Health Care Evolution

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Health Care Evolution"

Transcription

1 Health Care Evolution Patient-Centered Medical Home to Clinical Integration & Accountable Care Ken Bertka, MD

2 Agenda Top 3 Challenges of Health Care Reform PCMH & ACO Definitions Current State of Primary Care New Direction PCMH Evidence for the PCMH Path to Clinical Integration & Accountable Care 2

3 Payment Reform Population Management Patient Engagement Patient Engagement Enhanced Access Better communication Care coordination Self-management Team care Payment Reform Practice Efficiency Blended payments PMPM care coordination Pay-for-performance Transformation Population Management Data driven focus top chronic conditions at-risk populations preventive care Clinical Integration/ACO

4 PCMH & ACO Definitions 4

5 High-Level Definitions Patient-Centered Medical Home (PCMH) ~ Model of primary care high performing practice ~ Based on the Joint Principles of the PCMH ~ Key elements accessibility, comprehensiveness, coordination of care, continuity of care, team work, population management (practice level) Accountable Care Organization (ACO) subset of Clinical Integration ~ Local accountability for a defined population quality, access, cost, patient satisfaction ~ Aligned incentives across physicians, hospitals, other clinicians & providers of health care ~ Applies the Joint Principles of the PCMH across an entire system of care ~ Requires clinical integration (Advisory Board Definition) - Network of physicians working in collaboration - Physician-led initiatives to improve the quality & efficiency of care. Strong management and health information technology support. - Legal basis for collective negotiation by independent physicians on basis of improved clinical outcomes & efficiencies. 5

6 Current State of Primary Care 6

7 Primary Care is Stressed The demands on primary care are high Workforce shortage ~ 78 million baby boomers reach age 65 beginning in 2011 ~ Estimated shortage of 40,000-60,000 primary care physicians over the next 10 years Procedure-oriented payment system works against primary care Care coordination & population management are lacking Appointment wait times are too long Health care reform expanded coverage does not expand access and does not address work force 40% family physicians considered leaving their practices in 2010 (M3 USA poll of 3,729 FPs) 7

8 8 Source: The Advisory Board, 2010

9 9 Source: The Advisory Board, 2010

10 Cost Centers of Health Care Home health care, 3% Nursing care facilities, 5% Personal care, 5% Medical Public health, 3% goods, 3% Cost of insurance, 5% Hospital Care, 31% Investment, 6% Primary Care, 6% Specialists, 15% Dental & Other, 7% 10 Prescription Drugs, 10%

11 Medicare Hospital Readmissions 19.6% Hospital readmission rate within 30 days ~ 18.4% in CT Responsible for 17% of Medicare hospital payments Top re-admission diagnoses (initial admission dx) ~ Heart failure ~ Pneumonia ~ COPD ~ Psychoses ~ GI problems 2012 Hospital trust fund (Part A) revenues drop below expenditures 2024 Part A trust fund exhausted SGR 30% cut in 2012? Jencks, Williams, Coleman. N Engl J Med 2009; 360:

12 New Direction Patient-Centered Medical Home 12

13 Joint Principles of Patient- Centered Medical Home Personal physician Physician-directed medical practice Team approach Whole person orientation Coordination of care Quality & safety Enhanced access Payment for added value 13

14 Practice-based Care Team Great Outcomes Health Information Technology Practice Management Practice Organization Health IT Care Management Quality and Safety Quality Measures Patient Experience Access to Care and Information Continuity of Care Services Practice Services Patient-Centered Medical Home = High Performing Primary Care Practice 14

15 Payment Reform Advocacy Blended Payment Model Pay for Performance- Clinical and Patient Experience Pay for Performance- Clinical and Patient Experience Fee for Service for Visits/Procedures Fee for Service for Visits/Procedures Care Coordination Payment (monthly payment based upon the level of PCMH) Care Coordination Payment (monthly payment based upon the level of PCMH) 15

16 Today Tomorrow Traditional Practice My patients are those who make appointments with me Patients chief complaint determines care Care is determined by today s problem and time available today PCMH Our patients are those who are registered in our medical home We systematically assess all our patients health needs to plan care Care is determined by a proactive plan to meet patients needs without visits Care varies by scheduled time and memory or skill Care is standardized according to evidence-based of the doctor guidelines Patients are responsible for coordinating their own care I know I deliver high-quality care because I m well trained Acute care is delivered during the next available appointment and to walk-ins It s up to the patient to tell us what happened to them Clinic operations center on meeting the doctor s needs A team of professionals coordinates all patients care We measure our quality and make rapid changes to improve it Acute care is delivered by open-access and nonvisit contacts We track tests and consultations, and follow-up after ED and hospital visits A multidisciplinary team works at the top of our licenses/training to serve patients 16

17 Evidence for the PCMH Just Keeps Growing 17

18 PCMH Pilot Outcomes Pilot Incentives Hospitalization Reduction ED Visit Reduction Total Savings (per patient) Colorado Medical Home for Children Community Care of North Carolina P4P 18% $215-$1,129 PMPM payment 40% 16% $516 Geisinger (Proven Health Navigator) P4P PMPM payment Shared savings 18% $500 Group Health Cooperative PMPM payment 16% 29% $10 PMPM Intermountain Health Care (Care Management Plus) P4P % 0.7-3% $640-$1,650 MeritCare Health System & BCBS of ND PMPM payment Shared savings 6% 24% $530 Driving Quality Gains and Cost Savings Through Adoption of Medical Homes, Health Affairs $119K savings/pcp

19 Patient-Centered Care = Decreased Health Care Utilization 509 adult patients, 1 year study Davis Observation Codes measure patient-centeredness Controlled for sex, age, education, income, self-reported health status, obesity, alcohol abuse, & smoking Patient-centeredness above median associated with: ~ Decreased visits for specialty care ~ Decreased hospitalizations ~ Decreased laboratory & diagnostic tests ~ Decreased total charges 34% ($1,435 vs. $948) Bertakis et al., JABFM, May-June,

