Posts Tagged ‘physician incentives’

Infographic: Path Toward Value-Based Care

August 22nd, 2016 by Melanie Matthews

UnitedHealthcare recently recognized more than 1,900 care providers who earned more than $148 million in quality of care bonus payments for achieving performance metrics in the UnitedHealthcare PATH Excellence in Patient Service Awards for their commitment to improving health outcomes for people enrolled in its Medicare Advantage plans, according to a new infographic by UnitedHealthcare.

The infographic examines the components of the PATH program and some of the quality performance measurements and their impact.

A profitable by-product of CMS’s aggressive pursuit of value-based healthcare delivery is a menu of revenue opportunities associated with care management of the Medicare population.

Physician Reimbursement in 2016: 4 Billable Medicare Events to Maximize Care Management Revenue and Results details the ways in which Bon Secours Medical Group (BSMG) leverages a team-based care approach, expanded care access and technology to capitalize on four Medicare billing events: transitional care management, chronic care management, Medicare annual wellness visits and advance care planning.

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How Aligned Incentives and Evidence-Based Care Support Patient Engagement

December 8th, 2015 by Patricia Donovan

Best practice care standards and new models of provider compensation round out Intermountain Healthcare's patient engagement framework.

Intermountain Healthcare’s vision of shared accountability among patients, payors, providers and even the community is constructed around three key tenets: engaging patients, delivering evidence-based care and aligning provider assignments. Here, Tammy Richards, corporate director of patient and clinical engagement at Intermountain Healthcare, expands upon the latter two pillars, and how they support her organization’s six-stage patient engagement framework.

Regarding evidence-based care, Intermountain has demonstrated that higher quality often costs less. Patients typically have better health medical outcomes and tend to experience fewer complications and readmissions, and through our extensive data repositories, Intermountain’s clinical programs and services are ramping up developments and consistent use of those best practice standards. Our term for that is “care process models.”

Patient engagement means that patients are in involved in their own health and care choices and they interact meaningfully with caregivers. That’s the key. What does “meaningfully” mean and can it be accomplished through technology? Does it require face to face interactions? What portion of each will make the difference there? We engage patients in wellness and prevention decisions, choices about their care or develop models of care to support patients in their unique circumstances. Population health is most definitely the focus.

We are also looking at electronic tools. We’re aggressively pursuing transparency specifically and publicly reporting star ratings for individual providers and physicians, as well as those comments submitted by patients about those physicians. We’re also addressing the emotional labor of medicine and decision fatigue. By aligning financial incentives, we create a payment system that rewards hospitals and physicians for providing the right care rather than just more care.

Intermountain supports the Institute of Medicine recommendation to address these three types of substandard care: under-treatment, or doing too little; overtreatment, doing too much; and clinical mistakes. All three types of substandard care pose medical risks to patients, and we are addressing decision fatigue with that in mind.

We’re developing new models for compensating hospitals and physicians. These models are based on a combination of productivity, quality, service and total cost of care. In addition to that, SelectHealth, our insurance company, is designing health plan benefits that encourage members to participate in their care and to consider financial impacts of their healthcare decisions. Of course, we also focus traditionally on efficiency, which helps us manage costs.

We know regardless of our circumstances or histories, we also must now acknowledge that assuming full financial risk for patient populations and increasing pressures or reduced cost in healthcare means placing more emphasis on improving patient outcomes.

Source: Framework for Patient Engagement: 6 Stages to Success in a Value-Based Health System

Framework for Patient Engagement: 6 Stages to Success in a Value-Based Health System details Intermountain Healthcare’s multilayered approach and how it supports its corporate mission: Helping people live the healthiest lives possible.