Population Health Advisors

Size: px
Start display at page:

Download "Population Health Advisors"

Transcription

1 Population Health Advisors COVENANT HEALTH Lubbock Texasbased Covenant Health ( Covenant ) started using IBM s Explorys Platform for a deep dive into data analytics. The next step: figuring out how to use it to its full potential.

2 Seth Crouch, Covenant s vice president of ambulatory IT services, said, Some of us become a bit presumptuous with new technology and believe the sky is the limit. Later, it is discovered it is almost impossible to get off the ground. Your plans of presenting new revelations that could potentially improve your communities population health initiatives become more of a humbling task. With so much information at your fingertips you become overwhelmed trying to determine which bits of data are just informative, a nice to know, and which ones can actually help our care givers make a positive impact on our patients lives. Covenant turned to Dallas-based Population Health Advisors ( PHA ), which has experience leveraging the Explorys platform. PHA s valuable expertise allowed Covenant to bypass the growing pains many experience with a new technology system fraught with digital complexity.

3 PHA leverages the experience acquired in developing Baylor Scott & White Health s accountable care organization ( ACO ), Baylor Scott & White Quality Alliance. Baylor Scott & White is the largest not-forprofit health system in Texas. The ACO includes a network of more than 4,600 physicians, 49 hospitals and post-acute care facilities. Brandon Pope, Ph.D., PHA analytics senior consultant, said, We see many organizations struggling with analytics and the evolution from volume- to valuebased care. The reality is this is as much a symptom of strategy and operations as data and technology. The PHA analytics approach is to not only advance from a data and technology perspective, but also to elevate the ability of population health organizations to wield data and methodologies to educate, translate, and deliver insights through deeper integration and alignment with core business functions (network, clinical excellence, contracting and performance, care management) operating as a system. Covenant has a wholly owned subsidiary called Covenant Medical Group, a multi-specialty group with 170 physicians. Its ACO is Covenant Health Partners ( CHP ). Covenant is the most comprehensive health care network serving West Texas and Eastern New Mexico. Covenant is a member of Providence St. Joseph Health, one of the largest not-for-profit health systems in the U.S. Covenant was founded in 1998 through the merger of two of Lubbock s most venerable heath care facilities, St. Mary of the Plains Hospital and Lubbock Methodist Hospital System. The system serves a 62-county area with a population of more than 1.2 million people. H 62 county-area population of more than 1.2 million people

4 Crouch said, PHA came to Lubbock and reviewed our current state and what we wanted for our future state. They shared their experiences, both successful and unsuccessful which made a big difference in our decision making. Baylor Scott & White is so similar to us, we chose to mimic rather than recreate. Covenant s goal was to create Crouch said, We wanted our a digital foundation that could own data warehouse so we serve as what is known as could control the reporting a single source of truth processes, regardless of what where we were confident system we used. PHA taught us in its accuracy and could how to do that. We didn t want be accessed by all of our to be dependent on a vendor s population health care givers. turnaround time and its standard reporting capabilities. control the reporting processes... As a highly regulated industry, health care generates large amounts of data for record keeping, compliance and regulatory requirements and patient care. Health care data warehouses allow analysts to draw from a variety of sources to acquire meaningful insights on populations. Population health analytics draws from both provider and payer data, including the electronic medical records for clinical observations and ancillary services results; claims data from the payers to help provide a complete picture of each patient s utilization of healthcare services outside of the network; billing data to identify cohorts using diagnosis and procedure codes, charges and revenue; and cost data to gauge the effect of greater efficiency on profit margins. Benefits include data to drive value-based contracts, informing clinical decision-making, better care coordination, prediction of patient outcomes and improving overall patient health. CHP participates in the Medicare Shared Savings Program (MSSP) with 15,000 patients. CHP earned $2.5 million in shared savings in It had no shared savings in 2015 despite improved quality metrics because the Centers for Medicare and Medicaid Services raised the performance benchmarks. CHP is now in MSSP s Track 3, which is a two-sided risk model that allows providers to share in 75 percent or more of program savings or losses.

5 Crouch said the data warehouse allows the system to monitor performance at the physician level and make course corrections on a monthly basis. The ACO also has five commercial contracts with Blue Cross Blue Shield of Texas, United Healthcare and FirstCare Health Plans with a total of 48,000 lives. The data warehouse was invaluable in negotiating realistic permember-per-month rates. Crouch said, Payers sometimes ask for targets on quality metrics that seem impossible to measure during the negotiation process. Without the proper technology, you could end up agreeing on measures or PMPM rates that are unachievable. Now we only agree to financial and quality targets that we have the capability to accurately measure. It helps level the playing field. He said, CHP tries to set a profit margin for each contract. Like a budget, we figure out what actions we need to take to perform at the highest level. We can estimate what we need to do on a monthly basis to hit those benchmarks down to the patient level due to real time clinical data.

6 Crouch said he was surprised to discover how engaged providers were in the clinical dashboards. Our care givers now have the technology that allows them to determine gaps in care, take action, and inevitably save lives. Deirdre Marek James, PHA vice president, said, Data and analytics are the foundation for insight on population health. They allow identification of opportunities for actionable interventions and performance improvements. Many organizations aggregate data and metrics, but struggle with data deployment in a way that can be easily accessed and implemented by providers to benefit patient care. Crouch has been so pleased with PHA s involvement that Covenant recently amended its contract with PHA to develop network dashboards for post-acute care. He said Covenant executives have been digging into the administrative and finance dashboards to discover trends and gaps. (PHA) showed us report after report, and we said we wanted them all to the point that we didn t remember why we wanted them in the first place. PHA helped us sort out what we did and didn t need. Because of their experience, PHA was able to suggest which reports would be the most impactful, he said. Crouch said that although its contract with PHA involved data analytics, Covenant was able to draw on the larger population health lessons PHA learned through Baylor Scott & White s development of its ACO.