20 TransforMed Small Practice Results 2-year outcomes data 36 unrelated, independent practices Improved Finances ~ Practice revenue 11% increase ~ Physician salaries 14% increase ~ These results are without payment reform Improved Satisfaction ~ Physician satisfaction 58% increase ~ Staff satisfaction 66% increase Quality ~ One year data indicates that independent practices can improve quality while lowering costs consistent with results from large, integrated systems 20

21 PCMH Pilot Outcomes Physicians & Staff Happier staff Happier physicians Increased revenue Increased take-home pay in today s payment environment Team-based care Relatively rapid returns from transformation Increased standardization of care Patients Improved satisfaction Improved preventive care Improved quality measures Reduced ED utilization Reduced readmissions Reduced hospitalizations Longer team-based appointments Enhanced patient communication Reduced per capita cost for certain chronic conditions 21

22 Comprehensive Primary Care Initiative (October, 2011) 5-7 Regional markets ~ 75 primary care practices in each market ~ 200 Medicare patients/practice ~ EHR or registry; preference given to EHR MU Stage 1 Public- & private-payer partnership ~ 60% practices revenue generated from participating payers ~ letter of intent from payers by November 15 Medicare/Medicaid payment reform for primary care ~ Traditional fee-for-service payments ~ Risk adjusted care coordination PMPM fee average $20 (range $8-$40) reduces to average $15 in years 3 & 4 ~ Shared savings increased reliance in years 3 & 4 Operational Summer 2012 CMS has authority to expand to across the country if the initiative is shown to improve quality & lower costs 22

23 Path to Clinical Integration & Accountabilty 23

24 PCMH. Then what? What is missing? 24

25 Triple Aim Improved care for individuals patient experience Improved health for populations Reduced cost 25

26 PPACA Implications for Physicians Improved access ~ Include teams of non-physicians ~ Engage & monitor patients at home Incentives to change clinical practice ~ Exceptional patient experience ~ Shared clinical goals ~ Shared decision making ~ Proactively manage preventive care ~ Expand use of EHRs ~ Collaboration with hospitals dramatically reduce readmissions ~ Patient-centered outcomes research to tailor care Removing barriers ~ Administrative simplification 26 Annals of Internal Medicine, August 23, 2010 Robert Kocher, MD; Ezekiel Emanuel, MD; Nancy-Ann DeParle, JD

27 Evolution of Care All Physicians Team-based care Focus on the top of license, training & interest Improved communication patient engagement Clinical integration Patient engagement including those who need encouragement/incentive to engage Patient-centered aligned incentives outcomes, quality, cost Population management 27 External accountability outcomes, quality, cost Payment reform

28 Clinical Integration Accountable Care What is still missing?

29 Payment Reform will Drive Clinical Integration Today Today Pilots Today 2012 Pilots 2012 Pilots Source: The Advisory Board, Clinical Integration

30 New Bundled Payment Initiative August 23, 2011 Model 1 Model 2 Model 3 Model 4 Services Covered in Bundle Payment Hospital & physician services during hospitalization only Hospital, physician, & other providers during hospitalization & in post-acute discharge phase (includes lab & DME) Hospital, physician, & other providers during post-acute discharge phase only (includes lab & DME) Prospective bundled payment to hospital for hospital, physician, & other clinician services during hospitalization CMS Center for Innovation authorized by the Affordable Care Act Goal Better health, better care, lower cost Begins in 2012 Definition of episode of care to be defined 30

31 Medicare Shared Savings ACO 31

32 Clinical Integration Clinical Integration is NOT Physician employment A return to capitation of the 80s Electronic health records IPA/PHO messenger contract model Gimmick to bypass anti-trust law Program led by the hospital Clinical Integration is A network of physicians working in collaboration usually with a hospital A program of physician-led initiatives to improve the quality and efficiency of patient care. ~ Strong management and health information technology support. Legal basis for collective negotiation by independent physicians on the basis of improved clinical outcomes and efficiencies. Advisory Board,

33 Essential Elements for CI/ACO Physician commitment & leadership ~ Governance ~ PCMH ~ senior-level, full-time medical director ~ Culture of teamwork & shared commitment Financial resources ~ CMS estimate - $1.8 million to start ~ AHA-sponsored study - $ $26.1 million to start Clinical guidelines & standardized care across the continuum of care Data collection & analysis performance measurement Population management ~ Early identification of high-risk individuals Patient engagement ~ Proactive interactions Payment reform ~ Aligned financial incentives

34 Capitation vs. ACO Economics Management Environment Capitation Era Discounts Withholds Lower utilization Prevention Patients enroll into a gatekeeper model Booming economy Limited informatics ACO - Clinical Integration Contracts at current price Incentives Appropriate utilization Chronic disease management Attribution Relationships then care coordination Recession Robust informatics 34

35 Revised - Medicare Shared Savings ACO - 1 Term Organization Physiciandirected Proposed 3 years, participation voluntary, April 1 & July 1, 2012 start dates Separate legal entity, 75% of Board must be providers, 1 board member must represent Medicare beneficiaries Full-time medical director, physician-directed QA & PI committee Antitrust Safety zone below 30% market share, mandatory review above 50% Increased flexibility for rural hospitals & physicians Fraud & Abuse Size Patient Assignment 65 Quality measures minimal attainment levels after year #1 Waiver for shared savings distributions Minimum 5,000 lives, primary care coverage Assigned retrospectively at the end of each year based upon plurality of primary care services; patients have freedom of choice to have services performed anywhere Preliminary/prospective assignment with quarterly updates Patient/Caregiver experience 7 7 (CAHPS Survey) Care coordination 16 6 Patient safety 2 Preventive measures 9 8 At-risk/Frail elderly Reduced to 33 quality measures EHR Meaningful Use requirement waived

