Archive for the ‘Healthcare Costs’ Category

Guest Post: Three Steps To Controlling Healthcare Costs with Data

June 21st, 2018 by Will Herold

Three Steps To Controlling Healthcare Costs with Data

Data analytics is key to reaching the goal of controlling healthcare costs.

Data analysis plays a key role controlling and potentially lowering healthcare costs, according to DHS Group.

DHS Group, an employer and health plan solutions provider based in Houston and Cleveland, provides three steps to reach the goal of controlling healthcare costs:

  1. Invest in your partners: If data, and the information you gather from accessing, reading and interpreting it, is important to you, then the company you work for to get the job done should be too. Don’t underestimate the value of investing in a partner that will go above and beyond in making sure the money you’re investing is put to good use and you’re able to access and understand the information you’re looking to gain.

  2. See data as actionable information: If you’re taking the time, and spending the money, to gain access to your data, consider the idea that the “data” is more meaningful when viewed as a place where actionable information resides. Look for partners that will translate your data into “Key Health Metrics” or information that you can make real decisions with based on your goals and benchmarks.

  3. Integrate your systems: Use the actionable information you have gained from your data to make informed decisions on the health and wellbeing of your employees – expanding programs to include areas like mental health and financial wellbeing. Data-driven benefits programs work best alongside health and wellbeing programs that are being driven by the same numbers and facts.

“Most people don’t realize all that can be done with regular access to claims data,” Jim Pritchett, DHS Group CEO, said. “Better plan design, discovery of preventative initiatives, empowering your members to better manage their health, identifying hard-dollar pharmacy savings, improving engagement and measuring ROI.”

Will Herold

About the Author: With years of experience in HR and benefits industries, Will Herold leads DHS Group’s Business Development team with a strong understanding of the HR and benefits marketplace. As a sales leader, he is responsible for managing DHS Group’s revenue and working with other professionals to assist corporations in establishing clear, aligned strategies for impactful, cost-effective benefit and wellbeing program outcomes.

Infographic: The Healthcare Value Initiative

June 11th, 2018 by Melanie Matthews

Hospitals are taking the lead in addressing healthcare affordability, according to a new infographic by the American Hospital Association.

The infographic examines how hospitals and health systems have been able to hold price increases to under 2 percent in each of the last four years.

Predictive Healthcare Analytics: Four Pillars for SuccessWith an increasing percentage of at-risk healthcare payments, the Allina Health System’s Minneapolis Heart Institute began to drill down on the reasons for clinical variations among its cardiovascular patients. The Heart Institute’s Center for Healthcare Delivery Innovation, charged with analyzing and reducing unnecessary clinical variation, has saved over $155 million by reducing this unnecessary clinical variation through its predictive analytics programs.

During Predictive Healthcare Analytics: Four Pillars for Success, a 45-minute webinar in March 2018, now available for replay, Pam Rush, cardiovascular clinical service line program director at Allina Health, and Dr. Steven Bradley, cardiologist, Minneapolis Heart Institute (MHI) and associate director, MHI Healthcare Delivery Innovation Center, shared their organization’s four pillars of predictive analytics success…addressing population health issues, reducing clinical variation, testing new processes and leveraging an enterprise data warehouse. Click here for more information.

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Infographic: How Hospital Acquired Conditions Can Impact a Hospital’s Bottom Line

June 1st, 2018 by Melanie Matthews

In 2018, an estimated 32 percent of large U.S. hospitals will occupy the lowest performing quartile for hospital acquired conditions (HACs), according to a new infographic by 3M.

The infographic examines how HACs impact a hospital’s bottom line and how to stay out of the bottom quartile.

Predictive Healthcare Analytics: Four Pillars for SuccessWith an increasing percentage of at-risk healthcare payments, the Allina Health System’s Minneapolis Heart Institute began to drill down on the reasons for clinical variations among its cardiovascular patients. The Heart Institute’s Center for Healthcare Delivery Innovation, charged with analyzing and reducing unnecessary clinical variation, has saved over $155 million by reducing this unnecessary clinical variation through its predictive analytics programs.

During Predictive Healthcare Analytics: Four Pillars for Success, a 45-minute webinar, available on-demand, Pam Rush, cardiovascular clinical service line program director at Allina Health, and Dr. Steven Bradley, cardiologist, Minneapolis Heart Institute (MHI) and associate director, MHI Healthcare Delivery Innovation Center, shared their organization’s four pillars of predictive analytics success…addressing population health issues, reducing clinical variation, testing new processes and leveraging an enterprise data warehouse. Click here for more information.

