What's the right population health management approach for your organization? In this white paper, you'll get a working definition of population health and learn why it's more important now than ever before. Plus, you'll gain insight into the 12 criteria that every health system should consider when evaluating population health management companies for success today and into the future.
Boards have a duty to see that hospitals and health systems comply with all state and federal laws and regulations, but they generally delegate responsibility for establishing, managing, and monitoring compliance programs to management. They also have a fiduciary responsibility to see that charitable assets are used appropriately.
Published By: McKesson
Published Date: Mar 09, 2016
The ripple effect of healthcare reform is beginning to impact care delivery strategies as care management now falls increasingly to providers.
According to a recent HealthLeaders Intelligence survey, hospital leaders are making progress with care management efforts, but more robust tools will be needed if hospitals want to scale up. The October 2014 survey polled 134 senior, clinical, operations, finance, marketing, and information leaders across the healthcare spectrum. The majority of respondents were from nonprofit organizations (63%), while the remainder (37%) came from for-profit settings.
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.
In the coming era of accountable care, providers will finally have something to gain by actively engaging patients in taking care of their health—and a lot to lose by not doing so. The best way to do that is to manage every aspect of their care. But the patients themselves will remain free to defect to another provider whenever they choose, either temporarily or permanently. Persuading them to centralize their care will rapidly become job 1. This report explores survey results about the primary forces enabling patient engagement and features a case study about the active care management program in development at Beaufort Memorial Hospital in South Carolina.
Provider organizations can realize tremendous gains in financial performance by integrating electronic health record (EHR) and revenue cycle management (RCM) systems. Especially in the face of the transition to ICD-10, results include optimizing revenue streams directly at the point of care, maximizing and speeding reimbursement, minimizing denials and streamlining the collection process.
Healthcare billing and claims handling has become increasingly complex. With the transition to Version 5010 of the HIPAA electronic transaction standards, the expansion of billing codes under ICD-10, and the ever-changing requirements of insurance companies and the Centers for Medicare and Medicaid Services (CMS), it can be nearly impossible for providers to keep up.
Healthcare organizations are facing uncertain times, which is putting strains on their revenue cycle management. Automation can help lower staff costs, enhance clean claims rates, cut denial rates, improve patient collections and reduce bad debt.
Electronic health record (EHR) system implementation is one of the largest IT investments most healthcare systems have ever made but it’s success is largely dependent upon the data which feeds it. One the main data sources for the EHR is the item master, which drives not only supply chain processes but also a broad range of clinical and financial functions. Only with a clean, accurate and complete item master can a healthcare organization trust the outputs generated from its EHRs – from evaluating the clinical effectiveness of products to securing reimbursements. Learn how to execute a master data management strategy to derive the greatest value from your EHR investment.
HealthLeaders' survey on workforce management queried leaders from a cross-section of U.S. healthcare organizations, including hospitals, health systems, physician organizations, and long-term care/skilled nursing facilities. The 150 respondents represent executives across all disciplines — administration, clinical, operations, finance, marketing, and information. In the next three to five years, hospitals, health systems, and other patient service providers expect to augment their time-and-attendance and payroll systems with integrated applications that enable more sophisticated data crunching around labor analytics, acuity management, and staffing assignments. The goal? To convert the workforce from overhead to asset — a flexible, agile asset that will help organizations succeed in an increasingly demanding regulatory and competitive environment.
CEP America provides three case studies illustrating how integration across the acute care continuum and innovative models of care help manage populations by improving throughput, reducing readmissions, and producing superior hospital-wide metrics.
In this case study, large health systems implement IBM Watson Health to surface improvement opportunities. Using this tool, they were able to cut costs, reduce patients’ length of stay, acquire actionable data, address number of readmissions and improve management of COPD and sepsis.
Multinational companies (MNCs) are facing a unique combination of escalating customer, competitive and operational pressures which are forcing them to fundamentally change the way they do business and manage their IT infrastructures supporting network, security and mobility needs.
Lack of IT resources, limited capex and more complex global implementations are driving an increasing proportion of MNCs to offload, or 'out-task', various aspects of their day-to-day management responsibilities to skilled third-parties that can help perform these functions well.
The key benefit of creating a case management methodology is to multiply its effectiveness by replicating it across the organization's patient-facing departments, practices and functions. In this way, your organization can reduce costs, increase quality and streamline its operations.
Employer-sponsored health benefits provide coverage for over 60% of the insured persons in the United States. Even with the Affordable Care Act expanding healthcare coverage, reliance on employer based coverage will remain a key component of the market. Employers are challenged with a continuing, rising trend in the cost of healthcare which significantly contributes to the overall cost of business.
Good faith is a currency that’s difficult to build and easy to squander. It is the foundation upon which all healthy, long-term relationships, including business relationships, are built. When it comes to workplace safety and health programs, good faith—the sincerity and honesty that builds real trust between workers and management—can be the key element that transforms your safety program from a binder full of onerous rules and policies into a way of life and an integral part of your corporate culture.
This whitepaper examines four key strategies to help your company create and maintain a strong safety culture:
• Measure Safety
• Talk Safety
• Model Safety
• Reward Safety
Financial services firms are turning to Business Spend Management (BSM) as a Strategic Solution
Beset by competitors and burdened by ever-shifting regulatory requirements, financial services firms are turning to cloud-based technology to gain better control over—and visibility into—spending. In the process, they are becoming fiercer competitors.
Download this ebook for insights into how you can improve your organization's financial health and how:
A cloud complete-BSM solution can track and measure all purchasing activities, identifying patterns that provide opportunities for negotiating discounts, and better managing risk
To increase savings across source-to-contract, procure-to-pay, travel & expense management, as well as risk and supplier management
Modern technology enables the finance function to take cost-management to a deeper level—without investing in IT infrastructure
Insurers have long been plagued by fraud, error, waste, and abuse in health care payments. The costs are huge – amounting to as much as 25 percent of payments made. Today’s data management and
analytics platforms promise breakthroughs by incorporating comparative and behavioral data to predict as well as detect loss in all its forms. To explore the opportunities and how insurers can capitalize on them, IIA spoke with Ben Wright, Sr. Solutions Architect in SAS’s Security Intelligence Global Practice.
Case management frameworks built on business process management platforms help IT solutions architects deploy case-handling applications and offer an alternative to specialized case management applications and custom coding. According to Gartner, the complex architecture required to support case management has relegated it to the status of a niche application, typically addressed by specialist, commercial off-the-shelf application providers and system integrators. Case management as a process style is being applied in many sectors beyond government, legal and insurance, including healthcare, banking, higher education and retail. Industry and cross-industry case management frameworks are now available. "Adaptive case management" hype exceeds the reality of what buyers need. Gartner evaluated 12 vendors including Pegasystems against nine critical capabilities in four use cases.
Download this Gartner analysis and gain a better understanding of the case management frameworks solutions offe