In the post-ACA era, aligning physicians with organizational goals appears to be gaining traction in health systems and hospitals nationwide. Based on a February survey of the HealthLeaders Media Council, comprising executives from healthcare provider organizations across the country, physician alignment remains a complex challenge.
Even as value-based care continues to take effect, clinical integration or alignment is quickly emerging from a need to ensure quality, cut costs, and drive referrals across health systems and hospitals. Directly employing physicians has been one of the main strategies healthcare leaders are using to improve physician alignment with health systems.
Download this free report today, and learn about the results of aligning the goals of physicians and organizations.
Frost & Sullivan’s award was bestowed on GE’s Centricity Financial Risk Manager which enables healthcare systems to reduce the cost of administering risk-based contracts, thus improving profitability and maximizing efficient workflows.
Published By: PhoneTree
Published Date: Mar 18, 2014
Learn more about the cost and quality of Patient-Centered Medical Homes (PCMHs) and how studies between 2012 and 2013 show that there are improvements in costs, utilizations and overall health due to the initiation of PCMHs. Download the entire white paper to learn more.
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• Efficient mobile strategies for reducing hospital readmissions.
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• Six best practices for cost-effective patient- and physician-facing apps.
The Centers for Medicare & Medicaid Services, the nation’s largest payer, has set a clear direction with its publication of targets: By 2018, 50% of fee-for-service payments will be through alternative payment models, such as ACOs and bundled payments, and 90% of FFS payments will be tied to quality or value. And CMS has begun to introduce mandatory bundles. This suggests that all providers will
need to develop population health competencies, including the ability to manage risk for both cost and quality.
Nearly six years after passage of the Patient Protection and Affordable Care Act, the healthcare industry is in the midst of a massive retooling that is dramatically altering the way we think about cost management, strategic partnerships, and customer service.
Fee-for-service reimbursement is giving way to new models of care delivery and payment to support a system based on pay-for-value. With financial risk or payments tied to value measures (such as patient satisfaction, clinical performance, and population health), compensation and reimbursement will increasingly be tied to value-based incentives.
Healthcare reforms have prompted hospitals across the country to improve cost efficiencies wherever they can. In response, the accounts payable department of Southern Louisiana’s Ochsner Health System discovered a solution that helped improve cash management while reducing costs.
Workforce management and the pursuit of productivity have formed a consistent pain point for hospitals for several years. The Affordable Care Act has only exacerbated the problem, increasing the demand on providers as the number of insured grows and the bar continues to rise on quality of care. According to a recent HealthLeaders Media Council survey, workforce productivity and acuity-based staffing will continue to be top priorities this year. Karlene Kerfoot, PhD, chief clinical integration officer at API Healthcare, says the survey results indicate a shift taking place as workforce management initiatives are expected to deliver more than reduced labor costs.
An innovative staff scheduling model is reinventing how hospitals leverage their employees for better outcomes; including staff satisfaction, labor costs, and improved quality of care.
View the paper to learn the research behind this new approach!
Healthcare reform regulations, increasing costs, and more competition are driving employers and their health plans to focus more than ever on opportunities to reduce cost trends. For example, the country experienced a 3.0% growth in per capita gross (allowed) medical and pharmacy costs from 2012 to 2013. Truven Health Analytics anticipates those costs in 2014 and 2015 will increase by 4% to 5% or more. By taking a data-driven approach, payers can manage costs and, ultimately, make their benefit programs sustainable in the context of healthcare reform. They can also maximize opportunities to improve population health and productivity and optimize the delivery of care.
The annual Truven Health 100 Top Hospitals® identifies U.S. hospitals with the best overall performance across multiple organizational metrics, including clinical, operational, and financial. The ability of some hospitals to adapt as the industry is changing demonstrates leadership as the winners set the standards their peers seek to achieve. Study projections indicate that if the new national benchmarks of high performance were achieved by all hospitals in the United States, nearly 126,500 additional lives could be saved, almost 109,000 additional patients could be complication-free, and $1.8 billion in inpatient costs could be saved.