7 (PHA) discovered things through trial and error. They helped fit to scale what Baylor Scott & White s ACO does with patient navigation, work flows, care coordination and shared governance processes. They offered direction on every avenue and what s worked for them to reduce costs. That has proven invaluable. We ve used their advice for every aspect of what we do, he said. Crouch said, I would recommend PHA to anyone in population health, not just anyone on a similar platform but anyone needing assistance operationalizing workflows, data governance, and communication. Our CEO has been ecstatic (with PHA). Otherwise we wouldn t have continued to add services to our contract. PHA s James said, For a consulting engagement to be successful, it takes willing participants on both sides. Covenant has been a great client. We were able to work together as a team to develop solutions to address specific needs. Their executives have taken what they have learned from our resources, tools, and experience to advance their population management capabilities. Crouch said he is pleased with the shape of his source of truth, a catch phrase he heard the first time meeting with Brandon Pope. We will maintain our system equity no matter the direction we choose. Adding applications or changing vendors will no longer be a major endeavor. We now have the flexibility to move fluidly with this ever changing environment, he said. I would recommend PHA to anyone in population health...

8 2017 Baylor Scott & White Health. No Number 07/17 Rook

Population Health Advisors

Population Health Advisors Population Health Advisors CHI ST. LUKE S HEALTH CHI St. Luke s Health in Houston seeks out and bulks up population health skills to achieve the CEO s big hairy goals for the future. The chief medical

More information

Value-Based Readiness: Setting the Right Pace

Value-Based Readiness: Setting the Right Pace HEALTHLEADERS MEDIA INTELLIGENCE REPORT MAY 2017 Value-Based Readiness: Setting the Right Pace An Independent HealthLeaders Media Report Supported by: An Independent HealthLeaders Media Report Powered

More information

A strategy for building a value-based care program

A strategy for building a value-based care program 3M Health Information Systems A strategy for building a value-based care program How data can help you shift to value from fee-for-service payment What is value-based care? Value-based care is any structure

More information

ACO Practice Transformation Program

ACO Practice Transformation Program ACO Overview ACO Practice Transformation Program PROGRAM OVERVIEW As healthcare rapidly transforms to new value-based payment systems, your level of success will dramatically improve by participation in

More information

Value-Based Models: Two Successful Payer-Provider Approaches March 1, 2016

Value-Based Models: Two Successful Payer-Provider Approaches March 1, 2016 Value-Based Models: Two Successful Payer-Provider Approaches March 1, 2016 Clifford T. Fullerton, MD, MSc President, Baylor Scott & White Quality Alliance Chief Population Health Officer, Baylor Scott

More information

Quality Improvement in the Advent of Population Health Management WHITE PAPER

Quality Improvement in the Advent of Population Health Management WHITE PAPER Quality Improvement in the Advent of Population Health Management WHITE PAPER For healthcare organizations whose reimbursement and revenue are tied to patient outcomes, achieving performance on quality

More information

How an ACO Provides and Arranges for the Best Patient Care Using Clinical and Operational Analytics

How an ACO Provides and Arranges for the Best Patient Care Using Clinical and Operational Analytics Success Story How an ACO Provides and Arranges for the Best Patient Care Using Clinical and Operational Analytics HEALTHCARE ORGANIZATION Accountable Care Organization (ACO) TOP RESULTS Clinical and operational

More information

Launching an Enterprise Data Warehouse to Rapidly Reduce Waste in Asthma Care

Launching an Enterprise Data Warehouse to Rapidly Reduce Waste in Asthma Care Success Story Launching an Enterprise Data Warehouse to Rapidly Reduce Waste in Asthma Care HEALTHCARE ORGANIZATION Children s Hospital TOP RESULTS Decreased average length of stay by 11 hours Achieved

More information

Analytics in Action. Using Data to Improve Care and Reduce Costs CUSTOM MEDIA SPONSORED BY

Analytics in Action. Using Data to Improve Care and Reduce Costs CUSTOM MEDIA SPONSORED BY Analytics in Action Using Data to Improve Care and Reduce Costs CUSTOM MEDIA SPONSORED BY Imagine an 82-year-old gentleman walks in to your emergency department. He presents with a productive cough and

More information

WHITE PAPER. The Shift to Value-Based Care: 9 Steps to Readiness.

