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: 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.
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.
Published By: Zix corp
Published Date: May 11, 2016
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.
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. 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
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.
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.
Now there's an innovative new way to move enterprise applications to the public cloud while actually reducing risks and trade-offs. It's called multi-cloud storage, and it's an insanely simple, reliable, secure way to deploy your enterprise apps in the cloud and also move them between clouds and on-premises infrastructure, with no vendor lock-in. Multi-cloud storage allows you to simplify your infrastructure, meet your service-level agreements, and save a bundle.
Today’s leading-edge organizations differentiate themselves through analytics to further their competitive advantage by extracting value from all their data sources. Other companies are looking to become data-driven through the modernization of their data management deployments. These strategies do include challenges, such as the management of large growing volumes of data. Today’s digital world is already creating data at an explosive rate, and the next wave is on the horizon, driven by the emergence of IoT data sources. The physical data warehouses of the past were great for collecting data from across the enterprise for analysis, but the storage and compute resources needed to support them are not able to keep pace with the explosive growth. In addition, the manual cumbersome task of patch, update, upgrade poses risks to data due to human errors. To reduce risks, costs, complexity, and time to value, many organizations are taking their data warehouses to the cloud. Whether hosted lo
In this in depth report, readers will learn about the factors driving companies toward a human resources outsourcing model, along with the risks and advantages of outsourcing human resources functions and processes, and the approaches available.
Published By: Limelight
Published Date: Feb 16, 2018
Websites are indispensable for many companies to build their profits, but as the threat of cyber attacks increases, websites can also be a serious risk factor. Therefore companies need to simultaneously develop both the convenience and security of websites. This whitepaper outlines the optimal solution for smartly achieving these two aims at the same time.