Which Way? 6/1/2016. Respiratory Therapist Early Role/Value (1947) GPS Guidance As RCP s Where are We Going?
|
|
- Jemima Alexander
- 6 years ago
- Views:
Transcription
1 Which Way? 1. Understand where you came from and lessons learned The RCP GPS - Recalculating Roadmap for the Future Richard M Ford BS RRT FAARC Administrative Specialist UC San Diego Medical Center 2. Anticipate internal and external factors that may alter your path 3. Key strategies to consider 4. SB 525 and Telehealth recalculating 5. Always follow VALUE- PACE GPS Guidance As RCP s Where are We Going? Respiratory Therapist Early Role/Value (1947) Technician (O2 Technician) Provision of cylinder gas Delivery of aerosol therapy Provision of IPPB Assistance with operating ventilators Performance of diagnostic tests 1960 State of the Art Respiratory Care Bread and Butter for Respiratory Care
2 Vapor Oil At 40% alcohol plus 3 grams of opium per dose. It didn't cure you... but you didn't care! Early Aerosol Therapy Sugarloaf Conference on the scientific basis of respiratory therapy 2
3 Sugarloaf - Recalculating On May 2 4, 1974, the National Heart and Lung Institute and the American Thoracic Society sponsored a Conference on the Scientific Basis of Respiratory Therapy. The conference was held at the Sugarloaf Center in Philadelphia and became known as the Sugarloaf conference. Finance Reforms DRG and Capitated Shift from Revenue Center to Cost Center no convincing rationale for the use of IPPB in patients with COPD has been demonstrated and there is little data in the literature on which to base any conclusions as to whether IPPB is effective Reimbursed per Disease Encounter or per Day Less is Best Opportunity for a Scientific Basis The profession responded with a new focus on evidence driving the provision of Respiratory care. A set of instructions or interventions that are driven by the patient s condition or response to therapy in which the practitioner is allowed to initiate, refine, transition, discontinue, or restart therapy. (AARC) Emergence of Therapist Driven Protocols, RC Consult Services, and PDPs Judy Tietsort and George Burton MD (Wheatridge CO) Lucy Kester and Jamie Stoller MD (Cleveland) Jan Phillips Clar and David Burns MD (San Diego) Protocols The Intent The use of clinical protocols allows health care providers to offer appropriate diagnostic treatment and care services to patients, variance reports to purchasers and quality training to clinical staff Protocol based care enables staff to put evidence into practice by addressing the key questions of what should be done, when, where and by whom This standardization of practice reduces variation in the treatment of patients and improves the quality of care Communication is enhanced and timely response assured UCSD RC Protocols 3
4 Treatments Impact of PDPs on Routine Treatment Trends Jul-82 Jul-84 Jul-86 Jul-88 Jul-90 Jul-92 Jul-94 Jul-96 Jul-98 Jul-00 Your Staffing Programs Demand Based Flexible Cross Department Cross Site Beyond Acute Unique Value Minute Based RVUs = How Many Activity Frequency RVU(min) Time (total) Therapist Workday per Hour per Area Total: 6.12 Patient Care Hours Assessment Setup Med Aero CPT Suction Blood Gas Total 412 Direct Variable Time = 6 hours 52 minutes Minutes of Therapy Hour of Workday Total 6W 5W 11W 7W BICU 5W SICU 4
5 Value Plus - Productivity UCSD Thornton Respiratory Care Productivity Trends July 2004 through December 2011 Cost Saving Programs The AARC Has the Answer Hours Worked Hours Required Procedures/Activities How long do they take Staffing statements Staffing worksheets 2500 Hours Over 30 Protocols Policies and flowcharts References and CPGs How to start 0 Cost Saving Initiatives by UCSD RC Protocols and Cost Initiation of Patient Driven Protocols $600,000 Initiation of PDPs Thornton $180,000 Incorporation of Inpatient EKGs $150,000 Incorporation of Bronch Services $157,000 Incorporation of Bronchs Thornton $77,000 Consolidated RCS (PFT, PR,Clinics) $250,000 Vent Liberation Protocol $180,000 Creation of an Extern Program $24,000 Med Substitution $497,000 Nitric Oxide Protocol $1,200,000 All would agree that regardless how productive your staff is, that time spent in providing treatments that are not medically necessary is not productive, is a waste of time and materials and can possibly result in harm. You may be 100% productive in performing 10,000 Med Aerosols per month, but if only 4,000 are indicated, you have wasted resources to provide 6,000 interventions, thus only 40% effective productivity. 5
6 The Cost of Inhaled Meds Today The Hospital Bill in 1968 for a Tonsilectomy The Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare- Shift from Volume to Value THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (aka Obamacare ) Beginning in FY 2013 ACA was enacted and first phases implemented: Value Based Purchasing Patient Experience/Clinical Domain 30 Day Readmissions HF, MI, Pneumionia, COPD, CBG, Major Joint Bundled Payments Hospital Acquired Conditions 6
