Archive for the ‘Healthcare Utilization’ Category

Infographic: Community Health Navigators Address Social Determinants of Health to Impact High Hospital Utilization

July 29th, 2019 by Melanie Matthews

AmeriHealth Caritas leverages its community care management teams led by a medical director and consisting of community health navigators, community care managers, and a program manager to engage high- and emerging-risk members to increase their access to care and improve their overall healthcare experience through care management services delivered in member homes, with an emphasis in screening for and addressing social determinants of health (SDOH), according to a new infographic by AmeriHealth Caritas.

The infographic examines AmeriHealth Caritas’ success in identifying and addressing specific SDOH vulnerabilities at both the population and member levels.

Assessing Social Determinants of Health: Screening Tools, Triage and Workflows to Link High-Risk Patients to Community ServicesLeveraging the experience of several physician practices already screening patients for social determinants of health (SDOH), Montefiore Health System recently rolled out a two-tiered assessment program to measure SDOH positivity in its predominantly high-risk, government-insured population.

Assessing Social Determinants of Health: Screening Tools, Triage and Workflows to Link High-Risk Patients to Community Services outlines Montefiore’s approach to identifying SDOH markers such as housing, finances, healthcare access and violence that drive 85 percent of patients” well-being, and then connecting high-need individuals to community-based services. Click here for more information.

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Infographic: The Harms of Overuse in Healthcare

June 19th, 2019 by Melanie Matthews

It is estimated that up to 30 percent of all healthcare offers no clinical value to patients, according to a new infographic by The Commonwealth Fund.

The infographic explores the impact of healthcare overuse on patients, providers and the healthcare system as a whole.

2019 Healthcare Benchmarks: Reducing Avoidable Healthcare UtilizationMedicaid expansion programs, newly covered individuals under healthcare insurance exchanges, the rise of big data, and shifts in healthcare delivery models have influenced emergency department and hospital utilization.

2019 Healthcare Benchmarks: Reducing Avoidable Healthcare Utilization is a comprehensive analysis by the Healthcare Intelligence Network of how healthcare organizations define and address avoidable healthcare utilization. The report captures key actionable metrics on reducing avoidable healthcare utilization initiatives, challenges, case studies and innovative programming.

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Infographic: 4 Technologies Enabling the Outpatient Market

June 5th, 2019 by Melanie Matthews

Advancements in medical technology have played a key role in enabling many procedures to shift from traditionally inpatient to outpatient settings, according to a new infographic by Definitive Healthcare, LLC.

The infographic highlights four key technological enablers of the shift to outpatient care.

A New Vision for Remote Patient Monitoring: Creating Sustainable Financial, Operational and Clinical OutcomesAs healthcare moves out of the brick-and-mortar traditional setting into patients’ homes and their workplaces, and becomes much more proactive, the University of Pittsburgh Medical Center (UPMC) has been expanding its remote patient monitoring program. The remote patient monitoring program at UPMC has its roots in the heart failure program but has since expanded to additional disease states across the integrated delivery system’s continuum of care.

A New Vision for Remote Patient Monitoring: Creating Sustainable Financial, Operational and Clinical Outcomes delves into the evolution of UPMC’s remote patient monitoring program from its initial focus on heart failure to how the program was scaled vertically and horizontally. Click here for more information.

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Infographic: Millennials Are Reshaping Healthcare

May 27th, 2019 by Melanie Matthews

Millennials are redefining what is required of healthcare. Born between 1981 and 1996 and on track to become the largest generation in the United States, millennials are digital natives who use technology to manage every aspect of their daily lives. They expect the ease and efficiency that technology provides from their healthcare experience, according to a new infographic by UbiCare.

The infographic examines what the millennial generation means for healthcare providers as they try to engage members of this generation.

Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System Encouraged by early success in coaching 23 patients to wellness at home via remote monitoring, CHRISTUS Health expanded its remote patient monitoring (RPM) enrollment to 170 high-risk, high-cost patients. At that scaling-up juncture, the challenge for CHRISTUS shifted to balancing its mission of keeping patients healthy and in their homes with maintaining revenue streams sufficient to keep its doors open in a largely fee-for-service environment.

Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System chronicles the evolution of the CHRISTUS RPM pilot, which is framed around a Bluetooth®-enabled monitoring kit sent home with patients at hospital discharge.

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Guest Post: 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: Impact of Diagnostics on Healthcare Outcomes

April 20th, 2018 by Melanie Matthews

Diagnostic testing plays a key role in reducing hospitalizations, preventing infections, and improving healthcare outcomes, according to a new infographic by Health Industry Distributors Association.

The infographic explores the impact of diagnostic testing on healthcare utilization, infections, adverse health events, patient satisfaction and healthcare costs.

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.

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Infographic: Hospitals Drive Post-Acute Volume

April 2nd, 2018 by Melanie Matthews

Twenty-two percent of all hospital patients are discharged to post-acute care (PAC), according to a new infographic by the Health Industry Distributors Association.

The infographic examines other PAC trends, including the top five conditions discharged to PAC and PAC facilities with the highest volume of post-hospital discharge patients.

A Collaborative Blueprint for Reducing SNF Readmissions: Driving Results with Quality Reporting and Performance Metrics
Concerned about escalating hospital readmissions from skilled nursing facilities (SNFs) and the accompanying pinch of Medicare readmissions penalties, three Michigan healthcare organizations set competition aside to collaborate and reduce rehospitalizations from SNFs.

To solidify their coordinated approach, Henry Ford Health System (HFHS), the Detroit Medical Center and St. John’s Providence Health System formed the Tri-County SNF Collaborative with support from the Michigan Quality Improvement Organization (MPRO).

A Collaborative Blueprint for Reducing SNF Readmissions: Driving Results with Quality Reporting and Performance Metrics examines the evolution of the Tri-County SNF Collaborative, as well as the set of clinical and quality targets and metrics with which it operates.

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Infographic: 340B Hospitals Provide Healthcare Safety Net for Low-Income Americans

March 30th, 2018 by Melanie Matthews

340B hospitals treat significantly more low-income patients and provide a greater percentage of uncompensated and unreimbursed care, according to a new infographic by 340B Health.

The infographic examines the critical services 340B hospitals provide to low-income hospitals.

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: The Role of Medicaid in Addressing the Opioid Epidemic

March 7th, 2018 by Melanie Matthews

The opioid epidemic is increasing among Americans, with addiction to heroin, fentanyl, and prescription painkillers, such as oxycodone
and hydrocodone, contributing to this public health crisis. Medicaid plays a central role in the nation’s efforts to address the opioid epidemic, according to a new infographic by the Kaiser Family Foundation.

The infographic examines the escalation of the opioid epidemic, how states are responding and a state-by-state comparison of indicators of Medicaid’s role in addressing the opioid crisis.

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: How Much Is Your Unmanaged Population Costing You?

February 23rd, 2018 by Melanie Matthews

Population health management programs are a key factor in a healthcare organizations’ ability to improve health outcomes and lower healthcare costs, according to a new infographic by Conifer Health Solutions.

The infographic follows the journey of two health plan members for the cost and quality impact of implementing a successful population health management strategy.

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).

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