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: MedAssets
Published Date: Aug 06, 2015
How can you prepare for regulatory reimbursement changes? Scenario planning is proving essential to cope with value-based reimbursement, shrinking networks and the Affordable Care Act. Strategize and plan for success by downloading this checklist.
Published By: MedAssets
Published Date: Nov 05, 2015
The shift to value-based care is one of the most significant financial, cultural and technological challenges ever faced by the U.S. healthcare system—and it will affect every stakeholder in the system. Healthcare providers can no longer focus solely on process-oriented measures and instead need metrics that gauge progress to deliver high-value care. This healthcare executive report provides three steps hospital executives can take now as they transition from volume to value and break down silos to create the infrastructure, processes and workflows required to succeed.
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.
This report outlines the top challenges providers are facing in the transition to value-based care. The results this year reinforce both the magnitude of the task and leaders’ reluctance to make a full commitment while details of emerging but still largely unknown payment models are unresolved.
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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.
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.
The tax on high-cost health plans, which are often referred to as Cadillac plans, is expected to impact a considerable share of the plans provided by healthcare organizations for their own employees, as much as 39% by 2020. The implications are significant because the excess-benefits tax requires the employer to pay 40% on the value of the portion of the plan that exceeds thresholds set by the Patient Protection and Affordable Care Act. Employers also need to consider that the tax is measured as a direct function of plan cost, and not actuarial plan value, and that a number of factors can drive excise-tax exposure.
The shift from inpatient to outpatient care is increasing as hospitals transition from volume to value. A specific shift is seen in interventional cardiology treatment (cardiac catheterization, intracoronary stents, and percutaneous transluminal coronary angioplasties [PTCA]), which is moving from an inpatient hospital to outpatient hospital setting. Preliminary data show that most interventional cardiology procedures will soon be performed in the hospital outpatient setting. It will be important for hospitals to consider future demand and volume for interventional cardiology services; capacity for an increase in hospital outpatient volume; and staffing and operational implications.
Healthcare organizations are allocating significant dollars, time and resources to the implementation of electronic health records (EHRs). While several studies have estimated the cost to purchase and install an EHR to be anywhere between $15,000 to $70,000 per provider1, real-world implementations have soared into the billions.
As the healthcare industry shifts focus from volume to value, standardization is needed to accurately benchmark labor resource utilization. This is the premise of a survey conducted by HealthLeaders Media and sponsored by Kronos.
What constitutes direct patient care? Hands-on patient assessment, administering medications, and performing procedures clearly top the list. But can other activities be considered direct care too—even those not conducted in a patient’s presence?
Download the free report to get statistics and analysis from the survey questions below and much more
- Which of the following actions are considered direct patient care in your organization?
- Which of the following actions are considered indirect patient care in your organization?
- Which of the following actions are considered neither direct nor indirect care but are categorized separately as non-patient care in your organization?
U.S. healthcare providers are venturing into the treacherous waters of value-based care, and many are starting their voyages in leaky boats, according to a recent survey of industry executives conducted by HealthLeaders Media and sponsored by RelayHealth.
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.
Providers are increasingly making the leap and investing in their organizations in preparation for value-based care. However, while no one wants to be behind the competency curve when it arrives, it can be expensive to build competency for a new model before it is financially viable, causing providers to remain cautious.
Registered nurses, with targeted training, are the secret weapon in the race for comprehensive care coordination.
Accountable care organizations. Patient-centered medical homes. Value-based reimbursements. Bundled payments. Healthcare is experiencing a revolution brought on by the Patient Protection and Affordable Care Act that aims to put patients squarely in the middle of all their clinical and financial decisions. Payers, including government agencies and insurers, are tying the quality and safety of patient care to reimbursements, making patient-centered care a necessity in all settings.
In many aspects of healthcare, we see indications of change, with movement toward new payment models and investments in infrastructure to support the delivery of value-based care. Cost control remains a top financial lever, but the discipline is becoming more complex. From a brute-force perspective, controlling cost has a direct effect on operating margin, which provides the classic move of cost control through cost cutting. Now, though, organizations need new command over cost factors themselves.
The shift to healthcare’s value-based model is being accelerated by measurable goals and an aggressive timeline. With improved patient experience as the objective, addressing root causes that impact patient satisfaction scores is crucial to success.
The current is changing. And as healthcare organizations switch from fee-for-service to fee-for-value, leaders will face new challenges. This downloadable presentation provides critical information for leaders managing the volume to value transition.
Somnia’s new white paper, “Bending the Healthcare Cost Curve Toward Improved Anesthesia Value,” details how partnering with an anesthesia team that closely examines and leverages input and throughput opportunities help bend the healthcare cost curve toward improved anesthesia value.
Electronic health record (EHR) system implementation is one of the largest IT investments most healthcare systems have ever made but it’s success is largely dependent upon the data which feeds it. One the main data sources for the EHR is the item master, which drives not only supply chain processes but also a broad range of clinical and financial functions. Only with a clean, accurate and complete item master can a healthcare organization trust the outputs generated from its EHRs – from evaluating the clinical effectiveness of products to securing reimbursements. Learn how to execute a master data management strategy to derive the greatest value from your EHR investment.