Archive for the ‘Quality Improvement’ Category

Infographic: 5 Factors Driving Healthcare Digital Transformation

November 8th, 2017 by Melanie Matthews

Increases in life expectancy, changing consumer behavior, political uncertainties, inflation and rising number of chronic diseases are helping to drive the digital health transformation demand, according to a new infographic by InsightRush.

The infographic examines how each of these factors is contributing to the digital health transformation.

2016 Healthcare Benchmarks: Digital HealthDigital health, also referred to as ‘connected health,’ leverages technology to help identify, track and manage health problems and challenges faced by patients. Person-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health 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.

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.

4 Ways CMS 2018 Quality Payment Program Supports ‘Patients Over Paperwork’ Pledge

November 6th, 2017 by Patricia Donovan

“Patients Over Paperwork” is committed to removing regulatory obstacles that get in the way of providers spending time with patients.

Year 2 of the CMS Quality Payment Program promises continued flexibility and reduced provider burden, according to the program’s final rule with comment issued by the Centers for Medicare and Medicaid Services (CMS) last week.

The Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), is a quality payment incentive program for physicians and other eligible clinicians that rewards value and outcomes in one of two ways: through the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

A QPP Year 2 fact sheet issued by CMS highlights 2018 changes for providers under the QPP’s MIPS and APM tracks. The Year 2 fact sheet noted that stakeholder feedback helped to shape policies for QPP Year 2, and that  “CMS is continuing many of its transition year policies while introducing modest changes.”

In keeping with the federal payor’s recently launched “Patients Over Paperwork” initiative, QPP Year 2 reflects the following changes:

    • More options for small practices (groups of 15 or fewer clinicians). Options include exclusions for individual MIPS-eligible clinicians or groups with less than or equal to $90,000 in Part B allowed charges or less than or equal to 200 Part B beneficiaries, opportunities to earn additional points, and the choice to form or join a virtual group.
    • Addresses extreme and uncontrollable circumstances, such as hurricanes and other natural disasters, for both the 2017 transition year and the 2018 MIPS performance period, by offering hardship exception applications and limited exemptions.
    • Includes virtual groups as another participation option for Year 2. A virtual group is a combination of two more taxpayer identification numbers (TINs) made up of solo practitioners and groups of 10 or fewer eligible clinicians who come together ‘virtually’ (no matter specialty or location) to participate in MIPS for a performance period of a year. A CMS Virtual Groups Toolkit provides more information, including the election process to become a virtual group.
    • Makes it easier for clinicians to qualify for incentive payments by participating in Advanced APMs that begin or end in the middle of a year. Updated QPP policies for 2018 further encourage and reward participation in APMs in Medicare.
  • CMS describes its Patients Over Paperwork effort as “a cross-cutting, collaborative process that evaluates and streamlines regulations with a goal to reduce unnecessary burden, increase efficiencies and improve the beneficiary experience. This effort emphasizes a commitment to removing regulatory obstacles that get in the way of providers spending time with patients.”

    Data Analytics, SDOH Screenings Flag Disengaged and 12 More Patient Engagement Trends

    October 5th, 2017 by Patricia Donovan

    More than 70 percent of healthcare organizations have created formal patient engagement initiatives, according to 2017 benchmarks from the Healthcare Intelligence Network.


    To identify individuals that are poorly engaged in their health, nearly two-thirds (63 percent) of healthcare organizations mine clinical data analytics, according to the 2017 Patient Engagement Survey by the Healthcare Intelligence Network, while 37 percent screen patients for social determinants of health related to housing, care access, transportation, nutrition and finances.

    Patients who screen positive for social determinants of health (SDOH) and individuals with diabetes are typically the most difficult populations to engage, according to 2017 survey benchmarks.

    Thirty-five percent of respondents to the September 2017 survey said the presence of SDOHs, which the World Health Organization defines as “conditions in which people are born, grow, live, work and age,” pose the greatest challenge to health engagement, while 26 percent said a diabetes diagnosis presents the top clinical challenge to engagement interventions.

    One-quarter report some resolution of SDOH factors resulting from engagement efforts.

    To improve engagement, 75 percent of respondents rely on education of patients, family and caregivers, supported with telephonic outreach (13 percent) and home visits (13 percent).

    Efforts by 71 percent of respondents to create a formal patient engagement program underscore the critical role of engagement in healthcare’s value-based care and reimbursement models, particularly in regards to chronic illness.

    In other survey findings:

    • Patient experience rankings are the most reliable measure of engagement program success, say 43 percent.
    • For one quarter of respondents, patient engagement is the primary domain of case managers.
    • Eighty-three percent saw quality metrics improve as a result of patient engagement efforts.
    • Half attributed a drop in hospital emergency room visits to their patient engagement interventions.

    Download an executive summary of the 2017 Patient Engagement Survey.