WHITE PAPER. The Shift to Value-Based Care: 9 Steps to Readiness. The Shift to Value-Based Care: Table of Contents Overview 1 Value Based Care Is it here to stay? 1 1. Determine your risk tolerance 2 2. Know your cost structure 3 3. Establish your care delivery network

More information

Jumpstarting population health management

Jumpstarting population health management Jumpstarting population health management Issue Brief April 2016 kpmg.com Table of contents Taking small, tangible steps towards PHM for scalable achievements 2 The power of PHM: Five steps 3 Case study

More information

The National ACO, Bundled Payment and MACRA Summit. Success in Physician Led Bundles

The National ACO, Bundled Payment and MACRA Summit. Success in Physician Led Bundles The National ACO, Bundled Payment and MACRA Summit Success in Physician Led Bundles Disclaimer This material and/or presentation is provided for guidance and/or illustrative purposes only and should not

More information

As healthcare moves toward value-based care and risk-sharing payment models, many hospitals are taking a new look at ambulatory surgery centers (ASCs) as a transformational outpatient strategy with potential

More information

Value-Based Contracting

Value-Based Contracting Value-Based Contracting AUTHOR Melissa Stahl Research Manager, The Health Management Academy 2018 Lumeris, Inc 1.888.586.3747 lumeris.com Introduction As the healthcare industry continues to undergo transformative

More information

40,000 Covered Lives: Improving Performance on ACO MSSP Metrics

40,000 Covered Lives: Improving Performance on ACO MSSP Metrics Success Story 40,000 Covered Lives: Improving Performance on ACO MSSP Metrics EXECUTIVE SUMMARY The United States healthcare system is the most expensive in the world, but data consistently shows the U.S.

More information

Texas ACO invests in the Quanum portfolio to improve patient care

Texas ACO invests in the Quanum portfolio to improve patient care Case study: Premier Management Company North Texas Texas ACO invests in the Quanum portfolio to improve patient care Premier Management Company (PMC) manages 3 accountable care organizations (ACOs) in

More information

Insights as a Service. Balaji R. Krishnapuram Distinguished Engineer, Director of Analytics, IBM Watson Health

Insights as a Service. Balaji R. Krishnapuram Distinguished Engineer, Director of Analytics, IBM Watson Health Insights as a Service Balaji R. Krishnapuram Distinguished Engineer, Director of Analytics, IBM Watson Health Data & Knowledge Explosion: New data about individuals, used in new ways helps determines health

More information

page 30 MGMA Connexion April MGMA-ACMPE. All rights reserved.

page 30 MGMA Connexion April MGMA-ACMPE. All rights reserved. page 30 MGMA Connexion April 2013 Quality Management Deep dive: What lies beneath the surface? Reassessing your credentialing process could mean more money in your practice By Scott T. Friesen Effective

More information

Connecting Care Across the Continuum

Connecting Care Across the Continuum Connecting Care Across the Continuum A Guide for Providers > Discharging patients should be quick, easy, and painless for everyone including patients, families and the hospital. That s why a hospital that

More information

Session 10: Integrating Data and Analytics into Provider Workflows Improves ACO Quality and Financial Performance

Session 10: Integrating Data and Analytics into Provider Workflows Improves ACO Quality and Financial Performance Session 10: Integrating Data and Analytics into Provider Workflows Improves ACO Quality and Financial Performance Joan Valentine, MSA, RN Executive Vice President Visiting Physicians Association David

More information

UC HEALTH. 8/15/16 Working Document

UC HEALTH. 8/15/16 Working Document 1) UC Health Mission Our mission is to make health care better. Each UC health system works to advance this mission in its community and as a system of health systems, we work together to catalyze innovation

More information

producing an ROI with a PCMH

producing an ROI with a PCMH REPRINT April 2016 Emma Mandell Gray Rachel Aronovich healthcare financial management association hfma.org producing an ROI with a PCMH Patient-centered medical homes can deliver high-quality care and

More information

Managing Population Health in Northeast Georgia: One Medical Group's Experience

Managing Population Health in Northeast Georgia: One Medical Group's Experience September 21, 2013 Managing Population Health in Northeast Georgia: One Medical Group's Experience By Mark Hagland Northeast Georgia Physicians Group (NGPG), based in Gainesville, Georgia, a suburb of

More information

Using A Data Warehouse and Analytics to Drive Population Health Management

Using A Data Warehouse and Analytics to Drive Population Health Management Success Story Using A Data Warehouse and Analytics to Drive Population Health Management HEALTHCARE ORGANIZATION Large Medical Center TOP RESULTS Enabled pay-for-performance (P4P) incentive payment reporting

More information

Texas Care Alliance. Transforming Care Across Texas

Texas Care Alliance. Transforming Care Across Texas Texas Care Alliance Transforming Care Across Texas April 29, 2016 1 Overview 1. Story of Transformation 2. Market Dynamics Impacting Healthcare 3. Texas Care Alliance 2 TRANSFORMATION 3 On Friday, April

More information

State Medicaid Directors Driving Innovation: Continuous Quality Improvement February 25, 2013

State Medicaid Directors Driving Innovation: Continuous Quality Improvement February 25, 2013 State Medicaid Directors Driving Innovation: Continuous Quality Improvement February 25, 2013 The National Association of Medicaid Directors (NAMD) is engaging states in shared learning on how Medicaid

More information

CLINICAL INTEGRATION DRIVERS, IMPACT, AND OPTIONS JOBY KOLSUN, D.O. MEDICAL DIRECTOR CLINICAL INTEGRATION LEE PHO

CLINICAL INTEGRATION DRIVERS, IMPACT, AND OPTIONS JOBY KOLSUN, D.O. MEDICAL DIRECTOR CLINICAL INTEGRATION LEE PHO CLINICAL INTEGRATION DRIVERS, IMPACT, AND OPTIONS JOBY KOLSUN, D.O. MEDICAL DIRECTOR CLINICAL INTEGRATION LEE PHO Disclaimers My current position I am not offering advice on clinical integration Items

More information

Healthcare Solutions Nuance Clintegrity Quality Management Solutions. Quality. The Discipline to Win.