7 Hospitals Brace for New Medicare Payment Rules (4/1/16) Comprehensive Care for Joint Replacement Model The new rules will hold hospitals accountable for all the costs of hip and knee replacements for 90 days. If patients recover and go home quickly, hospitals could reap savings. If patients have complications or need lengthy stays in a rehab facility, hospitals could owe Medicare instead. The so-called bundled-payment initiative is the first mandatory program under the Obama administration s plan to shift at least 50% of Medicare spending to alternative-payment models by ,000 hip and knee replacements Medicare covers annually. The Centers for Medicare and Medicaid Services, or CMS, estimates the program will save $343 million on the $12.2 billion that Medicare will spend on the procedures over the next five years. Tim Wolters, Director of Reimbursement, Citizens Memorial Hospital, Bolivar, MO 7
8 Pulmonary Impairments on the Rise Recent studies indicate that in 2009, 40.3 million Americans were diagnosed with asthma or COPD (chronic bronchitis and emphysema). Of these, 25.1 million had asthma and 15.1 million had COPD. These numbers are increasing and are expected to increase to 43.9 million by 2016 While other major causes of death have been decreasing, COPD mortality has continued to rise. COPD is the 3rd leading cause of death. 12 million Americans are diagnosed with COPD; research shows that many do not get optimal treatment. An additional 12 million Americans may have COPD and remain undiagnosed. Recent advances in treatment for COPD offer real opportunities to improve your patient's quality and length of life COPD and 30 Day Readmission Fourth leading cause of 30 day readmission Significant cost, over 11 billion annually Readmission cost of $20, day readmission rates as high as 28% Assessment of care based on adherence to guidelines suggest numerous opportunities exist to improve COPD outcomes Gary Brown, Patrick Dunne, COPD In Patient Care: Time for a New Paradigm. AARC Times November 2011 The COPD Expert RCP Disease Management in the Acute Care Setting The single most important initiative to provide unique and clear value with VBP reform is the ability of the RCP to reduce COPD readmissions! Identify Patients Treat per Protocol Patient Driven Education Condition Driven Referral Pulmonary Rehab and Post Discharge Care The COPD Expert RCP Disease Management Beyond the Acute Care Setting RCPs in Clinics and MD offices Physical exam and history Home evaluation and family capability Action Plan to contact the MD, report to ER Coordinate care encounters Application of guidelines and protocols Measure outcomes across the continuum Telehealth California SB 525 and Congressional bill HR 2948, Medicare Telehealth Parity Act Ammendments to the Respiratory Care Practice Act No regulatory amendments since the Respiratory Care Practice Act was enacted 33 years ago in Lack of clarity through expert opinion review can often be a road block for the institution Complaints to the board of educators not liscensed to provide such instruction Scope pursued for unlicensed practice 8
9 SB 525 Amendment to the Respiratory Care Practice Act (Signed Sept 2, 2015 by Gov Brown) The therapy, management, rehabilitation, diagnostic evaluation, and care of patients with deficiencies and abnormalities which affect the heart and cardiovascular system Administration of medical gases and pharmacological agents for the purpose of inducing conscious or deep sedation under physicians and surgons supervision and the direct orders of the physician SB 525 More Educating students, health care professional, or consumers about respiratory care, including, but not limited to, education of respiratory core courses or clinical instruction provided as part of a respiratory care education program and educating health care professionals or consumers. The treatment, management, diagnostic testing, control, education and care of patients with sleep and wake disorders. SB 525 More All forms of extracorporeal life support, including, but not limited to ECMO and extracorporeal carbon dioxide removal (ECCO2R) Mechanical or physiological ventilator support as used in paragraph 4 subdivision (a) of 3702 includes, but is not limited to, any system, procedure, machine, catheter, equipment, or other device used in whole or in part, to provide ventilation or oxygenation support. SB 525 More The therapy, management, rehabilitation, diagnostic evaluation, and care for non-respiratory-related diagnosis or conditions provided a health care facility has authorized the RCP to provide these services and the RCP has maintained current competencies in the services provided. 525 New Navigation for RCPs Medical staff and executive team awareness of enhancement in scope Move forward with programs in which lack of clarity regarding scope has prevented or delayed initiatives Refine and update institutional policies related to both allowable scope and competencies Incorporate required competencies within formal education programs and forums Incorporate skill sets in Licensing Exams Develop roles in which RCPs can add value Partner with nursing and medical staff Medicare Telehealth Parity Act What does HR 2948 do for me? HR 2948 redefines Respiratory Therapists (RCP s) as healthcare professionals. This elevates our status as defined by the Medicare Act and statues. This makes it possible for RCP s to get reimbursed not only for telemedicine services, but also qualifies RCP s for reimbursement for services at levels similar to nursing and other healthcare professionals. This promotes the growth or our profession now and for the future 9
