Archive for the ‘Physician Practices’ Category

Infographic: 2019 Merit-based Incentive Payment System Adjustment for 2017 Performance Year

October 15th, 2018 by Melanie Matthews

Clinicians will receive a positive, neutral, or negative payment adjustment factor based on their 2017 Merit-based Incentive Payment System (MIPS) final score, according to a new infographic by the Centers for Medicare and Medicaid Services.

The infographic examines the MIPS final score and payment adjustment factors.

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.

Guest Post: 3 Strategies for Combating Physician Burnout

September 20th, 2018 by James Korman

Physicians now find themselves under more stress and pressure from a variety of sources beyond their control.

Physicians call it “Pajama Time.” But it has nothing to do with curling up with a good book before heading off to bed. In medical parlance, Pajama Time refers to the several hours at night that many physicians must set aside to catch up on completing notes, tasks and orders that they simply don’t have a time to manage during the workday.

Pajama Time is symptomatic of a larger and growing problem throughout the medical profession: physician burnout. Dealing with a flood of medical data is a major cause of physician burnout. But it’s not the only one.

Physicians now find themselves under more stress and pressure from a variety of sources beyond their control. For example, stress is sparked by increased patient volume, wrestling with complex and time-consuming electronic health records (EHRs), merging practices that result in a loss of autonomy and peer-to-peer interactions, and a sharper emphasis on outcome metrics and benchmarks.

Although many of these changes are necessary as medicine moves away from fee-for-service and toward fee-for-value, the triple aim that is meant to fix the U.S. healthcare system only magnifies and perpetuates the stress experienced among the nation’s physicians.

Often difficult to detect, physician burnout takes on many forms. Chief among them is emotional exhaustion, detachment and insensitivity toward patients and a lack of feeling successful and accomplished in their work.

The severity of physician burnout often depends on the type of medical specialty being practiced.

Tait Shanafelt, MD, a nationally recognized expert in physician wellness, in 2014 administered the Maslach Burnout Inventory to a large national physician sample showing that approximately 50 percent of U.S. physicians were experiencing at least one symptom of burnout. In 2013, the first year of the “Medscape Lifestyle Report,” showed that emergency medicine had the highest rates of burnout, just above 50 percent. That jumped to close to 60 percent in 2017. It also showed that physicians working in primary care tended to struggle most with burnout.

The consequences of physician burnout run far and wide.

Picture a Venn diagram, with burnout overlapping the personal and the professional effects. Personal consequences include anxiety, depression, alcohol and substance abuse, family conflict and an increased risk of suicide, according to the Mayo Clinic. Professional consequences range from decreased quality of care to increased medical errors to decreased patient satisfaction.

The rising level of physician burnout is simply unsustainable, with repercussions negatively affecting nearly every facet of the healthcare system.

Summit Medical Group, the nation’s largest independent multispecialty physician group, recognized the concerning trend of burnout among doctors even before it was talked about openly, and is at the forefront of this issue. The group is combating physician burnout on multiple fronts:

  1. Improve communications. One way to help physician burnout is to give physicians an avenue to express what they see as causing their stress and have someone take it seriously. Summit Medical Group (SMG) has made this a top priority by having its board of directors, who are practicing physicians, meet with the group’s physicians to obtain their feedback, thoughts and suggestions. By having regular small group meetings with physicians these leaders gain a keener sense of the possible remedies that SMG can adopt to reduce burnout. Also, most of the interventions that the group has adopted to address burnout has come from these meetings. To further help with communication, SMG assigned lead physicians to geographic regions to ensure that accurate and timely information gets down to the individual physician and their feedback gets up to leadership. Another way SMG has strengthened overall communication is through various electronic newsletters that keep its physicians informed and engaged about the medical group and their colleagues. They have also created a dedicated email address and voicemail allowing their physicians to leave confidential feedback at any time.

