Archive for the ‘Value-Based Reimbursement’ Category

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Infographic: 2020 Medicare Physician Fee Schedule: Chronic Care Management

January 24th, 2020 by Melanie Matthews

The Centers for Medicare and Medicaid Services’ final 2020 Physician Fee Schedule contains specific changes to the chronic care management program, according to a new infographic by Navigating Cancer, Inc.

The infographic outlines the top-level CCM changes.


Healthcare Trends & Forecasts in 2020: Performance Expectations for the Healthcare IndustryGiven the powerful patterns disrupting healthcare, what will it take to succeed as a high-velocity healthcare organization in the coming year?

Healthcare Trends & Forecasts in 2020: Performance Expectations for the Healthcare Industry, HIN’s 16th annual business forecast, is designed to support healthcare C-suite planning as leaders continue to strive to improve healthcare quality and access and reduce costs as the industry continues its move toward a value-based system.

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Posted in Chronic Care Management, Healthcare Administration, Healthcare Trends, Infographics, Physician Practices, Value-Based Reimbursement | No Comments »

Infographic: Healthcare’s Evolving Payment Landscape

January 20th, 2020 by Melanie Matthews

Value-based healthcare providers still need to persuade doctors that they offer better outcomes than fee-for-service models, according to a new infographic by Bain & Company.

The infographic examines physician perceptions of capitated payments, pay-for-performance and fee-for-service medicine as well as tools to support value-based care.


Healthcare Trends & Forecasts in 2020: Performance Expectations for the Healthcare IndustryGiven the powerful patterns disrupting healthcare, what will it take to succeed as a high-velocity healthcare organization in the coming year?

Healthcare Trends & Forecasts in 2020: Performance Expectations for the Healthcare Industry, HIN’s 16th annual business forecast, is designed to support healthcare C-suite planning as leaders continue to strive to improve healthcare quality and access and reduce costs as the industry continues its move toward a value-based system.

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.

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Posted in Healthcare Trends, Infographics, Value-Based Reimbursement | No Comments »

Infographic: Palliative Care Ensures Value

December 30th, 2019 by Melanie Matthews

Strong evidence exists proving the value of palliative care’s impact on quality, satisfaction, consumer demand, and cost. Because it focuses on the highest need and highest cost patient segment, palliative care is an essential strategy for population health management, according to a new infographic by the Center to Advance Palliative Care.

The infographic examines the impact of palliative care on quality of life, symptom burden, patient satisfaction and experience and healthcare spending and utilization.

When the prestigious Memorial Sloan Kettering Cancer Center (MSKCC) began to face tougher competition from hospitals with managed care contracts and limited networks, the state-of-the-art specialty hospital decided to implement a team-based care coordination approach to attract and retain healthcare payors focused on value-based care.

Integrated Case Management: Elevating Quality and Clinical Metrics with Multidisciplinary Team-Based Care details the framework and implementation of the service-based multidisciplinary program MSKCC adopted to demonstrate that the care it provides to more than 25,000 admitted patients each year is both cost-effective and cost-efficient.

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Infographic: 2020 U.S. Healthcare Delivery Outlook

December 23rd, 2019 by Melanie Matthews

2020 will mark a turning point in the evolution of a market-based model of healthcare, according to a new infographic by Numerof & Associates, Inc.

The infographic examines the accelerating pace of change in healthcare.


Healthcare Trends & Forecasts in 2020: Performance Expectations for the Healthcare IndustryGiven the powerful patterns disrupting healthcare, what will it take to succeed as a high-velocity healthcare organization in the coming year?

Healthcare Trends & Forecasts in 2020: Performance Expectations for the Healthcare Industry, HIN’s 16th annual business forecast, is designed to support healthcare C-suite planning as leaders continue to strive to improve healthcare quality and access and reduce costs as the industry continues its move toward a value-based system.

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.

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Infographic: 2018 Alternative Payment Model Trends

November 8th, 2019 by Melanie Matthews

In 2018, 35.8 percent of United States’ healthcare payments, representing approximately 226.5 million Americans and 77 percent of the covered population, flowed through alternative payment models, according to a new infographic by the Health Care Payment Learning & Action Network.

The infographic examines the types of models and their market share.

11 Profitable Value-Based Reimbursement Models: Lessons from Early AdoptersCMS’s ambitious agenda for moving Medicare into alternative payment models is driving the U.S. healthcare system toward greater value-based purchasing at a furious rate. Private payors also have pledged to continue to shift payments away from fee for service and into alternative payment models such as accountable care organizations (ACOs). Fortunately, many healthcare organizations are already exploring value-based payments—often a single innovation at a time—testing models that reward providers for meeting Triple Aim goals of improving patient experience and population health while reducing healthcare’s per capita cost.