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: Health Systems Rely on Distribution

May 11th, 2018 by Melanie Matthews

Nearly all hospitals and health systems rely on healthcare distributors to optimize their supply chain, according to a new infographic by the Health Industry Distributors Association.

The infographic details supply chain executives’ satisfaction with distributors’ expertise, and other healthcare supply chain trends.

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS SuccessA laser focus on population health interventions and processes can generate immediate revenue streams for fledgling accountable care organizations that support the hard work of creating a sustainable ACO business model. This population health priority has proven a lucrative strategy for Caravan Health, whose 23 ACO clients saved more than $26 million across approximately 250,000 covered lives in 2016 under the Medicare Shared Savings Program (MSSP).

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS Success examines Caravan Health’s population health-focused approach for ACOs and its potential for positioning ACOs for success under MSSP and MACRA’s Merit-based Incentive Payment System (MIPS).

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 Access and Affordability

May 9th, 2018 by Melanie Matthews

Affordability of healthcare plays a key role in advancing access to care. Community and legislative efforts are increasingly focused on this issue.

A new infographic by the American Hospital Association examines healthcare affordability concerns.

Healthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare IndustryHealthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare Industry, HIN’s 14th annual business forecast, is designed to support healthcare C-suite planning as leaders react to presidential priorities and seek new strategies for engaging providers, patients and health plan members in value-based care.

HIN’s highly anticipated annual strategic playbook opens with perspectives from industry thought leader Brian Sanderson, managing principal, healthcare services, Crowe Horwath, who outlines a roadmap to healthcare provider success by examining the key issues, challenges and opportunities facing providers in the year to come. Following Sanderson’s outlook is guidance for healthcare payors from David Buchanan, president, Buchanan Strategies, on navigating seven hot button areas for insurers, from the future of Obamacare to the changing face of telehealth to the surprising role grocery stores might one day play in healthcare delivery. Click here for more information.

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.

Mounting Pressure from Value-Based Reimbursement Models Drives Clinical Improvement Strategy at Allina Health System

April 17th, 2018 by Melanie Matthews

Value-Based Reimbursement Models Drive Clinical Improvement Strategy

As a greater percentage of hospital payments are through value-based contracts, hospitals that reduce costs while maintaining quality will survive, predicts Pam Rush, cardiovascular clinical service line program director at Allina Health.

“How do we improve outcomes and decrease costs?” Rush asked participants in the March 2018 webinar, Predictive Healthcare Analytics: Four Pillars for Success. “We need to start to look at the world differently.”

How can we be more creative and do things differently? How can we use different members of the healthcare teams in new ways, such as nurse practitioners or advanced practice providers, she added. In addition, “we need to invest in data analytics and data resources and have data analysts who can pull the information for us so we can find the variation. We need to invest in physician and caregiver time to look at the data, to make changes in how they improve care, to monitor and see what is working and what doesn’t work.”

These four pillars…population health management, reducing clinical variation, testing new care processes and new models of payment, and leveraging cutting edge technologies…have been critical to the work at Allina Health System’s Minneapolis Heart Institute Center for Healthcare Delivery Innovation, said Rush.

In population health management, we’re looking at how can we focus on adherence to guidelines, identify where there are gaps in care and partner with people across the system, primary care and specialists, to improve consistency and adherence to guidelines, she explained.

Allina is reducing clinical variation by looking at unnecessary variations in care where there is inconsistent care without an influence on outcomes.

“We’re also looking at new ways of doing things. How can we use our nurse practitioners, how do we care for patients once they’re discharged from the hospital and bring them back in for clinic visits? It’s really looking at the care model and how we can do things differently to reduce total cost of care,” she said.

In cardiology, there are so many new devices, procedures and techniques to monitor, said Rush, but we need to figure out who are the right providers to do that monitoring, who are the right patients to do these expensive procedures on and who achieves the best outcomes, because we can’t afford to do all of this new technology to every single person.

Allina looks at these four pillars across the continuum. Starting in primary care to partner on prevention strategies, moving to who gets referred to cardiology, and when they’re referred to cardiology, what are the set of tests or treatments and guidelines to adhere to along the continuum to subspecialties, emergency services and all the way up through advanced therapies, such as transplant.

During the webinar, Rush along with Dr. Steven Bradley, cardiologist, MHI and associate director, MHI Healthcare Delivery Innovation Center, shared these four pillars of predictive analytics success along with details on creating a culture of quality and innovation, building performance improvement dashboards, as well as several case examples of quality improvement initiatives contributing to these savings and much more.