36 Revised - Medicare Shared Savings ACO - 2 One-sided model (first 2 years then twosided) Two-sided model (all 3 years) Processes & strategy plans Benchmark calculation Marketing Proposed Savings threshold 3.9% (5,000 pts) 2% (50,000 pts) first dollar share in savings above threshold Share 50% of savings above threshold up to 7.5% maximum savings threshold Downside risk after year 2 removed 25% withhold on shared savings removed Savings threshold 2% - share in savings from first dollar once threshold is reached Share 60% of savings up to a 10% maximum savings threshold If loss above 2% threshold pay 40% (1 minus share rate) back to CMS up to a cap (5%, 7.5%, 10% - years 1, 2, 3) 25% withhold on shared savings removed Promote evidence-based medicine Patient engagement Report internally on quality & cost metrics Coordinate care 3-year lookback then updated annually Includes Indirect Graduate Medical Education (IME) - Removed Includes Disproportionate Share Hospital (DSH) payments - Removed Prior approval by CMS of all patient marketing materials Revised to file and use procedure as currently allowed for Medicare Advantage Plans

37 Current Delivery Systems with ACO Potential

38 High-Level Definitions Patient-Centered Medical Home (PCMH) ~ Model of primary care high performing practice ~ Based on the Joint Principles of the PCMH ~ Key elements accessibility, comprehensiveness, coordination of care, continuity of care, team work, population management (practice level) Accountable Care Organization (ACO) subset of Clinical Integration ~ Local accountability for a defined population quality, access, cost, patient satisfaction ~ Aligned incentives across physicians, hospitals, other clinicians & providers of health care ~ Applies the Joint Principles of the PCMH across an entire system of care ~ Requires clinical integration (Advisory Board Definition) - Network of physicians working in collaboration - Physician-led initiatives to improve the quality & efficiency of care. Strong management and health information technology support. - Legal basis for collective negotiation by independent physicians on basis of improved clinical outcomes & efficiencies. 38

39 The best way to predict the future is to create it Peter Drucker 39

40 Thank you!! Ken Bertka, MD, FAAFP Cell:

Long term commitment to a new vision. Medical Director February 9, 2011

Long term commitment to a new vision. Medical Director February 9, 2011 ACCOUNTABLE CARE ORGANIZATION (ACO): Long term commitment to a new vision Michael Belman MD Michael Belman MD Medical Director February 9, 2011 Physician Reimbursement There are three ways to pay a physician,

More information

ACOs: California Style

ACOs: California Style ACOs: California Style ACO Congress John E. Jenrette, M.D. Chief Executive Officer Sharp Community Medical Group November 2, 2011 California Style California Style A CO California Style California Style

More information

Succeeding in a New Era of Health Care Delivery

Succeeding in a New Era of Health Care Delivery March 14, 2012 Succeeding in a New Era of Health Care Delivery Building Value-Based Partnerships LeadingAge Pennsylvania Kathleen Griffin, PhD, National Director Post-Acute and Senior Services 1 Your Presenter

More information

4/9/2016. The changing health care market THE CHANGING HEALTH CARE MARKET. CPAs & ADVISORS

4/9/2016. The changing health care market THE CHANGING HEALTH CARE MARKET. CPAs & ADVISORS CPAs & ADVISORS experience support // ADVANCED PAYMENT MODELS: CJR Eric. M. Rogers MEd. RT(R) Managing Consultant The changing health care market THE CHANGING HEALTH CARE MARKET HHS goal of 30% of traditional

More information

Healthcare Financial Management Association October 13 th, 2016 Introduction to Accountable Care Organizations and Clinically Integrated Networks

Healthcare Financial Management Association October 13 th, 2016 Introduction to Accountable Care Organizations and Clinically Integrated Networks Healthcare Financial Management Association October 13 th, 2016 Introduction to Accountable Care Organizations and Clinically Integrated Networks Agenda Define ACO, CIN, and Coordinated Care Review ACO/CIN

More information

The Accountable Care Organization Specific Objectives

The Accountable Care Organization Specific Objectives Accountable Care Organizations and You E. Christopher h Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences CEO, OSU Faculty Group Practice Chair, Department of Surgery Ohio State

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

MEDICARE COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL (CCJR) Preparing for Risk-Based Outcomes of Bundled Care 8/12/2015.

MEDICARE COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL (CCJR) Preparing for Risk-Based Outcomes of Bundled Care 8/12/2015. MEDICARE COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL (CCJR) Preparing for Risk-Based Outcomes of Bundled Care August 13, 2015 Eric M. Rogers MEd RT(R) Managing Consultant erogers@bkd.com Jeff Bond President

More information

HOSPITALS & HEALTH SYSTEMS: DATA-DRIVEN STRATEGY FOR BUNDLED PAYMENT SUCCESS 4/19/2016. April 20, 2016

HOSPITALS & HEALTH SYSTEMS: DATA-DRIVEN STRATEGY FOR BUNDLED PAYMENT SUCCESS 4/19/2016. April 20, 2016 HOSPITALS & HEALTH SYSTEMS: DATA-DRIVEN STRATEGY FOR BUNDLED PAYMENT SUCCESS April 20, 2016 Eddie Marmouget National Industry Partner emarmouget@bkd.com Eric Rogers Managing Consultant erogers@bkd.com

More information

State Policy Report #47. October Health Center Payment Reform: State Initiatives to Meet the Triple Aim. Introduction

State Policy Report #47. October Health Center Payment Reform: State Initiatives to Meet the Triple Aim. Introduction Health Center Payment Reform: State Initiatives to Meet the Triple Aim State Policy Report #47 October 2013 Introduction Policymakers at both the federal and state levels are focusing on how best to structure

More information

Connected Care Partners

Connected Care Partners Connected Care Partners Our Discussion Today Introducing the Connected Care Partners CIN What is a Clinically Integrated Network (CIN) and why is the time right to join the Connected Care Partners CIN?

