Although quality-reporting programs such as meaningful use provide incentives to help providers implement and use electronic health records (EHRs) to collect and report on clinical data, practices often need help deciding what data to collect, which measures to report on, and how to best use their EHRs to do so. This white paper provides you with the basic information you need to choose appropriate CQMs for your practice, and offers tips on how to use your EHR to store the data in a structured format.
All healthcare delivery organizations will need to transform themselves in order to meet the quality, safety and cost challenges confronting healthcare. In this free ebook, Healthcare: a Better Way, you'll discover a strategic framework and a practical roadmap for developing a healthcare analytics approach for sustaining quality improvement. Download to learn more about navigating the challenges confronting healthcare today.
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.
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: TruBridge
Published Date: Apr 01, 2015
Rolling Plains Memorial Hospital achieved a substantial $438,000 reimbursement improvement in just 3 months by taking advantage of TruBridgeís Clinical Documentation Improvement (CDI) Training. Rolling Plains Memorial Hospital is an 85 bed community hospital located in Sweetwater, TX with annual revenue of $42 million. As the executives at this facility noticed a discrepancy in patientsí charts and the level of care the patients received, they knew something needed to change. TruBridge was able to make a dramatic difference in clinical documentation and capture the earned reimbursements.
Creating a successful patient experience strategy is a long-term investment in planning, surveying, training, and technology. Healthcare organizations hope these efforts will pay off at the very least with a growing base of loyal patients, better care quality, and stable reimbursement. And then there are those organizations that are turning patient experience into a movement. Whatís their endgame? They intend to build state-of-the-art service-oriented cultures that rival other industries, and they are doing it through data analytics, unique communication programs, radical cultural shifts, and consumer-centric technologies.
From Ebola preparedness to leading large-scale changes, todayís masterís degree programs are producing leaders eager to tackle this generationís 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. Heís 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.
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.
This report reveals how a growing number of patient experience programs have moved beyond focusing primarily on training nurses to also include physicians and a host of nonclinical staff. Another sign of the degree to which organizations are embracing patient experience is the increasing number which feature a chief patient experience officer (or individual with similar responsibilities) on the senior leadership team. Complete this short form to download your FREE copy of PATIENT EXPERIENCE: Cultural Transformation to Move Beyond HCAHPS
Most providers are involved in at-risk payment models of one kind or another. Their experience now should help them develop expertise that will be vital when value-based payments are the norm. Among the lessons to learn today is how to benefit from closer working relationships with payers in the future. In this latest report, peer leaders examine ways to benefit from closer working relationships with payers.
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.
Healthcare organizations with strong bond ratings are regarded favorably from a financial perspective, of course. In addition, research by the Truven Health AnalyticsTM ActionOIģ program shows that such organizations tend to excel in other categories, such as average length of stay and results of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys.
This Fact File examines trends in the detection and treatment of acute myocardial infarctions, or heart attacks, in two distinct groups:
STEMIóST segment elevation myocardial infarction, with the ST segment referring to a specific part of an electrocardiogram tracing. In STEMI, the coronary artery is completely blocked and cardiac muscle dies.
NSTEMIóNon-ST segment elevation myocardial infarction. In NSTEMI, a coronary artery is partially blocked.
Partners HealthCare has implemented a program that helps surgeons and other clinicians easily apply best practice guidelines to a patientís 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.
Published By: Parallon
Published Date: Sep 16, 2015
A recent HealthLeaders Media Intelligence survey asked respondents to rank their top challenges impacting financial performance and to identify specific areas of concern within each of those issues. Their top three issues were system implementation and interoperability, recruiting and retaining talent, and reengineering the revenue cycle. On the surface, itís tempting to think these findings arenít surprising. Yet emerging external factors, including the cumulative effects of the HITECH Act (meaningful use), the Affordable Care Act, and an aging U.S. population, are creating new frameworks in which to view and solve these traditional problems.
Published By: Parallon
Published Date: Dec 18, 2015
Download the free, on-demand version of this webcast that took place on December 16, 2015.
Change is commonplace within the healthcare industry. Executives are faced with many of the traditional challenges of operating hospitals. Now emerging external factors like the HITECH Act (meaningful use), the Affordable Care Act and an aging U.S. population are pushing providers to change the frameworks in how they view and solve these traditional problems.
Creating a state-of-the-art clinical documentation improvement (CDI) program isnít just about boosting coding accuracy. Itís 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 illóespecially in outpatient settingsóand 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.
In the coming era of accountable care, providers will finally have something to gain by actively engaging patients in taking care of their healthóand 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.
Published By: Caradigm
Published Date: Feb 16, 2015
Many organizations joined the ACO program with the idea of using it as the first step in the transition to new reimbursement models. Itís a critical time for more ACOs to achieve the milestone of shared savings in order to demonstrate the ability to lower costs for an ďat-riskĒ population. As best practices are emerging from early participants in the ACO program, ACOs have the opportunity to evolve their strategies in order to achieve more success.
In late August 2014, the Centers for Medicare and Medicaid Services (CMS) announced plans to reinstate the Recovery Audit program on a limited basis. CMS reports the delay in restarting the Recovery Audit program was to enable the various RAC regions to restructure, allowing time for the appeals to catch up. Soon, however, the hiatus will end and RACs in all regions will resume automated reviews; these will be in addition to select complex reviews based on topics chosen by CMS.
"Customers in the midst of digital transformation look first to the public cloud when
seeking dramatic simplification, cost, utilization and flexibility advantages for their new
application workloads. But using public cloud comes with its own challenges. Itís often
not as easy as advertised. And itís not always possible or practical for enterprises to retire
their traditional, on-premises enterprise system still running the companyís most mission-critical workloads. Hybrid IT Ė a balanced combination of traditional infrastructure,
private cloud and public cloud Ė is the answer. "