  2. Bolster physician support services. It is well-known that physicians are excellent at helping others, but not very good at asking for help themselves. It’s not in their DNA. That’s why it’s incumbent upon medical groups to proactively offer support services to their physicians with minimal barriers. For example, SMG has trained 14 volunteer physicians from different specialties to speak with their colleagues during times of acute stress, unexpected outcomes or when dealing with a medical malpractice lawsuit. These volunteer physicians often have been though similar situations, making it easier for them to offer support and advice. SMG also does not wait for their physicians to ask for help but will reach out to them to offer support whenever one has had a stressful event or appears in need. SMG further understands that at times medical providers need more than a peer to speak to and does have professional psychological services available to them. There are also other support services that SMG has implemented, including ways to help physicians unplug when they are on vacation. Because many physicians receive hundreds of patient orders and tasks per week it is no wonder that many feel compelled to log on to the EHR when they’re supposed to be recharging their batteries. And if they choose not to log-on many experience anxiety on vacation knowing what they are going to return to when they head back to the office. To help, SMG has hired Advanced Practicing Nurses and Physician Assistants to manage their doctors’ EMR inboxes when they are on vacation. This not only helps the vacationing physician but also reduces the burden on the office staff who are often managing their own work along with that of the vacationing doctor.

  3. Foster a sense of community. The ‘Physician Lounge,’ a physical space where doctors could unwind and exchange professional information and give each other support, used to be a staple of the medical profession. No longer. Physicians simply do not have the time to go to the lounge during busy work hours and many medical systems have eliminated them in favor of more clinical space. However, medical groups do need to find alternative means for their physicians to interact with each other to avoid having them feel isolated and siloed. For example, this summer SMG adopted a social media platform called Yammer. Yammer has been described as an on-line “Physician Lounge” where doctors can exchange medical information, consult on general medical cases, share social pleasantries and provide each other support. Similar to Facebook, Yammer is set up for each medical department throughout SMG as well as for the larger physician group. Perhaps most important, Yammer offers physicians a sense of community—a place where they can share ideas, frustrations and solutions to the stresses they face. In addition, SMG holds regular networking events, which give providers who may feel isolated in their work the opportunity to interact with colleagues both professionally and socially.

James Korman

James Korman

About the Author: James Korman, PSYD, FACT, is the director of behavioral health and provider engagement at Summit Medical Group.

Infographic: 6 Ways to Keep Patients Coming Back

September 17th, 2018 by Melanie Matthews

Normal attrition rates for physician practices range between 10 percent and 30 percent, according to a new infographic by Solutionreach, Inc.

The infographic looks at why patients leave practices and strategies to overcome patient attrition.

Improving the Patient Experience: Engaging Front-line Staff for a System-Wide Action PlanUnityPoint Health has moved from a siloed approach to improving the patient experience at each of its locations to a system-wide approach that encompasses a consistent, baseline experience while still allowing for each institution to address its specific needs. Armed with data from its Press Ganey and CAHPS ® Hospital Survey scores, UnityPoint’s patient experience team developed a front-line staff-driven improvement action plan.

During Improving the Patient Experience: Engaging Front-line Staff for a System-Wide Action Plan a 45-minute webina, now available for replay, Paige Moore, director, patient experience at UnityPoint Health—Des Moines, shares how the organization switched from a top-down, leadership-driven patient experience improvement approach to one that engages front-line staff to own the process.

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: Provider Appointment Wait Times

May 23rd, 2018 by Melanie Matthews

With an on-demand economy, patients value convenience in their healthcare experience, according to a new infographic by athenahealth, Inc.

The infographic examines patients’ perceptions and the impact of provider appointment wait times, along with ways to reduce these wait times.

UnityPoint Health has moved from a siloed approach to improving the patient experience at each of its locations to a system-wide approach that encompasses a consistent, baseline experience while still allowing for each institution to address its specific needs.

Armed with data from its Press Ganey and CAHPS® Hospital Survey scores, UnityPoint’s patient experience team developed a front-line staff-driven improvement action plan.

Improving the Patient Experience: Engaging Front-line Staff for a System-Wide Action Plan, a 45-minute webinar on July 27th, now available for replay, Paige Moore, director, patient experience at UnityPoint Health—Des Moines, shares how the organization switched from a top-down, leadership-driven patient experience improvement approach to one that engages front-line staff to own the process.

