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.
As healthcare organizations become more adept at collaboration, data mining, and understanding the unique populations they serve, they are designing innovative care programs that involve higher risks and rewards.
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 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.
In response to concerns raised by healthcare leaders that the absence of adjustment for socioeconomic status (SES) and race characteristics in patient populations impedes the fair comparison of hospitals on risk-standardized 30-day unplanned readmission rates, Truven Health AnalyticsTM evaluated the extent to which risk-adjusted readmission rates for acute myocardial infarction, heart failure, and pneumonia are affected by adjustments for community-level SES factors through its Community Need Index (CNI) and patient race. The study shows there is, indeed, a statistically significant effect. For more, visit truvenhealth.com/wp/readmissionpenalties.
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.
We know that primary care is challenging today, but these challenges don’t have to derail your practice’s success. This resource from Greenway takes the top three challenges in primary care and explains how specialty-specific tools can help you meet them by achieving better clinical outcomes, improving population health, lowering costs and increasing practice profitability, while still providing compassionate care to patients.
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.
The healthcare industry continues to debate the definition of population health, but for San Diego–based Scripps Health, it’s pretty simple: Population health is the future of healthcare.
Published By: McKesson
Published Date: May 27, 2015
The shift to value-based care creates a sharp increase in healthcare organizations and networks’ need for data collection, aggregation and analysis. This white paper outlines the challenges involved with performing population-level analyses, developing cost accounting and profitability analyses across care settings, evaluating care episodes and integrating quality data. It explores the limitations of targeted software solutions to provide cross-enterprise insights. Finally, it provides advice for healthcare executives regarding how to approach gathering quality and cost-related data and how to leverage technology and analytical expertise to drive risk-based contract success.
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.
"Discover the technological solutions to deliver better patient outcomes From patient satisfaction to mobility to security, technology’s role in healthcare is changing rapidly as costs go up and demands of an aging population skyrocket. Explore this infographic to learn the six major trends in smart healthcare you need to know now >"
Involved, informed patients are better able to manage their own care.
Today’s technology plays a big role in helping patients to take ownership of their health and collaborate more closely with providers to achieve better outcomes.
Here are 10 tips from Lenovo Health for putting technology to work to reach your patient engagement goals:
• Mobile devices, tablets, and interactive technology improve the patient experience
• Healthcare facilities can remotely monitor patient progress and health post-discharge
• Providers can leverage patient portals and other tools to promote population health
• Ensuring patient engagement success requires effective measurement
• And more...
Lenovo Health provides the solutions and expertise to help healthcare organizations engage patients and achieve the vision of customized care anywhere, from hospital to home.
Are you meeting your patient engagement goals?
Download this checklist now.
The NHS is currently evolving to meet the needs of an ageing population. This means that not only is the delivery of clinical care more challenging in the acute hospital setting but it increasingly relies on enhanced information access in the primary care, mental health and community environments too.
You are accountable for results. Your engagement partner should be too. Proof over promises: Total engagement can deliver proven clinical and fiscal success. Read this paper to learn how 8 elements can create total patient engagement that pays off.
This paper provides a framework to help healthcare organizations achieve effective, affordable and measurable patient empowerment, encouraging populations of patients to take greater responsibility for their own care.
Sharp is leading the way in the shift to shared risk. In this journey, they manage to the right financial metrics while still delivering appropriate care to their patient population. Watch the video to learn how GE Healthcare is helping Sharp make a difference.
Published By: Lumeris
Published Date: Aug 04, 2014
For health plans, health systems and delegated payer operations, or health systems wanting to become their own payer, Lumeris’ turnkey outsourcing offers expert support to design, build, operate, measure, and optimize value-based health plan operations that can drive clinical and financial excellence. This can be evidenced by our ability to help clients achieve higher revenue, lower costs, higher market share, and meeting mandates for medical cost ratio contained in the Patient Protection and Affordable Care Act.