Providers face an onslaught of daily practice management challenges. In this MGMA Body of Knowledge (BOK) brochure, uncover relevant and practical essentials to improve any medical practice. Explore areas such as operations and financial management, governance, patient care and adverse legal events. The MGMA Body of Knowledge helps you easily define improvement areas within your medical practice. It also assists all employees in building a sustainable business plan and optimizing daily operations for better performance.
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.
With the inception of Value-Based Purchasing, the measurement of successful patient care delivery has been redefined. The move from fee-for-service to pay-for-performance means that reimbursements are tied to the quality of care that is delivered.
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.
The Truven Health 15 Top Health Systems study annually identifies those health system leadership teams that have most effectively aligned outstanding performance across their organizations, and achieved more reliable outcomes in every member hospital. Truven Health Analytics measures U.S. health systems based on a balanced scorecard across a range of performance factors: care quality, patient safety, use of evidence-based medicine, operational efficiency, and customer perception of care.
The Truven Health Analytics 50 Top Cardiovascular Hospitals study identifies hospitals that achieve the best performance on a scorecard of performance measures. This year, based on comparisons between the winners and a peer group of similar high-volume hospitals that were not winners, the study found that if all cardiovascular providers performed at the level of this year’s winners, approximately 9,500 additional patients could survive, more than $1 billion could be saved, and almost 3,000 additional bypass and angioplasty patients could be complication-free. This is based on an analysis of Medicare patients; if the same standards were applied to all inpatients, the impact would be even greater.
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 annual Truven Health AnalyticsTM 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. The study revealed that the nation’s best hospitals had a lower mortality index, considering patient severity; had fewer patient complications; followed accepted care protocols; had lower 30-day mortality and 30-day readmission rates; sent patients home sooner; provided more timely emergency care; kept expenses low, both in-hospital and through the aftercare process; and scored better on patient surveys of hospital experience
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.
Creating a state-of-the-art clinical documentation improvement (CDI) program isn’t just about boosting coding accuracy. It’s a key strategy in managing the transition from volume-based to value-based care, say healthcare leaders. That transition is a risky endeavor that is putting hospital and physician financial performance to the test. As hospitals participate in new care and business models aimed at improving value, leaders must ensure that their organizations are able to maintain reimbursement levels, effectively treat the chronically ill—especially in outpatient settings—and gather accurate data that will allow them to assess performance and segment their varying populations. While some organizations often believe they are leaving revenue on the table because of documentation and coding issues, CDI offers numerous opportunities for improving financial performance, finds a recent HealthLeaders Media survey of 149 healthcare executives at provider organizations.
Somnia’s new white paper, “Five Warning Signs of an Underperforming Anesthesia Team,” reviews hospital and ASC management challenges, identifies five warning signs of underperformance in anesthesia, and shares specific elements for high performance in anesthesia management.
Published By: Parallon
Published Date: Oct 12, 2015
To succeed in today’s healthcare environment, hospitals and health systems must evaluate the best operating model for key functions to enhance efficiency and optimize performance. This often involves determining whether partnering with another organization to perform a business function makes sense for you.
Rehab programs will experience a major infux of medically complex patients, including those with neurological conditions, in the coming decades. The drastic increase is being spurred by an aging population. For instance, stroke prevalence is expected to rise by 21% by 2030, and more than 1.2 million citizens are projected to have Parkinson’s disease.
This leaves rehab leaders with one signifcant question: What can be done to prepare for the increase of medically complex patients? By evolving to meet the needs of this changing population, rehab programs can successfully meet the challenge, providing patients with the highest level of care while achieving greater performance standards.
In this whitepaper, we’ll examine the three areas that drive the greatest impact on treating medically complex patients: • Clinical staff • Tech innovation • Patient and family member experience
Published By: SAP Concur
Published Date: Sep 25, 2019
"Digital trends have impacted almost every aspect of today’s business world, from operational performance to customer service satisfaction. The payments department – the cash flow and working capital lifeline for an organisation – is no exception. Yet in Singapore and Malaysia, many organisations still have limited automation of the accounts payable (AP) process, or a heavy reliance on manual paper work. This report analyses the current AP landscape in Singapore and Malaysia, through surveys and interviews of 100 organisations in each country, across various industries.
Download this Deloitte study to understand why automation is the top initiative for organisations today.