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: Approaching MIPS and Quality

April 4th, 2018 by Melanie Matthews

Quality is one of the four components the Centers for Medicare and Medicaid Services will use to make payment adjustments under MIPS, according to a new infographic by athenahealth, Inc.

The infographic provides an overview of MIPS’ quality scoring as well as how to report the data and determine which reporting methods to use.

Under CMS’s “Pick Your Pace” choices for Year 1 Quality Payment Program participation, physician practices may opt for the minimum activity necessary to avoid a payment penalty in 2019 by simply submitting some data in 2017.

However, instead of delaying MACRA participation to the later part of this year, physicians should prepare and better position themselves today for MIPS success by analyzing their existing CMS data on their practices’ performance and laying a path now toward performance improvement.

Physician MACRA-Readiness: Mining QRUR and Other CMS Data to Maximize MIPS Performance describes the wealth of data analytics available from the CMS Enterprise Portal–Quality Resource Use Reports (QRURs) and other reports providing a window into practice performance under the Merit-Based Incentive Payment System (MIPS). MIPS is one of two MACRA reimbursement paths and the one where most physician practices are expected to align.

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: Physician Lifestyle and Happiness 2018 Report

March 16th, 2018 by Melanie Matthews

Physicians struggle with many of the same issues that other people do—friendships, relationships, exercising and maintaining a healthy weight, according to Medscape’s Physician Lifestyle and Happiness report.

A new infographic by Board Vitals highlights some of the survey findings including what role spiritual beliefs play in physicians’ coping skills, whether physicians are in a committed relationship and physician vacation habits.

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.

Population Health Tactics to Boost an ACO’s Medicare Annual Wellness Visit Rates

February 9th, 2018 by Patricia Donovan

One of the most important revenue opportunities for primary care physicians, and for population health nurses under their direct supervision, is the Medicare Annual Wellness Visit (AWV), advises Tim Gronninger, senior vice president of development and strategy, Caravan Health. The AWV offers an opportunity to check a number of Medicare quality boxes, including preventive check-ins, vaccinations and health screenings, to help make sure that a beneficiary’s medical needs are being met.

Here, Gronninger suggests ways that physician practices can improve all-important AWV rates.

Much of increasing annual wellness visit rates is about how to manage expectations of the practice and of the patient. You’ll be chasing your tail a lot if you are looking at your data and saying, “Well, these 1,000 patients haven’t had an annual wellness visit. I’m going to make a thousand phone calls, and then I’m going to make a thousand follow-up phone calls to try to schedule them all.”

It is very important for a practice to create a process where you have the time, the space and the plan, so that when a patient comes in the door for an Evaluation and Management (E&M) visit, the patient is handed off seamlessly to a nurse coordinator to complete an annual wellness visit at the same time. Obviously, different patients will require different handling. But we have found a very high acceptance rate from that approach among patients of clients that we work with.

It’s something that many patients take for granted, that their clinician knows this about them already. However, many times, the physician in practice doesn’t know whether the patient is up to date on their mammograms or other types of screenings.

Editor’s Note: Caravan Health’s ACOs saved more than $26 million in the Medicare Shared Savings Program (MSSP) and achieved higher than average quality scores and quality reporting scores in 2016.

Source: Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS Success

ACO population health

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).

2018 Success Strategy: Differentiate to Survive Next Wave of Healthcare

January 5th, 2018 by Patricia Donovan

Are supermarkets the next wave of healthcare?

Perhaps not, but if a health insurer can move into the community pharmacy, why not the local grocery store?

On the heels of the recent non-traditional CVS Health-Aetna merger and amidst other swirling consolidation rumors, industry thought leaders are encouraging healthcare organizations to embrace similar partnerships and synergies.

And given the presence of pharmacies inside many supermarkets, “there is potential for greater synergies around what we eat, what we buy and how our healthcare is actually purchased or delivered,” suggests David Buchanan, president of Buchanan Strategies.

“The bonanza [from this merger] might be where data can be shared between CVS’s customers and Aetna’s customers and whether we can steer those CVS customers to Aetna,” he added.

