Posts Tagged ‘healthcare access’

Infographic: Access to Health Services

October 17th, 2018 by Melanie Matthews

Individuals with an advanced degree are more likely to have health insurance than those with less than a high school degree, according to a new infographic by the U.S. Department of Health and Human Services’ Office of Disease Prevention and Health Promotion.

The infographic also examines how a person’s type of health insurance impacts access to a usual primary care provider.

Although nearly three-fourths of health outcomes are determined by social determinants, few clinicians can ably identify those patients facing challenges related to social and environmental conditions or other experiences that directly impact health and health status.

Social Determinants and Population Health: Redesigning Care Management to Bridge Clinical and Non-Medical Services, care teams will learn that by asking patients the right questions and listening carefully to their responses, they can begin to identify and address social determinants, dramatically impacting patient outcomes as well as their own financial success under value-based care.

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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.

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Use Annual Wellness Visit to Screen for Social Determinants of Health in High-Risk Medicare Population

December 13th, 2016 by Patricia Donovan

The social determinant of social isolation carries the same health risk as smoking, and double that of obesity.

With about a third of health outcomes determined by human behavior choices, according to a Robert Wood Johnson Foundation study, improving population health should be as straightforward as fostering healthy behaviors in patients and health plan members.

But what’s unstated in that data point is that the remaining 70 percent of health outcomes are determined by social determinants of health—areas that involve an individual’s social and environmental condition as well as experiences that directly impact health and health status.

By addressing social determinants, healthcare organizations can dramatically impact patient outcomes as well as their own financial success under value-based care, advised Dr. Randall Williams, chief executive officer, Pharos Innovations, during Social Determinants and Population Health: Moving Beyond Clinical Data in a Value-Based Healthcare System, a December 2016 webinar now available for replay.

“The challenge is that few healthcare systems are currently equipped to identify individuals within their populations who have social determinant challenges,” said Dr. Williams, “And few are still are structured to coordinate both medical and nonmedical support needs.”

The Medicare annual wellness visit is an ideal opportunity to screen beneficiaries for social determinants—particularly rising and high-risk patients, who frequently face a higher percentage of social determinant challenges.

Primary social determinants include the individual’s access to healthcare, their socio- and economic conditions, and factors related to their living environment such as air or water quality, availability of food, and transportation.

Dr. Williams presented several patient scenarios illustrating key social determinants, including social isolation, in which individuals, particularly the elderly, are lonely, lack companionship and frequently suffer from depression. “Social isolation carries the same health risk as smoking and double that of obesity,” he said.

While technology is useful in reducing social isolation, studies by the Pew Research Center determined that segments of the population with the highest percentage of chronic illness tend to be least connected to the Internet or even to mobile technologies.

“Accountable care organizations (ACOs) and other organizations managing populations must continue to push technology-enhanced care models,” said Dr. Williams, “But they also have to understand and assess technology barriers and inequalities in their populations, especially among those with chronic conditions.”

In another patient scenario, loss of transportation severely hampered an eighty-year-old woman’s ability to complete physical rehabilitation following a knee replacement.

Dr. Williams then described multiple approaches for healthcare organizations to begin to address social determinants in population health, including patients’ cultural biases, which may make them more or less open to specific care options. This fundamental care redesign should include an environmental assessment to catalog available social and community resources, he said, providing several examples.

“This is not the kind of information you’re going to find in a traditional electronic health record or even care management platforms,” he concluded.

6 Population Health Strategies to Set Stage for Physician Reimbursement

May 12th, 2016 by Patricia Donovan

Robert Fortini, PNP

A team-based, top-of-license approach is key to population health success, says Robert Fortini, PNP, Bon Secours Medical Group chief clinical officer.

In the last six years, Bon Secours Medical Group (BSMG) has deployed a half-dozen population health strategies as groundwork for its Next Generation Healthcare offering. Here, Robert Fortini, PNP, BSMG chief clinical officer, identifies the tactics his organization leverages to effect health behavior change.

The specific population health strategies Bon Secours has deployed over the last six years start with the patient-centered medical home (PCMH) concept. I’m an avid believer in the concept of a team of professionals working together, along with that ‘top of license’ aspect, where it’s not just the sole domain of the independent ‘cowboy’ physician taking care of the patients. It’s pharmacists, nurses, social workers, and registered dietitians. It’s the entire team, with everyone having a vested responsibility for practicing to the top of his or her license.

Next, access is huge. It is ridiculous to think we can manage chronic disease in four 15-minute visits a year scheduled between 8 a.m. and 5 p.m. Monday through Friday, while closing at lunchtime. It’s absolutely ludicrous. We are blowing that up by opening weekends and evenings and using technology to expand access, which is critical to affecting that behavioral change.

Third, know your population. Identifying effectively those who are most at risk with advanced analytics to make your efforts more efficient is very important.

Next is managed care contracting—aggressively coming to the table with our payors to help guide the conversations and craft the contracts and benefit designs that are attainable and achievable. That has been a new experience for Bon Secours in the last five years in particular. We have a CMS-based Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO) covering about 30,000 attributed lives. We also have a number of commercial ACO-type contractual relationships with our commercial payors.