Listen to Ms. Rush describe how MHI leveraged an enterprise data warehouse to identify care gaps and clinical quality improvement opportunities.

Infographic: Hospital Leadership’s Top Perioperative Priorities

April 11th, 2018 by Melanie Matthews

U.S. hospital leaders are reporting low surgical block utilization and high costs associated with suboptimal surgical staffing, according to a new infographic by Hospital IQ, Inc. As hospital leaders project ambitious surgical revenue targets over the next three years, they will need to leverage the vast amounts of data they have from existing IT infrastructure to fully capture revenue and margin opportunities.

The infographic explores the top perioperative priorities for hospital leadership, the key operating room (OR) challenges and the data and technology trends for OR leadership.

Healthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare IndustryHealthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare Industry, HIN’s 14th annual business forecast, is designed to support healthcare C-suite planning as leaders react to presidential priorities and seek new strategies for engaging providers, patients and health plan members in value-based care.

HIN’s highly anticipated annual strategic playbook opens with perspectives from industry thought leader Brian Sanderson, managing principal, healthcare services, Crowe Horwath, who outlines a roadmap to healthcare provider success by examining the key issues, challenges and opportunities facing providers in the year to come. Following Sanderson’s outlook is guidance for healthcare payors from David Buchanan, president, Buchanan Strategies, on navigating seven hot button areas for insurers, from the future of Obamacare to the changing face of telehealth to the surprising role grocery stores might one day play in healthcare delivery. Click here for more information.

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.

Guest Post: Outcomes Drive the Evidence-Based Practice Journey

March 29th, 2018 by Michele Farrington and Cindy Dawson

The Institute of Medicine set a goal that 90 percent of all healthcare decisions will be evidence-based by 2020. Executives and nursing leaders, at all levels within organizations, have clear responsibility for making this goal a reality and ensuring consistent, standardized use of evidence-based practice (EBP) in care delivery that will meet patient, family, clinician, and organizational outcomes.

Promoting use of evidence, valuing questioning of clinical and administrative practice, and building organizational capacity, culture, and commitment are pivotal to building a supportive organizational culture related to EBP.

Organizations must meet regulatory requirements, from the Centers for Medicare and Medicaid Services and The Joint Commission, that incorporate EBPs and the need for increasing public accountability and transparency (e.g., use of national benchmarks) for quality and safety. Financial incentives associated with pay-for-performance are also directly linked to EBP. Despite these outside forces in today’s healthcare environment, clinicians and executives cannot forget about the need to provide individualized patient care, which includes patient engagement strategies aimed at improving the overall patient experience.

EBP is a continuous journey for individual clinicians and organizations alike and starts with building organizational capacity.

Organizational Capacity

EBP capacity is built using a strategic, systematic approach to create a solid foundation and infrastructure to support the work. Before EBP work can be successful at the unit or clinic level, EBP must be integrated at the organizational level and a culture for change must exist.

The organization’s mission, vision, and strategic plan must include EBP language to ensure evidence-based healthcare is clearly portrayed as the organizational norm. Creating a culture valuing inquiry and innovation must start during orientation for new hires and continue during competency review for current employees and through ongoing training and professional development opportunities for both clinicians and executive leaders.

An infrastructure that directly integrates EBP work into the organizational governance structure is needed to support the mission, vision, and strategic plan. A crucial organizational decision is determining what group will hold primary accountability or functional responsibility for EBP to ensure it is integrated into practice processes, policies, and documentation.

Recruiting and hiring clinicians and executives with experience and/or interest in EBP will help build the desired culture and capacity. EBP mentors are developed from successful projects and are used to nurture the next generation.

A well-defined path for EBP includes adoption of an EBP-process model to guide implementation and sustained organizational change across disciplines. There are a number of EBP process models: The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care; Johns Hopkins Nursing Evidence-Based Practice Model; Stetler Model of Evidence-Based Practice; and Advancing Research and Clinical Practice Through Close Collaboration (ARCC) Model. Each model follows a step-by-step problem-solving process suitable for concurrent use with the organization’s quality improvement processes.

Culture

The governance structure must clearly outline the process and channels for communicating EBP work and obtaining necessary approvals from applicable committees. EBP discussions should be a regular agenda item for all shared governance committees.

Project results should be reported internally through the organization’s shared governance and quality improvement structures to promote practice change adoption, share learning, garner continued support (e.g., time, resources), and as a platform to recognize success for the institution’s EBP program.