Buchanan and Brian Sanderson, managing principal of healthcare services for Crowe Horwath, sketched a roadmap to help healthcare providers and payors navigate the key trends, challenges and opportunities that beckon in 2018 during Trends Shaping the Healthcare Industry in 2018: A Strategic Planning Session, a December 2017 webinar now available for rebroadcast.

Key guideposts on the road to success: data analytics, consolidation, population health management, patient and member engagement, and telemedicine, among other indicators. Also, organizations shouldn’t hesitate to test-drive new roles in order to differentiate themselves in the marketplace.

“If you are not differentiated, you will not survive in what is a very fluid marketplace,” Sanderson advised.

Honing in on the healthcare provider perspective, Sanderson posed five key questions to help shape physician, hospital and health system strategies, including, “What are the powerful patterns?” Industry mergers, an infusion of private equity money into areas like ambulatory care and emerging value-based payment models fall into this category, he suggested.

These patterns were echoed in four primary trends Sanderson outlined as shaping the direction of the healthcare market, which faces an increasingly “impatient” patient. “I could tell you the market wants care everywhere,” he said. “In the same way we have become impatient with our commoditized goods, so have patients become impatient with accessing care.”

Among these trends are “unclear models of reimbursement,” he noted, adding that after a self-imposed “pause” relative to healthcare reimbursement at the start of a new presidential administration, the industry is ready to “restart with some new sponsors now.”

Notably, Sanderson advised providers to embrace population management. “Don’t think population health, think population management. It’s no longer just the clinical aspects of a patient’s or a population’s health. It’s the overall management of their well-being.”

Following Sanderson’s five winning strategies for healthcare provider success, David Buchanan outlined his list of hot-button items for insurers, which ranged from the future of Obamacare and member engagement to telemedicine, healthcare payment costs and models and trends in Medicare and Medicaid.

Healthcare payors should not underestimate the value of engaging its members, who today possess higher levels of health literacy, he stated. “The member must be an integral part of healthcare transactions, as are the provider, the facility and the insurer. The member must have a greater level of personal responsibility and engagement in the process.”

Offering members wearable health technologies like fitness trackers is one way insurers might engage individuals in their health while creating ‘stickiness’ and member allegiance to the health plan.

Telemedicine, the fastest growing healthcare segment, is another means of extending payors’ reach and increasing profitability, he adds. “Telemedicine is not just for rural health settings anymore, but is finding another subset of adopters among people who can’t fit a doctor’s visit into their busy schedule.”

Payors should expect some competition in this area. “I believe the next wave [of telehealth] will be hospitals expanding into local telehealth services as a lead-in to their local clinics,” Buchanan predicted.

The use of artificial intelligence (AI) and robotics in healthcare is growing, but Buchanan and Sanderson agree that adoption will be slow. On the other hand, expect more collaboration between digital players like Amazon, Google and Apple and larger health plans.

“You will see [synergies] when you can put those two players together: the company that can bring the technology to the table as well as those companies that bring the users to the table,” concluded Buchanan.

Listen to a HIN HealthSounds podcast in which David Buchanan predicts the future of mega mergers in healthcare, the impact of the CVS-Aetna alliance on brand awareness, and the real ‘bonanza’ of the $69 billion partnership, beyond bringing healthcare closer to home for many consumers.

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

November 30th, 2017 by Patricia Donovan

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

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

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

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

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

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

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

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

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

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

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

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


Infographic: Monitoring and Managing Chronic Disease

November 22nd, 2017 by Melanie Matthews

Patients with chronic conditions rely on their healthcare teams to help them manage their health, according to a new infographic by West Corporation.

The infographic examines the steps providers can take to monitor and manage chronic disease among their patient populations.

In the sphere of value-based healthcare, chronic care management (CCM) is a critical component of primary care and population health management. Targeting the Triple Aim goals of better health and care for individuals while reducing spending, CCM is viewed as a stepping-stone to success under Medicare’s Quality Payment Program that launched January 1, 2017.

2017 Healthcare Benchmarks: Chronic Care captures tools, practices and lessons learned by the healthcare industry related to the management of chronic disease.

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.