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.
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.
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.
Published By: MedAssets
Published Date: Aug 06, 2015
How can you prepare for regulatory reimbursement changes? Scenario planning is proving essential to cope with value-based reimbursement, shrinking networks and the Affordable Care Act. Strategize and plan for success by downloading this checklist.
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.
From Ebola preparedness to leading large-scale changes, today’s master’s degree programs are producing leaders eager to tackle this generation’s most pressing challenges.
Rahul Anand, MD, is chief epidemiologist at Middlesex Hospital in Middletown, Connecticut, where he heads up all infectious disease prevention activities for the nonprofit integrated delivery network, from Ebola preparedness to hand washing. He’s also adjunct assistant professor in the department of medicine at the University of Utah, where he worked full time prior to moving to the East Coast. On top of that, he is one-third of the way through an MBA program at the University of Massachusetts Isenberg School of Management. It will take him another two years to finish the online program.
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.
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.
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.
As the healthcare industry shifts focus from volume to value, standardization is needed to accurately benchmark labor resource utilization. This is the premise of a survey conducted by HealthLeaders Media and sponsored by Kronos.
What constitutes direct patient care? Hands-on patient assessment, administering medications, and performing procedures clearly top the list. But can other activities be considered direct care too—even those not conducted in a patient’s presence?
Download the free report to get statistics and analysis from the survey questions below and much more
- Which of the following actions are considered direct patient care in your organization?
- Which of the following actions are considered indirect patient care in your organization?
- Which of the following actions are considered neither direct nor indirect care but are categorized separately as non-patient care in your organization?
Denials are a pervasive and persistent problem. There is no single root cause for denials, and problems that lead to a denied claim occur throughout the revenue cycle. Read our whitepaper to discover how to analyze, prevent and manage denials.
Discover how St. John’s Children's Hospital is improving pain management, patient satisfaction and nursing efficiencies through Interactive Patient Care (IPC). By integrating their IPC solution with the hospital's EMR and nursing notification badge, they’re managing patient expectations for pain control and streamlining assessments and documentation.
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.
Healthcare organizations are facing uncertain times, which is putting enormous strains on their RCM. This white paper will show how you can lower your staff costs, enhance clean claims rates, cut denial rates, improve patient collections and reduce bad debt.
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.
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.