Posts Tagged ‘population health’

Mounting Pressure from Value-Based Reimbursement Models Drives Clinical Improvement Strategy at Allina Health System

April 17th, 2018 by Melanie Matthews

Value-Based Reimbursement Models Drive Clinical Improvement Strategy

As a greater percentage of hospital payments are through value-based contracts, hospitals that reduce costs while maintaining quality will survive, predicts Pam Rush, cardiovascular clinical service line program director at Allina Health.

“How do we improve outcomes and decrease costs?” Rush asked participants in the March 2018 webinar, Predictive Healthcare Analytics: Four Pillars for Success. “We need to start to look at the world differently.”

How can we be more creative and do things differently? How can we use different members of the healthcare teams in new ways, such as nurse practitioners or advanced practice providers, she added. In addition, “we need to invest in data analytics and data resources and have data analysts who can pull the information for us so we can find the variation. We need to invest in physician and caregiver time to look at the data, to make changes in how they improve care, to monitor and see what is working and what doesn’t work.”

These four pillars…population health management, reducing clinical variation, testing new care processes and new models of payment, and leveraging cutting edge technologies…have been critical to the work at Allina Health System’s Minneapolis Heart Institute Center for Healthcare Delivery Innovation, said Rush.

In population health management, we’re looking at how can we focus on adherence to guidelines, identify where there are gaps in care and partner with people across the system, primary care and specialists, to improve consistency and adherence to guidelines, she explained.

Allina is reducing clinical variation by looking at unnecessary variations in care where there is inconsistent care without an influence on outcomes.

“We’re also looking at new ways of doing things. How can we use our nurse practitioners, how do we care for patients once they’re discharged from the hospital and bring them back in for clinic visits? It’s really looking at the care model and how we can do things differently to reduce total cost of care,” she said.

In cardiology, there are so many new devices, procedures and techniques to monitor, said Rush, but we need to figure out who are the right providers to do that monitoring, who are the right patients to do these expensive procedures on and who achieves the best outcomes, because we can’t afford to do all of this new technology to every single person.

Allina looks at these four pillars across the continuum. Starting in primary care to partner on prevention strategies, moving to who gets referred to cardiology, and when they’re referred to cardiology, what are the set of tests or treatments and guidelines to adhere to along the continuum to subspecialties, emergency services and all the way up through advanced therapies, such as transplant.

During the webinar, Rush along with Dr. Steven Bradley, cardiologist, MHI and associate director, MHI Healthcare Delivery Innovation Center, shared these four pillars of predictive analytics success along with details on creating a culture of quality and innovation, building performance improvement dashboards, as well as several case examples of quality improvement initiatives contributing to these savings and much more.

Listen to Ms. Rush describe how MHI leveraged an enterprise data warehouse to identify care gaps and clinical quality improvement opportunities.

Infographic: Unlocking the Power of Population Health

April 16th, 2018 by Melanie Matthews

Population health management is one of the primary strategies for achieving greater value in healthcare, according to a new infographic by leidos.

The infographic examines how healthcare organizations can create effective and sustainable population health programs.

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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Guest Post: Clinical, Quality and Financial Benefits of Incorporating Technology into Healthcare Practices

April 10th, 2018 by Brooke LeVasseur

New technology adoption playing an increasingly vital role in healthcare practices.

Adoption of new technology is playing an increasingly vital role in the future of healthcare practices. Through population health solutions, artificial intelligence and new expanded telehealth offerings, healthcare stakeholders are better able to achieve triple aim goals with increased access to care, reduced readmissions and transfers, improved care coordination and more efficient clinical workflows.

These technological advancements have the potential to improve patient outcomes while significantly decreasing the overall cost of care.

  • According to the Certification Commission of Healthcare Information Technology, it is estimated that about 50 percent of healthcare finances are wasted, due to inefficient processes.
  • Empowering providers with new communications tools can lead to increased efficiency and improved care coordination at a lower cost.
  • New advances in care delivery models such as eConsults allow providers to have immediate access to the necessary information to treat their patients without the constraints of physical location. eConsults allow for providers to connect with specialists to collaborate on treatment plans, all within the primary care setting.

While telehealth can deliver substantial cost savings, it can also deliver clinical advantages.

  • Telemedicine allows for greater access to care for those living in areas where either population congestion or geographic proximity makes gaining access to healthcare more difficult. Providers are also able to have access to more patients per day versus a traditional office visit.
  • Smart Care Platforms are making strides in the senior and Medicaid managed care industries because it allows for the elderly population to receive eConsult specialty care from the comfort of their primary care setting.
  • Prison systems have also taken advantage of Smart Care Platforms to alleviate the extra staff/security and financial costs of transferring an inmate to a hospital or specialty care setting.

About the Author:

Brooke LeVasseur

Brooke LeVasseur, CEO of AristaMD, has over 15 years of leadership experience launching new, innovative healthcare products and solutions to payers and providers. After graduating from Stanford University, she worked in equity research, covering medtech companies for Thomas Weisel Partners. Since then, LeVasseur has worked with numerous start-ups in a variety of capacities, including: corporate and commercial strategy, marketing and new business creation where she has led teams to successfully commercialize new healthcare tools and gain widespread clinician adoption and reimbursement.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remains with them. The company accepts no liability for any errors, omissions or representations.

Infographic: How Much Is Your Unmanaged Population Costing You?

February 23rd, 2018 by Melanie Matthews

Population health management programs are a key factor in a healthcare organizations’ ability to improve health outcomes and lower healthcare costs, according to a new infographic by Conifer Health Solutions.

The infographic follows the journey of two health plan members for the cost and quality impact of implementing a successful population health management strategy.

