Posts Tagged ‘Kaiser Permanente’

HINfographic: Secrets from a Medicare Advantage ‘Star Czar’

October 2nd, 2013 by Jackie Lyons

Kaiser Permanente is known as a ‘star czar’ in Medicare Advantage (MA) circles. Ninety percent of Americans in a five-star health plan belong to a Kaiser Permanente plan, according to a new infographic from the Healthcare Intelligence Network.

This infographic goes behind the CMS Star Quality Rating System for MA plans and shares key population health management strategies behind Kaiser Permanente’s high-tech, high touch five-star success.

Secrets from a Medicare Advantage 'Star Czar'

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.

Information presented in this infographic was excerpted from: Formula for CMS Five-Star Quality Population Health Management. If you would like to learn more about star quality improvement strategies, this resource includes even more information, including an in-depth case study in Kaiser Permanente’s total panel ownership approach, advice from L.E.K. Consulting on stratifying and prioritizing strategies to improve quality ratings, tactics to engage providers and members in improvement efforts, and insight into CMS’s future direction for this quality improvement effort.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Kaiser Permanente Population Health Management: Team Approach, One Member at a Time

August 8th, 2013 by Patricia Donovan

Kaiser Permanente population health management

It takes a team to manage the health of Kaiser Permanente’s 9 million members. And like all winning teams, Kaiser’s has a mantra: total panel ownership.

That motto describes a transition within the integrated healthcare delivery system that occurred about ten years ago: when doctors shifted from being accountable solely for the patients presenting for care on a particular day in their clinic setting to being accountable for all patients in their panel, explains Jim Burrows, Ph.D., senior director of evaluation and analytics for Kaiser Permanente.

This quest for total panel ownership is achievable with a focus on three key areas: people, systems and technology, he says. Burrows shared highlights from these areas during a recent webinar on Managing Population Health with Integrated Registries and Effective Patient Touchpoints.

At the outset, Kaiser eschewed a condition-specific approach in favor of developing robust infrastructure that could support management of all conditions. At the heart is an integrated regional outreach system that tracks patients’ clinical touchpoints as they move through the system via an outpatient visit or a call to a nurse advice line.

In Kaiser Permanente’s “Proactive Care” approach, even specialists are part of its population health management approach: presenting at a dermatology appointment, a patient might be reminded of an overdue colonoscopy.

“The specialists themselves can view themselves as managers of populations and not only as physician specialists for whom individual patients are consulted,” notes Burrows.

At the primary care level, there’s an integrated panel management assistant who interacts with the physician and performs pre- and post-visit tasks so patients get the most from their visits.

Technology provides a backbone for Kaiser’s proactive care: its EPIC® EHR provides evidence-based support; its patient portal an opportunity to review past visits and perform a myriad of tasks; its proprietary integrated registry tool the identification of care gaps for all members and specific patient recommendations.

With Kaiser’s health registries in high demand within the organization, how does the health plan determine which ones to develop? “It comes down to a Triple Aim assessment where we think we can do the best job of improving health, improving care and improving the affordability of our system,” answers Burrows.

Kaiser Permanente has achieved excellent results in public reporting: the plan leads the five-star space, notes Burrows, with ninety percent of Americans in five-star Medicare Advantage plans belonging to a Kaiser plan. It can also boast of having the most HEDIS® measures in which it’s the number one health plan not in the local market area, but in the country.

Click here for an audio interview with Jim Burrows in which he discusses Kaiser’s registry use in more detail.