Chesapeake Regional Healthcare. by Ramil Bollozos Margarita Bondarenko Jeff Wan

Size: px
Start display at page:

Download "Chesapeake Regional Healthcare. by Ramil Bollozos Margarita Bondarenko Jeff Wan"

Transcription

1 Chesapeake Regional Healthcare by Ramil Bollozos Margarita Bondarenko Jeff Wan

2 Strategic Plan

3 Physician Engagement

4 Physician Engagement Hospitalists Physician Satisfaction Physicians with Admitting Privileges Patient referrals Unaffiliated External Physicians Establish new ties with unaffiliated physicians

5 Healthcare Organization (HCO) Engagement

6 HCO Engagement MARKET SHARE INITIATIVE: CRMC will further strengthen as well as maintain its market position and engage Healthcare organizations Objective 1: By 2018, CRMC will develop as well as enhance existing services by identifying and meeting distinct local market needs Action Plan: Improve rehabilitation services Develop 24/7 home health service with a focus on caregiver quality improvement Improve internal medicine service line Engage Bayview medical group to improve existing services with a focus on preventative care

7 HCO Engagement Objective: Emphasize convenience and increase awareness of tools that are available Action Plan: Contract with medical transportation agency Continue to educate public on Epic EHR System on accessibility Actively engage and encourage practitioners to use tools available to them Build collaborative relationships with Epic to promote this objective

8 HCO Engagement Objective: By 2017, CRMC will contract managed care plans to increase managed care reimbursement as well as Action Plan: Will negotiate reimbursement rates and set up contract with Anthem Blue Cross Medicare Advantage HMO plan Collaborate with managed care plans to develop innovative reimbursement programs Build relationships with major employers such as Dollar Tree

9 Patient Engagement

10 Primary Service Area Analysis Zip codes: 23320, 23322, make up almost 50% of CRH discharges Median age for 3 zip codes: (Virginia State median age: 37.6) Major Competitors Sentara Virginia Beach, 2 nd largest market share Sentara Norfolk General Sentara Leigh Hospital

11 Patient Engagement Enhance Online Presence Reviews Yelp Google Social Media Twitter Facebook Instagram Integrate Specialties with Hospital Marketing Physician Biography Specialty Clinic Information Community Relations Community Partnerships Community Outreach

12 Projected Outcomes

13 Physician Engagement Projected Outcomes Target Baseline Year 1 Goal Year 2 Goal Year 3 Goal Hospitalist Physician satisfaction surveys 20% sample 2% increase in scores from baseline year 0 6% increase in scores from baseline year 0 15% increase in scores from baseline year 0 Admitting Privileges Management rounds Evaluate data on patient referral sources Not quantifiable Not quantifiable Not quantifiable 2% increase from baseline year 0 in patients from referring physicians 5% increase from baseline year 0 in patients from referring physicians 9% increase from baseline year 0 in patients from referring physicians External Physicians Increase numbers of referring physicians N/A 0.5% increase from baseline year 1% increase from baseline year

14 HCO Engagement Projected Outcomes Target Baseline Year 1 Goal Year 2 Goal Year 3 Goal Rehab Current market share 10% increase in market share from baseline year 20% increase in market share from baseline year 25% increase in market share from baseline year Transportation Services Current patient reliant on transportation services 10% increase in patient volume from baseline year 20% increase in patient volume from baseline year 25% increase in market share from baseline year Anthem Blue Cross Current Anthem BC volume Meet needs of new Anthem BC contract 10% increase in volume from baseline year 20% increase in volume from baseline year Medicare Advantage NA Introduce potential Medicare product to Anthem BC Anthem BC agrees with Medicare product Finalize contract

15 Patient Engagement Projected Outcomes Target Baseline Year 1 Goal Year 2 Goal Year 3 Goal Online Presence Specialty Clinics Community Relations Current number of online hits $6 million operating loss of specialties Patient volume from current community relations 10% increase from baseline Decrease to $3 million loss 5% increase in volume from baseline 15% increase from baseline Break even 10% increase in volume from baseline 20% increase from baseline Produce a profit 15% increase in volume from baseline

16 Thank you

CareMore Special Needs Plans Model of Care. Annual Evaluation 2015 Performance

CareMore Special Needs Plans Model of Care. Annual Evaluation 2015 Performance CareMore Special Needs Plans Model of Care Annual Evaluation 2015 Performance The Special Needs Plans (SNPs) Medicare SNPs are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit

More information

TERESA L. EDWARDS, MHA, FACHE

TERESA L. EDWARDS, MHA, FACHE TERESA L. EDWARDS, MHA, FACHE PROFESSIONAL EXPERIENCE PRESIDENT Sentara Leigh Hospital - Norfolk, VA (September 2008-Present) - 250-inpatient beds, 16 surgical suites, with 3 rd largest orthopedic program

