’t address these issues as we’re addressing someone’s health, we get high readmissions, negative outcomes and dissatisfaction. There’s also increased cost and increased risk,” noted Ms. Buckels during Social Determinants of Health: Using Empathy Interviewing To Help Care Teams Understand Factors Impacting Patient Health, a September 2017 webinar now available for rebroadcast.

    To encourage individuals to open up about economic, educational, nutritional, or community deficits they face that drive 60 percent of their health outcomes, TAV Health recommends care teams employ empathy interviewing, also known as motivational interviewing (MI).

    “With motivational interviewing, you’re entering into a relationship with a person, not as the expert, but as a partner coming alongside to help them find their own strengths, and affirming them as a person in order to affect positive change,” said Ms. Buckels. Her presentation included a review of the four core skills of motivational interviewing (“Listen for that positive nugget,” she urges), as well as ‘back pocket’ questions to ask when the conversation stalls.

    Finally, she outlined traps for care teams to avoid during an MI session, such as the urge to give advice. “Always ask permission to give information or advice. Don’t just assume that’s something that you can do, because you’ve picked up the phone and called them.”

    It may take time to master, but ultimately, motivational interviewing is more effective than healthcare’s typical “Chunk-Check-Change” education approach in transforming patient ambivalence and effecting positive behavior change, she said.

    Information gleaned from motivational interviewing, even minor details like a patient’s nickname or the presence of a cherished pet, should become part of the patient’s record so that every person along the care continuum who ‘touches’ that patient can access it.

    “For example, if a patient’s legal name is Charlene, but she goes by Michelle, if you really want to build a relationship with her and gain her trust, you start by calling her what she goes by, which is Michelle.”

    In closing, Ms. Buckels outlined a patient-centric workflow connecting all supportive organizations, healthcare providers, community organizations and family and friends within the patient’s circle of care, which places more eyes and ears on the individual. With communal oversight to report anything worrisome, the likelihood is much less that a socially supported patient will visit the ER or be admitted to the hospital.

    Listen to Cindy Buckels explain the advantages of motivational interviewing over the “Chunk-Check-Change” educational approach.

    SDOH Video: Tackling the Social, Economic and Environmental Factors That Shape Health

    September 7th, 2017 by Patricia Donovan

    Initiatives such as CMS’ Accountable Health Communities Model and other population health platforms encourage healthcare organizations to tackle the broad range of social, economic and environmental factors known as social determinants of health (SDOH) that shape an individual’s health.

    This video from the Healthcare Intelligence Network highlights how healthcare organizations address SDOH factors, based on benchmarks from HIN’s 2017 Social Determinants of Health Survey.

     

     

    Source: 2017 Healthcare Benchmarks: Social Determinants of Health

    SDOH benchmarks

    2017 Healthcare Benchmarks: Social Determinants of Health documents the efforts of more than 140 healthcare organizations to assess social, economic and environmental factors in patients and to begin to redesign care management to account for these factors. These metrics are compiled from responses to the February 2017 Social Determinants of Health survey by the Healthcare Intelligence Network.

    Food for Thought: Nutrition Programs Reduce Hospital Visits and Readmissions by Vulnerable Populations

    August 18th, 2017 by Patricia Donovan

    Malnutrition is a social determinant of health that negatively impacts health outcomes.

    It’s a difficult statistic to digest: one in three people enter the hospital malnourished or at risk of malnutrition, a state that impacts their recovery and increases their risk of health complications and rehospitalizations.

    Two studies this week highlight the clinical benefits of addressing patients’ nutrition needs before and during hospital stays as well as savings that can result from identification of social determinants of health (SDOH) like access to nutrition that drive 85 percent of health outcomes.

    In the first, a study of elderly Maryland residents by Benefits Data Trust, a national nonprofit based in Philadelphia, found that when it comes to low-income seniors, access to quality food via food stamps can also save money by reducing the number and duration of hospital visits and nursing home admissions.

    In the second, research published in American Health & Drug Benefits journal and supported by Abbott found that when Advocate Health Care implemented a nutrition care program at four of its Chicago area hospitals, it showed more than $4.8 million in cost savings due to shorter hospital stays and lower readmission rates.

    The Benefits Data Trust research found that participation by low-income seniors in the federal Supplemental Nutrition Assistance Program (SNAP) cut their odds of hospital admissions by 14 percent. The food stamps also reduced the need for ER visits by 10 percent, and cut their likelihood of going into a nursing home by nearly one quarter.

    Finally, SNAP participation also led to an 8 to 10 percent drop in the number of days a patient who was admitted remained in one of these facilities.

    As a result, hospitals and health care systems such as Advocate Health Care are looking at the value of nutrition to improve care and help patients get back to living a healthier life.

    Starting in 2014, Advocate Health Care, the largest health system in Illinois and one of the largest accountable care organizations (ACO) in the country, implemented two models of a nutrition care program for patients at risk of malnutrition. The nutrition-focused quality improvement program, which targeted malnourished hospitalized patients, consisted of screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence.

    The leader in population health found that by doing so, it reduced 30-day readmission rates by 27 percent and the average hospital stay by nearly two days.

    More recently, to evaluate the cost-savings of the Advocate approach, researchers used a novel, web-based budget impact model to assess the potential cost savings from the avoided readmissions and reduced time in hospital. Compared to the hospitals’ previous readmission rates and patients’ average length of stay, researchers found that optimizing nutrition care in the four hospitals resulted in roughly $3,800 cost savings per patient treated for malnutrition.

    Given the healthcare industry’s appetite for value- and quality-based programs, SDOH screenings and the fortification of nutrition programs in both community and inpatient settings appear to be just what the doctor ordered. However, while a 2017 study on Social Determinants of Health identified widespread adoption of SDOH screenings by providers, it also documented a scarcity of supportive community services for SDOH-positive individuals.

    HINfographic: Measuring Accountable Care Success

    July 31st, 2017 by Melanie Matthews

    What are the hallmarks of a flourishing accountable care organization (ACO)? Robust clinical outcomes and satisfied patients, say respondents to the 2017 ACO Survey by the Healthcare Intelligence Network. Adoption of ACOs more than doubled in the last four years, and ACO leadership shifted from physician-hospital organizations to integrated delivery systems.

    A new infographic by HIN examines what other measures healthcare organizations use to measure ACO success, ACO physician staff size and ACO administration trends.

    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 fourth compendium of metrics on ACOs, captures ACO operation in today’s value- and quality-focused healthcare environment. This 50-page report, now in its fourth edition, delivers actionable data from healthcare companies who completed HIN’s fourth comprehensive ACO assessment in May 2017.

    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: Healthcare Technology Trends 2017

    July 12th, 2017 by Melanie Matthews

    With it’s renewed focus on patient engagement and experience, the healthcare industry is adopting the latest in digital technologies to enhance the quality of patient care, data security, and cost control, according to a new infographic by Experion Technologies.

    The infographic examines how nine key technology trends are impacting the industry.

    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.

    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.