11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters encapsulates nearly a dozen such approaches, from Bon Secours’ building of a business case for its multidisciplinary care team to the John C. Lincoln ACO’s deep dive into data analytics to identify and manage the care of high-risk, high-cost ‘VIP’ patients to ‘beat the benchmark’ to WellPoint’s engagement of specialists in care coordination.

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Infographic: Key Strategies for Developing Successful Consumer-Driven Ambulatory Businesses

November 6th, 2019 by Melanie Matthews

To build a successful consumer-driven ambulatory care business in a value-based market, health systems must retool their ambulatory approach by investing time and resources in six key business strategies, according to a new infographic by BDC Advisors.

The infographic examines these six strategies.

2019 Healthcare Benchmarks: Patient EngagementThe perennial challenge for healthcare organizations as they continue to develop and refine programs aimed at improving healthcare quality while reducing costs is engaging patients in these initiatives. Actively engaged patients have been shown to have lower costs and improved outcomes.

In fact, a recent study released by Humana on its wellness rewards program, Go365®, found that high-engaged members had lower healthcare cost increases than members with low or medium engagement. These highly engaged members paid a per member per month average of 22 percent less in healthcare than low-engaged members, had 35 percent fewer emergency room visits and 30 percent fewer hospital admissions than low-engaged members and had 11 percent more preventive doctor’s office visits than low-engaged members.

2019 Healthcare Benchmarks: Patient Engagement is the third comprehensive analysis by the Healthcare Intelligence Network of programs aimed at improving patient engagement, including how patients are identified for patient engagement interventions, populations presenting the most significant challenges, program components and results and ROI, based on responses from over 50 healthcare organizations to the October 2019 patient engagement survey.

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Infographic: 5 Recommendations for Improving Patient Experience

October 21st, 2019 by Melanie Matthews

Healthcare organizations are working diligently to improve patient satisfaction and the patient experience of care. After all, patient experience of care is a critical quality domain used to evaluate hospital performance under the 2016 CMS Hospital Value-Based Purchasing (VBP) Program (accounts for 25 percent of a hospital’s VBP score)—and comes with the potential for a penalty or bonus, according to a new infographic by Health Catalyst.

The infographic provides five key recommendations for improving the patient experience.

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 webinar, 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.

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Infographic: Four Ways To Navigate the Changing Landscape in Value-based Healthcare

September 27th, 2019 by Melanie Matthews

Value-based healthcare is, by all signs, the future of providing, and getting paid, for healthcare. Recent research indicates that hospitals are experiencing success by emphasizing several action areas, with changing mindsets being as important as altering operational models, according to a new infographic by Tork.

The infographic provides four opportunity areas every hospital manager or administrator should consider.

11 Profitable Value-Based Reimbursement Models: Lessons from Early AdoptersCMS’s ambitious agenda for moving Medicare into alternative payment models is driving the U.S. healthcare system toward greater value-based purchasing at a furious rate. Private payors also have pledged to continue to shift payments away from fee for service and into alternative payment models such as accountable care organizations (ACOs). Fortunately, many healthcare organizations are already exploring value-based payments—often a single innovation at a time—testing models that reward providers for meeting Triple Aim goals of improving patient experience and population health while reducing healthcare’s per capita cost.

11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters encapsulates nearly a dozen such approaches, from Bon Secours’ building of a business case for its multidisciplinary care team to the John C. Lincoln ACO’s deep dive into data analytics to identify and manage the care of high-risk, high-cost ‘VIP’ patients to ‘beat the benchmark’ to WellPoint’s engagement of specialists in care coordination.

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.

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Infographic: High-Deductible Health Plan-Plus: The Future of HSA-HDHPs

September 20th, 2019 by Melanie Matthews

Health savings account/high-deductible health plan enrollment and out-of-pocket expenses is continuing to grow, according to a new infographic by the University of Michigan Center for Value-Based Insurance Design.

The infographic examines this growth as well as 2019 healthcare policy changes for these types of plans.

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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Infographic: Healthcare Providers Are Prepared to Increase Risk Model Participation

July 26th, 2019 by Melanie Matthews

Healthcare providers are ready and planning to assume increased levels of risk through commercial payer and Medicare contracting models and Medicare Advantage, according to a new infographic by Navigant, based on an analysis of survey conducted by HFMA.

The infographic examines how providers are partnering on or launching provider-sponsored health plans (PSHPs) as a part of their risk-assumption strategy.

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.

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