Posts Tagged ‘Healthcare Trends’

Infographic: 9 Factors for Retail Healthcare Facility Success

May 29th, 2019 by Melanie Matthews

Healthcare facilities—urgent care, doctor’s offices, clinics and more—are increasingly being built in new and existing retail developments. But what many don’t realize is that transportation, parking, and access are crucial and unique aspects of these facilities—they cannot be treated like any other retail space, according to a new infographic by Wells + Associates.

The infographic examines nine factors that can make a retail healthcare facility a success.

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: 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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Infographic: 2019 Global Healthcare Outlook

May 24th, 2019 by Melanie Matthews

Global healthcare spending continues to increase dramatically, according to a new Infographic by Deloitte.

The infographic examines factors impacting healthcare costs and how stakeholders will respond.

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: 5 Tech Trends That Will Disrupt Healthcare in 2020

May 20th, 2019 by Melanie Matthews

The healthcare industry has seen technology inspire progress and innovation, according to a new infographic by UnfoldLabs.

The infographic examines the five most disruptive healthcare technology trends.

2018 Healthcare Benchmarks: Telehealth & Remote Patient MonitoringArtificial intelligence. Automation. Blockchain. Robotics.

Once the domain of science fiction, these telehealth technologies have begun to transform the fabric of healthcare delivery systems. As further proof of telehealth’s explosive growth, the use of wearable health-tracking devices and remote patient monitoring has proliferated, and the Centers for Medicare and Medicaid Services (CMS) has added several new provider telehealth billing codes for calendar year 2018.

2018 Healthcare Benchmarks: Telehealth & Remote Patient Monitoring delivers the latest actionable telehealth and remote patient monitoring metrics on tools, applications, challenges, successes and ROI from healthcare organizations across the care spectrum. This 60-page report, now in its fifth edition, documents benchmarks on current and planned telehealth and remote patient monitoring initiatives as well as the use of emerging technologies in the healthcare space.

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Infographic: 7 Healthcare Predictions for 2019

April 5th, 2019 by Melanie Matthews

Big tech, artificial intelligence, cost takeout, the 2020 presidential race, pharma, and tomorrow’s “new front door” are among the trends expected to impact the healthcare industry in 2019, according to a new infographic by Oliver Wyman.

The infographic explores these trends and their expected healthcare industry impact.

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: Top 10 Health Economics and Outcomes Research Trends

February 6th, 2019 by Melanie Matthews

Interest in the field of health economics and outcomes research (HEOR) has grown exponentially as governments and other payers grapple with how to provide the best possible health outcomes at affordable costs, according to a new infographic by ISPOR—The Professional Society for Health Economics and Outcomes Research.

The infographic identifies the top 10 HEOR trends that will shape the field in the near future.

Stratifying High-Risk, High-Cost Patients: Benchmarks, Predictive Algorithms and Data AnalyticsHealthcare organizations employ a variety of tools and analytics to identify high-risk, high-cost patients for targeted population health interventions.

Stratifying High-Risk, High-Cost Patients: Benchmarks, Predictive Algorithms and Data Analytics presents a range of risk stratification practices to determine candidates for health coaching, case management, home visits, remote monitoring and other initiatives designed to engage individuals with chronic illness, improve health outcomes and reduce healthcare spend.

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Infographic: Health and Life Sciences in 2025 and Beyond

February 4th, 2019 by Melanie Matthews

Beyond 2019, the convergence of the health and life sciences supply chains will quicken, as consumer-centric disruption continues, according to a new infographic by BDO USA, LLP.

The infographic provides BDO’s top predictions for developments in 2025 and beyond that will help entities break down silos to drive value across the health and life sciences ecosystem.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results Between Medicare’s aggressive migration to value-based payment models and MACRA’s 2017 Quality Payment Program rollout, healthcare providers must accept the inevitability of participation in fee-for-quality reimbursement design—as well as cultivating a grounding in health data analytics to enhance success.