Healthcare Solutions Nuance Clintegrity Quality Management Solutions. Quality. The Discipline to Win. Quality. The Discipline to Win. Brochure 2 It s not wanting to win that makes you a winner; it s refusing to fail. Peyton Manning, the first NFL quarterback to achieve 200 career wins (regular and post-season)

More information

Using Data for Proactive Patient Population Management

Using Data for Proactive Patient Population Management Using Data for Proactive Patient Population Management Kate Lichtenberg, DO, MPH, FAAFP October 16, 2013 Topics Review population based care Understand the use of registries Harnessing the power of EHRs

More information

STAYING THE COURSE ON VALUE

STAYING THE COURSE ON VALUE 32 % of respondents say the fee-for-service payment model is least effective in quality and cost improvements INTELLIGENCE REPORT MAY/JUNE 2018 STAYING THE COURSE ON VALUE ANALYSIS... 2 SURVEY RESULTS...

More information

The Nurses Take on EHRs Data collected through the Research Cloud

The Nurses Take on EHRs Data collected through the Research Cloud www.reactiondata.com The Nurses Take on EHRs Data collected through the Research Cloud Executive Summary Some (mainly vendors) have questioned why we conduct research to frontline users of core HIT systems,

More information

Examining the Differences Between Commercial and Medicare ACO Models

Examining the Differences Between Commercial and Medicare ACO Models Examining the Differences Between Commercial and Medicare ACO Models Michelle Copenhaver December 10, 2015 Agenda 1 Understanding Accountable Care Organizations 2 Moving to Accountable Care: Enhancing

More information

Implementing Medicaid Value-Based Purchasing Initiatives with Federally Qualified Health Centers

Implementing Medicaid Value-Based Purchasing Initiatives with Federally Qualified Health Centers Implementing Medicaid Value-Based Purchasing Initiatives with Federally Qualified Health Centers Beth Waldman, JD, MPH June 14, 2016 Presentation Overview 1. Brief overview of payment reform strategies

More information

IBM Watson Health Utica Park Clinic The need The solution The benefit

IBM Watson Health Utica Park Clinic The need The solution The benefit Utica Park Clinic Population health management helps Utica Park Clinic ease the transition to value-based care Overview The need Utica Park Clinic needed to balance the challenging financial implications

More information

Advisory Board Fellows

Advisory Board Fellows Talent Development Advisory Board Fellows Delivering impact through a signature initiative Talent Development s marquee leadership program, the Advisory Board Fellowship, is an accelerated two-year, MBA-like

More information

Getting Started in a Medicare Shared Savings Program Accountable Care Organization

Getting Started in a Medicare Shared Savings Program Accountable Care Organization 1 Getting Started in a Medicare Shared Savings Program Accountable Care Organization Tuesday, September 16 th Pam Maxwell, Chief Growth Officer What is an ACO? Accountable Care Organizations (ACOs) are

More information

Interoperability is Happening Now

Interoperability is Happening Now Interoperability is Happening Now Nick Knowlton and Tammy Ordoyne-Vial Brightree and Ochsner HME Interoperability - Better Business, Better Outcomes Shifts in the Healthcare Ecosystem impact our HME Space

More information

2017 Oncology Insights

2017 Oncology Insights Cardinal Health Specialty Solutions 2017 Oncology Insights Views on Reimbursement, Access and Data from Specialty Physicians Nationwide A message from the President Joe DePinto On behalf of our team at

More information

The Evolution of ASC Joint Ventures: Key Trends for Value-Based Care

The Evolution of ASC Joint Ventures: Key Trends for Value-Based Care The Evolution of ASC Joint Ventures: Key Trends for Value-Based Care The Evolution of ASC Joint Ventures: Key Trends for Value-Based Care By Laura Dyrda As healthcare moves toward value-based care and

More information

Integrated Health System

Integrated Health System Integrated Health System Please note that the views expressed are those of the conference speakers and do not necessarily reflect the views of the American Hospital Association and Health Forum. Page 2

More information

Essentia Health. A View on Information Technology. ND HIMS Conference April 12, Tim Sayler, COO Essentia Health - West

Essentia Health. A View on Information Technology. ND HIMS Conference April 12, Tim Sayler, COO Essentia Health - West Essentia Health A View on Information Technology ND HIMS Conference April 12, 2017 Tim Sayler, COO Essentia Health - West Me Discussing Information Technology Who is Essentia Overview Why: Information

More information

One Medicine: Incorporating Population Health Principles and Best Practices into Clinical Workflow

One Medicine: Incorporating Population Health Principles and Best Practices into Clinical Workflow One Medicine: Incorporating Population Health Principles and Best Practices into Clinical Workflow March 5, 2018 Jayne Bassler President, Population Health Services Organization Senior Vice President,

More information

improvement program to Electronic Health variety of reasons, experts suggest that up to

improvement program to Electronic Health variety of reasons, experts suggest that up to Reducing Hospital Readmissions March/2017 The readmission rate for patients discharged to a skilled nursing facility is 25% within 30 days1. What can senior care providers do to reduce these hospital readmissions?

