Posts Tagged ‘referrals’

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.

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: 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.

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.

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.