As an early adopter of the Medicare Shared Savings Program (MSSP) and the largest sponsor of MSSP accountable care organizations (ACOs), Collaborative Health Systems (CHS) is uniquely positioned to advise providers on the benefits of data analytics and technology, which CHS views as a major driver in its achievements in the MSSP arena. In performance year 2014, nine of CHS’s 24 MSSP ACOs generated savings and received payments of almost $27 million.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results documents the accomplishments of CHS’s 24 ACOs under the MSSP program, the crucial role of data analytics in CHS operations, and the many lessons learned as an early trailblazer in value-based care delivery.

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Infographic: 2019 Global Healthcare Outlook

January 23rd, 2019 by Melanie Matthews

With financial sustainability, care delivery, patient centricity, digital transformation, and regulatory compliance at the top of the agenda, healthcare sector leaders need to collaborate with all stakeholders—both within the healthcare ecosystem and those in converging industries—as they look to shape the future of healthcare and establish a sustainable smart health community, according to a new infographic by Deloitte.

The infographic reviews the current state of the global healthcare sector and explores trends and issues impacting healthcare providers, governments, payers, patients, and other stakeholders. It also outlines suggestions for these stakeholders as they seek to redefine the healthcare ecosystem and looks at examples from the market.

2018 Healthcare Benchmarks: Population Health ManagementAs the healthcare industry’s pace from volume-based to value-based healthcare payment models accelerates so does the demand for more effective management of population health. With the growth of these payment models, healthcare organizations are taking on more risk in terms of shared savings and shared risk arrangements and are investing heavily in programs to support population health. These programs are expanding in both scope of services and health conditions and disease states managed. With the help of advanced technologies in healthcare, this growth will only continue.

2018 Healthcare Benchmarks: Population Health Management is the fourth comprehensive analysis of population health management by the Healthcare Intelligence Network, capturing key metrics such as populations, health conditions and health risk levels targeted by population health management programs; risk stratification criteria; prevalence of value-based payment models supporting population health management programs; population health management processes, tools, workflows and forms; and program outcomes and ROI from responding healthcare organizations. Click here for more information.

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Guest Post: Medicare Advantage Environment Sparks Effective Risk, Quality and Care Strategies to Battle New Challenges

January 17th, 2019 by Jay Baker

Commercial insurers remain interested in competing for MA beneficiaries.

Projections show that national health expenditure growth is expected to average 5.5 percent annually to reach $5.7 trillion by 2026—higher than the projected increase in Gross Domestic Product (GDP). Fortunately, trends of insurers entering and exiting the program show that the Medicare Advantage (MA) market is stable yet dynamic—roughly the same numbers of plans enter/exit the program each year. Data shows that commercial insurers remain interested in competing for MA beneficiaries.

Given the benefits and challenges of value-based healthcare, stakeholders should gain a full understanding of Medicare Advantage (MA) plans, as well as strategies for optimizing this approach. What’s more, research indicates that the successes of MA are already having a positive impact on the broader healthcare delivery and payment landscape. In fact, fee-for-service Medicare spending has trended down in markets with high MA plan participation, indicating that doctors and other medical professionals operating in markets with high MA penetration adapt their practice patterns in alignment with MA plans’ strategies that control spending and use. This, in turn, helps to reduce use and costs for all their patients—including those enrolled in traditional Medicare and commercial/employer-sponsored plans.

MA plan coverage offered by private companies approved by Medicare provide all Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage.

Optimizing the MA Plan Opportunity

An effective MA plan that significantly improves outcomes takes a whole patient approach and applies an end-to-end solution designed to enhance care coordination using analytics, in-home care, retrospective solutions and care management.

Value-based contracting generates cost efficiencies and improves clinical outcomes in MA. The challenge is to design MA plans and risk-bearing entities to remain sustainable. This requires innovative quality and risk adjustment programs to meet the growing demand for effective care strategies. For instance, MA plans can gain clinical insight into risk-adjusting conditions to enhance their traditional analytical platforms.

Understanding a Risk Adjustment Model

Risk adjustment is an actuarial tool used to calibrate payments to health plans based on the relative health of the at-risk populations. If insurers are limited in the extent to which premiums can vary by health status or other factors that are associated with health spending, risk adjustment ensures that health plans are appropriately compensated for the risks they enroll.