More information

ACO REVIVAL. Medicare Shared Savings Program Final Regulation Overview. Blue & Co., LLC Healthcare Reform Symposium Thursday, November 3, 2011

ACO REVIVAL. Medicare Shared Savings Program Final Regulation Overview. Blue & Co., LLC Healthcare Reform Symposium Thursday, November 3, 2011 ACO REVIVAL Medicare Shared Savings Program Final Regulation Overview Blue & Co., LLC Healthcare Reform Symposium Thursday, November 3, 2011 11/03/2011 1 Introductions John Redding, MD, MBA Manager Healthcare

More information

Healthcare Reimbursement Change VBP -The Future is Now

Healthcare Reimbursement Change VBP -The Future is Now Healthcare Reimbursement Change VBP -The Future is Now 1 On the Move Volume/ Fee-for-Service Fee-for-service reimbursement High quality not rewarded No shared financial risk Stand-alone systems can thrive

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

11/15/2017 Using Data to Measure Performance Advancing Value-Based Payment Methodologies for FQHCs and RHCs Art Jones, MD

11/15/2017 Using Data to Measure Performance Advancing Value-Based Payment Methodologies for FQHCs and RHCs Art Jones, MD 11/15/2017 Using Data to Measure Performance Advancing Value-Based Payment Methodologies for FQHCs and RHCs Art Jones, MD FQHC/RHC Variable Revenue= PPS Rate X Face-to-face Billable Encounters That any

More information

CPAs & ADVISORS. experience support // ADVANCED PAYMENT MODELS: CJR

CPAs & ADVISORS. experience support // ADVANCED PAYMENT MODELS: CJR CPAs & ADVISORS experience support // ADVANCED PAYMENT MODELS: CJR Andy M. Williams Partner BKD Eric M. Rogers Managing Consultant BKD Will McLeod VP of Patient Services McLeod Health Emily Adams Associate

More information

Accountable Care Organizations. What the Nurse Executive Needs to Know. Rebecca F. Cady, Esq., RNC, BSN, JD, CPHRM

Accountable Care Organizations. What the Nurse Executive Needs to Know. Rebecca F. Cady, Esq., RNC, BSN, JD, CPHRM JONA S Healthcare Law, Ethics, and Regulation / Volume 13, Number 2 / Copyright B 2011 Wolters Kluwer Health Lippincott Williams & Wilkins Accountable Care Organizations What the Nurse Executive Needs

More information

Episode Payment Models Final Rule & Analysis

Episode Payment Models Final Rule & Analysis Episode Payment Models Final Rule & Analysis February 15, 2017 Agenda Overview Changes from Proposed Rule Categorization of Episodes Episode Attribution Reconciliation Quality Performance Cardiac Rehab

More information

REPORT OF THE BOARD OF TRUSTEES

REPORT OF THE BOARD OF TRUSTEES REPORT OF THE BOARD OF TRUSTEES B of T Report 21-A-17 Subject: Presented by: Risk Adjustment Refinement in Accountable Care Organization (ACO) Settings and Medicare Shared Savings Programs (MSSP) Patrice

More information

MIPS, MACRA, & CJR: Medicare Payment Transformation. Presenter: Thomas Barber, M.D. May 31, 2016

MIPS, MACRA, & CJR: Medicare Payment Transformation. Presenter: Thomas Barber, M.D. May 31, 2016 MIPS, MACRA, & CJR: Medicare Payment Transformation Presenter: Thomas Barber, M.D. May 31, 2016 Michael Porter- Value Based Care Delivery, Annals of Surgery 2008 Principals: Define Value as a Goal Care

More information

PHCA Webinar January 30, Latsha Davis & McKenna, P.C. Kimber L. Latsha, Esq.

PHCA Webinar January 30, Latsha Davis & McKenna, P.C. Kimber L. Latsha, Esq. PHCA Webinar January 30, 2014 Latsha Davis & McKenna, P.C. Kimber L. Latsha, Esq. 1 2 Intended to: Encourage the development of ACOs in Medicare Promotes accountability for a patient population and coordinates

More information

Improving Care and Managing Costs: Team-Based Care for the Chronically Ill

Improving Care and Managing Costs: Team-Based Care for the Chronically Ill Improving Care and Managing Costs: Team-Based Care for the Chronically Ill Cathy Schoen Senior Vice President The Commonwealth Fund www.commonwealthfund.org cs@cmwf.org High Cost Beneficiaries: What Can

More information

Accountable Care Organizations Overview of Proposed Rule. Kevin J. Bozic, MD, MBA Chair, AAOS Health Care Systems Committee

Accountable Care Organizations Overview of Proposed Rule. Kevin J. Bozic, MD, MBA Chair, AAOS Health Care Systems Committee Accountable Care Organizations Overview of Proposed Rule Kevin J. Bozic, MD, MBA Chair, AAOS Health Care Systems Committee Disclosures/Conflicts of Interest Research Support AHRQ, NIH Consulting Income

More information

State Leadership for Health Care Reform

State Leadership for Health Care Reform State Leadership for Health Care Reform Mark McClellan, MD, PhD Director, Engelberg Center for Health Care Reform Senior Fellow, Economic Studies Leonard D. Schaeffer Chair in Health Policy Studies Brookings

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

Redesigning Post-Acute Care: Value Based Payment Models

Redesigning Post-Acute Care: Value Based Payment Models Redesigning Post-Acute Care: Value Based Payment Models Liz Almeida-Sanborn, MS, PT President Preferred Therapy Solutions This session will address: Discussion of the emergence of voluntary and mandatory

More information

The Patient Centered Medical Home Will It Make A Difference?