Successful EBP work takes time and effort, so successes should be celebrated and rewarded throughout the process. Celebrations are an opportunity to spotlight clinicians for doing this work and helps build a pervasive culture that supports and expects use of evidence in practice. These strategies promote organizational buy-in and commitment for the EBP process and set higher standards as a foundation for future efforts.

Expected behaviors from clinicians across all job classifications at every level must clearly demonstrate the value of EBP. Behavioral expectations regarding EBP are easily set if they are built into every job description and can be quickly reviewed annually during the performance appraisal process. Utilizing documents and mechanisms that already occur is an easy and efficient way to promote positive reinforcement and priority setting in busy work environments with many ongoing and competing demands for clinicians’ and leaders’ time and attention.

Benefits

EBP is value-added with a strong return on investment and responds to current priorities. A single project may improve patient and clinician safety, improve clinical outcomes, improve patient/family satisfaction, promote innovate care, and/or reduce costs.

Clinicians, nurses, and leaders all influence an organization’s capacity for EBP. Leaders who demonstrate and expect EBP will promote its use in clinical and operational decision-making at the unit or clinic and organizational levels. Building on the organization’s mission, vision, capacity, and value for delivery of reliable, safe, high quality care provides a foundation for success.

About the Authors:

Michele Farrington, BSN, RN, CPHON, is a clinical healthcare research associate at the University of Iowa Hospitals and Clinics. She is certified in pediatric hematology/oncology nursing and received her BSN from the University of Iowa. She has been leading, co-leading, or mentoring EBP initiatives since 2003, and her work has been awarded extramural funding, validating the strength of the projects and impact on nursing care. She is widely published and has given multiple local, regional, national, and international presentations.

Cindy Dawson, MSN, RN, CORLN, is the chief nurse executive and associate director of the University of Iowa Hospitals and Clinics. She received her BSN from the University of Iowa, MSN from the University of Phoenix, and is a Certified Otorhinolaryngology Nurse. Over the course of her career, she has published extensively on EBP, nurse triage, nursing management/leadership, and clinical practice guidelines and has given numerous local, regional, national, and international presentations on these topics.

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 remains with them. The company accepts no liability for any errors, omissions or representations.

Infographic: How Your Hospital Can Curb Rework and Burnout

March 19th, 2018 by Melanie Matthews

Hospital staff burnout is fueled by documentation rework and retrospective queries and burnout leads to an exponential rise in medical errors, denials, and increased costs, according to a new infographic by Nuance Communications, Inc.

The infographic examines how staff burnout impacts medical errors and contributes to increased financial costs to healthcare organizations.

Healthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare IndustryHealthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare Industry, HIN’s 14th annual business forecast, is designed to support healthcare C-suite planning as leaders react to presidential priorities and seek new strategies for engaging providers, patients and health plan members in value-based care.

HIN’s highly anticipated annual strategic playbook opens with perspectives from industry thought leader Brian Sanderson, managing principal, healthcare services, Crowe Horwath, who outlines a roadmap to healthcare provider success by examining the key issues, challenges and opportunities facing providers in the year to come. Following Sanderson’s outlook is guidance for healthcare payors from David Buchanan, president, Buchanan Strategies, on navigating seven hot button areas for insurers, from the future of Obamacare to the changing face of telehealth to the surprising role grocery stores might one day play in healthcare delivery. Click here for more information.

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.

Guest Post: How U.S. Healthcare Mega-Mergers Hurt Patients

March 14th, 2018 by Robert E. Grant, Founder/CEO, CONCIERGE KEY Health

From the National Economic Council to the healthcare public policy experts at Harvard University, leading medical advisors and economists alike continue to invoke the words of Adam Smith, the eighteenth century British political economist and author of The Wealth of Nations who stated some 300 years ago, “Seldom do businessmen (companies) of the same trade get together but that it results in some detriment to the general public.”

Take the colossal U.S. financial collapse in 2008, for example, which followed an all-time mergers-and-acquisitions (M&A) high of $4.3 trillion in deals. Not more than five years passed before companies were willing to hedge their bets again—especially in the healthcare sector—but with markedly higher stakes. The same year the Journal of the American Medical Association released a thoughtful examination of hospital consolidation, penned by leading medical authorities from the Harvard School of Public Health who opposed the notion of mega-mergers, Teva Pharmaceuticals announced its plan to acquire Allergan’s generics business, Actavis Generics, for $66 billion.