Keep in mind that most claims in fee-for-service Medicare are paid using procedure codes, which offer little incentive for providers to record more diagnosis codes than necessary to justify ordering a procedure. In contrast, MA plans have a built-in financial incentive since the current risk adjustment model was introduced that prompts providers to record all possible diagnoses. This is important because higher enrollee risk scores result in higher payments to the plan.

Consider MA plans that rely upon Physician Record Review (PRR), a two-stage retrospective chart review process from a 1) certified coder and 2) board-certified physician. These same plans also use Prospective Health Assessments (PHA) to gain a robust view of members and their care needs. Providers also rely on PHAs to lay the groundwork for developing more accurate reporting documentation, improving patient engagement and compliance, enhancing disease management, and reducing utilization.

This kind of full-spectrum, end-to-end approach to care helps providers identify gaps in care and manage plan members more productively. It also helps health plans that are serving as intermediaries, executing solutions and assuming risk. Fortunately, plan members gain the most form this approach because they are guided toward more preventive care and self-management early in the care process.

Risk-Based Contracting on the Rise

Medicare beneficiaries in fee-for-service Medicare are normally required to pay multiple premiums and deductibles and face a confusing array of cost-sharing arrangements for benefits and services from physicians, pharmacies, and hospitals.

In contrast, when a Medicare beneficiary enrolls in a MA plan it is usually a comprehensive, integrated health plan that includes richer benefits and solid catastrophic coverage. Unburdened of siloed benefits and payments, MA beneficiaries’ plan structure is simpler, and they are able to receive more coordinated care.

The value-based world is enlarging to the benefit of MA patients. In a recent move, CMS expanded its definition of “primarily health-related” benefits that private insurers are allowed to include in their MA policies. These extras include, for instance, air conditioners for people with asthma, healthy food, rides to medical appointments and home-delivered meals. This means MA beneficiaries will have more supplemental benefits and be better able to lead healthier, more independent lives.

Jay Baker

Jay Baker is the senior vice president of quality and risk adjustment solutions at Advantmed, LLC. He was most recently responsible for the ACA risk adjustment strategy and execution for UnitedHealth Group’s Optum division. His accomplishments included standing up an end-to-end service offering and exceeding revenue goals for the first two years of the program. As one of the founders of Dynamic Healthcare Systems, he was responsible for the original design for each of their 10 Medicare Advantage software modules. He is an ACA and Medicare Advantage industry leader and expert in policy, compliance, systems and plans operations.

Advantmed recently developed a white paper that discusses federal policy and the economics of Medicare. Advantmed, LLC is a healthcare solutions company dedicated to partnering with health plans, provider groups and risk-bearing entities to optimize risk adjustment and quality improvement programs. Our integrated and technology-enabled solutions improve health plan financial results and offer insights on health plan members. For more information on Advantmed’s solutions visit www.advantmed.com.

Infographic: 2018 Milliman Medical Index

December 10th, 2018 by Melanie Matthews

While healthcare cost growth has slowed, costs are still at a record level, according to a new infographic by Milliman.

The infographic explores healthcare cost growth rate since 2010 as well as the impact on employers and employees.

2018 Healthcare Benchmarks: Population Health ManagementAs the healthcare industry’s pace from volume-based to value-based healthcare payment models accelerates so does the demand for more effective management of population health. With the growth of these payment models, healthcare organizations are taking on more risk in terms of shared savings and shared risk arrangements and are investing heavily in programs to support population health. These programs are expanding in both scope of services and health conditions and disease states managed. With the help of advanced technologies in healthcare, this growth will only continue.

2018 Healthcare Benchmarks: Population Health Management is the fourth comprehensive analysis of population health management by the Healthcare Intelligence Network, capturing key metrics such as populations, health conditions and health risk levels targeted by population health management programs; risk stratification criteria; prevalence of value-based payment models supporting population health management programs; population health management processes, tools, workflows and forms; and program outcomes and ROI from responding healthcare organizations. 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.