Posts Tagged ‘hospital’

Infographic: Impact of Hospital Mergers

February 10th, 2017 by Melanie Matthews

Hospital mergers between 2009 and 2014 reduced annual operating expenses at acquired hospitals by 2.5 percent, and are driving quality and service improvements for patients, according to a new infographic by the American Hospital Association.

The infographic examines how hospital mergers help drive high-value, high-performing healthcare.

Healthcare Trends & Forecasts in 2017: Performance Expectations for the Healthcare Industry Not in recent history has the outcome of a U.S. presidential election portended so much for the healthcare industry. Will the Trump administration repeal or replace the Affordable Care Act (ACA)? What will be the fate of MACRA? Will Medicare and Medicaid survive?

These and other uncertainties compound an already daunting landscape that is steering healthcare organizations toward value-based care and alternative payment models and challenging them to up their quality game.

Healthcare Trends & Forecasts in 2017: Performance Expectations for the Healthcare Industry, HIN’s 13th annual business forecast, is designed to support healthcare C-suite planning during this historic transition as leaders prepare for both a new year and new presidential leadership.

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.

2015 Healthcare Headlines: Top Stories Trace Route to Value-Based Reimbursement and Care

December 28th, 2015 by Patricia Donovan

Month by month, the industry's top stories confirmed that value-based innovations and collaborations are here to stay.

A look back at the year’s top healthcare stories captures the industry’s commitment to enhance the quality and efficiency of care delivered while reining in cost. Nearly all of HIN’s most-read stories fell into one of two categories: announcements of new value-based models or pilots, or results from existing quality-focused initiatives.

Here are the stories that captured the attention of healthcare executives in 2015:

HHS Announces Timetable, Goals for Medicare Value-Based Reimbursement
Medicare kicks off 2015 with the rollout of an ambitious multi-year agenda for a shift to value-based reimbursement and alternative payment models.

Cigna Collaborative Care Reduced Avoidable ER Visits by 16 Percent
The February release of Cigna’s second-year results from a collaborative care initiative with Granite Healthcare Network documented significant progress in improved health and affordability.

2015 Hospital Market Will Hasten Transition to Value-Based Payment Business Model
The early 2015 economic outlook for the hospital industry continued to favor the largest, most geographically diverse health systems in the market, according to this January 2015 forecast from BDC Advisors.

Medicare Discharge Planning Proposed Rule: More Focus on Patient Preferences, Follow-Up Care and Communication
CMS proposed in October a revision of discharge planning requirements that hospitals, including long-term care hospitals and inpatient rehabilitation facilities, critical access hospitals, and home health agencies, must meet in order to participate in the Medicare and Medicaid programs.

Senate’s Repeal of Medicare Sustainable Growth Rate Strengthens Move Toward Value-Based Physician Reimbursement
April 2015 saw the U.S. Senate’s landmark repeal of the Medicare Physician Payment Reform Bill, otherwise known as the Sustainable Growth Rate (SGR), a mechanism used to calculate Medicare payments to physicians.

One-Fifth to Launch ‘Next Generation ACO’ in 2015
Twenty percent of healthcare organizations plan to participate in CMS’s new ‘Next Generation ACO’ model in the coming year, according to 2015 Accountable Care Organization metrics compiled in May.

8 Wellmark Medicare ACOs Saved $17 Million in 2014, Boosted Quality by 8%
September saw the release of Wellmark Blue Cross and Blue Shield’s 2014 Accountable Care Organization (ACO) Shared Savings model data, in which eight participating ACOs improved their overall quality scores by 8 percent and saved more than $17 million during 2014.

CMS Launches New ACO Dialysis Model
CMS announced in October its Comprehensive ESRD Care (CEC) Model, designed specifically for beneficiaries with ESRD and built on lessons learned from other models and programs with ACOs, including the Pioneer ACO Model and the Medicare Shared Savings Program.

Final Rule for Joint Replacement Bundled Payments Favors Composite Quality Score
In November, CMS finalized its Comprehensive Care for Joint Replacement (CJR) model, set to begin on April 1, 2016, which will hold hospitals accountable for the quality of care they deliver to Medicare fee-for-service beneficiaries for hip and knee replacements and/or other major leg procedures from surgery through recovery.