    Infographic: Industry Perspectives on Value-Based Payment

    October 4th, 2017 by Melanie Matthews

    The shift to value-based payment is a slow one, with most health plans not yet making the transition to risk, according to a new infographic by HealthScape Advisors.

    The infographic examines the percentage of plans in upside and downside risk contracts, the impact of health plan sponsor on risk contracts, cost and quality impacts for risk contracts, value-based payment enablers and recommendations for success in value-based contracts.

    The accountable care organization, or ACO, has become a cornerstone of healthcare delivery system and payment reform by raising the bar on healthcare quality and reducing unnecessary costs. There are now more than 700 ACOs in existence today, by a 2017 SK&A estimate.

    2017 Healthcare Benchmarks: Accountable Care Organizations, HIN’s fifth compendium of metrics on ACOs, captures ACO operation in today’s value- and quality-focused healthcare environment.

    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: Food Insecurity Among Medicaid Seniors

    October 2nd, 2017 by Melanie Matthews

    There’s an estimated 5.2 million seniors who are eligible for the Supplemental Nutrition Assistance Program (SNAP) but are not enrolled, according to a new infographic by Benefits Data Trust.

    The infographic examines the impact of food insecurity on seniors’ health and healthcare costs and quality.

    2017 Healthcare Benchmarks: Social Determinants of HealthInitiatives such as CMS’ Accountable Health Communities Model and other population health platforms encourage healthcare organizations to tackle the broad range of social, economic and environmental factors that shape an individual’s health. To underscore the need to address social determinants of health, Healthy People 2020 included “Create social and physical environments that promote good health for all” among its four overarching goals for the decade.

    In one measure of their impact, 2015 research by Brigham Young University found that the social determinants of loneliness and social isolation are just as much a threat to longevity as obesity.

    2017 Healthcare Benchmarks: Social Determinants of Health documents the efforts of more than 140 healthcare organizations to assess social, economic and environmental factors in patients and to begin to redesign care management to account for these factors.

    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: Patients Want a Better Healthcare Experience

    September 1st, 2017 by Melanie Matthews

    Patients are demanding more from their healthcare experience, according to a new infographic by MM&M. Technology can help solve these demands, but providers will likely have to make changes to the way they practice medicine to improve patient satisfaction.

    The infographic lists the top five things patients say improves their satisfaction with healthcare providers and provides insight into the healthcare consumer mindset.

    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.

    Food for Thought: Nutrition Programs Reduce Hospital Visits and Readmissions by Vulnerable Populations

    August 18th, 2017 by Patricia Donovan

    Malnutrition is a social determinant of health that negatively impacts health outcomes.

    It’s a difficult statistic to digest: one in three people enter the hospital malnourished or at risk of malnutrition, a state that impacts their recovery and increases their risk of health complications and rehospitalizations.

    Two studies this week highlight the clinical benefits of addressing patients’ nutrition needs before and during hospital stays as well as savings that can result from identification of social determinants of health (SDOH) like access to nutrition that drive 85 percent of health outcomes.

    In the first, a study of elderly Maryland residents by Benefits Data Trust, a national nonprofit based in Philadelphia, found that when it comes to low-income seniors, access to quality food via food stamps can also save money by reducing the number and duration of hospital visits and nursing home admissions.

    In the second, research published in American Health & Drug Benefits journal and supported by Abbott found that when Advocate Health Care implemented a nutrition care program at four of its Chicago area hospitals, it showed more than $4.8 million in cost savings due to shorter hospital stays and lower readmission rates.

    The Benefits Data Trust research found that participation by low-income seniors in the federal Supplemental Nutrition Assistance Program (SNAP) cut their odds of hospital admissions by 14 percent. The food stamps also reduced the need for ER visits by 10 percent, and cut their likelihood of going into a nursing home by nearly one quarter.

    Finally, SNAP participation also led to an 8 to 10 percent drop in the number of days a patient who was admitted remained in one of these facilities.

    As a result, hospitals and health care systems such as Advocate Health Care are looking at the value of nutrition to improve care and help patients get back to living a healthier life.

    Starting in 2014, Advocate Health Care, the largest health system in Illinois and one of the largest accountable care organizations (ACO) in the country, implemented two models of a nutrition care program for patients at risk of malnutrition. The nutrition-focused quality improvement program, which targeted malnourished hospitalized patients, consisted of screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence.

    The leader in population health found that by doing so, it reduced 30-day readmission rates by 27 percent and the average hospital stay by nearly two days.

    More recently, to evaluate the cost-savings of the Advocate approach, researchers used a novel, web-based budget impact model to assess the potential cost savings from the avoided readmissions and reduced time in hospital. Compared to the hospitals’ previous readmission rates and patients’ average length of stay, researchers found that optimizing nutrition care in the four hospitals resulted in roughly $3,800 cost savings per patient treated for malnutrition.