More information

Saving Lives with Best Practices and Improvements in Sepsis Care

Saving Lives with Best Practices and Improvements in Sepsis Care Success Story Saving Lives with Best Practices and Improvements in Sepsis Care EXECUTIVE SUMMARY Although Thibodaux Regional Medical Center had achieved sepsis mortality rates below the national average,

More information

Kristen Miranda Vice President Strategic Partnerships and Innovation March 20, 2013

Kristen Miranda Vice President Strategic Partnerships and Innovation March 20, 2013 california case study: a model for accountable care Kristen Miranda Vice President Strategic Partnerships and Innovation March 20, 2013 1 program framework and core tenets To achieve measurable results,

More information

WHITE PAPER. NCQA Accreditation of Accountable Care Organizations

WHITE PAPER. NCQA Accreditation of Accountable Care Organizations WHITE PAPER NCQA Accreditation of Accountable Care Organizations CONTENTS Introduction 3 What are ACOs, and what do we want them to achieve? 3 Building from patient-centered medical homes 4 Program elements

More information

TELEHEALTH INDEX: 2015 PHYSICIAN SURVEY

TELEHEALTH INDEX: 2015 PHYSICIAN SURVEY TELEHEALTH INDEX: 2015 PHYSICIAN SURVEY Overview Telehealth is accelerating in 2015. As many as 37% of hospital systems have at least one type of telemedicine solution to meet a variety of objectives,

More information

UNITED STATES HEALTH CARE REFORM: EARLY LESSONS FROM ACCOUNTABLE CARE ORGANIZATIONS

UNITED STATES HEALTH CARE REFORM: EARLY LESSONS FROM ACCOUNTABLE CARE ORGANIZATIONS UNITED STATES HEALTH CARE REFORM: EARLY LESSONS FROM ACCOUNTABLE CARE ORGANIZATIONS Stephen M. Shortell, Ph.D., M.P.H, M.B.A. Blue Cross of California Distinguished Professor of Health Policy and Management

More information

INNOVATIONS IN CARE MANAGEMENT. Michael Burcham, Narus Health

INNOVATIONS IN CARE MANAGEMENT. Michael Burcham, Narus Health INNOVATIONS IN CARE MANAGEMENT Michael Burcham, Narus Health Innovations in Care Management Dr. Michael Burcham, CEO Narus Health Part 1 Care Management Trends & Headwinds Four Mega Trends Transforming

More information

June 25, Dear Administrator Verma,

June 25, Dear Administrator Verma, June 25, 2018 Seema Verma Administrator Centers for Medicare and Medicaid Services U.S. Department of Health and Human Services Room 445 G, Hubert H. Humphrey Building 200 Independence Avenue SW Washington,

More information

Improving Care and Lowering Costs: The Use of Clinical Data by Medicaid Managed Care Organizations. April 26, 2018

Improving Care and Lowering Costs: The Use of Clinical Data by Medicaid Managed Care Organizations. April 26, 2018 Improving Care and Lowering Costs: The Use of Clinical Data by Medicaid Managed Care Organizations April 26, 2018 Agenda Welcome and Overview of Interview Results Claudia Ellison, Director of Programs,

More information

Midmark White Paper Building Your Connected Point of Care Ecosystem. Point Of Care Ecosystem Series Part Four

Midmark White Paper Building Your Connected Point of Care Ecosystem. Point Of Care Ecosystem Series Part Four Midmark White Paper Introduction Before embarking on any construction project, it is always a good idea to have a set of blueprints or a detailed plan to guide progress and ensure alignment with objectives.

More information

F O R G R E AT E R H E A LT H

F O R G R E AT E R H E A LT H FOR GREATER HEALTH Whether you re sending medical records or retrieving them, it can be a complicated process. Layer on top of that the need to protect your revenue and leverage data in an impactful way.

More information

Reducing Hospital Admissions Through the Use of IT. Steven Milligan MD Medical Director of ACO Management Colorado Health Neighborhoods

Reducing Hospital Admissions Through the Use of IT. Steven Milligan MD Medical Director of ACO Management Colorado Health Neighborhoods Reducing Hospital Admissions Through the Use of IT Steven Milligan MD Medical Director of ACO Management Colorado Health Neighborhoods Conflict of Interest Steven Milligan, MD Has no real or apparent conflicts

More information

Finding a Faster Path to Value-Based Care

Finding a Faster Path to Value-Based Care Finding a Faster Path to Value-Based Care June 2016 Executive Summary The U.S. healthcare system is progressing along a continuum from volume- to valuebased care models where physicians and health systems

More information

Patient Payment Check-Up

Patient Payment Check-Up Patient Payment Check-Up SURVEY REPORT 2017 Attitudes and behavior among those billing for healthcare and those paying for it CONDUCTED BY 2017 Patient Payment Check-Up Report 1 Patient demand is ahead

More information

Visualizing the Patient Experience Using an Agile Framework

Visualizing the Patient Experience Using an Agile Framework Visualizing the Patient Experience Using an Agile Framework Session 173, March 7, 2018 Chris Mitchell, Snr. Business Intelligence Developer University of Virginia Medical Center 1 Today s Presenter Chris

More information

From Bundles to Global Capitation: Aligning Care Models to Payment Models. The 16 th Annual Population Health Colloquium Philadelphia, PA

From Bundles to Global Capitation: Aligning Care Models to Payment Models. The 16 th Annual Population Health Colloquium Philadelphia, PA From Bundles to Global Capitation: Aligning Care Models to Payment Models The 16 th Annual Population Health Colloquium Philadelphia, PA March 8, 2016 The U.S. Payer Market is Committed to Dramatically

More information

From Fee for Service to Value Based Healthcare Managing The Pace of Change in Clinical Transformation A Panel Discussion The Fourth Annual

