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

Size: px
Start display at page:

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

Transcription

1 One Medicine: Incorporating Population Health Principles and Best Practices into Clinical Workflow March 5, 2018 Jayne Bassler President, Population Health Services Organization Senior Vice President, Population Health Management Adventist Health System 1

2 Conflict of Interest (30pt Verdana) Jayne Bassler Has no real or apparent conflicts of interest to report. 2

3 Learning Objectives Define Clinical integration and discuss the process and challenges in implementation across diverse partnerships Outline leading trends in care team strategy, transitional care, and care coordination across the healthcare continuum Summarize techniques to achieve better outcomes and close care gaps using clinical systems and steps to mitigate current system limitations Identify early warning signs of physician burnout and discuss strategies providers can take to circumvent Recognize best practices for long-term consumer engagement and person-centered care delivery. 3

4 4

5 Three Strategies Individuals Employers 5

6 Population Health Framework Quality Experience Total Cost Payer & Government Direct to Employer Health Plan Clinical Documentation Integrity - Ambulatory Care Gap Closures Health Mgmt/Utilization Network Integrity CIN ACO Preferred Providers 6

7 Clinical Performance New Care Models Longitudinal Care Mgmt Contact/Memb Exp Svcs Wellness Quality Systems Network Developmen t & Operations Network Design & Optimization Provider Engagement Communication Credentialing Analytics Risk Stratification Predictive Models Benchmarks Provider Tools Finance / Contracting Financial Management Incentive/Dist Models Actuary Services Payer/Employer Contracting Business Development Direct to Employer Partnerships Information Systems & Interoperability 7

8 Health Plan Provider Sponsored Health Plan Risk- Bearing Entity IDN #1 Population Health Services Organization (PHSO) Medicare Advantage Commercial o Individual o Large Group o Small Group IDN #2 Health Plan Network Mgmt Care Mgmt Legacy Network CINs Medical Mgmt Analytics Care Mgmt Medical Mgmt Analytics Administrative Svcs Claims Authorization Sales Customer Service Regulatory 8

9 Networks Florida 1 Statewide ACO & 3 CINs West Florida CIN Central Florida CIN East Florida CIN Kansas 1 Super CIN with 3 Partners North Carolina - 1 ACO with Partner 9

10 Physician Alignment Models HIGH System Resources Required Quality/Service Line Chairs Orthopedic Service Line Agreement Hospital-Based Physician Performance Incentive Academic Affiliation Agreement Employed Medical Group Co-Management Agreements PHOs CIN ACO Medical Directorships PCMH LOW Voluntary Medical Staff Independent Strategic Alignment Venture Alignment Clinical/Financial Integration Degree of Alignment 10

11 Physician Burnout Causes of Burnout Loss of Control Over Work Increased Performance Measurement Inefficiencies in Practice Environment Signs of Burnout Reduce Time Devoted to Clinical Work Unnecessary Testing & Referrals Poor Quality/Medication Errors Leave Profession/Retire Early Physician Burnout Is A Public Health Crisis: A Message To Our Fellow Health Care CEOs, " Health Affairs Blog, March 28, DOI: /hblog

12 Provider Services 1.0 Care Management Longitudinal Care Management Assigned or Embedded Provider Reps/Population Management Advisors Recruitment Contracting & Credentialing Initial Onboarding & Education Frequent Outreach Support High Level Practice Education Performance Scorecards Provider Education EHR Program Subsidy & Support Optimize EHR Workflows Provider Management Tools Data Collection Templates Ease Practice Burden Vendor & Network Best Practice 12

13 Transform the Network 2.0 Engage Empower Equip 13

14 Engage Simplify messaging Decrease number of channels & increase frequency Re-envision modality of communication Incentive 14

15 Empower Education Socialization Involvement 15

16 Equip Tools Process Platform Information 16

17 Anatomy of a Pop Health Suite 17

18 Provider & Management Dashboards Provider Scorecard PHSO Cost Analysis Utilization Scorecard Risk Adjustment 18

19 RAF Summary KPIs

20 Practice & Physician Level KPIs 20

21 Care Gap Preferred Metric Scorecard 21

22 A better network - A new care delivery model Exclusive single signature network of expanded primary care with new service standard. Aligned physicians but not exclusive Broader network for adequacy and some specialty collaborations 22