More information

Hardwiring Technology into Care Delivery to Increase HCAHPS

Hardwiring Technology into Care Delivery to Increase HCAHPS Hardwiring Technology into Care Delivery to Increase HCAHPS March 1, 2016 Peggy Grant, Ph.D. Director of Innovation and Performance Improvement Community Regional Medical Center Conflict of Interest Peggy

More information

Re: Non-participation in the new Horizon Medicare Blue Patient-Centered w/rx (HMO) product

Re: Non-participation in the new Horizon Medicare Blue Patient-Centered w/rx (HMO) product Three Penn Plaza East Newark, NJ 07105-2200 HorizonBlue.com October 2014 Re: Non-participation in the new Horizon Medicare Blue Patient-Centered w/rx (HMO) product

More information

Flexible Network FAQs

Flexible Network FAQs Flexible Network FAQs A tiered PPO network for self-insured national accounts Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is working with other Blue Cross and Blue Shield Plans (Blue Plans)

More information

Best Practices: Case Management and Keys to a Successful Implementation

Best Practices: Case Management and Keys to a Successful Implementation Best Practices: Case Management and Keys to a Successful Implementation Teresa Gonzalvo, RN, BSN, MPA, CPHQ, ACM Vice President, Care Coordination Sentara Healthcare Sherry Norquist, RN, BSN, ACM Manager,

More information

SENTARA HEALTHCARE. Norfolk, VA

SENTARA HEALTHCARE. Norfolk, VA SENTARA HEALTHCARE Norfolk, VA 1 Sentara Healthcare Overview 11 Acute Care Hospitals in Virginia with a total of 2572 licensed beds 1E Extended dstay hospital 9 Ambulatory Care Campuses; 5 with freestanding

More information

Meridian Health Physician Survey

Meridian Health Physician Survey Meridian Health Physician Survey This survey will take just five minutes to complete. Responses are anonymous. Information will be used in the aggregate form to make actionable improvements. Responses

More information

INTEGRATED DATA ANALYTICS AND CARE WORKFLOW OPTIMIZATION

INTEGRATED DATA ANALYTICS AND CARE WORKFLOW OPTIMIZATION INTEGRATED DATA ANALYTICS AND CARE WORKFLOW OPTIMIZATION CASE STUDY October 2016 1 AGENDA 1 2 3 INTRODUCTIONS Speaker and System 4 Q+A VALUE OF INTEGRATED DATA Why effective ACOs require EHR, Claims, and

More information

Post Acute Continuum Lessons Learned from Geisinger s ProvenHealth Navigator

Post Acute Continuum Lessons Learned from Geisinger s ProvenHealth Navigator Post Acute Continuum Lessons Learned from Geisinger s ProvenHealth Navigator Janet Tomcavage, RN, MSN VP Health Services, Geisinger Health Plan Danville, PA February 3, 2012 Patient-centered primary care

More information

Optima Medicare Value and

Optima Medicare Value and Medicare Advantage HMO Plans Optima Medicare Value and Optima Medicare Prime Now serving Williamsburg & James City County Chesapeake, Hampton, James City County, Newport News, Norfolk, Poquoson, Portsmouth,

More information

Objectives. Assisted Living. O 2 : Opportunities & Outcomes in Assisted Living. Presented by: Chief Clinical Officer

Objectives. Assisted Living. O 2 : Opportunities & Outcomes in Assisted Living. Presented by: Chief Clinical Officer O 2 : Opportunities & Outcomes in Assisted Living Presented by: Leigh Ann Frick, PT, MBA Chief Clinical Officer Melissa Moffitt, MS, CCC-SLP Senior Vice President of Senior Living Objectives Identify the

More information

PROFESSIONAL FEE BILLING POLICY FOR CLINICAL FELLOWS IN ACCREDITED PROGRAMS

PROFESSIONAL FEE BILLING POLICY FOR CLINICAL FELLOWS IN ACCREDITED PROGRAMS PROFESSIONAL FEE BILLING POLICY FOR CLINICAL FELLOWS IN ACCREDITED PROGRAMS BACKGROUND: Federal regulations and the Medicare program have established rules governing the payment for services performed

More information

SURVIVING AND THRIVING

SURVIVING AND THRIVING SURVIVING AND THRIVING IN A PRIVATE FAMILY MEDICINE PRACTICE Janet Mullins, MD Kachina Family Practice Phoenix, Arizona STAYIN ALIVE IN PRIVATE PRACTICE 2015 JANET MULLINS, MD KACHINA FAMILY PRACITCE PHOENIX,

More information

Frequently Asked Questions

Frequently Asked Questions Frequently Asked Questions Q: What is a clinically integrated network? A: Clinically integrated (CI) networks are integrated systems of hospitals, physicians and other medical facilities that collaborate

More information

Naval Station Norfolk Transit Extension Study Public Involvement Workshop. June 12, 17, and 19, 2013