From Fee for Service to Value Based Healthcare Managing The Pace of Change in Clinical Transformation A Panel Discussion The Fourth Annual From Fee for Service to Value Based Healthcare Managing The Pace of Change in Clinical Transformation A Panel Discussion The Fourth Annual Accountable Care Organization Summit June 12 14, 2013 Hyatt Regency

More information

Complex Patient Care Redesign: ThedaCare Innovation. Gregory Long, MD Chief Medical Officer

Complex Patient Care Redesign: ThedaCare Innovation. Gregory Long, MD Chief Medical Officer Complex Patient Care Redesign: ThedaCare Innovation Gregory Long, MD Chief Medical Officer ThedaCare Northeastern Wisconsin An Integrated Community Health System; >7000 employees Primary service area of

More information

Managed care consulting services

Managed care consulting services Managed care consulting services WeiserMazars Health Care Consulting Services WeiserMazars LLP is an independent member firm of Mazars Group. WeiserMazars Health Care Group Managed Care consulting services

More information

A Practical Approach Toward Accountable Care and Risk-Based Contracting: Design to Implementation

A Practical Approach Toward Accountable Care and Risk-Based Contracting: Design to Implementation A Practical Approach Toward Accountable Care and Risk-Based Contracting: Design to Implementation Daniel J. Marino, President/CEO, Health Directions Asad Zaman, MD June 19, 2013 Session Objectives Establish

More information

Payment Reform Strategies. Ann Thomas Burnett BlueCross BlueShield of South Carolina

Payment Reform Strategies. Ann Thomas Burnett BlueCross BlueShield of South Carolina Payment Reform Strategies Ann Thomas Burnett BlueCross BlueShield of South Carolina Disclosure I have no relevant financial relationships with commercial interests to disclose. The Current Market Landscape

More information

MANAGED CARE CONSULTING SERVICES

MANAGED CARE CONSULTING SERVICES CONSULTING SERVICES WeiserMazars Health Care Consulting Services THE NEW JERSEY HOSPITAL ASSOCIATION April 30,2013 WeiserMazars LLP is an independent member firm of Mazars Group. WEISERMAZARS HEALTH CARE

More information

POPULATION HEALTH PLAYBOOK. Mark Wendling, MD Executive Director LVPHO/Valley Preferred 1

POPULATION HEALTH PLAYBOOK. Mark Wendling, MD Executive Director LVPHO/Valley Preferred   1 POPULATION HEALTH PLAYBOOK Mark Wendling, MD Executive Director LVPHO/Valley Preferred www.populytics.com 1 Today s Agenda Outline LVHN, LVPHO and Populytics Overview Population Health Approach Population

More information

Future of Community Healthcare Providers. Author: Mr. Raj Shah, CEO, CTIS Inc.

Future of Community Healthcare Providers. Author: Mr. Raj Shah, CEO, CTIS Inc. Author: Mr. Raj Shah, CEO, CTIS Inc. Healthcare providers range from government to commercial sectors. In the government sector, this includes both civilian and military hospitals, academic medical and

More information

An Overview of NCQA Relative Resource Use Measures. Today s Agenda

An Overview of NCQA Relative Resource Use Measures. Today s Agenda An Overview of NCQA Relative Resource Use Measures Today s Agenda The need for measures of Resource Use Development and testing RRU measures Key features of NCQA RRU measures How NCQA calculates benchmarks

More information

A Battelle White Paper. How Do You Turn Hospital Quality Data into Insight?

A Battelle White Paper. How Do You Turn Hospital Quality Data into Insight? A Battelle White Paper How Do You Turn Hospital Quality Data into Insight? Data-driven quality improvement is one of the cornerstones of modern healthcare. Hospitals and healthcare providers now record,

More information

VALUE BASED ORTHOPEDIC CARE

VALUE BASED ORTHOPEDIC CARE VALUE BASED ORTHOPEDIC CARE Becker's 14th Annual Spine, Orthopedic and Pain Management- Driven ASC Conference + The Future of Spine June 9-11, 2016 Swissotel, Chicago, IL LES JEBSON Administrator, Adjunct

More information

CROSS-COMMUNITY SUMMIT SESSION 2 CONSIDERATIONS FOR HEALTH CENTERS AND HOSPITALS IN DEVELOPING SUCCESSFUL PARTNERSHIPS. Speakers:

CROSS-COMMUNITY SUMMIT SESSION 2 CONSIDERATIONS FOR HEALTH CENTERS AND HOSPITALS IN DEVELOPING SUCCESSFUL PARTNERSHIPS. Speakers: SESSION 2 CONSIDERATIONS FOR HEALTH CENTERS AND HOSPITALS IN DEVELOPING SUCCESSFUL PARTNERSHIPS Speakers: Arthur Jones, M.D., Principal, has over 25 years of experience as a founding physician and CEO

More information

Roadmap to accountable care: The chicken or the egg technology investment or clinical process improvement?