23 PHYSICIAN CARE ACUTE CARE PCPs Specialists Virtual Care Retail Pharmacy Urgent Care Outpatient Network Acute Care Network Inpatient Outpatient Cancer Centers ASCs Imaging Centers Outpatient Rehab DME Occ Med Retail Pharmacy Physician Care Network Post-Acute Care Network Rehab Hospitals Home Health/Hospice SNF LTAC Hospice OUTPATIENT Never Discharge a Patient 23 POST-ACUTE CARE

24 Care Navigation Model 24

25 Consumer Ecosystem 25

26 Questions Jayne Bassler Senior Vice President, Population Health Management Adventist Health System President, Population Health Services Organization Reminder Complete Online Session Evaluation 26

27 Please use blank slide if more space is required for charts, graphs, etc. To remove background graphics, right click on selected slide, choose Format Background and check Hide background graphics.

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

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

More information

Building a Multi-System Clinically Integrated Network

Building a Multi-System Clinically Integrated Network Building a Multi-System Clinically Integrated Network 22 nd Annual AHA Leadership Summit July 2014 Valence Health Has Been Helping Provider Organizations Progress Toward Value-Based Care Since 1996 Technology-enabled

More information

Adopting Accountable Care An Implementation Guide for Physician Practices

Adopting Accountable Care An Implementation Guide for Physician Practices Adopting Accountable Care An Implementation Guide for Physician Practices EXECUTIVE SUMMARY November 2014 A resource developed by the ACO Learning Network www.acolearningnetwork.org Executive Summary Our

More information

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

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

More information

Physician Alignment Strategies and Options. June 1, 2011

Physician Alignment Strategies and Options. June 1, 2011 Physician Alignment Strategies and Options June 1, 2011 1 Today s Discussion Review physician-hospital alignment objectives Understand the changing paradigm Evaluate alignment strategies for a new delivery

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

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

Jumpstarting population health management

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

More information

ABCs of Building a Clinically Integrated Network

ABCs of Building a Clinically Integrated Network ABCs of Building a Clinically Integrated Network St. Vincent s Health Partners, Inc. Dr. Thomas A. Raskauskas President/CEO Thomas.raskauskas@stvincentshealthpartners.org Dr. Michael G. Hunt CMO/CMIO Bridgeport,

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

Mission Health Care Network. April 2017

Mission Health Care Network. April 2017 Mission Health Care Network April 2017 WHAT IS MISSION HEALTH CARE NETWORK? Mission Health Care Network is a Clinically Integrated Network including groups of doctors, the hospital and other health care

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

2018 MGMA Practice Profile Survey Guide

2018 MGMA Practice Profile Survey Guide 2018 MGMA Practice Profile Opens: October 23, 2017 This document is intended to serve as a guide for completing the 2018 MGMA Practice Profile. The Practice Profile must be completed in full before beginning

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

Population Health: Tamara Cull, MSW, LCSW, ACM National Director, Care Management, Value Based Programs and Operations November, 2014

Population Health: Tamara Cull, MSW, LCSW, ACM National Director, Care Management, Value Based Programs and Operations November, 2014 In the Hospital and Health System ACO Tamara Cull, MSW, LCSW, ACM National Director, Care Management, Value Based Programs and Operations November, 2014 What We ll Be Discussing Who is CHI What are we

More information

Quality, Cost and Business Intelligence in Healthcare

Quality, Cost and Business Intelligence in Healthcare Quality, Cost and Business Intelligence in Healthcare Maitri Vaidya Population Health Executive DBA, MHA, CPHQ May 2016 Where are we going? IHI Triple Aim Improve the patient experience of care Lower

More information

Value Based Care An ACO Perspective

Value Based Care An ACO Perspective Value Based Care An ACO Perspective NCIOM Task Force on Accountable Care Communities January 24, 2018 Steve Neorr Chief Administrative Officer 2 3 4 5 Source: Banthin, Jessica. Healthcare Spending Today

More information

Practical Population Health

Practical Population Health Practical Population Health Key Steps to Identify, Stratify, and Manage Patients HFMA Managed Care Meeting January 29, 2015 Objectives Discuss the key capabilities for an effective care model for population

More information

EMPI Patient Matching Solution Product Use Cases: Epic Electronic Health Record Integration

EMPI Patient Matching Solution Product Use Cases: Epic Electronic Health Record Integration EMPI Patient Matching Solution Product Use Cases: Epic Electronic Health Record Integration Enterprise Master Patient Index (EMPI) Product Overview NextGate can break down the patient identification barriers

