Archive for the ‘Healthcare Costs’ Category

Infographic: The Impact of Cost-Sharing Reduction Payments on Insurance Markets

November 6th, 2017 by Melanie Matthews

The loss of cost-sharing reduction (CSR) payments in the health insurance marketplaces would destabilize insurance markets and add to the federal deficit, according to a new infographic by NEJM Catalyst.

The infographic examines the impact of ending the CSR payments on premiums of silver plans on the exchange as well as for Medicaid expansion and non-expansion states and the impact on the federal deficit through 2026.

Trends Shaping the Healthcare Industry in 2018: A Strategic Planning SessionUncertainty regarding the future of the Affordable Care Act (ACA), combined with industry market forces, including consolidations and strategic partnerships, positioning for value-based healthcare, cost containment efforts, an emphasis on technology and efforts to understand and address the whole patient as part of population health management have been the key drivers in the healthcare industry this year.

With the efforts to repeal and replace the ACA now focused on the elimination of the cost-sharing reduction (CSR) payments to insurers and changes to regulations governing association health plans, short-term, limited-duration insurance and health reimbursement arrangements, the healthcare industry can put aside the uncertainty of this year and move forward with the market forces in play.

During Trends Shaping the Healthcare Industry in 2018: A Strategic Planning Session, a 60-minute webinar on December 7th, two industry thought leaders Cynthia Kilroy, principal at Cynthia Kilroy Consulting and Brian Sanderson, managing principal, healthcare services, Crowe Horwath, will provide a roadmap to the key issues, challenges and opportunities for healthcare organizations in 2018.

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Healthcare Hotwire: Care Coordination

November 2nd, 2017 by Melanie Matthews

Care coordination organizes patient care activities and information for safer and more effective care.

Care coordination involves deliberately organizing patient care activities and sharing information among all vested participants to achieve safer and more effective care, per the Agency for Healthcare Research and Quality (AHRQ).

These patient care activities span all care settings, including the patient’s home, according to the Healthcare Intelligence Network’s Benchmark Survey on Care Coordination.

Initiatives aimed at coordinating care for high-risk patients are reporting healthcare cost savings, reductions in expensive sites of care and improvements in quality, outcomes and patient satisfaction.

In the new edition of Healthcare Hotwire, you’ll get details on enhanced care coordination Medicare savings, reducing emergency department utilization through care coordination and the impact of care coordination efforts on patient and provider satisfaction.

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

Infographic: Reducing Healthcare Supply Chain Expenses

October 25th, 2017 by Melanie Matthews

The pressure on hospitals and health systems to simultaneously improve quality and reduce costs will only intensify, no matter the outcome of healthcare reform, according to a new infographic by Navigant.

The infographic examines the substantial savings opportunities within the healthcare supply chain.

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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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.

Cityblock Health to Open First ‘Neighborhood Health Hub’ for Underserved Urban Populations in NYC

October 6th, 2017 by Patricia Donovan

Cityblock Health neighborhood health hubs for underserved urban populations: “Where health and community converge.”

Cityblock Health expects to open its first community-based clinic for underserved urban populations, known as a neighborhood health hub, in New York City in 2018, according to a Medium post this week by Cityblock Health Co-Founder and CEO Iyah Romm.

Cityblock Health is a spinout of Sidewalk Labs focused on the root causes of health for underserved urban populations. Sidewalk Labs is an Alphabet company focused on accelerating urban innovation.

The neighborhood health hub, where members can connect with care teams and access services, is one of several key member benefits outlined on the Cityblock Health web site. Other advantages include a personalized care team available 24/7, a personalized technology-supported Member Action Plan (MAP), and a designated Community Health Partner to help members navigate all aspects of their care.

According to Romm, who brings a decade of healthcare experience to the initiative, the neighborhood hubs will be designed as visible, physical meeting spaces where health and community converge. Caregivers, members, and local organizations will use the hubs to engage with each other and address the many factors that affect health at the local level, Romm said.

For example, Cityblock Health states it will offer members rides to the hub if needed. Transportation, care access, and finances are among multiple social determinants of health that drive health outcomes, particularly for populations in urban areas.

Where possible, the hubs will be built within existing, trusted spaces operated by its partners and staffed with local hires, he added. Cityblock envisions offering a range health, educational, and social events, including support groups and fitness classes.