Roadmap to accountable care: The chicken or the egg technology investment or clinical process improvement? Roadmap to accountable care: The chicken or the egg technology investment or clinical process improvement? August 29, 2012 Meet the Presenters Michael Griffis CIO Innovative Practices Tucson, AZ Beth Hartquist,

More information

The ins and outs of CDE 10 steps for addressing clinical documentation excellence

The ins and outs of CDE 10 steps for addressing clinical documentation excellence The ins and outs of CDE 10 steps for addressing clinical documentation excellence What s at stake for CDE outpatient/inpatient integration? Historically, provider organizations have focused their clinical

More information

IMPROVING TRANSITIONS OF CARE IN POPULATION HEALTH

IMPROVING TRANSITIONS OF CARE IN POPULATION HEALTH IMPROVING TRANSITIONS OF CARE IN POPULATION HEALTH TABLE OF CONTENTS 1. The Transitions Challenge 2. Impact of Care Transitions 3. Patient Insights from Project Boost 4. Identifying Patients 5. Improving

More information

CPC+ CHANGE PACKAGE January 2017

CPC+ CHANGE PACKAGE January 2017 CPC+ CHANGE PACKAGE January 2017 Table of Contents CPC+ DRIVER DIAGRAM... 3 CPC+ CHANGE PACKAGE... 4 DRIVER 1: Five Comprehensive Primary Care Functions... 4 FUNCTION 1: Access and Continuity... 4 FUNCTION

More information

Yo u r Ke y t o Pay -f o r-

Yo u r Ke y t o Pay -f o r- Cha p t e r On e : HCAHPS Co u n t s: Wh y It s Yo u r Ke y t o Pay -f o r- Performance Success A Brief Introduction to HCAHPS If you re a newer leader, you may appreciate this quick overview. HCAHPS stands

More information

NCQA WHITE PAPER. NCQA Accreditation of Accountable Care Organizations. Better Quality. Lower Cost. Coordinated Care

NCQA WHITE PAPER. NCQA Accreditation of Accountable Care Organizations. Better Quality. Lower Cost. Coordinated Care NCQA Accreditation of Accountable Care Organizations Better Quality. Lower Cost. Coordinated Care. NCQA WHITE PAPER NCQA Accreditation of Accountable Care Organizations Accountable Care Organizations (ACO)

More information

To successfully submit a full application, hospitals must complete both the online application and the Self-assessment.

To successfully submit a full application, hospitals must complete both the online application and the Self-assessment. SMALL RURAL HOSPITAL TRANSITION (SRHT) PROJECT To successfully submit a full application, hospitals must complete both the online application and the Self-assessment. Applications must be submitted online,

More information

EXECUTIVE INSIGHTS. Post-Acute Care (PAC) Providers: Strategies for a Value-Based Future. Key Macro Trends Affecting PAC Providers

EXECUTIVE INSIGHTS. Post-Acute Care (PAC) Providers: Strategies for a Value-Based Future. Key Macro Trends Affecting PAC Providers VOLUME XVII, ISSUE 35 Post-Acute Care (PAC) Providers: Strategies for a Value-Based Future The healthcare industry s transformation from a volume-based environment to a value-based environment is well

More information

EP LAB BENCHMARKING WHITEPAPER

EP LAB BENCHMARKING WHITEPAPER EP LAB BENCHMARKING WHITEPAPER C. DeLaughter, MD; K. Heist, MD, PhD; B.Kind, HRSCS in sights EP LAB BENCHMARKING EXPERT PANEL INTRODUCTION C. DeLaughter, MD; K. Heist, MD, PhD; B.Kind, HRSCS In early 2014,

More information

Best Practices Contracting for Health IT Supporting Pay-for-Performance (P4P) Early Findings

Best Practices Contracting for Health IT Supporting Pay-for-Performance (P4P) Early Findings Best Practices Contracting for Health IT Supporting Pay-for-Performance (P4P) Early Findings Researchers: Martin, Thomas R. PhD, Assistant Professor St. Joseph s University Department of Health Services;

More information

Integration of Clinical Care and Public Health Systems: The need as reflected in the work of the Alliance to Reduce Disparities in Diabetes

Integration of Clinical Care and Public Health Systems: The need as reflected in the work of the Alliance to Reduce Disparities in Diabetes Integration of Clinical Care and Public Health Systems: The need as reflected in the work of the Alliance to Reduce Disparities in Diabetes Moderator and Presenter Belinda W. Nelson, PhD Center for Managing

More information

Cloud Analytics As A Service

Cloud Analytics As A Service Cloud Analytics As A Service Enabling Actionable Realtime Data Analytics July 13, 2016 Joanne White, CIO Mark Gerschutz, Director of IT Rick Crawford, Interface Architect Christine Wulff, RN, ED Analyst

More information

How to Align Quality Reporting Across PQRS, MU, and VBPM

How to Align Quality Reporting Across PQRS, MU, and VBPM Health Care IT Advisor How to Align Quality Reporting Across PQRS, MU, and VBPM Anantachai (Tony) Panjamapirom Senior Consultant, Health Care IT Advisor Debe Gash CIO, St. Luke s Health System March 10,

More information

On the Road to ACO: Plotting a Course for Quality and Cost-Effective Care

On the Road to ACO: Plotting a Course for Quality and Cost-Effective Care On the Road to ACO: Plotting a Course for Quality and Cost-Effective Care By Susan Birk Few would dispute the merits of the goals for improvement in patient care quality, efficiency and access that form

More information

Population Health. Collaborative Care. One interoperable platform. NextGen Care

Population Health. Collaborative Care. One interoperable platform. NextGen Care Population Health. Collaborative Care. One interoperable platform. NextGen Care We ve become very proactive in identifying at-risk patients and getting them in our door before they get sick. Our physicians

More information

Are physicians ready for macra/qpp?