Geisinger Pilots Patient Experience ‘Warranty’ for Select Surgeries
The Pennsylvania health system generated headlines in November with the launch of its innovative ProvenExperience™ warranty, a program that keeps the patient experience front and center by offering refunds to patients undergoing select surgical procedures whose expectations weren’t met based on kindness and compassion.

To stay abreast of the latest healthcare headlines in 2016, subscribe free to HIN’s Healthcare Business Weekly Update.

9 Hospital Discharge Communications Tactics to Curb Readmissions

January 27th, 2015 by Cheryl Miller

For heart failure patients making the transition from hospital to home, an effective discharge summary can mean the difference in whether the patient recovers quickly or returns to the hospital, according to two new studies from Yale School of Medicine researchers. To be effective, discharge summaries must have three key factors: they must be timely, be quickly forwarded to the outside physician, and contain detailed and useful information.

We asked the 116 respondents to the fourth annual Healthcare Intelligence Network’s (HIN) Reducing Hospital Readmissions Survey, conducted in December 2013, what hospital discharge communications tools they used to lower their readmissions rate. Following are their responses.

  • Follow-up with patient post-facility discharge by case managers embedded in our physician practices.
  • Improved communication between inpatient (hospital) care coordination and outpatient (medical group) services.
  • Follow-up appointments with the doctor and home care arrangements are made prior to discharge from the facility if appropriate. Discharge information with medications are sent to the doctor’s office by the facility doctor on discharge for availability on follow-up appointment.
  • Increased oversight of high-risk patients; increased communication among clinical teams and health providers.
  • We utilize a transitional care program to engage with patients while in facility and continue to follow with in-home visits on discharge to continue education and teach-back as well as monitor and oversee progress.
  • Post-acute touch (home health) within 24 hours of discharge; medication reconciliation, signs and symptoms education and scheduling primary care physician (PCP) office visit appointment.
  • All discharges are called by our nursing supervisor or other designee to determine their post-discharge status and ensure they keep their follow-up primary care appointment.
  • Reaching the patient within one to two days post-discharge. Assuring the patients have a follow-up appointment and transportation, understand discharge medications, red flag symptoms and who to call if necessary.
  • Follow-up in the home for 35 days post-transition to home.

Source: 2014 Healthcare Benchmarks: Reducing Hospital Readmissions

http://hin.3dcartstores.com/2014-Healthcare-Benchmarks-Reducing-Hospital-Readmissions_p_4786.html

2014 Healthcare Benchmarks: Reducing Hospital Readmissions documents the latest key initiatives and partnerships to reduce readmissions by patients with these costly conditions and others by more than 100 healthcare organizations.

Infographic: Timeline of the Patient Experience

March 24th, 2014 by Jackie Lyons

From the first encounter on a benefits enrollment website to hospital discharge, the healthcare industry is looking to improve care quality and patient satisfaction.

However, 83 percent of Americans do not follow treatment plans given by their doctor as prescribed, according to a new infographic from Codebaby. This infographic chronicles the average experience of Americans, from making an appointment to follow-up treatment and everywhere in between.

Looking to enhance the patient experience and better coordinate care? You may also be interested in this webinar replay: Integrating Mobile Health Remote Patient Monitoring with Telephonic Care Management for Improved Care Coordination Results. Improving care coordination improves the overall patient experience and satisfaction. During this webinar, Gail Miller, the vice president of telephonic clinical operations in Humana’s care management organization, Humana Cares/SeniorBridge, shared details of their telephonic care management program and how these remote monitoring pilots will enhance their care coordination efforts.

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: Lack of Supply-Chain Visibility Is High Cost for Hospitals

March 21st, 2014 by Jackie Lyons

Seventy percent of executives say keeping supply chain costs low is very important to addressing key financial hospital issues, according to a new infographic from the Global Healthcare Exchange.

This infographic also identifies inefficiencies in current hospital supply chains, the cost of these inefficiencies, the origin of surgical delays and disconnected systems leading to unsatisfied patients and more.