More information

Building the Universal Roadmap to Population Health Management

Building the Universal Roadmap to Population Health Management Building the Universal Roadmap to Population Health Management Executive Webinar January 21, 2016 Karen Handmaker, MPP, PCMH CCE IBM Watson Health House Keeping 1. Using the control panel Use the control

More information

Care Management in the Patient Centered Medical Home. Self Study Module

Care Management in the Patient Centered Medical Home. Self Study Module Care Management in the Patient Centered Medical Home Self Study Module Objectives Describe the goals of care management Identify elements of successful care management Recognize the 5 step Care Management

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

Accountable Care: Clinical Integration is the Foundation

Accountable Care: Clinical Integration is the Foundation Solutions for Value-Based Care Accountable Care: Clinical Integration is the Foundation CLINICAL INTEGRATION CARE COORDINATION ACO INFORMATION TECHNOLOGY FINANCIAL MANAGEMENT The Accountable Care Organization

More information

State Innovation Model

State Innovation Model State Innovation Model April 20, 2016 healthier and more productive lives, no matter their stage in life. 1 SIM Overview Overview and Vision Goals and Objectives Strategic approach for roll out Patient

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

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

update An Inside Look Into the EHR Intersections of the Updated Patient-Centered Medical Home (PCMH) Care Model May 12, 2016

update An Inside Look Into the EHR Intersections of the Updated Patient-Centered Medical Home (PCMH) Care Model May 12, 2016 update An Inside Look Into the EHR Intersections of the Updated Patient-Centered Medical Home (PCMH) Care Model May 12, 2016 Agenda PCMH: 360 o PCMH to date o Evidence based results o Updated Standards:

More information

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

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

More information

Interoperability is Happening Now

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

More information

Saint Francis Care and Cigna CAC Meeting the Triple Aim Together

Saint Francis Care and Cigna CAC Meeting the Triple Aim Together Saint Francis Care and Cigna CAC Meeting the Triple Aim Together Christopher M. Dadlez, President and CEO Saint Francis Care Jess Kupec, President and CEO Saint Francis HealthCare Partners 22 nd Annual

More information

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

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

More information

The greatest difficulty in the world is not for people to accept new ideas but to get them to forget their old ones.

The greatest difficulty in the world is not for people to accept new ideas but to get them to forget their old ones. Dr. Marie S, Gustin Nursing Excellence Conference, 2012 The greatest difficulty in the world is not for people to accept new ideas but to get them to forget their old ones. John Maynard Keynes Chaos, Complexity,

More information

MassHealth Initiatives:

MassHealth Initiatives: MassHealth Initiatives: PCMHI, DUALS, PCC/BH Integration, PCPR Dr. Julian Harris CBHI and CYF Advisory Committee Joint Meeting November 5, 2012 Our Mission To improve the health outcomes of our diverse

More information

Aligning Health IT with Delivery System Reform: Technology Gaps in Coordinating Patient Care

Aligning Health IT with Delivery System Reform: Technology Gaps in Coordinating Patient Care Aligning Health IT with Delivery System Reform: Technology Gaps in Coordinating Patient Care Peggi M. Czinger MPH Director, Network Care Management COE The Care Management Company of Montefiore The Bronx:

More information

Population Health Management in the Safety Net Elaine Batchlor, MD, MPH CEO, Martin Luther King, Jr. Community Hospital

Population Health Management in the Safety Net Elaine Batchlor, MD, MPH CEO, Martin Luther King, Jr. Community Hospital Population Health Management in the Safety Net Elaine Batchlor, MD, MPH CEO, Martin Luther King, Jr. Community Hospital November 5, 2013 Martin Luther King, Jr. Community Hospital Page 1 11/05/2013 Agenda

More information

Health Information Technology

Health Information Technology ACO Congress Oct 25, 2010 Los Angeles, CA Patient Centered Medical Home and Accountable Care Organizations Health Information Technology David K. Nace MD, Medical Director, McKesson Corporation Co-Chair,

More information

Leverage Information and Technology, Now and in the Future

Leverage Information and Technology, Now and in the Future June 25, 2018 Ms. Seema Verma Administrator Centers for Medicare & Medicaid Services US Department of Health and Human Services Baltimore, MD 21244-1850 Donald Rucker, MD National Coordinator for Health