Are physicians ready for macra/qpp? Are physicians ready for macra/qpp? Results from a KPMG-AMA Survey kpmg.com ama-assn.org Contents Summary Executive Summary 2 Background and Survey Objectives 5 What is MACRA? 5 AMA and KPMG collaboration

More information

Use Case Study: Remote Patient Monitoring for Chronic Disease

Use Case Study: Remote Patient Monitoring for Chronic Disease Use Case Study: Remote Patient Monitoring for Chronic Disease Hackensack Alliance Accountable Care Organization New Jersey March 2014 The Hackensack Alliance Accountable Care Organization (ACO) was established

More information

From Volume to Value: Toward the Second Curve AHA Sections for Metropolitan and Small or Rural Hospitals

From Volume to Value: Toward the Second Curve AHA Sections for Metropolitan and Small or Rural Hospitals From Volume to Value: Toward the Second Curve AHA Sections for Metropolitan and Small or Rural Hospitals A Network Affiliation the Preserves Hospital Independence Nebraska Regional Provider Network Kimberly

More information

Advocate Cerner Partnership Creates Big Data Analytics for Population Health

Advocate Cerner Partnership Creates Big Data Analytics for Population Health Advocate Cerner Partnership Creates Big Data Analytics for Population Health Tina Esposito, VP Center for Health Information Services Rishi Sikka, MD, Senior VP Clinical Operations Scottsdale Institute

More information

uncovering key data points to improve OR profitability

uncovering key data points to improve OR profitability REPRINT March 2014 Robert A. Stiefel Howard Greenfield healthcare financial management association hfma.org uncovering key data points to improve OR profitability Hospital finance leaders can increase

More information

LEGISLATIVE REPORT NORTH CAROLINA HEALTH TRANSFORMATION CENTER (TRANSFORMATION INNOVATIONS CENTER) PROGRAM DESIGN AND BUDGET PROPOSAL

LEGISLATIVE REPORT NORTH CAROLINA HEALTH TRANSFORMATION CENTER (TRANSFORMATION INNOVATIONS CENTER) PROGRAM DESIGN AND BUDGET PROPOSAL LEGISLATIVE REPORT NORTH CAROLINA HEALTH TRANSFORMATION CENTER (TRANSFORMATION INNOVATIONS CENTER) PROGRAM DESIGN AND BUDGET PROPOSAL SESSION LAW 2015-245, SECTION 8 FINAL REPORT State of North Carolina

More information

POPULATION HEALTH LEARNING NETWORK 1

POPULATION HEALTH LEARNING NETWORK 1 In partnership with the California Health Care Foundation (CHCF) and the Blue Shield of California Foundation (BSCF), the Center for Care Innovations (CCI) is launching a Population Heath Learning Network

More information

OCTOBER 19, 2017 GOING ABOVE AND BEYOND THE EHR TO OPTIMIZE QPP PERFORMANCE

OCTOBER 19, 2017 GOING ABOVE AND BEYOND THE EHR TO OPTIMIZE QPP PERFORMANCE OCTOBER 19, 2017 GOING ABOVE AND BEYOND THE EHR TO OPTIMIZE QPP PERFORMANCE ABCs of the QPP Panel BETH HOUCK, MBA Vice President, Client Services, SA Ignite RON ROCKWOOD EHR Clinic Coordinator, Jefferson

More information

Care Coordination in a no discharge system

Care Coordination in a no discharge system Care Coordination in a no discharge system Barry Bittman, MD Estes Park Institute Let s begin with a basic question. Who should be responsible? How can we align physicians with our hospital? Can we continue

More information

Accountable Care Organizations American Osteopathic Association Health Policy Day September 23, 2011

Accountable Care Organizations American Osteopathic Association Health Policy Day September 23, 2011 Accountable Care Organizations American Osteopathic Association Health Policy Day September 23, 2011 Cary Sennett MD PhD Cary Sennett, MD, PhD Managing Director, Engelberg Center for Health Care Reform

More information

The Alternative Quality Contract (AQC): Improving Quality While Slowing Spending Growth

The Alternative Quality Contract (AQC): Improving Quality While Slowing Spending Growth The Alternative Quality Contract (AQC): Improving Quality While Slowing Spending Growth Dana Gelb Safran, ScD Senior Vice President, Performance Measurement and Improvement Presented at: MAHQ 16 April

More information

White Paper BKLYN Incubator

White Paper BKLYN Incubator Administrative Information Brooklyn Public Library: BKLYN Incubator Amount Awarded: $25,000 Total Project Cost: $78,653 Project Dates: November 1, 2015 October 31, 2016 Project Administrators: BKLYN Incubator

More information

Bundled Payments. AMGA September 25, 2013 AGENDA. Who Are We. Our Business Challenge. Episode Process. Experience

Bundled Payments. AMGA September 25, 2013 AGENDA. Who Are We. Our Business Challenge. Episode Process. Experience Bundled Payments AMGA September 25, 2013 Who Are We AGENDA Our Business Challenge Episode Process Experience 1 Cleveland Clinic is transforming Fee for service Fee for value 3 Fast Facts 41,200 employees

More information

Big Data NLP for improved healthcare outcomes

Big Data NLP for improved healthcare outcomes Big Data NLP for improved healthcare outcomes A white paper Big Data NLP for improved healthcare outcomes Executive summary Shifting payment models based on quality and value are fueling the demand for

More information

Trends in Health Information Exchange (HIE) and Links to Medicaid Led Quality Improvement

Trends in Health Information Exchange (HIE) and Links to Medicaid Led Quality Improvement Trends in Health Information Exchange (HIE) and Links to Medicaid Led Quality Improvement July 25, 2007 Regional Quality Improvement Initiative Shannah Koss Avalere Health LLC Avalere Health LLC The intersection

More information