In the post-ACA era, aligning physicians with organizational goals appears to be gaining traction in health systems and hospitals nationwide. Based on a February survey of the HealthLeaders Media Council, comprising executives from healthcare provider organizations across the country, physician alignment remains a complex challenge.
Even as value-based care continues to take effect, clinical integration or alignment is quickly emerging from a need to ensure quality, cut costs, and drive referrals across health systems and hospitals. Directly employing physicians has been one of the main strategies healthcare leaders are using to improve physician alignment with health systems.
Download this free report today, and learn about the results of aligning the goals of physicians and organizations.
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.
Published By: McKesson
Published Date: Jul 09, 2015
When it comes to making decisions that positively impact care delivery and business outcomes, great leaders will tell you it’s better to rely on data than on myth. Through healthcare analytics, the clinical and financial leadership at Regions Hospital in Saint Paul, Minnesota used data to do just that—and set a strong course for reliable, trusted decision-making that helps address their most pressing issues. Using strong IT systems, accompanied by a cooperative and inquisitive organizational culture that brings together clinical and financial decision makers together to address pressing issues, put Regions on the path to create powerful healthcare analytics that fuel organizational change.
As an executive-level guide to consumerism in clinical integration, A New Meeting Place offers critical insights into healthcare consumerism as it relates to convenience of care, technology integration, and pricing competition and transparency.
Published By: MedAssets
Published Date: Aug 01, 2014
While the challenges of implementing ICD-10 are well documented, the impact to the revenue cycle is not as well known. Revenue cycle leaders must model their payor contracts now to mitigate the risks that ICD-10 will bring.
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 HealthLeaders Media Physician Alignment Survey confirms there is continued deep support for clinical integration across our industry. We see some clear trends in how hospitals and health systems use clinical integration and risk sharing to work toward physician alignment and better access.
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.
The need for analytic tools to make sense of disparate data sources will certainly be expanding in the upcoming years. This report highlights what analytical data healthcare leaders are currently focusing on, as well as the challenges they expect to face when using analytics to support their organizations in the future.
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 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.
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.
Hospital communications used to be a lot simpler. If you needed to find a doctor, you could dial 0 and the operators would connect you or send a page on your behalf. People communicated through paper charts, wrote key phone numbers on grease boards, and kept on-call schedules in binders. Some of this still happens today, but communications across healthcare have become progressively more convoluted. The use of diverse mobile devices (smartphones, tablets, pagers, Wi-Fi phones, etc.), and the rise in care complexity necessitating care team coordination mean more sophisticated communication technology is required.
Today in healthcare the communication infrastructure is the backbone in IT. New reimbursement models are amplifying the need for care coordination, and communication between multiple departments, constituencies, and workflows is required. High-performing healthcare systems are adopting enterprise communication solutions to eliminate silos of information, improve patient care during critical situations, and make the most of their IT budget.
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.
The Truven Health 15 Top Health Systems® in the United States outperform their peers by demonstrating balanced excellence—operating effectively across all functional areas of their organizations. Investigating the winner and nonwinner data from this study is a useful way to see how the nation’s health and the industry’s bottom lines could be improved. For apples-to-apples comparisons, the 15 Top Health Systems were placed into size categories by total operating expense: large (>$1.5 billion), medium ($750 million–$1.5 billion), and small (<$750 million).
Healthcare providers can deliver much more effective care if they have an understanding of the characteristics, attitudes, and self-reported health status of a patient’s age group. By communicating effectively and delivering care in a manner that resonates with that particular group of patients, healthcare providers can strive to achieve better outcomes and higher patient satisfaction.
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.
Truven Health Analytics™ evaluated the extent to which community need— a measure of the underlying economic and social factors that affect the overall health of a community, including income, cultural/language barriers, education, insurance and housing—is associated with elevated rates of preventable hospitalizations or an increased risk of hospitalization believed to be preventable with quality ambulatory care. The results of this investigation reveal a modest but statistically significant association between community need and an increased risk of hospitalizations that are believed to be preventable with good-quality ambulatory care.