The Patient Centered Medical Home Will It Make A Difference? The Patient Centered Medical Home Will It Make A Difference? 2009 Population Health Colloquium Department of Health Policy Thomas Jefferson University March 2009 Michael S. Barr, MD, MBA, FACP Vice President,

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

South Carolina Public Health Institute southcarolinahealthcarevoices. Quality-related Initiatives in the ACA

South Carolina Public Health Institute southcarolinahealthcarevoices. Quality-related Initiatives in the ACA South Carolina Public Health Institute southcarolinahealthcarevoices Quality-related Initiatives in the ACA Presented by Joyce Dubow AARP Office of Policy and Strategy March 28, 2011 Impetus behind HCR

More information

Understanding Value in Healthcare

Understanding Value in Healthcare Understanding Value in Healthcare OONE November 6, 2014 Jacqueline Matthews, RN, MS Senior Director, Quality Reporting & Reform Quality and Patient Safety Institute Cleveland Clinic The promise of our

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

PATIENT-CENTERED MEDICAL HOMES: PROGRESS, NOT PERFECTION

PATIENT-CENTERED MEDICAL HOMES: PROGRESS, NOT PERFECTION PATIENT-CENTERED MEDICAL HOMES: PROGRESS, NOT PERFECTION J O N AT H A N G R I F F I N, M D, M H A M M A P H Y S I C I A N L E A D E R S H I P E F F E C T I V E N E S S P R O G R A M J A N U A R Y 1 6,

More information

ESSENTIAL STRATEGIES IN MEDI-CAL PAYMENT REFORM. Richard Popper, Director, Medicaid & Duals Strategy August 3, 2017

ESSENTIAL STRATEGIES IN MEDI-CAL PAYMENT REFORM. Richard Popper, Director, Medicaid & Duals Strategy August 3, 2017 ESSENTIAL STRATEGIES IN MEDI-CAL PAYMENT REFORM Richard Popper, Director, Medicaid & Duals Strategy August 3, 2017 1 DISCLAIMER The enclosed materials are highly sensitive, proprietary and confidential.

More information

Reforming Health Care with Savings to Pay for Better Health

Reforming Health Care with Savings to Pay for Better Health Reforming Health Care with Savings to Pay for Better Health Mark McClellan, MD PhD Director, Initiative on Health Care Value and Innovation Senior Fellow, Economic Studies October 2014 National Forum on

More information

Patient-Centered Medical Home 101: General Overview

Patient-Centered Medical Home 101: General Overview Patient-Centered Medical Home 101: General Overview Publicly Available Slide Deck Last Updated: January 2015 Suggested Citation: PCPCC Map Tools. (2015). Patient-Centered Medical Home 101: General Overview.

More information

5D QAPI from an Operational Approach. Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Pathway Health 2013

5D QAPI from an Operational Approach. Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Pathway Health 2013 5D QAPI from an Operational Approach Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Objectives Review the post-acute care data agenda. Explain QAPI principles Describe leadership

More information

MACRA & Implications for Telemedicine. June 20, 2016

MACRA & Implications for Telemedicine. June 20, 2016 MACRA & Implications for Telemedicine June 20, 2016 Presentation Overview Introductions Deep Dive Into MACRA Implications for Telemedicine Questions Growth in Value-Based Care Over Next Two Years Growth

More information

Informatics, PCMHs and ACOs: A Brave New World

Informatics, PCMHs and ACOs: A Brave New World Informatics, PCMHs and ACOs: A Brave New World R. Clark Campbell, MSN, RN-BC, CPHIMS, FHIMSS Kathleen Kimmel, RN, BSN, MHA, CPHIMS, FHIMSS Engagement Executive with Health Catalyst Objectives - Define

More information

Physician Engagement

Physician Engagement Pathways for Successful Accountable Care Organizations: Physician Engagement Thomas Kloos, MD Jim Barr, MD Atlantic ACO & Optimus Healthcare Partners ACO Helping providers Care Better for their patients.

More information

MACRA Fall into Place. By Stephanie Cecchini, CPC, CEMC, CHISP, AAPC Fellow, AAPC MACRA Prof

MACRA Fall into Place. By Stephanie Cecchini, CPC, CEMC, CHISP, AAPC Fellow, AAPC MACRA Prof MACRA Fall into Place By Stephanie Cecchini, CPC, CEMC, CHISP, AAPC Fellow, AAPC MACRA Prof About the Presenter https://www.linkedin.com/in/stephaniececchini 2 Introduction Love it Hate it Don t know a

More information

THE MEDICAL HOME AND ACO RESEARCH AGENDA: WHAT WE KNOW, DON T KNOW AND NEED TO KNOW

THE MEDICAL HOME AND ACO RESEARCH AGENDA: WHAT WE KNOW, DON T KNOW AND NEED TO KNOW THE MEDICAL HOME AND ACO RESEARCH AGENDA: WHAT WE KNOW, DON T KNOW AND NEED TO KNOW Stephen M. Shortell, Ph.D. Blue Cross of California Distinguished Professor of Health Policy and Management Dean, School

More information

Oregon s Health System Transformation: The Coordinated Care Model. March 2014 Jeanene Smith MD, MPH Chief Medical Officer- Oregon Health Authority

Oregon s Health System Transformation: The Coordinated Care Model. March 2014 Jeanene Smith MD, MPH Chief Medical Officer- Oregon Health Authority Oregon s Health System Transformation: The Coordinated Care Model March 2014 Jeanene Smith MD, MPH Chief Medical Officer- Oregon Health Authority The Challenges Oregon Faced Rising healthcare costs outpacing

More information

NCQA s Patient-Centered Medical Home Recognition and Beyond. Tricia Marine Barrett, VP Product Development

NCQA s Patient-Centered Medical Home Recognition and Beyond. Tricia Marine Barrett, VP Product Development NCQA s Patient-Centered Medical Home Recognition and Beyond Tricia Marine Barrett, VP Product Development National Committee for Quality Assurance (NCQA) Private, independent non-profit health care quality

More information

Accountable Care Organizations Under Medicare Shared Savings Program PROPOSED RULE

Accountable Care Organizations Under Medicare Shared Savings Program PROPOSED RULE Accountable Care Organizations Under Medicare Shared Savings Program PROPOSED RULE The information in this document summarizes a proposed rule issued by the Centers for Medicare and Medicaid id Services.