More information

Advancing Primary Care Delivery

Advancing Primary Care Delivery Advancing Primary Care Delivery Tenth National Pay for Performance Summit March 3, 2015 Simeon Schwartz, MD CEO, WESTMED Medical Group, P.C. WESTMED Medical Group Established 1996 by 16 physicians 300

More information

HIE Data: Value Proposition for Payers and Providers

HIE Data: Value Proposition for Payers and Providers HIE Data: Value Proposition for Payers and Providers Session #21, March 6, 2018 Laura McCrary, Executive Director, KHIN Tara Orear, Senior Ambulatory Systems Analyst, Newman Regional Health Dirk Rittenhouse,

More information

A strategy for building a value-based care program

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

More information

Innovative Business Activities in Health Care with Commercial Partners

Innovative Business Activities in Health Care with Commercial Partners Innovative Business Activities in Health Care with Commercial Partners Steve Witman, CPA, MBA Vice President of Business Development / Financial and Capital Planning LifeBridge Health March 4, 2014 Business

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

All ACO materials are available at What are my network and plan design options?

All ACO materials are available at   What are my network and plan design options? ACO Toolkit: A Roadmap for Employers What is an ACO? Is an ACO strategy right for my company? Which ACOs are ready? All ACO materials are available at www.businessgrouphealth.org What are my network and

More information

Disclaimer This webinar may be recorded. This webinar presents a sampling of best practices and overviews, generalities, and some laws.

Disclaimer This webinar may be recorded. This webinar presents a sampling of best practices and overviews, generalities, and some laws. Disclaimer This webinar may be recorded. This webinar presents a sampling of best practices and overviews, generalities, and some laws. This should not be used as legal advice. Itentive recognizes that

More information

From Reactive to Proactive: Creating a Population Management Platform

From Reactive to Proactive: Creating a Population Management Platform Session D9 / E9 From Reactive to Proactive: Creating a Population Management Platform Richard Gitomer, MD Director, Brigham and Women s Primary Care Center of Excellence Vice Chair, Primary Care, Dept.

More information

New Strategies in Value Based Care

New Strategies in Value Based Care New Strategies in Value Based Care D. Keith Fernandez, M.D. Chief Clinical Officer, Privia Health CEO, Privia Medical Group Gulf Coast 713-545-1366 kfernandez@priviahealth.com none Disclosures Learning

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

Medical Home as a Platform for Population Health

Medical Home as a Platform for Population Health Medical Home as a Platform for Population Health Population Health Colloquium March 8, 2016 Emily Brower Vice President, Population Health Atrius Health Emily_Brower@atriushealth.org 2016 Atrius Health,

More information

INNOVATIONS IN CARE MANAGEMENT. Michael Burcham, Narus Health

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

More information

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

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

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

More information

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

Patient-Centered Medical Home (PCMH) & Patient-Centered Specialty Practice (PCSP)

Patient-Centered Medical Home (PCMH) & Patient-Centered Specialty Practice (PCSP) Patient-Centered Medical Home (PCMH) & Patient-Centered Specialty Practice (PCSP) Foundation for a Better Health Care System Presenter Jeanette Ikan, M.D., MHAI Objectives: Definition and benefits of PCMH,

More information

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

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

More information

ACQA THE FUTURE DEPENDS ON WHAT YOU DO TODAY

ACQA THE FUTURE DEPENDS ON WHAT YOU DO TODAY ACQA THE FUTURE DEPENDS ON WHAT YOU DO TODAY WHAT IS ACQA Accountable Care and Quality Agreement between St. Joseph s Health System and Excellus. Outcome: Increased quality Improve the health of patients

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

MACRA is Coming: Reimbursement for Quality and the Shift to Population-Based Care

MACRA is Coming: Reimbursement for Quality and the Shift to Population-Based Care MACRA is Coming: Reimbursement for Quality and the Shift to Population-Based Care AMERICAN NEUROLOGICAL ASSOCIATION October 17, 2017 Marc R. Nuwer, MD PhD Professor and Vice Chair UCLA Lyell K. Jones,

More information

SWAN Alerts and Best Practices for Improved Care Coordination

SWAN Alerts and Best Practices for Improved Care Coordination SWAN Alerts and Best Practices for Improved Care Coordination IHIN and SWAN Course Overview Our Goal: To educate healthcare providers in how to manage SWAN alerts for meaningful impact at the point of