10 4 Reasons to Embrace Telemedicine Can help reach approximately 80 million people in federally designated underserved areas Can bring timely services and even some followup therapy (speech therapy) to recently discharged patients unable to leave their homes Engages patients who would otherwise leave their condition untreated due to transportation issues related to medical appointments. Half day of travel in 15 minutes. Offers providers the opportunity to hold virtual visits with patients being referred and improved followup to optimize the patients and provider time. HR 5380 Now and Future RCPs as qualified provider RCPs into Medicare Statute Coverage of remote patient management (COPD) Expands existing coverage Calls for studies on readmission * Adds other OP services * Adds home as a telehealth site for hospice, dialysis, DME Telehealth Services Professional consultations Patient Monitoring Patient Training Clinical Observations Assessment Treatment RCPs could perform this services within their scope of practice, however the act does not change current payment policies in which billing remains through the MD. Benefits of Telemed and Virtual Visits Providers protect market share Facilitates additional capacity Reduce expense Patient access Patient engagement Patient convenience Early identification and referral 39.5 Billion US Adults Using Wearables FDA approved 33 digital health solutions in 2014 FDA to approve 100 more by devices available today RCPs are ideally positioned 10
11 RCPs and Telehealth Congressional bill HR 2948, Medicare Telehealth Parity Act Covers RCPs as qualified telehealth providers Incorporates RCPs into Medicare Statutes (billed by MD/Facility) Adds remote patient monitoring for patients with COPD Expands coverage in 2 and 4 year phases April 12, over 40,000 messages California well represented! Are You Ready Roadmap for Respiratory Services Must differentiate respiratory care from other services in the hospital RT orders are not static, but dynamic, thus often need to change using protocol driven care and MD extenders Physicians rely on the assessment and documentation of RT in which duplication is minimized and teamwork exist Focus on the added value, do you make a difference? Unique advanced expertise and competence for new roles Data driven managers with a focus on value will create environments where RCPs thrive Plan Your Road Trip with Your Staff Don t Leave Home without Them Recalculating the Value Proposition Revenue Cost Value
National Institutes of Health, National Heart, Lung and Blood Institute (NHLBI)
October 27, 2016 To: Subject: National Institutes of Health, National Heart, Lung and Blood Institute (NHLBI) COPD National Action Plan As the national professional organization with a membership of over
More informationCoding Guidelines for Certain Respiratory Care Services January 2018 (updates in red)
Coding Guidelines for Certain Respiratory Care Services (updates in red) Overview From time to time the AARC receives inquiries about respiratory-related coding and coverage issues through its Help Line
More informationThe President s and Other Bipartisan Proposals to Reform Medicare: Post-Acute Care (PAC) Reform. Summary
Current Law The President s and Other Bipartisan Proposals to Reform Medicare: Post-Acute Care (PAC) Reform Summary Home Health Agencies Under current law, beneficiaries who are generally restricted to
More informationThe Role of the RT in Homecare and Pulmonary Rehab: What the Future May Hold
The Role of the RT in Homecare and Pulmonary Rehab: What the Future May Hold Presented by Kenneth A. Wyka, MS, RRT, AE-C, FAARC Director Clinical Education and Associate Dean Independence University, Salt
More informationPatient Safety and Respiratory Care Staffing Strategies: Presented By
Patient Safety and Respiratory Care Staffing Strategies: Presented By Dan Grady, RRT, FAARC, M Ed. Clinical Specialist for Research and Education Mission Health System Asheville, NC AARC Congress 2012
More information9/8/14. Re-hospitalizations among patients in the Medicare Fee-for-service Program
Rachael Ali-Permell, BS, RT, RRT-NPS, ACCS, AE-C Manager Respiratory Therapy Department Bayhealth Milford Memorial Hospital, Delaware Faculty Quinones Healthcare Seminars, LLC Hospital Readmission Reduction
More informationKrystal M Craddock, RRT-NPS, CCM, COPD Case Manager A HEALTHIER WORLD THROUGH BOLD INNOVATION