Naval Station Norfolk Transit Extension Study Public Involvement Workshop. June 12, 17, and 19, 2013 Naval Station Norfolk Transit Extension Study Public Involvement Workshop June 12, 17, and 19, 2013 NSNTES Corridor Planning STUDY PROCESS 2 Current Phase Funded Corridor Planning Pre NEPA Future Phases

More information

Community-based Care Coordination (CCC) Maturity Assessment RidgePointe Healthcare District

Community-based Care Coordination (CCC) Maturity Assessment RidgePointe Healthcare District Who/What Program Elements Level 1. Beginning Level 2. Progressing Level 3. Intermediate Level 4. Advanced Organization(s) sponsoring CCC Providers Community services Patients (pts) Payers A. LEADERSHIP

More information

CRITICAL ACCESS HOSPITAL SWING BED PROGRAM

CRITICAL ACCESS HOSPITAL SWING BED PROGRAM CRITICAL ACCESS HOSPITAL SWING BED PROGRAM Operational and Management Strategies March 1, 2016 Andrea Elliott, CPA Senior Managing Consultant aelliott@bkd.com Suzy Harvey, RN-BC, RAC-CT Managing Consultant

More information

ACOs the Medicare Shared Savings Program And Other Healthcare Reform Payment Methods

ACOs the Medicare Shared Savings Program And Other Healthcare Reform Payment Methods A unique vision for an ever-changing healthcare environment ACOs the Medicare Shared Savings Program And Other Healthcare Reform Payment Methods Presented by Joe Laden, President, ORVA, LLC The Environment

More information

Managed Care 101: Understanding the Basics and Opportunities for Partnership. Bruce A. Chernof, M.D. President & CEO

Managed Care 101: Understanding the Basics and Opportunities for Partnership. Bruce A. Chernof, M.D. President & CEO TSF Webinar January 8, 2013 Managed Care 101: Understanding the Basics and Opportunities for Partnership Bruce A. Chernof, M.D. President & CEO Presentation Overview: Managed Care 101 Background Goals

More information

Transforming Physician Practices: Evolution of ACOs in California. National Association of ACOs - Washington, DC October 2015

Transforming Physician Practices: Evolution of ACOs in California. National Association of ACOs - Washington, DC October 2015 Transforming Physician Practices: Evolution of ACOs in California National Association of ACOs - Washington, DC October 2015 Integrated Healthcare Association Statewide multi-stakeholder leadership group

More information

Patient-Centered Medical Home Best Practices: Case Study Examples

Patient-Centered Medical Home Best Practices: Case Study Examples Patient-Centered Medical Home Best Practices: Case Study Examples Mona Chitre, PharmD, CGP Director of Clinical Services, Strategy, and Policy FLRx Pharmacy Management Excellus Health Plans Disclosures

More information

10/5/2017 THE SEVEN PILLARS OF GROWTH MOST ORGANIZATIONS WANT TO THE DAYS OF MUFFIN MARKETING ARE OVER. The way marketing use to be:

10/5/2017 THE SEVEN PILLARS OF GROWTH MOST ORGANIZATIONS WANT TO THE DAYS OF MUFFIN MARKETING ARE OVER. The way marketing use to be: THE SEVEN PILLARS OF GROWTH A ROAD MAP TO SERVE MORE PATIENTS AND GROW WITH AUTHOR SPEAKER COACH, KURT KAZANOWSKI MS, RN, CHE MOST ORGANIZATIONS WANT TO GROW BUT MOST ORGANIZATIONS ARE NOT WILLING TO DO

More information

WHO SHARES? A look at the status of HIT and HIE in Arkansas

WHO SHARES? A look at the status of HIT and HIE in Arkansas WHO SHARES? A look at the status of HIT and HIE in Arkansas Arkansas Association for Healthcare Documentation Integrity Christy Williams, Public Information Officer Arkansas Office of Health Information

More information

HIMSS 2011 Implementation of Standardized Terminologies Survey Results

HIMSS 2011 Implementation of Standardized Terminologies Survey Results HIMSS 2011 Implementation of Standardized Terminologies Survey Results The current healthcare climate, with rising costs and decreased reimbursement, necessitates fiscal responsibility. Elements of the

More information

Monica E. Oss, Chief Executive Officer, OPEN MINDS CBHC Annual Conference September 29, 2012 / 10:00 am

Monica E. Oss, Chief Executive Officer, OPEN MINDS CBHC Annual Conference September 29, 2012 / 10:00 am Monica E. Oss, Chief Executive Officer, OPEN MINDS CBHC Annual Conference September 29, 2012 / 10:00 am Why the demand for coordinated care? What factors are shaping emerging models? What are the emerging

More information

Integrated Health Networks and Healthcare Reform in the U.S. Howard P. Kern, President Sentara Healthcare Norfolk, Virginia USA

Integrated Health Networks and Healthcare Reform in the U.S. Howard P. Kern, President Sentara Healthcare Norfolk, Virginia USA Integrated Health Networks and Healthcare Reform in the U.S. Howard P. Kern, President Sentara Healthcare Norfolk, Virginia USA Agenda Current Structure of Healthcare Delivery in the U.S. Sentara Healthcare