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: Improving Community-Wide Population Health

June 26th, 2017 by Melanie Matthews

Social determinants play a significant role in one’s health and well-being, according to a new infographic by AcademyHealth.

The infographic examines what communities must do to improve health and the elements needed to encourage collaboration and support financing.

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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HINfographic: During Annual Wellness Visit, Screen for Social Health Determinants

June 12th, 2017 by Melanie Matthews

Seventy 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, according to the Pew Research Center in its report, Chronic Disease and the Internet.

A new infographic by HIN examines the impact of SDOH on health status, why the Medicare annual visit is an ideal time to screen for SDOH and the correlation between technology and social isolation.

The move from fee-for-service to value-based healthcare is driving the need for increased capabilities in population health management, including addressing all of the areas that may impact a person’s health. There is growing recognition that a broad range of social, economic and environmental factors shape an individual’s health, according to the New England Journal of Medicine. In fact, 60 percent of premature deaths are due to either individual behaviors or social and environmental factors. Healthcare providers who adopt value-based reimbursement models have an economic interest in all of the factors that impact a person’s health and providers must develop new skills and data gathering capabilities and forge community partnerships to understand and impact these factors.

During Social Determinants and Population Health: Moving Beyond Clinical Data in a Value-Based Healthcare System, a December 8th webinar, now available for replay, Dr. Randall Williams, chief executive officer, Pharos Innovations, shares his insight on the opportunity available to providers to impact population health beyond traditional clinical factors.

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HINfographic: Social Determinants of Health: Screenings Abound, But Support Services Scarce

April 26th, 2017 by Melanie Matthews

Social determinants of health like food insecurity, unsafe neighborhoods and even loneliness can impact quality of life and population health. Although more than two-thirds of healthcare organizations now screen populations for social determinants of health (SDOH) as part of ongoing care management, one-third are challenged by a lack of supportive services, according to the December 2016 SDOH survey by the Healthcare Intelligence Network.

A new infographic by HIN examines priority populations for SDOH screening, the greatest SDOH need and SDOH integration and tools.

2017 Healthcare Benchmarks: Social Determinants of HealthInitiatives such as CMS’ Accountable Health Communities Model and other population health platforms encourage healthcare organizations to tackle the broad range of social, economic and environmental factors that shape an individual’s health. To underscore the need to address social determinants of health, Healthy People 2020 included “Create social and physical environments that promote good health for all” among its four overarching goals for the decade.

In one measure of their impact, 2015 research by Brigham Young University found that the social determinants of loneliness and social isolation are just as much a threat to longevity as obesity.

2017 Healthcare Benchmarks: Social Determinants of Health documents the efforts of more than 140 healthcare organizations to assess social, economic and environmental factors in patients and to begin to redesign care management to account for these factors.

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Infographic: Social Determinants of Health

January 9th, 2017 by Melanie Matthews

Health IT data platforms and delivery systems are increasingly including social determinants of health into population health management goals, and many public-private initiatives are advancing and fine-tuning ways to gauge impact and improvement, according to a new infographic by Philips Wellcentive.

While addressing social determinants of health is an effective strategy to impact population health, it requires focused collaboration. The infographic details six promising examples of current programs and stakeholders.

Social Determinants of Health

Social Determinants and Population Health: Redesigning Care Management to Bridge Clinical and Non-Medical ServicesAlthough 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.

In 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.

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: Patient Attribution Guide for Population-based Payment Models

January 2nd, 2017 by Melanie Matthews

Patient Attribution Guide for Population-based Payment Models

Patient attribution is a foundational component of population-based payment (PBP) models, which are based on a simple concept: providers accepting accountability for managing the full continuum of care for their patients, according to a new infographic by the Health Care Payment Learning and Action Network.

The infographic outlines the key steps in patient attribution.

Chronic Care Management Reimbursement Compliance: Physician Requirements for Value-Based RevenueBeyond providing added revenue, billing via Medicare Chronic Care Management (CCM) CPT codes helps to bridge physician practices to value-based care delivery models like the accountable care organization (ACO) or patient-centered medical home (PCMH). Use of the CCM codes is also an opportunity to launch or enhance a chronic care management program. According to 2015 market data, nearly half of responding healthcare organizations lack a formal chronic care management structure, leaving critical reimbursement dollars on the table.

However, practices poised to bill under CCM codes must contend with vague guidance from CMS in certain areas and conflicting interpretations from outside sources on CCM implementation.

Chronic Care Management Reimbursement Compliance: Physician Requirements for Value-Based Revenue sets the record straight on CCM reimbursement compliance, offering strategies for navigating obstacles and meeting requirements.

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HINfographic: The Rising Risk: Harvesting Population Health’s Low-Hanging Fruit

October 5th, 2016 by Melanie Matthews

Paramount to population health management success under risk-based contracts is strategic oversight of the ‘rising risk’—individuals with two or more unmanaged health conditions. One quarter of respondents to the 2016 Population Health Management survey by the Healthcare Intelligence Network zero in on their own ‘rising risk’ populations.

A new infographic by HIN examines the health risks served by population health management programs and how population health management services are delivered.

2016 Healthcare Benchmarks: Population Health Management2016 Healthcare Benchmarks: Population Health Management analyzes responses of more than 100 healthcare organizations to HIN’s third comprehensive industry survey on PHM trends administered in spring 2016. It delivers the latest metrics on current and future PHM initiatives, providing actionable data on the most effective PHM tools and workflows, risk identification strategies, communication and engagement tools, program delivery modalities, results and challenges, and much, much more.

2016 Healthcare Benchmarks: Population Health Management is supported with more than 50 graphs and tables and describes many successes respondents have achieved with a PHM approach. Participating organizations also weigh in on the sustainability of a population health management approach. Click here for more information.

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