Fifth on the list: aggressive growth for palliative and hospice. We have invested very significantly in management of advanced illness that occurs at the end of life. The Medicare numbers around that are staggering: 40 percent of Medicare spend occurs in the last two years of life, and the pain, suffering, and emotional angst that occurs for patients and their families is incredible. Investing in the resources necessary to manage that effectively has been our strategic initiative at Bon Secours. We have a very large, well-versed palliative program that provides inpatient, outpatient and even home-based palliative services. And our hospice agency, which I am responsible for in addition to our medical group, has quadrupled in size in the last two years alone.

Then, finally, we manage the white space with powered care coordination, which includes health promotion, chronic disease management, care transition management, and more.

Source: Physician Reimbursement in 2016: 4 Billable Medicare Events to Maximize Care Management Revenue and Results

http://hin.3dcartstores.com/Physician-Reimbursement-in-2016-4-Billable-Medicare-Events-to-Maximize-Care-Management-Revenue-and-Results_p_5143.html

Physician Reimbursement in 2016: 4 Billable Medicare Events to Maximize Care Management Revenue and Results details the ways in which Bon Secours Medical Group (BSMG) leverages a team-based care approach, expanded care access and technology to capitalize on four Medicare billing events: transitional care management, chronic care management, Medicare annual wellness visits and advance care planning.

Infographic: Healthcare Coverage and Access for Men

July 8th, 2015 by Melanie Matthews

Fewer men than women gained health insurance coverage between October 2013 and March 2015, and the uninsured rate continues to be higher for men than women, according to a new infographic by the Henry J. Kaiser Family Foundation.

The infographic also examines cost barriers to care and the likelihood of males to obtain regular screenings.

Private Insurance Exchanges: Adapting Insurer Strategies to the New MarketplacesSkyrocketing private exchange participation rates — industry estimates predict more than 40 million people may be enrolled in private insurance exchanges within three years — carry implications for health insurers in terms of how the various market segments are succeeding or failing to attract business.

Private Insurance Exchanges: Adapting Insurer Strategies to the New Marketplaces details the radical transformation underway in how employers and consumers offer and shop for coverage. It discusses the current status of private exchanges, reviews the inventory in existence today, and shares thoughts from market consultants and insurance executives on how new business strategies will be influenced by new entrants to the private exchange space and the participation of insurers and brokers.

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6 Data Analytics Driving Successful Population Health Management

April 2nd, 2013 by Jessica Fornarotto

population health data analytics

Webinar Replay: Achieving Population Health Management Results in Value-Based Healthcare

The development of a successful population health management (PHM) effort starts with the data and the data analysis, states Patricia Curran, principal in Buck Consultants’ National Clinical Practice. Curran describes the role of data and data analysis, the six critical PHM data areas, and the “influences” and the “influencers” that affect a population’s road to better health.

Where are we today and where do we want to be in the future? All of the data that you can gather is carefully evaluated to consider several points: the culture of the company and the employees, the business objectives, the health literacy of the population, compliance and risk scores and the utilization trends.

Data is essential to understanding the population you wish to manage and designing programs to meet the needs of a specific population. Buck Consultants takes all the raw data that we can gather, analyzes it, and transforms it into knowledge. The ‘aha’ moment is when it all comes together and we use it to build a strategy for an organization’s PHM program. It’s important to use your own data to identify the population’s specific needs and target your program to those needs. There are six areas that form the foundation for a successful PHM program:

  • Clinical data is biometric data or lab data, and possibly health risk assessment (HRA) data, that helps identify risks and cost drivers and is used to monitor the program’s success.
  • Utilization data would be the utilization patterns. For example, how are people accessing their healthcare?
  • Adherence is beginning to replace the word ‘compliance.’ This refers to how well members and providers are adhering to evidence-based medicine guidelines. Are they filling their prescriptions consistently? Are they getting preventive care?
  • Operational data is participation data, productivity data, disability data and other information that helps to monitor and develop the programs.
  • Financial data shows how this healthcare activity that you’re offering translates to dollars and opportunities for real hard dollar savings. This data is key in order to get senior management support and finances to continue the program.
  • Satisfaction data is necessary to monitor how participants and your key stakeholders view your efforts.

Part of the data analysis also includes identifying all the things that influence the decisions people are making and the influencers that are affecting what you’re trying to accomplish. For example, influencers might be spouses, family members, friends, healthcare providers, and employer management staff. Influences might be a fear of financial issues, ignorance, indifference, and inconvenience.

Take this scenario as an example: an employer may have a goal to increase the level of mammogram participation or people getting mammograms on a regular basis. They bring in a mobile unit to provide on site mammograms. But after they do this, they find that there is still no change with mammogram compliance. They will then go back to their employee population and discover that the reason they didn’t have any improvement was because the supervisors on the line didn’t allow people off the line to participate. The line supervisor is the influencer that needs to be identified and rectified before there’s going to be any change.

Infographic: Healthcare Disparities

December 3rd, 2012 by Melanie Matthews

Where you live impacts your access to healthcare as well as the quality of care you receive, according to an infographic by The Commonwealth Fund, even for the insured.

The differences can be see in such measures as a usual source of care to evidence-based care guidelines.

Healthcare Disparities

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