More information

ACCOUNTABLE CARE: ROADMAP TO VALUE

ACCOUNTABLE CARE: ROADMAP TO VALUE ACCOUNTABLE CARE: ROADMAP TO VALUE Perspective The adoption of Accountable Care and value-based reimbursement has dramatically increased these past several years. New organizations are being established

More information

Working with Anthem Subject Specific Webinar Series

Working with Anthem Subject Specific Webinar Series Working with Anthem Subject Specific Webinar Series Special Session Working with Anthem Medicaid Access audio conference: 877-497-8913 Conference code: 132-281-9809# Please Mute Your Phone Use the mute

More information

March 14, Good afternoon

March 14, Good afternoon March 14, 2013 Good afternoon In an effort to assist with implementation of the Affordable Care Act, the IHS Director convened a team that consists of IHS, Tribal and Urban participants to develop a ACA

More information

Care Compact Guide Patient-Centered Specialty Care (PCSC) A Component of Medical Neighborhood Initiatives

Care Compact Guide Patient-Centered Specialty Care (PCSC) A Component of Medical Neighborhood Initiatives Compact Guide Patient-Centered Specialty (PCSC) A Component of Medical Neighborhood Initiatives Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical

More information

Transforming Outcomes through Implementation of a Nurse Practitioner Hospitalist Service. About Long Beach, CA. About Memorial Care

Transforming Outcomes through Implementation of a Nurse Practitioner Hospitalist Service. About Long Beach, CA. About Memorial Care Transforming Outcomes through Implementation of a Nurse Practitioner Hospitalist Service Judy Fix, MSN, CNO Megan Liego, DNP, ACNP-BC About Long Beach, CA Located in South Los Angeles County Seventh largest

More information

STRATEGIES AND SOLUTIONS FOR REDUCING INAPPROPRIATE READMISSIONS

STRATEGIES AND SOLUTIONS FOR REDUCING INAPPROPRIATE READMISSIONS WHITE PAPER STRATEGIES AND SOLUTIONS FOR REDUCING INAPPROPRIATE READMISSIONS This paper offers a two-pronged approach to lower readmission rates and avoid Federal penalties. Jasen W. Gundersen, M.D., M.B.A.,

More information

SUMMARY OF BENEFITS. Hamilton County Department of Education Network Copay Plan. Connecticut General Life Insurance Co.

SUMMARY OF BENEFITS. Hamilton County Department of Education Network Copay Plan. Connecticut General Life Insurance Co. SUMMARY OF BENEFITS Connecticut General Life Insurance Co. Hamilton County Department of Education Annual deductibles and maximums Lifetime maximum Pre-Existing Condition Limitation (PCL) Coinsurance All

More information

HOME IS THE HUB. An Initiative to Accelerate Progress to Reduce Readmissions in Virginia Deep Dive: Post-Acute Care Strategies May 17, 2017

HOME IS THE HUB. An Initiative to Accelerate Progress to Reduce Readmissions in Virginia Deep Dive: Post-Acute Care Strategies May 17, 2017 HOME IS THE HUB An Initiative to Accelerate Progress to Reduce Readmissions in Virginia Deep Dive: Post-Acute Care Strategies May 17, 2017 HOUSEKEEPING Slides were sent this morning Webinar is being recorded

More information

June 18, 2009 Page 1

June 18, 2009 Page 1 Base Year Current LOC base rates calculated using: Wyoming Medicaid inpatient hospital claims data from July 1, 1994 through December 31, 1996 Most recently audited Medicare cost report with provider fiscal

More information

The Patient. Achieving Patient Satisfaction

The Patient. Achieving Patient Satisfaction The Patient Achieving Patient Satisfaction Considerations What happens at the appointment is only 25% of the interaction Patients are in the driver s seat Ethical conundrum for providers How Important

More information

System Options to Achieve the Triple Aim

System Options to Achieve the Triple Aim D30/E30 This presenter has nothing to disclose System Options to Achieve the Triple Aim David M. Williams, MD, CPE Medical Director UnityPoint Health Partners December 10, 2014 Objectives Evaluate their

More information

PCPCC s Strategic Plan, Aligning & Engaging our Stakeholders to Drive Health System Transformation

PCPCC s Strategic Plan, Aligning & Engaging our Stakeholders to Drive Health System Transformation 1 PCPCC s Strategic Plan, 2015-2018 Aligning & Engaging our Stakeholders to Drive Health System Transformation Welcome & Acknowledgments Marci Nielsen, PhD, MPH Chief Executive Officer Patient- Centered

More information

Pitch Perfect: Selling Your Services to LTC Facilities

Pitch Perfect: Selling Your Services to LTC Facilities Pitch Perfect: Selling Your Services to LTC Facilities Lou Ann Brubaker, President Brubaker Consulting www.brubakerconsulting.com 301 535 5449 brubak97@aol.com Linkedin Disclosure Lou Ann Brubaker is the