The hubs are part of Cityblock Health’s larger vision to provide Medicaid and lower-income Medicare beneficiaries access to high-value, readily available personalized health services in a collaborative, team-based model, Romm explained in his post. The organization will partner with community-based organizations, health plans, and provider organizations to reconfigure the delivery of health and social services and apply “leading-edge care models that fully integrate primary care, behavioral health, and social services.”

Three key health inequities related to underserved urban populations motivated the formation of Cityblock Health: disproportionately poor health outcomes, interventions coming much later in the care continuum, and the significantly higher cost of interventions in urban areas as compared to other populations.

Cityblock Health will use its custom-built technology to enhance strong relationships between members and care teams, while simultaneously empowering and incentivizing the health system to do better, he added.

Guest Post: 3 Key Reasons Companies Should Embrace Corporate Clinics

September 26th, 2017 by Rob Indresano, COO, Barton Associates

A number of large corporations are taking a unique approach to healthcare by employing a resident physician, nurse practitioner or physician assistant to tend to the needs of workers and their families.

Models range from small clinics, such as the CVS Minute Clinic, to larger facilities that offer a full array of primary care services. While many companies opt to house the clinics on-site, some organizations have partnered with internal branches or outside firms to provide healthcare services at off-site locations.

For companies and employees alike, corporate clinics are an attractive option. These clinics keep costs in-house, giving companies greater control of healthcare expenditures. Corporate clinics can also reduce the time employees take off work to receive basic medical care, encouraging workers to seek routine care more regularly. In turn, this leads to better overall employee health and fewer sick days.

Better yet, these in-house clinics are available to employees as well as their dependents. Corporations spend less money to provide employees and their loved ones with more and better care. It’s a win-win situation.

The corporate clinic movement stems from a dramatic rise in overall healthcare costs and the amount of time employees aren’t at work for minor medical issues. The movement stuck because employees and their families became healthier and happier, with productivity booming for companies that adopted the model.

As corporate clinics became more popular, many factors combined to guarantee their success. Locum tenens, for instance, made it possible for corporations to seamlessly launch and staff corporate clinics as the need arose. Telemedicine continues to grow in popularity — Kaiser Permanente reported 52 percent of its 110 million patient visits in 2015 were done via telemedicine — making it possible for corporations to expand the scope of care while driving down costs.

Making the Case for In-House Care

The average American spends more than 90,000 hours at work over the course of her life. As the Centers for Disease Control and Prevention has noted, personal and family health problems cost companies about $226 billion annually in lost productivity. It’s easy to understand why a healthy work environment is vital to a happy and productive workforce.

Some companies already enjoy the benefits of on-site clinics. The clinics bring employees everything from primary and preventive healthcare to physical therapy, pharmacists, dentists, optometrists, and more. These clinics help lower insurance costs, improve health and job satisfaction, and increase productivity.

Toyota in 2007 opened a $9 million corporate clinic at its San Antonio truck manufacturing plant. The company has reported a 33 percent decrease in specialist referrals and a 25 percent drop in employee visits to urgent care clinics and emergency rooms.

Intel had similar goals when the technology titan launched its own corporate clinics in 2011. Company officials hoped workers would be more likely to visit the in-house doctors, ideally curtailing chronic issues such as heart disease and diabetes in the process. The company paid about $1 million to build and another $1.5 million to operate each clinic, though Intel has since managed to break even on those operating costs.

Employers enjoy short-term benefits such as greater control over direct costs for specialist visits, prescriptions, and trips to the emergency room. In the long run — and perhaps more important — corporate clinics can help establish new healthcare policies and wellness programs to promote healthier lifestyle choices for employees.

How Corporate Clinics Will Change the Business World

With perpetually increasing healthcare costs and a tremendous potential for return on investment, the corporate clinic model is set to alter healthcare and business in three important ways:

1. Reduced healthcare spending. Corporations with on-site or near-site health services spend less money on healthcare. It’s as simple as that. HanesBrands, for example, reports saving about $1.40 for every $1 the company spends on its in-house clinic. Companies can then take that savings and instead invest in other business-related purposes.