Published By: SAP Concur
Published Date: Sep 25, 2019
"Organizations across the globe are undertaking digital transformation (DX) journeys to maximize employee productivity, reduce operating expenses, and improve business performance. IDC interviewed multiple organizations using SAP Concur for their business travel, expense reporting, and/or invoicing needs. The interviewees told IDC they realize significant business value from SAP Concur, especially increased employee productivity and business travel savings.
Download this report to understand the steps taken by organisations to automate their business processes. "
Published By: NTT Ltd.
Published Date: Aug 15, 2019
As businesses are driven to digital transformation by changing market forces and customer expectations, many are looking to new technologies, including new infrastructure environments, as enablers. As a result, we are seeing a near-universal appetite for hybrid outcomes as business functions are executed across multiple on-premises and external infrastructure environments in pursuit of agility, cost, performance and other business benefits. Hybrid IT has become a key strategic imperative for a large portion of enterprises, impacting their IT objectives and expectations, and likely leading to new engagements with service provides for help designing, building and operating hybrid environments.
As water is increasingly being recognized as a high-value commodity, aging assets present a major threat to organizations that treat and deliver it. Improving asset performance is one of the most effective strategies water and wastewater plants and networks can implement to reduce costs and protect quality.
Published By: Gigamon
Published Date: Sep 03, 2019
Network operations teams can no longer ignore the application layer. Application experience can make or
break a digital enterprise, and today most enterprises are digital. To deliver optimal performance, network
operations tools must be application-aware. However, application-awareness in the network and security tool
layer is expensive and difficult to scale. Enterprises can mitigate these challenges with a network visibility
architecture that includes application-aware network packet brokers (NPBs).
EMA recommends that today’s network operations teams modernize their approach with full application
visibility. EMA research has found that network teams are increasingly focused on directly addressing security
risk reduction, service quality, end-user experience, and application performance. All of these new network
operations benchmarks will require deeper application-level visibility. For instance, a network team focused
on service quality will want to take a top-down approach to perfo
Published By: Gigamon
Published Date: Sep 03, 2019
Network performance and security are vital
elements of any business. Organisations are
increasingly adopting virtualisation and cloud
technologies to boost productivity, cost savings
and market reach.
With the added complexity of distributed
network architectures, full visibility is necessary
to ensure continued high performance and
security. Greater volumes of data, rapidlyevolving threats and stricter regulations have
forced organisations to deploy new categories
of security tools, e.g. Web Access Firewalls
(WAFs) or Intrusion Prevention Systems (IPS).
Yet, simply adding more security tools may not
always be the most efficient solution.
To stay competitive and satisfy your customers in today’s digital economy, you need faster, scalable and more efficient IT performance. Adopting all-flash solutions can meet these performance demands. Now is the time to consider Hitachi as your long-term strategic partner for fast-evolving all-flash technology.
Distributed cloud architectures will play an important role in Communication Service Providers’ network transformations. The distributed cloud will be made of numerous edge locations, from the customer premises to mobile base stations to central offices, each of which has its benefits and constraints. CSPs will need to consider attributes such as performance, availability, security, integration, and data and traffic volume to optimize the infrastructure for a myriad of workloads. Learn more about Heavy Reading’s survey results on CSPs adopting a distributed cloud strategy and delivering new services in this white paper.
"SD-WAN largely exists today to support two key enterprise transformations: multicloud and the software-defined branch (SD-Branch).
Multicloud has changed the center of gravity for enterprise applications, and with that, has changed traffic patterns too. No longer does traffic need to flow to enterprise data center sites or central internet peering points and breakouts. That’s because most traffic from users and devices in the enterprise campus and branch today goes to cloud-based applications scattered across a host of clouds.
It’s neither economical nor efficient to haul traffic over WAN-dedicated links to a central enterprise site. So to optimize the cost and performance of multicloud-bound traffic, modern WAN edge routers, often called customer premises equipment (CPE), are now equipped with hybrid WAN links and routing. Hybrid WAN interfaces may include WAN provider-dedicated links such as MPLS, as well as direct internet links over xDSL, broadband and 4G/LTE wireless."
As ride-hailing, e-commerce and food delivery services continue to grow, the value of curbside space is increasingly apparent. Though valuable and potentially lucrative, its original design is failing to live up to the needs of today's society. The demand for curbside space is growing, but the asset itself is fixed.
To reduce urban congestion, ensure optimal roadway performance management, encourage new mobility solutions and facilitate on-demand delivery efficiency, it is vital that the curb be better utilized.
In this eBook, gain insight from six visionaries and thought leaders with a stake in the landscape of urban mobility as they share how to better optimize curbside space.