More information

Practice Transformation: Patient Centered Medical Home Overview

Practice Transformation: Patient Centered Medical Home Overview Practice Transformation: Patient Centered Medical Home Overview Megan A. Housley, MBA Business Development Director Kentucky Regional Extension Center The Triple Aim Population Health TRIPLE AIM Per Capita

More information

Individual and Organizational Coaching Intensive Assessment and Consultation. Eden Leaders Institute. Introduction and Overview

Individual and Organizational Coaching Intensive Assessment and Consultation. Eden Leaders Institute. Introduction and Overview Individual and Organizational Coaching Intensive Assessment and Consultation Eden Leaders Institute Introduction and Overview Licensed Clinical Psychologist President, Eden Leaders Institute President,

More information

Administrators. Medical Directors. 61% The negative impact on our hospital-based program s. 44% We will need to consider the most appropriate or most

Administrators. Medical Directors. 61% The negative impact on our hospital-based program s. 44% We will need to consider the most appropriate or most 2016 This annual survey, which began in 2009, provides key insight into nationwide developments in the business of cancer care. To better capture information from its multidisciplinary membership, this

More information

Medicare Advantage PFFS Products HFMA 2008 Spring Education Conference Kiet Lam Senior Manager, Triage Consulting Group

Medicare Advantage PFFS Products HFMA 2008 Spring Education Conference Kiet Lam Senior Manager, Triage Consulting Group Medicare Advantage PFFS Products HFMA 2008 Spring Education Conference Kiet Lam Senior Manager, Triage Consulting Group In the news Medicare Audits Show Problems in Private Plans NY Times (Oct 2007) Medicare

More information

2019 Quality Improvement Program Description Overview

2019 Quality Improvement Program Description Overview 2019 Quality Improvement Program Description Overview Introduction Eon/Clear Spring s Quality Improvement (QI) program guides the company s activities to improve care and treatment for the member s we

More information

Anthem Blue Cross Cal MediConnect Plan (Medicare- Medicaid Plan) Santa Clara County Behavioral Health provider training

Anthem Blue Cross Cal MediConnect Plan (Medicare- Medicaid Plan) Santa Clara County Behavioral Health provider training Anthem Blue Cross Cal MediConnect Plan (Medicare- Medicaid Plan) Santa Clara County Behavioral Health provider training Anthem Blue Cross Cal MediConnect Plan Effective January 1, 2015, Anthem Blue Cross

More information

Referrals, Prior Authorizations, Medical Management, and Appeals

Referrals, Prior Authorizations, Medical Management, and Appeals Referrals, Prior Authorizations, Medical Management, and Appeals 1 An Independent Licensee of the Blue Cross Blue Shield Association 044506 (12-21-2017) 2017 Premera. Proprietary and Confidential. Referrals

More information

FY2016 City Funding Application

FY2016 City Funding Application Sustainable Housing Matters October 2014 www.nrha.us Summary Each year NRHA receives various sources of funding from the City of Norfolk to implement its programs. Funding is provided by the City of Norfolk

More information

Gender. Age DEMOGRAPHICS POINTS OF DISTINCTION COMISSION FOR ACCREDITATION OF REHABILITATION FACILITIES STATE OF FLORIDA BRAIN AND SPINAL CORD PROGRAM

Gender. Age DEMOGRAPHICS POINTS OF DISTINCTION COMISSION FOR ACCREDITATION OF REHABILITATION FACILITIES STATE OF FLORIDA BRAIN AND SPINAL CORD PROGRAM POINTS OF DISTINCTION 89-bed Acute Adult Inpatient Rehabilitation Unit, All private rooms 4 th largest Rehabilitation provider in the state of Florida Admitted 2157 patients from April 2017 through March

More information

n/a n/a n/a n/a CEO Engage in professional search firms to recruit additional FNP s and additional primary care physicians CEO

n/a n/a n/a n/a CEO Engage in professional search firms to recruit additional FNP s and additional primary care physicians CEO Identified Priority Area: Access to Care Plan not to address: Provider reimbursement, high deductible plans/ co-pay costs/ lack of health insurance The hospital does not have the ability to change reimbursement

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

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

Managing Patients with Multiple Chronic Conditions

Managing Patients with Multiple Chronic Conditions Best Practices Managing Patients with Multiple Chronic Conditions Fletcher Allen Health Care Case Study Organization Profile Located in Burlington, Fletcher Allen Health Care (FAHC) is Vermont s university

More information

Coordinated Outreach Achieving Community Health (COACH) for Heart Failure Learning Objectives

Coordinated Outreach Achieving Community Health (COACH) for Heart Failure Learning Objectives Coordinated Outreach Achieving Community Health (COACH) for Heart Failure Session C917 October 9, 2015 Colleen Cameron, DNP, FNP-BC Rochelle Eggleton, MBA, BS, RN Susan Spink, BSN, RN-BC Linda Griffin,

