Archive for the ‘Healthcare Costs’ Category

Guest Post: The Provider’s Responsibility for Building Patient Relationships

July 31st, 2018 by Dr. Delanor Doyle

A foundational element of healthcare is the relationship between a patient and their PCP.

One of the foundational elements of healthcare is, or at least should be, the relationship between a patient and their primary care physician (PCP). And yet, it seems many Americans are not fully utilizing their PCP and instead are turning to emergency rooms or urgent care clinics for non-urgent conditions and illnesses. In fact, only 9 percent of emergency department visits result in a hospital admission. This means it is likely that many of these cases could have been avoided by seeking the care of a PCP.

Emergency department visits not only result in hefty costs to the patient and their employer, but also create wastes of time and resources in the healthcare system. The impact in terms of costs, for the patients can have many down-stream consequences. In fact, a recent report by the U.S. Federal Reserve found that four out of 10 adults in the United States could not cover an unexpected $400 expense. In some cases, this amount can easily be reached for a single emergency room visit between out-of-pocket costs for the visit, medications and laboratory services —especially when dealing with out-of-network issues. Providers should work to keep patients out of emergency rooms and urgent care facilities and to emphasize the importance and purpose of the PCP in the patient’s healthcare journey.

Until the 1940s, about 40 percent of all physician visits were house calls and while today patients don’t have this same expectation, providers should treat patients with that same level of personalized, individual care that builds a strong relationship. Providers can consider implementing the following best practices with their patients:

Every Discharge Deserves a Follow-Up

In many cases the PCP is not the provider who admitted or cared for the patient while in the hospital. However, it is imperative that the PCP insist on receiving information about the patient’s admission, so that he or she can be a part of the discharge plan. The patient should be seen back in the practice within three to five days after discharge —even if they were seen just prior to going into the hospital. In fact, this should be scheduled for the patient prior to hospital discharge. Timely follow-up appointments have been associated with a decreased risk of readmission. A converse association also exists. A study published in Clinical Interventions of Aging found only half of patients discharged following heart failure had a follow-up appointment scheduled and the readmission rate was significantly higher in those that had no follow-up scheduled.

Follow-up appointments allow for the provider to engage or re-engage the patient and ensures the patient is aware of any care transition recommendations. Concerns regarding disease process, expectations and convalescence should be addressed at this time. Working to schedule all patients for timely follow-up post discharge eliminates the risk of the patient forgetting to schedule the appointments themselves. Many patients report a higher sense of satisfaction with the communication between themselves and their provider and with their overall care.

Encourage Virtual Care Options

For after-hours needs, do your patients know there are virtual care options they can use in lieu of going to the emergency room or urgent care clinics for non-urgent concerns? Many patients are simply unaware of these services or aren’t sure how to use them so they don’t consider it as an option. According to the National Business Group on Health, only 8 percent of employees utilize telemedicine services, yet the cost of healthcare benefits is expected to increase an average of 5 percent due in part to pharmaceutical costs but also to site of service issues as well. Spend a few minutes during the visit to educate patients on the services available as well as when to use them.

Promote Health Plan Resources

Unfortunately, many patients are also not familiar with the services or programs offered by their health plans. These materials are good resources for preventative care measures and offer proactive suggestions for patients. For example, their insurance provider might offer diabetes educational materials and resources. Most health plans have programs for diabetes and other chronic conditions. If members are encouraged to access the materials available online, telephonically and in print they might be more likely to seek out that information and if contacted by the health plan they will be much more likely to engage. It is important that patients begin to get a sense that the health plan and the providers are collaborating for the patient’s benefit.

We are still in a fee-for-service world but moving toward fee-for-value. This is being driven by the Centers for Medicare and Medicaid Services (CMS) and all the major health plans. To be successful in this new world, improved patient outcomes should be a major focus for providers. Strategies that engage the patient and simplify the healthcare experience when and where it is needed most are going to be produce the winners in this new era. The literature is replete with strategies that can produce population health success, but few are shown to be consistently correlated to economic success combined with improved patient satisfaction and outcomes. The exceptions have been those that employ heavy care coordination in a face-to-face venue and that address the social determinants of disease.