More information

Accountable Care Organizations: An AHA Research Synthesis Report

Accountable Care Organizations: An AHA Research Synthesis Report Accountable Care Organizations: An AHA Research Synthesis Report June 2010 TRANSFORMING HEALTH CARE THROUGH RESEARCH AND EDUCATION Accountable Care Organizations: An AHA Research Synthesis Report Accountable

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

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

Roadmap for Transforming America s Health Care System

Roadmap for Transforming America s Health Care System Roadmap for Transforming America s Health Care System America s health care system requires transformational change to provide all health care participants with broader access and choice, improved quality

More information

Cathy Schoen. The Commonwealth Fund Grantmakers In Health Webinar October 3, 2012

Cathy Schoen. The Commonwealth Fund  Grantmakers In Health Webinar October 3, 2012 Innovating Care for Chronically Ill Patients Cathy Schoen Senior Vice President The Commonwealth Fund www.commonwealthfund.org cs@cmwf.org Grantmakers In Health Webinar October 3, 2012 Chronically Ill:

More information

Re: Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations, Proposed rule.

Re: Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations, Proposed rule. June 3, 2011 Donald Berwick, MD Administrator Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1345-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore,

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

Succeeding in Value-Based Care CareConnect Journey

Succeeding in Value-Based Care CareConnect Journey Succeeding in Value-Based Care CareConnect Journey Donna Mueller VP Network Development dmueller@infinityrehab.com 360-201-2703 Jake Arrastia VP Strategy Development & Innovation jrarrastia@infinityrehab.com

More information

The healthcare world is changing in ways that many of us have never seen in our lifetime, with the possible exception of Medicare.

The healthcare world is changing in ways that many of us have never seen in our lifetime, with the possible exception of Medicare. Patient Centered Medical Home A Medicaid Managed Care Alternative Tad P. Fisher Executive Vice President Florida Academy of Family Physicians The healthcare world is changing in ways that many of us have

More information

Patient Centered Medical Home: Transforming Primary Care in Massachusetts

Patient Centered Medical Home: Transforming Primary Care in Massachusetts Patient Centered Medical Home: Transforming Primary Care in Massachusetts Judith Steinberg, MD, MPH Deputy Chief Medical Officer Commonwealth Medicine UMass Medical School Agenda Overview of Patient Centered

More information

The Potential Impact of Health Care Reform on Critical Access and Rural PPS Hospitals

The Potential Impact of Health Care Reform on Critical Access and Rural PPS Hospitals The Potential Impact of Health Care Reform on Critical Access and Rural PPS Hospitals How to Develop Long-Term Strategies for Success 1:30 p.m. Date to or 3:00 subtitle p.m. - Session 7 January 19, 2012

More information

7/7/17. Value and Quality in Health Care. Kevin Shah, MD MBA. Overview of Quality. Define. Measure. Improve

7/7/17. Value and Quality in Health Care. Kevin Shah, MD MBA. Overview of Quality. Define. Measure. Improve Value and Quality in Health Care Kevin Shah, MD MBA 1 Overview of Quality Define Measure 2 1 Define Health care reform is transitioning financing from volume to value based reimbursement Today Fee for

More information

The Influence of Health Policy on Clinical Practice. Dr. Kim Kuebler, DNP, APRN, ANP-BC Multiple Chronic Conditions Resource Center

The Influence of Health Policy on Clinical Practice. Dr. Kim Kuebler, DNP, APRN, ANP-BC Multiple Chronic Conditions Resource Center The Influence of Health Policy on Clinical Practice Dr. Kim Kuebler, DNP, APRN, ANP-BC Multiple Chronic Conditions Resource Center Disclaimer Director: Multiple Chronic Conditions Resource Center www.multiplechronicconditions.org

More information

Strategic Implications & Conclusion

Strategic Implications & Conclusion Kelly Court Chief Quality Officer Wisconsin Hospital Association Brian Vamstad Government Relations Consultant Gundersen Health System Overview and Key Takeaways of the Medicare Quality Payment Program

More information

Models of Accountable Care

Models of Accountable Care Models of Accountable Care Medical Home, Episodes and ACOs Making it work Elliott Fisher, MD, MPH Director, Population Health and Policy The Dartmouth Institute for Health Policy and Clinical Practice

More information

Laying the Foundation for Successful Clinical Integration

Laying the Foundation for Successful Clinical Integration The Governance Institute Laying the Foundation for Successful Clinical Integration Webinar November 29, 2011, 2:00pm ET/11:00am PT Daniel M. Grauman President & CEO DGA Partners, Bala Cynwyd, PA dgrauman@dgapartners.com

More information

UW Health Delivery System Innovation. ACOs and Bundled Payments: Moving Toward Population Health

UW Health Delivery System Innovation. ACOs and Bundled Payments: Moving Toward Population Health UW Health Delivery System Innovation ACOs and Bundled Payments: Moving Toward Population Health The Structure of Health Care Reform Affordable Care Act Health care reform offers tools and incentives to

More information

Using Quality Data to Market to Referral Sources BUSINESS OF HEALTHCARE

Using Quality Data to Market to Referral Sources BUSINESS OF HEALTHCARE Using Quality Data to Market to Referral Sources Cindy Mason Change as a Matter of Survival BUSINESS OF HEALTHCARE 2 National Transformation of Healthcare the Affordable Care Act provides CMS the flexibility

More information

Objectives. Background. Active Learning Question. Facts Concerning ACO s: Where Pharmacy Fits in this Vital Component of.

Objectives. Background. Active Learning Question. Facts Concerning ACO s: Where Pharmacy Fits in this Vital Component of. The Pharmacist's Expanded Role: Need to Know Updates in Accountable-Care Organizations Disclosures The program chair and presenters for this continuing pharmacy education activity report no relevant financial

More information

PHOTO HERE. Lessons Learned from the Pioneer ACOs: Monarch HealthCare ACO, Performance Year 1

PHOTO HERE. Lessons Learned from the Pioneer ACOs: Monarch HealthCare ACO, Performance Year 1 PHOTO HERE Lessons Learned from the Pioneer ACOs: Monarch HealthCare ACO, Performance Year 1 Agenda About Monarch HealthCare Why Did Monarch Choose to Participate in the Pioneer Program? Performance Year

More information

COLLABORATION AFFILIATION INNOVATION COME HOME TO CAROLINA YOUR HEALTH CARE HOME RIGHT HERE AT HOME

COLLABORATION AFFILIATION INNOVATION COME HOME TO CAROLINA YOUR HEALTH CARE HOME RIGHT HERE AT HOME COLLABORATION AFFILIATION INNOVATION COME HOME TO CAROLINA YOUR HEALTH CARE HOME RIGHT HERE AT HOME Simple Logic # 1: If we invest our resources in prevention and chronic disease management we are more