More information

Succeeding with Accountable Care Organizations

Succeeding with Accountable Care Organizations Succeeding with Accountable Care Organizations The Point B Webinar Series October 25, 2011 Today s Discussion Key ACO trends and emerging models Critical success factors for building an ACO Developing

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

On the. Services for our Medicare health plan members who are visiting other Kaiser Permanente regions or Group Health Cooperative service areas

On the. Services for our Medicare health plan members who are visiting other Kaiser Permanente regions or Group Health Cooperative service areas On the GO Services for our Medicare health plan members who are visiting other Kaiser Permanente regions or Group Health Cooperative service areas Y0043_N011615 accepted Travel WELL and get the care YOU

More information

Frequently Asked Questions

Frequently Asked Questions Frequently Asked Questions Each of the following questions is answered in this document. Click on a question below to link directly to the answer. 1) What is UT CONNECT? 2) Which physicians and hospitals

More information

Troubleshooting Audio

Troubleshooting Audio Welcome! Audio for this event is available via ReadyTalk Internet Streaming. No telephone line is required. Computer speakers or headphones are necessary to listen to streaming audio. Limited dial-in lines

More information

NEED, RESPONSE, EVALUATIVE MEASURES, RESOURCES/CAPABILITIES, GOVERNANCE

NEED, RESPONSE, EVALUATIVE MEASURES, RESOURCES/CAPABILITIES, GOVERNANCE New Access Point application (2014) Considering Need The following selected excerpts on need were taken from the most recent New Access Point (NAP) funding announcement. Although each new HRSA funding

More information

Sutter-Yuba Mental Health Plan

Sutter-Yuba Mental Health Plan Sutter-Yuba Mental Health Plan Quality Improvement Work Plan Fiscal Year 2016/2017 TABLE OF CONTENTS Title Page.....1 Table of Contents... 2 Description of Quality Improvement... 3 Quality Improvement

More information

Indiana Medicaid Update

Indiana Medicaid Update Indiana Medicaid Update HIP 2.0 Financing, Hospital Assessment Fee (HAF), and Other Updates November 27, 2017 Basics of the HAF Legal authority for fees Who is assessed or exempt Basis of fee Fee rates

More information

VALUE-BASED HEALTH CARE

VALUE-BASED HEALTH CARE 1 Value-Based Health Care VALUE-BASED HEALTH CARE How Florida Blue is using Accountable Care Organizations and Patient-Centered Medical Homes to help businesses and consumers save money and improve their

More information

Michigan Primary Care Association

Michigan Primary Care Association Michigan Primary Care Association Improving Outcomes Finance & Quality through Integrated Information Conference June 2-3, 2016 Shanty Creek Resorts Bellaire, MI Definition and Purpose HRSA s Health Center

More information

Service Year Recruitment Best Practices

Service Year Recruitment Best Practices Service Year Recruitment Best Practices Public awareness of what a service year is a significant barrier to recruiting qualified candidates for service year positions. In a market survey that Service Year

More information

Transitions of Care: Primary Care Perspective. Patrick Noonan, DO

Transitions of Care: Primary Care Perspective. Patrick Noonan, DO Transitions of Care: Primary Care Perspective Patrick Noonan, DO Disclosures None Bio Outpatient primary care internist at New Pueblo Medicine Completed residency at the University of Iowa Graduated from

More information

Acclaim Physician Group, Inc.

Acclaim Physician Group, Inc. Attendees: Charlie Powell x Sharon Clark x Dr. James Johnson x Bill Whitman x Robert Earley x Ralph Emerson x Acclaim Physician Group, Inc. Executive Committee March 28, 2016 Also in attendance: Scott

More information

Best Practices: Access Case Management

Best Practices: Access Case Management Best Practices: Access Case Management Sarah M. Clark, RN-BC, BSN, MHA/INF, CCM Manager, Care Coordination Education Sentara Healthcare August 15, 2013 1 Objectives Identify key components of an effective

More information

Health Information Exchange in Minnesota

Health Information Exchange in Minnesota Health Information Exchange in Minnesota Minnesota Rural Health Conference Duluth, MN June 21, 2016 Anne Schloegel Minnesota Department of Health Office of Health Information Technology Office of Health

More information

Anthem Blue Cross Provider Operations and Technology

Anthem Blue Cross Provider Operations and Technology Termination of Provider Enrollee Notification Initial Policy Approval Date: 12/17/2001 Policy Review/Revision Approval Date(s): 06/17/2002, 6/16/2003, 3/29/2004, 06/19/2007 Filed DMHC, 1/17/2014 Products:

More information

Telehealth. Telehealth? 6/1/2016. A tool for enhancing health care, communication and information.