According to data from the financial information firm Dealogic, that was just the tip of the iceberg. The close of 2017 bore witness to the consolidation of private practices, private equity funds and pharmaceutical companies at the current and future expense of the American healthcare patient, who in turn, experiences fewer choices and a decreased quality of care—all for a higher price.

Healthcare’s Merger Epidemic

In 2015, global M&As skyrocketed and set new records by exceeding $5 trillion. It was no surprise that the healthcare sector emerged a frontrunner, leading the charge that year with a total of $723.7 billion in deals. Gaining even more momentum with Abbott Laboratories announcing its definitive agreement to acquire St. Jude Medical for $25 billion in 2016, and a 2017 announcement by CVS to acquire the health insurance giant, Aetna, for roughly $70 billion, the industry innocuously sent a clear message that there was no longer a sky—or an effective governing body—to set any limits.

As the world heads toward the fourth industrial revolution, where artificial intelligence and automation are taking organizations to new heights, health systems and hospitals are falling in line to compete and retain a market share. In 2017 alone, consulting firm Kaufman Hall and Associates reported 115 hospital and health system mergers, which represented a 13 percent increase from 2016. Many experts believe part of the consolidation epidemic stems from the enactment of the Affordable Care Act (Obamacare) in 2010. Even Bob Kocher—the only medical doctor on the National Economic Council advising President Obama—recanted his support of consolidating hospitals, health systems and doctors into larger groups in an effort he believed could drastically improve the delivery of patient care. In 2016, he laid bare his soul in a Wall Street Journal op-ed titled, How I Was Wrong About ObamaCare.

But it’s not just the architects of Obamacare that have failed to heed the words of economists who, like Adam Smith, understand how fewer market participants and less competition are very likely to result in higher prices for consumers, without an improvement in quality.

Not All Mergers are Alike

It is important to note that not all mergers are considered equal. Consolidation driven by organic and natural forces of the market can undoubtedly decrease costs for consumers while improving the quality of a product or service. But if escalating healthcare costs and insurance premiums—along with a flawed system where seeing a specialist requires a referral protocol that can delay a visit by weeks or months—are any indication of the manic consolidations taking place today, it should be proof enough that we are headed for a reckoning.

Demanding More for Less

Even in a growing on-demand, digital economy where consumers can influence the decisions of others through multiple channels and social media platforms, the patient experience has yet to be addressed. In addition to soaring healthcare insurance premiums, in just three years the average new patient doctor appointment wait times in the U.S. increased by 30 percent, according to a 2017 Merritt Hawkins survey. In large markets, the average wait time to see a doctor was 24.1 days (up 30 percent from 2014), with average wait times to see a family medicine doctor up 50 percent. That may not mean much to a healthy individual relocating and searching for a new doctor, but for someone facing a potentially life-threatening illness, it could become a matter of life and death. Furthermore, prior studies such as the 2004 analysis of the 1996 Aetna acquisition of U.S. Healthcare put forth by University of California, Berkeley health economist, James C. Robinson, offer solid evidence that hospital and insurance mergers, in particular, almost always lead to higher costs, less efficiency and less innovation. Why? Because, as Adam Smith warned, mergers reduce competition, which is the driving factor of a free market.

Perhaps the greatest irony in all of human healthcare is that organizations came into existence for the very purpose of helping people get and stay well, yet it seems the survival of the organization has taken priority over the patient and obscured who the consumer actually is. Never before have health consumers been asked to pay so much for so little. It’s time to allow the invisible hand of the U.S. economy to operate as intended. It’s time to look past the bottom line and look to new business models that put patients at the center of the healthcare experience.

Robert E. Grant, Founder/CEO of CONCIERGE KEY Health

About the Author: Robert E. Grant is founder and chief executive officer of CONCIERGE KEY Health, the world’s first mobile app for on-demand access to elite doctors, including specialists and care facilities. An entrepreneur, inventor and investor, he has played a pivotal role for more than 20 years in successful technology and business development in pharmaceutical, medical device and healthcare markets. In addition to founding CONCIERGE KEY, Grant is founder and vice chairman of ALPHAEON Corporation, as well as founder, chairman and managing partner of its parent company, Strathspey Crown Holdings, LLC.

Most recently, Grant was CEO and president of Bausch+Lomb Surgical, leading the significant growth of its product portfolio. From 2006 to 2010, he served as president of Allergan Medical; Grant also served as director, board chairman, CEO, president, COO and CFO of Biolase Technology from 2003 to 2006.

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 remains with them. The company accepts no liability for any errors, omissions or representations.