Spending on supplies and pharmaceutical services varies among U.S. hospitals. It is not uncommon for hospitals with similar types of patients, including case mix and severity, to have significant differences in purchasing intensity for certain clinical services. Even small changes in efficiency can make a difference for hospitals and health systems, because supply-chain spending typically accounts for hospitals’ biggest spend after labor costs. Costs totaled about $74 billion in 2012, according to the Healthcare Supply Chain Association.
The tax on high-cost health plans, which are often referred to as Cadillac plans, is expected to impact a considerable share of the plans provided by healthcare organizations for their own employees, as much as 39% by 2020. The implications are significant because the excess-benefits tax requires the employer to pay 40% on the value of the portion of the plan that exceeds thresholds set by the Patient Protection and Affordable Care Act. Employers also need to consider that the tax is measured as a direct function of plan cost, and not actuarial plan value, and that a number of factors can drive excise-tax exposure.
Medicare spend per beneficiary (MSPB) information is a Centers for Medicare & Medicaid Services metric that reflects the average cost of an episode of care for Medicare patients. This measure is important to consider as part of a hospital’s national balanced scorecard, as it reflects executives’ efforts to transform the healthcare delivery system and manage the full continuum of care, including the prominent shift from inpatient to outpatient utilization.
The Truven Health Analytics 50 Top Cardiovascular Hospitals study identifies U.S. hospitals that have achieved the best performance on a balanced scorecard of performance measures. Based on comparisons between study winners and a peer group of similar hospitals that were not winners, winners are achieving better outcomes while operating more efficiently and at a lower cost. If all cardiovascular providers performed at the same level of this year’s winners, almost 8,000 additional lives could be saved; nearly 3,500 heart patients could be complication free; and more than $1.3 billion could be saved.
The changing healthcare environment has put pressure on healthcare organizations to deliver top-quality care while keeping costs under control. Superior operational and financial performance can be measured by high margins and low costs. But there are significant operational indicators that differ between high- and low-performing hospitals, depending on whether performance is defined by expense or by margin. Often, hospitals with the lowest costs are considered the most successful. But low-cost hospitals do not necessarily behave the same way as hospitals with healthy margins. Low-cost hospitals can include both efficient hospitals and hospitals that are in dire financial circumstances that have forced them to even eliminate expenses necessary for their long-term fiscal health.
Healthcare organizations are allocating significant dollars, time and resources to the implementation of electronic health records (EHRs). While several studies have estimated the cost to purchase and install an EHR to be anywhere between $15,000 to $70,000 per provider1, real-world implementations have soared into the billions.
Partners HealthCare has implemented a program that helps surgeons and other clinicians easily apply best practice guidelines to a patient’s unique status. In this case study executives share the secret to boosting rates of appropriate use of high-cost procedures, and eliminating medical necessity reviews.
Even as the move to electronic health records (EHR) progresses in earnest, there are a myriad of challenges involving legacy data systems. Chief among these challenges is the cost of maintaining obsolete systems solely for the patient information they contain. When up to 70% of a typical IT budget is spent on maintaining the current IT infrastructure and application portfolio, organizations have little left to invest in much-needed innovation. According to a recent HealthLeaders Media Survey, many organizations are still adjusting after their migration to a new EHR system. Hospitals need to get a better grasp on all forms and sources of data that they have—and the data they don’t yet have—so that the right information can be delivered to the right individual, and in the right context, at the point of care.
In many aspects of healthcare, we see indications of change, with movement toward new payment models and investments in infrastructure to support the delivery of value-based care. Cost control remains a top financial lever, but the discipline is becoming more complex. From a brute-force perspective, controlling cost has a direct effect on operating margin, which provides the classic move of cost control through cost cutting. Now, though, organizations need new command over cost factors themselves.