Another major cost to hospitals is unnecessary readmissions. Therefore, you may also be interested in Health Care Operations and Supply Chain Management: Strategy, Operations, Planning, and Control. This resource offers a thorough foundation in operations management, supply chain management, and the strategic implementation of programs, techniques, and tools for reducing costs and improving quality in health care organizations.


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.

Hospitals More Likely to Offer Nutrition Health Coaching, Group Sessions

February 26th, 2014 by Jessica Fornarotto

Health coaching is a critical tool in population health management, helping to boost self-management of disease and reduce risk and associated cost across the health continuum. In its fourth Health Coaching e-survey, conducted in 2013, the Healthcare Intelligence Network captured the ways in which healthcare organizations implement health coaching as well as the financial and clinical outcomes that result from this health improvement strategy.

Drilling down to the hospital/health system perspective, this survey analyzed this sector’s health coaching program components, delivery methods, and more.

Health coaching programs by hospitals and health systems are more inclined to address weight management, tobacco cessation and nutrition than coaching programs overall, survey results reveal. For example, 87 percent of responding hospitals offer nutrition-related coaching, versus 70 percent overall.

Conversely, this sector, which comprised 27 percent of survey respondents, is only a third as likely to address falls prevention (7 percent versus 19 percent overall) and much less likely to address medication adherence (33 percent versus 51 percent overall).

When Coaching is Provided

Coaching delivery methods differed for this sector as well. While no respondent in this sector reported the use of a smartphone app, responding hospitals/health systems were three times as likely as health coaching or disease management respondents to conduct group coaching sessions (53 percent of hospitals versus 14 percent of health coaching or disease management organizations), and significantly more likely to conduct face-to-face coaching (73 percent versus 59 percent overall).

Hospitals/health systems are only half as likely to mandate participation in coaching (7 percent versus 12 percent overall), yet are more likely to incent program participation (60 percent of hospitals/health systems versus 50 percent overall).

Excerpted from: 2013 Healthcare Benchmarks: Health Coaching

4 Trends for Healthcare Providers in 2014

January 30th, 2014 by Jessica Fornarotto

Dual-track medical homes, e-visits, retooled patient handoffs and more post-acute care are predicted provider trends for 2014, according to Steven Valentine, president of The Camden Group. HIN interviewed Valentine prior to his presentation during an October webinar on Healthcare Trends & Forecasts in 2014: A Strategic Planning Session.

HIN: What is the physician practice going to look like in 2014? How has the primary care team evolved to meet the Triple Aim values inherent in the PCMH and accountable care models?

(Steven Valentine): We should expect to continue to see consolidation amongst the medical groups. The independent practice associations will begin to assimilate together because they need to put more money into their infrastructure. And many of the organizations have underperformed, in all honesty.

The primary care team is still critical. We’ve benefitted by keeping many primary care doctors around because they were negatively hurt with their net worth in the recession in 2008-2010. But it’s slowly coming back and we’re starting to see those physicians thinking about retirement again. The reality is, we’re never going to replace all of these primary care doctors as they wind down their practice. We need to do a better job of getting telehealth going and utilizing e-visits. We’re seeing the health plans starting to pay for those e-visits, as well as having the consumer who uses them use a credit card and pay at that time, just like a visit.

We’re going to have to look at different models. Obviously, the nurse practitioner is getting more involved with the primary care. And yes, they’re still pursuing the Triple Aim. We know that quality scores, satisfaction scores and trying to manage cost per unit is still a critical focus of the triple aim moving forward with population health.

Lastly, with a PCMH in accountable care, while some of the pioneer accountable care organizations (ACOs) reduce themselves out of pioneer into the Medicare Shared Savings Program (MSSP), we still have a number of organizations and it’s growing. The commercial ACOs have been very successful in California.

We fully expect accountable care to continue. We think the PCMH will evolve into two tracks. The first track is a primary care PCMH. The spinoff is a chronic care medical home that has the multidisciplinary team organized around a chronic disease. This is a model developed by CareMore years ago in Southern California and it’s been expanded across the country. As I travel the country, I run into organizations that have set up these chronic care centers around the chronic disease.

HIN: Regarding the Pioneer ACO program, one of the top performers in the CMS pioneer program, Monarch HealthCare, told us that it’s going to be working to engage specialists in care coordination roles in year two and year three. What’s ahead for specialists in terms of quality and performance improvement as well as shouldering perhaps more care coordination duties, especially for Medicare patients?