Telehealth. Telehealth? 6/1/2016. A tool for enhancing health care, communication and information. Telehealth June 2016 Telehealth? A tool for enhancing health care, public Providing/receiving health, and health education health delivery care services and support, at using a distance. electronic communication

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

Improving Hospital Performance Through Clinical Integration

Improving Hospital Performance Through Clinical Integration white paper Improving Hospital Performance Through Clinical Integration Rohit Uppal, MD President of Acute Hospital Medicine, TeamHealth In the typical hospital, most clinical service lines operate as

More information

How Hospitals Hope to Boost Ratings on Yelp, HealthGrades, ZocDoc and Vitals

How Hospitals Hope to Boost Ratings on Yelp, HealthGrades, ZocDoc and Vitals How Hospitals Hope to Boost Ratings on Yelp, HealthGrades, ZocDoc and Vitals Laura Markowski is in charge of Carilion Clinic s social media and reputation management. (Stephanie Klein-Davis for The Washington

More information

Case managers are consummate team players, working with. IssueBrief

Case managers are consummate team players, working with. IssueBrief IssueBrief May 2016 Making hospital care management an organizational priority: Dartmouth-Hitchcock deploys case managers so patients are at the right place at the right time Case managers are consummate

More information

Radiation oncology prior authorization

Radiation oncology prior authorization Radiation oncology prior authorization Prior authorization (PA) decision tree Are you ready to deliver services to an Anthem HealthKeepers Medicare-Medicaid Plan (MMP), a Commonwealth Coordinated Care

More information

Making the Case for Change Without a Burning Platform

Making the Case for Change Without a Burning Platform Making the Case for Change Without a Burning Platform Presented By: Rex P. Budde, CPA, MBA President and CEO Southern Illinois Healthcare, Carbondale, IL Region s second largest employer 3,700 total employees

More information

6/19/2018. L.A. Care Health Plan Benefits. L.A. Care Local Initiative: History. L.A. Care Health Plan

6/19/2018. L.A. Care Health Plan Benefits. L.A. Care Local Initiative: History. L.A. Care Health Plan L.A. Care Health Plan Benefits Melissa Gutierrez, Director of Sales & Business Development Phoi Tran, Specialist, Business Development Margarita Lopez, Field Manager 1 L.A. Care Local Initiative: History

More information

Transitions of Care: From Hospital to Home

Transitions of Care: From Hospital to Home Transitions of Care: From Hospital to Home Danielle Hansen, DO, MS (Med Ed) Associate Director, LECOM VP Acute Care Services & Quality/Performance Improvement, Millcreek Community Hospital Objectives Discuss

More information

Methodist Hospital. Community Health Needs Assessment Implementation Strategy 2017 to 2019

Methodist Hospital. Community Health Needs Assessment Implementation Strategy 2017 to 2019 Methodist Hospital Community Health Needs Assessment Implementation Strategy 2017 to 2019 Introduction Hospital Community Methodist Hospital serves the communities of Arcadia, Monrovia, Bradbury, Duarte,

More information

2016/17 Quality Improvement Plan "Improvement Targets and Initiatives"

2016/17 Quality Improvement Plan Improvement Targets and Initiatives 2016/17 Quality Improvement Plan "Improvement Targets and Initiatives" Queensway-Carleton Hospital 3045 Baseline Road AIM Measure Quality dimension Objective Measure/Indicator Unit / Population Source

More information

INFORMATION ABOUT YOUR OXFORD COVERAGE REIMBURSEMENT PART I OXFORD HEALTH PLANS OXFORD HEALTH PLANS (NJ), INC.

INFORMATION ABOUT YOUR OXFORD COVERAGE REIMBURSEMENT PART I OXFORD HEALTH PLANS OXFORD HEALTH PLANS (NJ), INC. OXFORD HEALTH PLANS (NJ), INC. INFORMATION ABOUT YOUR OXFORD COVERAGE PART I REIMBURSEMENT Overview of Provider Reimbursement Methodologies Generally, Oxford pays Network Providers on a fee-for-service

More information

ICD-10 Frequently Asked Questions for Providers Q Updates

ICD-10 Frequently Asked Questions for Providers Q Updates ICD-10 Frequently Asked Questions for Providers Q4 2012 Updates What is ICD-10? International Classification of Diseases, 10th Revision (ICD-10) is a diagnostic and procedure coding system endorsed by

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

I. PERSONAL INFORMATION. Degree and/or Title SS# . Non-physician Practitioner (Please specify )

I. PERSONAL INFORMATION. Degree and/or Title SS#  . Non-physician Practitioner (Please specify ) Pennsylvania Standard Application This form should be typed or legibly printed in black or blue ink. Please answer all questions completely and fully. If more space is needed than provided on this application,

More information

First-time Attendees: Logistics

First-time Attendees: Logistics First-time Attendees: Logistics Thomas Cornwell, MD President, AAHCM AAHCM Downstream Revenue: 2003-2013 HomeCare Physicians Referrals to CNS Home Health and Hospice Home Health Hospice Private Duty HCP