More information

NEWS RELEASE FOR IMMEDIATE RELEASE. EMS Organizations Collaborate on New Vision Statement for Mobile Integrated Healthcare and Community Paramedicine

NEWS RELEASE FOR IMMEDIATE RELEASE. EMS Organizations Collaborate on New Vision Statement for Mobile Integrated Healthcare and Community Paramedicine NEWS RELEASE FOR IMMEDIATE RELEASE February 6, 2014 Contact: Kathleen Taormina 1-800-346-2368 kathleen.taormina@naemt.org EMS Organizations Collaborate on New Vision Statement for Mobile Integrated Healthcare

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

Medicare Access and CHIP Reauthorization Act (MACRA)

Medicare Access and CHIP Reauthorization Act (MACRA) Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program Final Rule The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law on April 16, 2015. This bipartisan legislation

More information

WELCOME. Kate Gainer, PharmD Executive Vice President and CEO Iowa Pharmacy Association

WELCOME. Kate Gainer, PharmD Executive Vice President and CEO Iowa Pharmacy Association WHAT IS MACRA? WELCOME Kate Gainer, PharmD Executive Vice President and CEO Iowa Pharmacy Association WELCOME Anthony Pudlo, PharmD, MBA, BCACP Vice President of Professional Affairs Iowa Pharmacy Association

More information

MACRA Made Easy for 2018

MACRA Made Easy for 2018 MACRA Made Easy for 2018 A presentation on Merit Based Incentives by QVHSystems TM Michael Sexton M.D. Chief Executive Officer, QVHSystems Dr. Sexton brings his 40 years of experience as a physician practicing

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

The New World of Value Driven Cardiac Care

The New World of Value Driven Cardiac Care 1 The New World of Value Driven Cardiac Care Disclosures MPA Healthcare Solutions is an analytic health care consultancy that provides clients with insight into clinical performance; aids them in the evaluation,

More information

Medicare / Accountable Care Organization CHS Finance Division CPE Day November 2, 2015

Medicare / Accountable Care Organization CHS Finance Division CPE Day November 2, 2015 Medicare / Accountable Care Organization CHS Finance Division CPE Day November 2, 2015 Steve Neorr Chief Administrative Officer, Triad HealthCare Network Jeff Jones Chief Financial Officer, Cone Health

More information

Issue Brief. Raising the Bar. Standards for Accountable Care Organizations to Truly Improve Health Care Quality and Affordability in the United States

Issue Brief. Raising the Bar. Standards for Accountable Care Organizations to Truly Improve Health Care Quality and Affordability in the United States Raising the Bar Standards for Accountable Care Organizations to Truly Improve Health Care Quality and Affordability in the United States Issue Brief Introduction Health care costs continue to rise at an

More information

Payer s Perspective on Clinical Pathways and Value-based Care

Payer s Perspective on Clinical Pathways and Value-based Care Payer s Perspective on Clinical Pathways and Value-based Care Faculty Stephen Perkins, MD Chief Medical Officer Commercial & Medicare Services UPMC Health Plan Pittsburgh, Pennsylvania perkinss@upmc.edu

More information

Managed Care Trends for Strategic Positioning

Managed Care Trends for Strategic Positioning Managed Care Trends for Strategic Positioning NELLIE JOHNSON AUGUST 25, 2016 Overview - The P s of Managed Care Trends 2012-13 Leading Age Michigan Conferences Product Medicare Advantage ACOs; bundled

More information

Getting Ready for the Maryland Primary Care Program

Getting Ready for the Maryland Primary Care Program Getting Ready for the Maryland Primary Care Program Presentation to Maryland Academy of Nutrition and Dietetics March 19, 2018 Maryland Department of Health All-Payer Model: Performance to Date Performance

More information

Exhibit 1. Medicare Shared Savings Program: Year 1 Performance of Participating Accountable Care Organizations (2013)

Exhibit 1. Medicare Shared Savings Program: Year 1 Performance of Participating Accountable Care Organizations (2013) Exhibit 1. Medicare Shared Savings Program: Year 1 Performance of Participating Accountable Care Organizations (2013) 24 percent (52 ACOs) earned shared savings bonus 27 percent (60 ACOs) reduced spending,

More information

Medicare & Medicaid EHR Incentive Program. Betsy L. Thompson, MD, DrPH EHR Summit October 4, 2010

Medicare & Medicaid EHR Incentive Program. Betsy L. Thompson, MD, DrPH EHR Summit October 4, 2010 Medicare & Medicaid EHR Incentive Program Betsy L. Thompson, MD, DrPH EHR Summit October 4, 2010 1 Overview Background and Policy Context EHR Incentive Program Basics Who is Eligible to Participate How

More information

Accountable Care Organizations

Accountable Care Organizations Accountable Care Organizations Randy Wexler, MD, MPH, FAAFP Associate Professor Vice Chair, Clinical Services Department of Family Medicine The Ohio State University Wexner Medical Center Objectives To

More information

HEALTHCARE 20/20: LEARNING FORWARD

HEALTHCARE 20/20: LEARNING FORWARD HEALTHCARE 20/20: LEARNING FORWARD Quality Improvement Workshop - Pfizer Webinar #1 April 15, 2013 Bernard M. Rosof, MD CEO Louis H. Diamond, MD President QHC is dedicated to improving the quality and

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

Value-Based Payments 101: Moving from Volume to Value in Behavioral Health Care

Value-Based Payments 101: Moving from Volume to Value in Behavioral Health Care Value-Based Payments 101: Moving from Volume to Value in Behavioral Health Care Nina Marshall, MSW Senior Director, Policy and Practice Improvement NinaM@TheNationalCouncil.org Bill Hudock Senior Public

More information

Collaborative Ventures Network CMS and State Innovation. Tony Rodgers Executive Healthcare Consultant and Strategist

