Posts Tagged ‘referrals’

Infographic: The Broken Healthcare Referral System

November 13th, 2019 by Melanie Matthews

Across the healthcare industry, it is generally agreed that in-network care coordination is important. However, with 19.7 million clinically inappropriate network referrals occurring each year, contradictions in referral behavior remain a concern, according to a new infographic by Evariant.

The infographic pinpoints shortcomings of the current healthcare referral system and highlights opportunities to solve these obstacles.

The release of the Centers for Medicare and Medicaid Services’ care coordination toolkit provides further evidence that care coordination is an integral part of the current healthcare delivery landscape. Whether part of the primary care office, emergency department or health plan, care coordinators are having a positive impact on both the clinical and financial outcomes for healthcare organizations.

2019 Healthcare Benchmarks: Care Coordination is a comprehensive analysis by the Healthcare Intelligence Network of care coordination settings, strategies, targeted populations, supporting technologies, results and ROI, based on responses from over 75 healthcare organizations to the May 2019 Care Coordination survey.

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Infographic: Your Pre-Admissions Path: Old & Rocky or New & Smooth?

August 21st, 2019 by Melanie Matthews

As the healthcare world grows increasingly interconnected, new regulations like Patient Driven Payment Model mandate patient-centered care, and data replaces rapport as the foundation of referral relationships—facilities’ care coordination processes are becoming more pivotal than ever. From beating out the competition for acute referrals to paving the way for better clinical outcomes, a modern method of managing care coordination unlocks benefits that extend far beyond the pre-admissions episode, according to a new infographic by Cantata Health.

The infographic looks at a traditional versus a modern care coordination process and highlights the potential results of each option.

The release of the Centers for Medicare and Medicaid Services’ care coordination toolkit provides further evidence that care coordination is an integral part of the current healthcare delivery landscape. Whether part of the primary care office, emergency department or health plan, care coordinators are having a positive impact on both the clinical and financial outcomes for healthcare organizations.

2019 Healthcare Benchmarks: Care Coordination is a comprehensive analysis by the Healthcare Intelligence Network of care coordination settings, strategies, targeted populations, supporting technologies, results and ROI, based on responses from over 75 healthcare organizations to the May 2019 Care Coordination survey.

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: How Much Referrals are Costing You?

December 14th, 2018 by Melanie Matthews

More than 70 percent of routine specialist referrals can be done by an eConsult, according to a new infographic by AristaMD.

The infographic examines the impact of referrals on healthcare costs and timely access to care.

Under CMS’s “Pick Your Pace” choices for Year 1 Quality Payment Program participation, physician practices may opt for the minimum activity necessary to avoid a payment penalty in 2019 by simply submitting some data in 2017.

However, instead of delaying MACRA participation to the later part of this year, physicians should prepare and better position themselves today for MIPS success by analyzing their existing CMS data on their practices’ performance and laying a path now toward performance improvement.

Physician MACRA-Readiness: Mining QRUR and Other CMS Data to Maximize MIPS Performance describes the wealth of data analytics available from the CMS Enterprise Portal–Quality Resource Use Reports (QRURs) and other reports providing a window into practice performance under the Merit-Based Incentive Payment System (MIPS). MIPS is one of two MACRA reimbursement paths and the one where most physician practices are expected to align.

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Infographic: 2018 Healthcare Provider Referral Trends

October 10th, 2018 by Melanie Matthews

While 77 percent of healthcare providers recognize the importance of keeping patients in-network for care coordination, a notable 79 percent say they refer patients out of network, according to a new infographic by Kyruus.

The infographic looks at contradictions in today’s referral behaviors, key barriers to keeping patients in-network and turning obstacles into opportunities.

When the prestigious Memorial Sloan Kettering Cancer Center (MSKCC) began to face tougher competition from hospitals with managed care contracts and limited networks, the state-of-the-art specialty hospital decided to implement a team-based care coordination approach to attract and retain healthcare payors focused on value-based care.

Integrated Case Management: Elevating Quality and Clinical Metrics with Multidisciplinary Team-Based Care details the framework and implementation of the service-based multidisciplinary program MSKCC adopted to demonstrate that the care it provides to more than 25,000 admitted patients each year is both cost-effective and cost-efficient.

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Top Risk Stratification Tools for Telephonic Case Management

December 18th, 2014 by Patricia Donovan

The case management assessment is the top tool for stratifying candidates for telephonic case management contact, according to market data from HIN’s 2014 survey on Telephonic Case Management.

Sixty-one percent of respondents use a case management assessment to identify high-risk, high-cost individuals who would benefit from telephonic follow-up and care coordination.

Other risk stratification tools reported by survey respondents include the following:

  • Provider referral: 60 percent

  • Claims utilization data: 55 percent

  • Hospital census and discharge reports: 48 percent

  • Predictive modeling: 39 percent

  • Self- or family referrals: 37 percent

In other market data, more than 84 percent of respondents utilize telephonic case managers, with more than half—54 percent—making contact with patients from virtual home offices.

The complex comorbid are the primary targets of telephonic case managers (TCMs), the survey found, but the newly discharged, those in acute stages of chronic illness, frequent utilizers and high-risk, high-cost patients also receive their fair share of telephonic attention from these case managers.

Source: Stratifying High-Risk, High-Cost Patients: Benchmarks, Predictive Algorithms and Data Analytics

http://hin.3dcartstores.com/Stratifying-High-Risk-High-Cost-Patients-Benchmarks-Predictive-Algorithms-and-Data-Analytics_p_4934.html

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.

Each program discussion is supplemented by market data on risk stratification approaches for that care coordination intervention.