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

ACOs & the Accountable Care Era: Emerging Healthcare Risks & Exposures. Jeffrey Lunn, CPCU Senior Strategist, Healthcare

ACOs & the Accountable Care Era: Emerging Healthcare Risks & Exposures. Jeffrey Lunn, CPCU Senior Strategist, Healthcare ACOs & the Accountable Care Era: Emerging Healthcare Risks & Exposures Jeffrey Lunn, CPCU Senior Strategist, Healthcare Ohio Hospital Association June 10, 2014 Accountable Care & Emerging Healthcare Risks:

More information

FIVE FIVE FIVE FIVE FIV

FIVE FIVE FIVE FIVE FIV Technology and Data s Impact on Population Health FIVE FIVE FIVE FIVE FIV 5 Steps to an Effective and Sustainable Population Health Management Program This ebook will share critical information about population

More information

Building the Oncology Medical Home. Susan Tofani, MS, Director Network and Payer Relations, Oncology Management Services, Inc.

Building the Oncology Medical Home. Susan Tofani, MS, Director Network and Payer Relations, Oncology Management Services, Inc. Building the Oncology Medical Home Susan Tofani, MS, Director Network and Payer Relations, Oncology Management Services, Inc. Quality, Performance Improvement, Certification / Recognition Keep the doors

More information

Finding a Faster Path to Value-Based Care

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

More information

What s Next for CMS Innovation Center?

What s Next for CMS Innovation Center? What s Next for CMS Innovation Center? A Guide to Building Successful Value-Based Payment Models Given CMMI s New Focus on Voluntary, Home-Grown Initiatives W W W. H E A L T H M A N A G E M E N T. C O

More information

Monarch HealthCare, a Medical Group, Inc.

Monarch HealthCare, a Medical Group, Inc. Monarch HealthCare, a Medical Group, Inc. Accountable Care in the Independent Practice Model June 7, 2010 Jay J. Cohen, MD, MBA President/Chairman Monarch HealthCare Monarch HealthCare, a Medical Group,

More information

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

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

More information

Katherine Schneider, MD, MPhil Senior Vice President, Health Engagement July 29, 2011

Katherine Schneider, MD, MPhil Senior Vice President, Health Engagement July 29, 2011 Accountable Care: Health System View CHC Best Practices Forum Katherine Schneider, MD, MPhil Senior Vice President, Health Engagement July 29, 2011 Who we are Southeastern New Jersey s largest health system

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

Bundled Payments to Align Providers and Increase Value to Patients

Bundled Payments to Align Providers and Increase Value to Patients Bundled Payments to Align Providers and Increase Value to Patients Stephanie Calcasola, MSN, RN-BC Director of Quality and Medical Management Baystate Health Baystate Medical Center Baystate Health Is

More information

Central Ohio Primary Care (COPC) Spotlight on Innovation

Central Ohio Primary Care (COPC) Spotlight on Innovation Central Ohio Primary Care (COPC) Spotlight on Innovation BY BETTER MEDICARE ALLIANCE MARCH 2017 Central Ohio Primary Care Spotlight on Innovation 1 Central Ohio Primary Care (COPC) Spotlight on Innovation

More information

How to Establish an Accountable Post-Acute Preferred Provider Network. November 14, 2016

How to Establish an Accountable Post-Acute Preferred Provider Network. November 14, 2016 How to Establish an Accountable Post-Acute Preferred Provider Network November 14, 2016 How to Establish an Accountable Post-Acute Preferred Provider Network Maura McQueeney, MPH, DNP President, Baystate

More information

Beyond the Horizon: What s Next? Session PH6, March 5, 2018 Don Calcagno, President, Advocate Physician Partners

Beyond the Horizon: What s Next? Session PH6, March 5, 2018 Don Calcagno, President, Advocate Physician Partners Beyond the Horizon: What s Next? Session PH6, March 5, 2018 Don Calcagno, President, Advocate Physician Partners 1 Conflict of Interest Don Calcagno Has no real or apparent conflicts of interest to report.