2. Healthier, happier, and more productive employees. Rather than taking time off work to visit a doctor or risking lost income, employees often forgo care for relatively minor issues. This becomes problematic, considering the chronic diseases doctors often detect through repeat visits account for 75 percent of U.S. healthcare spending. Easy access to primary care services means employees are willing and able to see on-site providers for more routine health concerns they might have otherwise neglected.

3. Greater transparency regarding treatment costs. Almost everyone has received a bill from his insurance at some point listing a litany of codes and featuring a hefty amount due at the end. On the flip side of that coin, most physicians are kept in the dark about the costs of treatments so they can prioritize patient care above all else. Corporate clinics can alleviate some of the secrecy surrounding healthcare costs by being transparent about employee treatment. This can actually lead to improved care and lowered costs, with on-site physicians working in tandem with company leaders to drive down expenses.

As more companies find value in corporate clinics, an increasing number of large corporations will likely bring medical services in-house to help drive down bloated healthcare costs. Mid-sized businesses might also be tempted to explore the possibility of creating their own clinics given the potential cost savings. The shift will help foster a culture of health in the United States that benefits employers, employees, and communities.

Rob Indresano, Chief Operations Officer, Barton Associates

About the Author: Rob Indresano is president and COO of Barton Associates, a national recruiting and staffing firm based in the Boston area that specializes in temporary healthcare assignments. Rob is responsible for managing operations as well as the company’s strategic vision. Before joining the Barton team, Rob was vice president and general counsel for Oxford Global Resources Inc. and corporate counsel for Oracle Corp.

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: 3 Steps to Achieving Document Efficiency in Healthcare

September 4th, 2017 by Melanie Matthews

Even with the use of electronic health records, printing documents continues to be one of the highest expenses for hospitals. In fact, the average 1,500-bed hospital prints over 8 million pages per month, resulting in annual costs of $3.8 million on average. There are numerous opportunities to increase efficiency in print environments, thereby reducing costs, according to a new infographic by CynergisTek.

The infographic details three steps hospitals should take to increase their print environment efficiency.

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.

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: U.S. Healthcare Spending

August 16th, 2017 by Melanie Matthews

Total healthcare spending is expected to rise to one-fifth of the U.S. economy by 2025, according to a new infographic by the Peterson Center on Healthcare.

The infographic drills down on U.S. healthcare spending trends as well as the impact of unnecessary and ineffective spending.

HIN’s Healthcare Benchmark Series provides continuous qualitative data on industry trends to empower healthcare companies to assess strengths, weaknesses and opportunities to improve by comparing organizational performance to reported metrics.

Details about HIN Benchmark resources:

  • Feedback from 1,000 respondents annually;
  • Thousands of sector-specific data points, sorted by hospital, health plan and provider;
  • Year-over-year data analysis;
  • 8 to 10 trending topics annually.

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Infographic: Reducing Clinical Variation Through Analytics

August 11th, 2017 by Melanie Matthews

Some 42 percent of wasteful healthcare spending in the United States is attributed to clinical variation, according to a new infographic by Qlik.

The infographic looks at the financial and social cost of clinical variation and how to advance positive outcomes using analytics.

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 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: How Will Aging Baby Boomers Challenge Healthcare?

August 9th, 2017 by Melanie Matthews

By 2029, the last of the Baby Boom generation will reach retirement age. As this population gets older, they present increasing challenges but also opportunities for the U.S. healthcare system, according to a new infographic by Adventist University’s Masters in Health Administration program.

The infographic examines Baby Boomers and their health; health spending on Baby Boomers; the challenges Baby Boomers bring to the healthcare system; and strategies to address the healthcare needs of Baby Boomers.

From home sensors that track daily motion and sleep abnormalities to video visits via teleconferencing, Humana’s nine pilots of remote patient monitoring test technologies to keep the frail elderly at home as long as possible. When integrated with telephonic care management, remote monitoring has helped to avert medical emergencies and preventable hospitalizations among individuals with serious medical and functional challenges.

In Remote Patient Monitoring for Enhanced Care Coordination: Technology to Manage an Aging Population, Gail Miller, vice president of telephonic clinical operations in Humana’s care management organization, Humana Cares/SeniorBridge, reviews Humana’s expanded continuum of care aimed at improving health outcomes, increasing satisfaction and reducing overall healthcare costs with a more holistic approach.

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