risk

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.

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.

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.

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.

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.

Driving financial performance in the outpa­tient setting is a top-of-mind priority among senior health system leaders. But managing the differing clinical documentation methodologies and risk assessment strategies present the great­est challenges to optimizing this important source of reve­nue, according to a recent HealthLeaders Intelligence survey. Provider organizations are finding the ambulatory setting is still a ‘Wild, Wild West’ in terms of assessing risk, clinical documentation, coding billing and medical record keeping practices. Download this report to discover key targets to improve ambulatory revenue.

For a non-profit enterprise seeking to design effective investment portfolios for its asset pools, understanding the role of each of those asset pools is a crucial first step. The organization's goals and exposures can impact all parts of its portfolio construction process, from initial broad decisions on risk tolerance to more targeted decisions on asset-class exposures and investment vehicle preferences.

Email is the most used communication tool in business. It's so easy to click that seemingly innocent 'Send' button that you may not realize the risk. Find out your next steps to an implementing an effective secure email strategy.

Many organizations joined the ACO program with the idea of using it as the first step in the transition to new reimbursement models. It’s a critical time for more ACOs to achieve the milestone of shared savings in order to demonstrate the ability to lower costs for an “at-risk” 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.

Download this whitepaper to learn the following: 1. Background and basis of decreasing payments and increasing risks 2. Challenges and opportunities associated with the trend 3. How to thrive versus simply survive in this new healthcare environment

To achieve population health success, providers must identify high-risk patient populations, apply evidence-based care plans and interventions, and engage patients in their own care. Learn how.

To achieve population health success, providers must identify high-risk patient populations, apply evidence-based care plans and interventions, and engage patients in their own care. Learn how.

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.

There is a growing need for granular de-identified health information, but many organizations are unsure of where to begin. This Privacy Analytics white paper is designed to guide you through the process of risk-based de-identification.

No organization is safe from cyber attacks. Organized crime drives the rapid growth and sophisticated evolution of advanced threats that put your entire website ecosystem at risk. And the threat landscape will only grow more dangerous as attackers create more innovative and damaging ways to profit from their efforts. That’s why you need Complete Website Security to harmonize and fortify your website security. Across the board, we deliver best-in-class solutions for securing your website environment. Secure your websites. Protect your business.

Organized crime is driving the rapid growth and sophisticated evolution of advanced threats that put entire website ecosystems at risk, and no organization is safe. The stealthy nature of these threats gives cybercriminals the time to go deeper into website environments, very often with severe consequences. Website security must be evolved in line with these growing threats and challenges. Download this whitepaper to find out more about how Digicert can help.

Protect your business, brand and customers in a constantly evolving threat landscape. As market and business needs evolve, and the technological arms race between cybercriminals and the security industry continues, the boundaries of website and web security are shifting. This paper explores the opportunities, risks and challenges, associated with this rapidly evolving landscape both from a business and technical standpoint, and lays out key guidelines for building an effective security strategy for the future.

The Internet of Things (IoT) has rapidly transformed the digital landscape and the world we live in. Intelligent devices and sensors connect smart cars, robotic manufacturing equipment, smart medical equipment, smart cities, industrial control systems, and much more in a way that improves lives and saves businesses billions of dollars. But along with its benefits, rapid IoT growth introduces a new dimension of security vulnerabilities that dramatically escalates the nature and seriousness of cybercrime risks. In addition to traditional confidentiality cyber risks, IoT threats include attacks that can: • Render smart appliances useless • Shut down city power grids • Threaten lives through hacked pacemakers and other medical devices. Such security flaws not only endanger lives, frustrate customers, and disrupt business operations, but they create significant cost and public relations damage for IoT developers and manufacturers.

Regulatory compliance is more than a series of rules to adhere to, and getting it right could save you time and money. Historically, compliance has been regarded as a checklist of fixed requirements. But this reactive outlook risks being too short-sighted. It can lead to higher compliance costs, audit deficiencies, greater business downtime and an increased risk of data loss. Furthermore, it can lead to missed opportunities to achieve greater levels of operational effectiveness for your business. The only way to achieve a greater level of operational efficiency is to adopt a proactive strategy and stay ahead of the compliance curve.