(Steven Valentine): The specialists are going to be a critical piece to this whole solution. They have been a tremendous asset in the area of bundled payments, where you have the facility fee and physician fee combined into one payment. That works for both the Medicare as well as the commercial side. You’re beginning to see more of the bundled payments within an ACO.

The ACO manages what we call ‘frequency’ — in other words, the number of procedures to be done. Specialists are involved in satisfaction, quality scores, and resource consumption once the decision is made that the procedure needs to be done.

We expect the specialists to be involved with quality and performance. Everybody is putting in incentive programs to help drive higher quality, better performance, and a lower cost.

HIN: Hospitals have tightened the patient discharge process as a means of shoring up care transitions. But what other work needs to be done in terms of collaborations, perhaps with skilled nursing facilities (SNFs), long-term care and home health, for example, to improve patient handoffs and reduce hospital readmissions?

(Steven Valentine): Handoffs have probably been one of the areas where we’ve seen the most disappointment or underperformance within many ACOs. They have not effectively involved the hospitalists and the care/case managers who are typically embedded within the medical group that would oversee the patient throughout the care continuum. Or if it’s a health system, emanate centralized care/case management function where they manage all of the transitions from pre-acute, acute to post-acute. We think this will get better. As the doctors are more at risk, they will get more engaged with the care/case managers to manage these transitions and handoffs.

We also know that, while not in 2014 but the trend will start, we’ll see lower acute care utilization, pushing more patients to post-acute care. This means, in any given area, acute care hospitals will begin to convert excess capacity to post-acute care services like skilled nursing, long-term care, palliative care, hospice care, home care and rehab care. You will begin to see a closer proximity. The care managers will be able to work more effectively with the doctors and hospitals to manage the patient through the continuum, smooth out these transitions and have a better patient experience with better satisfaction scores at a lower cost.

Excerpted from: Healthcare Trends & Forecasts in 2014: Performance Expectations for the Healthcare Industry

How Taconic IPA Embedded Case Managers Risk-Stratify High-Risk, High-Cost Patients

November 5th, 2013 by Jessica Fornarotto

Using a self-developed approach that combines elements of Geisinger’s Proven Health® Navigator, Johns Hopkins Guided Care Nursing and the Wagner Chronic Care Model, Taconic Professional Resources is assisting physician practices in the New York Hudson Valley to improve population health and care for their sickest patients through the use of embedded RN case managers.

During HIN’s webinar on Improving Population Health With Embedded Case Managers in an Open, Multi-Payor Community, Annette Watson, senior vice president of community transformation for Taconic, described how case managers identify high-risk, high-cost patients.

How does a case manager go in and identify who is high-risk or who is high-cost? You can do it a number of ways, and they can be formal and informal. You can use internal sources and when we do go in, that’s one of the baselines you have to understand. Who are the patients and what is the population? If they have not been using data or have not been in an Advanced Primary Care initiative, it’s highly unlikely that a practice has a quantitative method in place when we arrive.

We begin by asking the practice providers who are the sickest patients? We can then use data that’s available at the practice level, such as registries or reports, that can be run from the EHR. We also look at what kind of data they’re getting from external sources. Are they getting reports from payors that perhaps show some utilization activity?

One thing about many of those reports is that they may be somewhat aged. They’re not necessarily timely, which creates actionable questionability. But we’re finding more and more reports about recent ER use or discharges from payors that are more and more timely that allow the practices to look at data retrospectively in most cases, but much more quickly than they were getting in the past.

And when it comes to hospital admission and discharge information, many times in a primary care practice depending on the model, if they are not the admitting physician, whether it’s a specialist or a hospitalist or someone that comes through the ER, it’s not a given. People think they know about their patients being in the hospital. They don’t always, and that is a challenge and a workflow implementation that we often spend a lot of time on when we get into a practice — how to get the timely information about admissions and discharges.