    Given the healthcare industry’s appetite for value- and quality-based programs, SDOH screenings and the fortification of nutrition programs in both community and inpatient settings appear to be just what the doctor ordered. However, while a 2017 study on Social Determinants of Health identified widespread adoption of SDOH screenings by providers, it also documented a scarcity of supportive community services for SDOH-positive individuals.

    Service Action Teams Turn Front-Line Staff into Patient Experience Ambassadors

    August 8th, 2017 by Patricia Donovan
    Patient Experience

    Increasingly, patient satisfaction scores figure into payors’ healthcare reimbursement formulas.

    UnityPoint Health is so invested in the concept of patient experience that it charges each member of its organization, whether healthcare provider or not, with a set of basic behaviors designed to improve it.

    These four foundational behaviors, rooted in courtesy and common sense, drive the manner in which patients, families and visitors are greeted and assisted at all times.

    “We know there are dozens of initiatives and tactics that can be used to help improve patient experience,” said Paige Moore, director of patient experience at UnityPoint Health-Des Moines, “But the four we chose were driven by patient and visitor comments and feedback.”

    Ms. Moore shared these behaviors, as well as an inside look at her organization’s patient experience improvement plan, during Improving the Patient Experience: Engaging Front-line Staff for a System-Wide Action Plan, a July 2017 webinar now available in on-demand and training formats.

    Having established this system-wide coda for all employees, UnityPoint Health next looked at further enlisting its frontline staff in efforts to improve the patient experience. To do so, it created a set of seven service action teams, with two more in the works.

    Each service action team is composed of at least 50 percent of that department’s frontline staff, rounded out by an executive sponsor and team lead.

    “We want all of our team members to be actively engaged in the projects, to take responsibility for them, to be ambassadors and patient experience champions throughout the organization,” explained Ms. Moore.

    Each team reviews results from HCAHPS® and Press Ganey® patient experience surveys to identify department priorities, such as nurses’ narration of care, physicians’ use of clear language, or discharge or transfer processes.

    UnityPoint Health launched its first service action team in 2014 for outpatient services. “This was our largest volume for surveys and it also had some of our lowest patient experience performance. We really wanted to get in and see what could we do to make the biggest impact on the highest number of our patients.”

    Once that team developed some tactics to improve patient privacy concerns, wait times and registration processes, it saw improvements in those areas.

    During the program, Ms. Moore outlined priorities and shared results from each service action team.

    Importantly, there are two support service action teams: a measurements team to educate employees on the relevance of patient experience scores and their role in them, and a communications team to convey information on patient experience activities throughout UnityPoint Health. The health system also recently launched an “Excellence in Patient Experience” awards program.

    And rounding out the program is the placement of patient experience directors like Ms. Moore throughout the organization, each supported by a physician champion.

    Physician education in patient experience is ongoing, she added, whether during rounds or mandatory one-on-one shadowing and coaching for patient experience for all new hires.

    Listen to an interview with Paige Moore on UnityPointHealth’s four foundational behaviors.

    Infographic: Patient Matching Errors

    July 21st, 2017 by Melanie Matthews

    Mistaken identities and unmatched patient healthcare records can have serious consequences, according to a new infographic by The Pew Charitable Trusts.

    The infographic looks at common patient matching problems and the impact on healthcare quality and costs.

    The Science of Successful Care Transition Management: Leveraging Home Visits to Improve Readmissions and ROIA care transitions management program operated by Sun Health since 2011 has significantly reduced hospital readmissions for nearly 12,000 Medicare patients, resulting in $14.8 million in savings to the Medicare program.

    Using home visits as a core strategy, the Sun Health Care Transitions program was a top performer in CMS’s recently concluded Community-Based Care Transitions (CBCT) demonstration project, which was launched in 2012 to explore new solutions for reducing hospital readmissions, improving quality and achieving measurable savings for Medicare.

    The Science of Successful Care Transition Management: Leveraging Home Visits to Improve Readmissions and ROI explores the critical five pillars of the Arizona non-profit’s leading care transitions management initiative, adapted from the Coleman Care Transitions Intervention®.

    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.

    “My Pleasure” or “No Problem”: Which Response Would Healthcare Consumers Prefer to Hear?

    July 19th, 2017 by Melanie Matthews

    Healthcare Scripting

    How effective is scripting in the healthcare setting?

    Years ago an article I read in a business magazine suggested replacing the phrase “No problem” with “My pleasure” when responding to a customer request. Attune to this language nuance, it began to irk me when someone would say “No problem” and conversely when I respond “My pleasure” a customer interaction takes a more positive spin.

    Fast forward many years, and I’ve started to hear an increasing number of healthcare organizations using scripting in a variety of ways…to improve the patient experience, increase patient engagement, protect patient privacy and in a host of other circumstances.

    How effective are these scripts? Can they help increase patient satisfaction and engagement? Will they have an impact on HCAHPS and HEDIS scores? What’s your experience with scripting in patient and member interactions?