More information

Patient Engagement in the Population Health Management Era

Patient Engagement in the Population Health Management Era Patient Engagement in the Population Health Management Era Creagh Milford, DO, MPH President, Population Health Services A Catholic healthcare ministry serving Ohio and Kentucky Agenda Agenda I. Overview

More information

Minnesota Perspective: Fairview Health Services. National Accountable Care Organization Congress October 25, 2010

Minnesota Perspective: Fairview Health Services. National Accountable Care Organization Congress October 25, 2010 Minnesota Perspective: Fairview Health Services National Accountable Care Organization Congress October 25, 2010 Fairview Overview Not-for-profit organization established in 1906 Partner with the University

More information

L8: Care Management for Complex Patients: Strategies, Tools and Outcomes

L8: Care Management for Complex Patients: Strategies, Tools and Outcomes The Triple Aim 16 th Annual Summit: Institutes for Healthcare Improvement - Improving Patient Care in the Office Practice and the Community March 16, 2015 Dallas, Texas L8: Care Management for Complex

More information

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

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

More information

Improving Patient Health Through Real-Time ADT Integration

Improving Patient Health Through Real-Time ADT Integration Improving Patient Health Through Real-Time ADT Integration Session 209, March 08, 2018 John Whitington, CIO, South Country Health Alliance Megan LaCanne, Sr Business Systems Analyst, South Country Health

More information

Lab Strategies In an Era of Health Care Reform

Lab Strategies In an Era of Health Care Reform Lab Strategies In an Era of Health Care Reform Brian Jackson, MD, MS Director Medical Informatics Joe Miles, MT(ASCP), MHS Sr. Consultant Outreach Development Agenda A look back at healthcare reform Healthcare

More information

Post-Acute Care Networks: How to Succeed and Why Many Fail to Deliver JULY 18, 2016

Post-Acute Care Networks: How to Succeed and Why Many Fail to Deliver JULY 18, 2016 Post-Acute Care Networks: How to Succeed and Why Many Fail to Deliver HEALTH FORUM AND AHA LEADERSHIP SUMMIT JULY 18, 2016 SAN DIEGO, CALIFORNIA Please note that the views expressed are those of the conference

More information

Transforming Health Care with Health IT

Transforming Health Care with Health IT Transforming Health Care with Health IT Meaningful Use Stage 2 and Beyond Mat Kendall, Director of the Office of Provider Adoption Support (OPAS) March 19 th 2014 The Big Picture Better Healthcare Better

More information

CLINICAL INTEGRATION STRATEGY

CLINICAL INTEGRATION STRATEGY CLINICAL INTEGRATION STRATEGY ABSTRACT The Suffolk Care Collaborative Clinical Integration Strategy focuses on the ability to coordinate care across the continuum through clinically interoperable systems.

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

The Partner of Choice for Leading Health Systems. Learning Objectives. 45+ Health System Partners 750K+ Surgical Procedures $1.

The Partner of Choice for Leading Health Systems. Learning Objectives. 45+ Health System Partners 750K+ Surgical Procedures $1. http://www.advocatehealth.com/images/logo_advocatehealthcare.gif Co-Management: Successfully Improving Care Along the Surgical Continuum Gerald Biala, SCA Senior Vice President of Perioperative Services

More information

Payer Perspectives On Value-based Contracting

Payer Perspectives On Value-based Contracting Payer Perspectives On Value-based Contracting Miles Snowden, MD, MPH, CEBS Chief Medical Officer 1 A simple goal Making the health system work better for everyone 2 Optum serves 60,000,000+ individuals

More information

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

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

More information

Tribal Health. Integrated Tribal Health Center Solutions Five Steps to Better Tribal Health Outcomes

Tribal Health. Integrated Tribal Health Center Solutions Five Steps to Better Tribal Health Outcomes Tribal Health Integrated Tribal Health Center Solutions Five Steps to Better Tribal Health Outcomes Join the Tribal Health leader Tap into the single, shared database of our EHR and practice management

More information

Explaining the Value to Payers

Explaining the Value to Payers Explaining the Value to Payers Explaining the Value to Payers This document has been created to provide talking points for EMS agencies to explain to payers the value of EMS 3.0 services. Please review

More information

Emerging Models of Care Delivery Christy Mokrohisky Ex. Dir. of PI & Emerging Models

Emerging Models of Care Delivery Christy Mokrohisky Ex. Dir. of PI & Emerging Models Emerging Models of Care Delivery Christy Mokrohisky Ex. Dir. of PI & Emerging Models 1 Sacred Encounters Perfect Care Healthiest Communities St. Joseph Heritage Healthcare Founded in 1994 Manage 7 Medical