We also implement new processes in the practice to formally assess the risk of patients using validated tools. In the Hudson Valley, the tool that was easily adopted and modified in a variety of EHR’s is from the American Academy of Family Physicians (AAFP). This tool allows for a quantifiable way to put a risk level on every patient in a practice who is seen, and it changes over time. It’s the kind of tool that when a case manager goes into a practice, we look at risk stratification as an important characteristic of identifying those patients and managing those patients over time.

Deeper Data Dive Improves ACO Performance, Quality

August 1st, 2013 by Jessica Fornarotto

Performance Quality Measurement and Reporting for Accountable Care webinar replay

What started as a closer look at John C. Lincoln Network’s 30-day Medicare readmissions for heart attack, heart failure and pneumonia kicked off a plethora of quality improvements for the Medicare Shared Savings Program, including the hiring of care transition coaches, extension of primary care hours and tightening of key gaps in care.

During HIN’s webinar, Performance Quality Measurement and Reporting for Accountable Care, two experts from JCL shared how their organization modified reporting processes — from workflow changes to customizations within its EMR — to improve performance results during its 2013 reporting year.

For its transition coach program, developed to reduce Medicare 30-day readmissions, JCL hired trained military medics to help recently discharged patients transition more easily from one setting to another, explained Heather Jelonek, chief operating officer for ACOs at JCL.

“These transition coaches go into the hospitals and meet with patients when they are admitted. They get to know the patients, they develop a rapport, and they also start to prepare the patients for discharge.”

After discharge, these coaches follow the patient for a minimum of 30 days to follow up on medical care, monitor blood pressure, explain medications and teach the patient about nutrition with the help of a registered dietician.

A deeper data dive also identified a trend among its Meals on Wheels beneficiaries: 85 percent of these patients were readmitted within 30 days almost always on Friday evenings. The patients did not have enough food to get them through the weekend since Meals on Wheels only delivers during the week.

This program has helped to reduce readmission readmission rates from almost 20 percent to just under 2 percent for those patients receiving Meals on Wheels and became an assessment area for the transitions coaches.

Encouraged, JCL sought to learn what additional data they needed from their system to respond to the reporting requirements for CMS’s 33 quality measures. They determined their course of action for 2012 and the building requirements for 2013. According to Karen Furbush, business consultant for JCL, “we have to continually re-educate each of the practices at the hospital and the ED so that they can continue to remember what’s important. And it’s not just for the ACO measures, but in general for better coordinated care.”

One change implemented immediately was the addition of a new message within EPIC, an ADT inbasket message that alerts the primary care physician (PCP) to schedule a follow-up visit within seven days. The PCP then reviews the message and forwards it to the medical assistant (MA) to schedule the visit. This change helped to meet one of the ACO quality measure as well as the transitional care management incentive.

Realizing that enhancements were needed for quality reporting, JCL added additional logic to its patient health questionnaire for future fall risk, aspirin usage and a depression scale. JCL also has ACO patient navigators who analyze reports to determine which patients were missing required measurement values and then schedule those patients by the end of the year as needed, noted Ms. Furbush. “We learned how to get the information out and quickly assess who hasn’t had the influenza or pneumococcal shots, or […] a mammography or a colorectal screening. We wanted to go out and capture that information as quickly as possible because we still had three months left to be able to find that information, whether it was in a previous system or if it was in our current EMR,” explains Furbush.

“We immediately tried to get on the phone to start scheduling these appointments, working through all the things that we need to do for the ACO, as well as just bringing the patient into the EMR completely,” Furbush continued.

Furbush also started a weekly ACO quality reporting call to discuss a group of measures to see what kind of challenges were being faced and what was being implemented. JCL also hosted two EPIC-specific subset calls to learn how everyone was using EPIC.

Once JCL received its patient sample from CMS, it sent samples to each practice. According to Furbush, “We said [to the practices] this is what CMS said this person happens to be associated with. There are 15 categories and CMS will provide a rank of one to 616, one being the highest. You have to report on 411. We had to let them know where the patients ranked for each of the disease states and that we needed information back from them if we couldn’t get it from the EMR.”

JCL continues to struggle with integration opportunities. According to Jelonek, “This includes talking to other communities and looking at HIEs as we’re making an acquisition of a new practice or signing a new community physician onto the ACO. In other words, bringing everybody to the table so that we’re all speaking the same language.”