Collaborative Ventures Network CMS and State Innovation. Tony Rodgers Executive Healthcare Consultant and Strategist Collaborative Ventures Network CMS and State Innovation Tony Rodgers Executive Healthcare Consultant and Strategist 1 Topics Covered The US Healthcare Cost Dilemma Drivers of Healthcare Innovation CMS

More information

Questions and Answers on the CMS Comprehensive Care for Joint Replacement Model

Questions and Answers on the CMS Comprehensive Care for Joint Replacement Model Questions and Answers on the CMS Comprehensive Care for Joint Replacement Model MEGGAN BUSHEE, ESQ. 704.343.2360 mbushee@mcguirewoods.com 201 North Tryon Street, Suite 3000 Charlotte, North Carolina 28202-2146

More information

Alternative Managed Care Reimbursement Models

Alternative Managed Care Reimbursement Models Alternative Managed Care Reimbursement Models David R. Swann, MA, LCSA, CCS, LPC, NCC Senior Healthcare Integration Consultant MTM Services Healthcare Reform Trends in 2015 Moving from carve out Medicaid

More information

Regulatory Relief Requests July 2017

Regulatory Relief Requests July 2017 Government & External Affairs 1776 West Lakes Parkway, Suite 400 West Des Moines, IA 50266 unitypoint.org Regulatory Relief Requests July 2017 DRUG PRICES Medicare and Medicaid Direct negotiation on drug

More information

Quality Circles. Nursing as a Revenue Center NDNQI

Quality Circles. Nursing as a Revenue Center NDNQI IS YOUR ORGANIZATION ACCOUNTABLE? 2011 NDNQI Conference Miami, FL Victoria L. Rich, PhD, RN, FAAN Chief Nurse Executive, University of Pennsylvania Medical Center Associate Executive Director, Hospital

More information

Accountable Care and Governance Challenges Under the Affordable Care Act

Accountable Care and Governance Challenges Under the Affordable Care Act Accountable Care and Governance Challenges Under the Affordable Care Act The First National Congress on Healthcare Clinical Innovations, Quality Improvement and Cost Containment October 26, 2011 Doug Hastings

More information

Health Care Reform and Care Transitions

Health Care Reform and Care Transitions Health Care Reform and Care Transitions Mark V. Williams, MD, FHM Professor & Chief, Division of Hospital Medicine Principal Investigator, Project BOOST A Problem for a long time Rosenthal, J. M. and D.

More information

Population Health or Single-payer The future is in our hands. Robert J. Margolis, MD

Population Health or Single-payer The future is in our hands. Robert J. Margolis, MD Population Health or Single-payer The future is in our hands Robert J. Margolis, MD Today s problems Interim steps Population health Alternatives Conclusions Outline $3,000,000,000,000 $1,000,000,000,000

More information

Lessons Learned: A Close Up Look at Cost-Effective Population Health Strategies

Lessons Learned: A Close Up Look at Cost-Effective Population Health Strategies Lessons Learned: A Close Up Look at Cost-Effective Population Health Strategies Hospital and Physician Relations Executive Summit March 2, 2015 Today's Speakers Steven Stout, Vice President McKesson Business

More information

Thought Leadership Series White Paper The Journey to Population Health and Risk

Thought Leadership Series White Paper The Journey to Population Health and Risk AMGA Consulting Thought Leadership Series White Paper The Journey to Population Health and Risk The Journey to Population Health and Risk Howard B. Graman, M.D., FACP White Paper, January 2016 While the

More information

Accountable Care A path toward accountability for health and health care

Accountable Care A path toward accountability for health and health care 1 Accountable Care A path toward accountability for health and health care Managing Health System Capacity: Market and Policy Solutions December 1, 2008 Elliott Fisher, MD, MPH The Dartmouth Institute

More information

Introduction of the Care Cycle Management Industry Presented to: Illinois Home Care & Hospice Conference March 16-18, 2011 McKesson s Executive

Introduction of the Care Cycle Management Industry Presented to: Illinois Home Care & Hospice Conference March 16-18, 2011 McKesson s Executive Introduction of the Care Cycle Management Industry Presented to: Illinois Home Care & Hospice Conference March 16-18, 2011 McKesson s Executive Conference April 12, May 1, June 9, 2011 Strategic Overview

More information

CMS Quality Payment Program: Performance and Reporting Requirements

CMS Quality Payment Program: Performance and Reporting Requirements CMS Quality Payment Program: Performance and Reporting Requirements Session #QU1, February 19, 2017 Kristine Martin Anderson, Executive Vice President, Booz Allen Hamilton Colleen Bruce, Lead Associate,

More information

The Future is Ahead of Schedule *** Quality, Service & the Bottom Line

The Future is Ahead of Schedule *** Quality, Service & the Bottom Line The Future is Ahead of Schedule *** Quality, Service & the Bottom Line Jay Kaplan, MD, FACEP President-elect, American College of Emergency Physicians Practicing Clinician and Director, Patient Experience,

More information

Next Generation Physician Compensation Design in a Schizophrenic Payer Environment

Next Generation Physician Compensation Design in a Schizophrenic Payer Environment Next Generation Physician Compensation Design in a Schizophrenic Payer Environment Presented to: 2015 Spring Managed Care Forum Friday, April 24, 2015 Today s agenda Setting the Stage Why are we Here?

More information

Integrating Population Health into Delivery System Reform

Integrating Population Health into Delivery System Reform Integrating Population Health into Delivery System Reform Population Health Roundtable IOM Jim Hester Washington DC June 13, 2013 Theme The health care system is transitioning from payment rewarding volume

More information

Requirements for Medicare's Quality Payment Program (MIPS and MACRA) for 2019

Requirements for Medicare's Quality Payment Program (MIPS and MACRA) for 2019 Requirements for Medicare's Quality Payment Program (MIPS and MACRA) for 2019 Presented by Dr. Dan Mingle For Maine Chapter HFMA 2019 Mingle Health 1 Mingle Health is your Partner for Value-Based Care

More information