More information

Clinical Integration and P4P: Using Pay for Performance to Build Clinical Integration within a Physician-Hospital IPA

Clinical Integration and P4P: Using Pay for Performance to Build Clinical Integration within a Physician-Hospital IPA Clinical Integration and P4P: Using Pay for Performance to Build Clinical Integration within a Physician-Hospital IPA March 9, 2010 Presented by: Michael Edbauer, DO, Vice President, Medical Affairs CIPA

More information

I. Coordinating Quality Strategies Across Managed Care Plans

I. Coordinating Quality Strategies Across Managed Care Plans Jennifer Kent Director California Department of Health Care Services 1501 Capitol Avenue Sacramento, CA 95814 SUBJECT: California Department of Health Care Services Medi-Cal Managed Care Quality Strategy

More information

Physician Performance Analytics: A Key to Cost Savings

Physician Performance Analytics: A Key to Cost Savings Physician Performance Analytics: A Key to Cost Savings Session #90, February 21, 2017 Jim Gera, SVP of Business Development, Signature Medical Group, Inc. 1 Speaker Introduction Jim Gera, MBA SVP of Business

More information

Planning a Course to Population Health Management

Planning a Course to Population Health Management Planning a Course to Population Health Management A Complimentary Webinar From healthsystemcio.com Your Line Will Be Silent Until Our Event Begins at 12:00 ET Thank You! Slide Deck: http://goo.gl/1w119j

More information

Sandra Robinson, RN, MSN, ACM, CEN

Sandra Robinson, RN, MSN, ACM, CEN Developing and Measuring Care Coordination Outcome Goals and Objectives ACMA National Conference April 28, 2015 Cleveland Clinic Care Management Sandra Robinson, RN, MSN, ACM, CEN (robinss12@ccf.org) Joan

More information

Streamlining care processes with a data-driven approach

Streamlining care processes with a data-driven approach Streamlining care processes with a data-driven approach With Innovaccer s efficient and end-to-end care management solution Case Study Leading Iowa-based Mercy ACO deployed InCare to enable every member

More information

VALUE BASED ORTHOPEDIC CARE

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

More information

Innovations in Community- Based Advanced Illness Care: A Population Health Approach

Innovations in Community- Based Advanced Illness Care: A Population Health Approach Innovations in Community- Based Advanced Illness Care: A Population Health Approach LORI YOSICK, LISW -S, CHPCA DIRECTOR COMMUNITY PALLIATIVE CARE TRINITY HEALTH TERRI MAXWELL PHD, APRN CHIEF CLINICAL

More information

Summary and Analysis of CMS Proposed and Final Rules versus AAOS Comments: Comprehensive Care for Joint Replacement Model (CJR)

Summary and Analysis of CMS Proposed and Final Rules versus AAOS Comments: Comprehensive Care for Joint Replacement Model (CJR) Summary and Analysis of CMS Proposed and Final Rules versus AAOS Comments: Comprehensive Care for Joint Replacement Model (CJR) The table below summarizes the specific provisions noted in the Medicare

More information

Managing Patients with Multiple Chronic Conditions

Managing Patients with Multiple Chronic Conditions Best Practices Managing Patients with Multiple Chronic Conditions Dartmouth-Hitchcock Physicians Case Study Organization Profile Headquartered in Bedford, New Hampshire, Dartmouth-Hitchcock is a large

More information

Post-Acute Care Networks: How to Succeed and Why Many Fail to Deliver JULY 18, 2016

Post-Acute Care Networks: How to Succeed and Why Many Fail to Deliver JULY 18, 2016 Post-Acute Care Networks: How to Succeed and Why Many Fail to Deliver HEALTH FORUM AND AHA LEADERSHIP SUMMIT JULY 18, 2016 SAN DIEGO, CALIFORNIA Please note that the views expressed are those of the conference

More information

UTILIZING LEAN MANAGEMENT PRINCIPLES DURING A MEDITECH 6.1 IMPLEMENTATION

UTILIZING LEAN MANAGEMENT PRINCIPLES DURING A MEDITECH 6.1 IMPLEMENTATION UTILIZING LEAN MANAGEMENT PRINCIPLES DURING A MEDITECH 6.1 IMPLEMENTATION II UTILIZING LEAN MANAGEMENT PRINCIPLES DURING A MEDITECH 6.1 IMPLEMENTATION EXECUTIVE SUMMARY Healthcare may be the only industry

More information