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

Documentation for CCC Reimbursement

Documentation for CCC Reimbursement Section 4.6 Implement Documentation for CCC Reimbursement This tool describes the importance of documentation and potential workflow changes to take advantage of any opportunity for reimbursement of services

More information

Continuity of Care Implementing Compacts: A small practice journey

Continuity of Care Implementing Compacts: A small practice journey Continuity of Care Implementing Compacts: A small practice journey R. Scott Hammond, MD Chair, CAFP PCMH Task Force Medical Director, SOC-PCMH Grant, Colorado Associate Clinical Professor, Dept. of Family

More information

Comprehensive Primary Care: Our Success Story

Comprehensive Primary Care: Our Success Story Comprehensive Primary Care: Our Success Story March 2, 2016 Tamra Lavengood, RN, BSN, MSN CPC Coordinator and Clinical Performance Coordinator Centura Health Physician Group, Centura Health Will McConnell,

More information

19. Covered California Quality Improvement Strategy (QIS) - INSTRUCTIONS FOR DATA TEMPLATE

19. Covered California Quality Improvement Strategy (QIS) - INSTRUCTIONS FOR DATA TEMPLATE 19. Covered California Quality Improvement Strategy (QIS) - INSTRUCTIONS FOR DATA TEMPLATE Section 19.2 of the QIS requires applicants to submit data for each initiative area. Some questions can be completed

More information

Strategy Guide Specialty Care Practice Assessment

Strategy Guide Specialty Care Practice Assessment Practice Transformation Network Strategy Guide Specialty Care Practice Assessment 1/20/2017 1 Strategy Guide: Specialty Care PAT 2.2 Contents: Demographics Tab: 3 Question 1: Aims... 3 Question 2: Aims...

More information

Transitioning to a Value-Based Accountable Health System Preparing for the New Business Model. The New Accountable Care Business Model

Transitioning to a Value-Based Accountable Health System Preparing for the New Business Model. The New Accountable Care Business Model Transitioning to a Value-Based Accountable Health System Preparing for the New Business Model Michael C. Tobin, D.O., M.B.A. Interim Chief medical Officer Health Networks February 12, 2011 2011 North Iowa

More information

Innovative Ways to Finance Mental Health Services in a Primary Care Setting

Innovative Ways to Finance Mental Health Services in a Primary Care Setting Innovative Ways to Finance Mental Health Services in a Primary Care Setting Prepared by: Kathleen Reynolds, MSW, ACSW Executive Director And Virginia Koster, MSW, ACSW Integrated Initiatives Coordinator

More information

OMC Strategic Plan Final Draft. Dear Community, Working together to provide excellence in health care.

OMC Strategic Plan Final Draft. Dear Community, Working together to provide excellence in health care. Dear Community, Working together to provide excellence in health care. This mission statement, established nearly two decades ago, continues to be fulfilled by our employees and medical staff. This mission

More information

Anthem Blue Cross and Blue Shield. Medicaid

Anthem Blue Cross and Blue Shield. Medicaid Anthem Blue Cross and Blue Shield Medicaid Introduction Ken Groves Manager, Provider Network Management Jackie Richie Network Relations Specialist 2 Service Area Statewide - except Region 3 counties We

More information

Chapter 7. Unit 1: Overview - Fee-for-Service Payment

Chapter 7. Unit 1: Overview - Fee-for-Service Payment Chapter 7 Unit 1: Overview - Fee-for-Service Payment In this unit Topic See Page Unit 1: Overview Fee-For Service Payment Introduction to the QualityBLUE Program Fee-for- 2 Service Payment QualityBLUE

More information

MAKING IT HAPPEN. WHAT IS MEDI-CAL? A Booklet for Regional Center Clients and Families

MAKING IT HAPPEN. WHAT IS MEDI-CAL? A Booklet for Regional Center Clients and Families MAKING IT HAPPEN WHAT IS MEDI-CAL? A Booklet for Regional Center Clients and Families INTRODUCTION This booklet contains information about the Medi-Cal program. It provides a general overview of the program

More information

Evidence of Coverage

Evidence of Coverage January 1 December 31, 2017 Evidence of Coverage Your Medicare Health Benefits and Services as a Member of Kaiser Permanente Medicare Plus (Cost) This booklet gives you the details about your Medicare

More information

THE 2017 QUALIS HEALTH AWARDS OF EXCELLENCE IN HEALTHCARE QUALITY IN WASHINGTON

THE 2017 QUALIS HEALTH AWARDS OF EXCELLENCE IN HEALTHCARE QUALITY IN WASHINGTON THE 2017 QUALIS HEALTH AWARDS OF EXCELLENCE IN HEALTHCARE QUALITY IN WASHINGTON Since 2002, Qualis Health has presented the annual Awards of Excellence in Healthcare Quality to outstanding organizations

More information