Fully leveraging these strategies is going to require the development of trust between the patient and provider so that patients know we are not just treating a disease but caring for the whole person. When that level of trust is reached it becomes easier to influence utilization of the PCP practice and other more appropriate levels of care instead of the ED. Similarly, it becomes easier to impact the readmission rate in one’s own panel of patients.

About the Author:

Dr. Delanor Doyle

Dr. Delanor Doyle

Dr. Delanor Doyle is the chief medical officer of Texas Health Aetna. Leveraging the strengths of two leading organizations, Texas Health Aetna is blurring the lines of traditional health care plans and health systems to create a truly integrated solution that’s simple to navigate and puts the member’s experience first. The local health plan is committed to providing affordable, high-quality health care services and delivering customized care to members throughout the Dallas-Fort Worth metroplex. For more information about Texas Health Aetna, visit www.texashealthaetna.com.

Infographic: Tackling Hospital Staffing Problems

July 18th, 2018 by Melanie Matthews

Healthcare staffing remains a problem for hospitals. Thirty-one percent of hospitals cannot find enough candidates to fill open positions. Only slightly more than 25 percent of leadership positions are being filled within three months. Medium and large hospitals spend between $10,000 and $30,000 to hire leadership positions, according to a new infographic by TargetRecruit.

The infographic examines healthcare staffing trends and how healthcare organizations can tackle these problems.

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.

Infographic: Reducing the Use of Low-Value Healthcare Services

July 16th, 2018 by Melanie Matthews

The United States spends more, both per capita and as a percent of GDP, on healthcare than any other country, yet fails to achieve commensurate health outcomes. One reason for this discrepancy between health spending and outcomes is the significant amount—upwards of $200 billion per year—that the United States spends on low-value care, according to the University of Michigan Value-Based Insurance Design (V-BID) Center.

A new infographic by the V-BID Center provides a list of the top five low-value clinical services for purchasers to target for reduction. The selected services were chosen based on their association with harm, their cost, their prevalence, and the availability of concrete methods to reduce their use.

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: Sepsis Alert

July 4th, 2018 by Melanie Matthews

Sepsis is the leading cause of death in United States’ hospitals today. Moreover, 62 percent of patients hospitalized with sepsis are re-hospitalized within 30 days, according to a new infographic by TigerConnect, Inc.

The infographic examines how a secure communication solution can speed sepsis response times for better patient outcomes.

2018 Healthcare Benchmarks: Telehealth & Remote Patient MonitoringArtificial intelligence. Automation. Blockchain. Robotics. Once the domain of science fiction, these telehealth technologies have begun to transform the fabric of healthcare delivery systems. As further proof of telehealth’s explosive growth, the use of wearable health-tracking devices and remote patient monitoring has proliferated, and the Centers for Medicare and Medicaid Services (CMS) has added several new provider telehealth billing codes for calendar year 2018.

2018 Healthcare Benchmarks: Telehealth & Remote Patient Monitoring delivers the latest actionable telehealth and remote patient monitoring metrics on tools, applications, challenges, successes and ROI from healthcare organizations across the care spectrum. This 60-page report, now in its fifth edition, documents benchmarks on current and planned telehealth and remote patient monitoring initiatives as well as the use of emerging technologies in the healthcare space.

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: Relieving the Burden of Prior Authorizations

June 27th, 2018 by Melanie Matthews

Prior authorizations are necessary and unavoidable, costing healthcare organizations time and money and contributing to physician burnout, according to a new infographic by athenahealth, Inc.

The infographic provides options for managing prior authorizations and best practices for handling them.

Proactive Care Management in a Top-Performing ACO: Closing Quality and Care Gaps in High-Risk, High-Utilization PopulationsAs one of 2016’s top 10 performing MSSP accountable care organizations, UT Southwestern Accountable Care Network (UTSACN) generated nearly $17.5 million in shared savings.

Proactive Care Management in a Top-Performing ACO: Closing Quality and Care Gaps in High-Risk, High-Utilization Populations divulges some of the secrets behind UTSACN’s success in the Medicare Shared Savings Program (MSSP) for ACOs. Winning strategies of the UTSACN ACO include a commitment to data analytics to inform programming and improve utilization and quality as well as holding its healthcare providers accountable for clinical and fiscal decisions. 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: 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.

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: 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.