Krystal M Craddock, RRT-NPS, CCM, COPD Case Manager Department of Respiratory Care UC Davis Medical Center, Sacramento CA UC Davis ROAD Center kmcraddock@ucdavis.edu University of California Davis ROAD
More informationA Brave New World: Lessons Learned From Healthcare Reform. Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage
A Brave New World: Lessons Learned From Healthcare Reform Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage 1 Learning Objectives Participants will understand: The impact health
More informationProviding and Billing Medicare for Transitional Care Management
PYALeadership Briefing Providing and Billing Medicare for Transitional Care Management Updated November 2014 2014 Pershing Yoakley & Associates, PC (PYA). No portion of this white paper may be used or
More informationSENTARA HEALTHCARE. Norfolk, VA
SENTARA HEALTHCARE Norfolk, VA 1 Sentara Healthcare Overview 11 Acute Care Hospitals in Virginia with a total of 2572 licensed beds 1E Extended dstay hospital 9 Ambulatory Care Campuses; 5 with freestanding
More informationFinal Rule LSA Document #14-337(F) DIGEST 405 IAC ; 405 IAC ; 405 IAC ; 405 IAC ; 405 IAC ; 405 IAC
TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES Final Rule LSA Document #14-337(F) DIGEST Amends 405 IAC 5-22-1 to amend the definition of maintenance therapy and add a definition for rehabilitative
More informationCourse Module Objectives
Course Module Objectives CM100-18: Scope of Services, Practice, and Education CM200-18: The Professional Case Manager Case Management History, Regulations and Practice Settings Case Management Scope of
More informationAARC Benchmarking 2.0. Project Objectives:
Project Objectives: The new AARC Benchmarking 2.0 will continue to measure metrics important to respiratory therapy departments to provide accurate data to support administrative decisions and identify
More informationEmerging Issues in Post Acute Care Trends
Emerging Issues in Post Acute Care Trends Lavonne Elston, PT Senior Director of Operations & Strategic Initiatives Skilled Nursing & Rehabilitation Kingston HealthCare Company April 28, 2016 Disclosures
More informationMEDICAL POLICY No R2 TELEMEDICINE
Summary of Changes Clarifications: Page 1, Section I. A 6, additional language added for clarification. Deletions: Additions Page 4, Section IV, Description, additional language added in regards to telemedicine.
More informationGuidelines & Standards. The American Association for Respiratory Care Ables Lane Dallas, Texas 75229
Guidelines & Standards The American Association for Respiratory Care 11030 Ables Lane Dallas, Texas 75229 / Administrative Standards for Respiratory Care Services and Personnel An Official Statement from
More informationHealthcare 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 informationMEDICAL POLICY No R1 TELEMEDICINE
Summary of Changes MEDICAL POLICY TELEMEDICINE Effective Date: March 1, 2016 Review Dates: 12/12, 12/13, 11/14, 11/15 Date Of Origin: December 12, 2012 Status: Current Clarifications: Deletions: Pg. 4,
More informationSECTION III WORKLOADS AND CONCURRENT THERAPY
SECTION III WORKLOADS AND CONCURRENT THERAPY The Patient Protection and Affordability Act 18 were signed into law on March 23 2010 as well as the Healthcare and Education Reconciliation Act 19. These two
More informationTHE BEST OF TIMES: PHARMACY IN AN ERA OF
OBJECTIVES THE BEST OF TIMES: PHARMACY IN AN ERA OF ACCOUNTABLE CARE Toni Fera, BS, PharmD October 17, 2014 1. Describe the role of pharmacists in accountable care organizations (ACO). 2. List four key
More informationLong Term Care Hospital Clinical Coverage Policy No: 2A-2 Services (LTCH) Amended Date: October 1, Table of Contents
Long Term Care Hospital Clinical Coverage Policy No: 2A-2 Services (LTCH) Table of Contents 1.0 Description of the Procedure, Product, or Service... 1 1.1 Definitions... 1 2.0 Eligibility Requirements...
More informationDE SOTO CENTER NORTHWEST MISSISSIPPI COMMUNITY COLLEGE
DE SOTO CENTER NORTHWEST MISSISSIPPI COMMUNITY COLLEGE Dear Prospective Student: Thank you for your interest in our associate degree program in respiratory therapy. Respiratory therapy is the allied health
More informationTexas Medicaid. Provider Procedures Manual. Provider Handbooks. Telecommunication Services Handbook
Texas Medicaid Provider Procedures Manual Provider Handbooks December 2017 Telecommunication Services Handbook The Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid
More informationHR Telehealth Enhancement Act of 2015
HR 2066 - Telehealth Enhancement Act of 2015 Rep. Harper (R-MS), Rep. Thompson (D-CA), Rep. Black (R-TN) & Rep. Welch (D-VT) Author Intent: To promote and expand telehealth application under Medicare and
More informationJoint Statement on Ambulance Reform
Joint Statement on Ambulance Reform Policymakers Should Examine Short- and Intermediate-Term Policies to Promote Innovation in the Delivery of Emergency and Non- Emergency Care Provided by Ambulance Services
More informationTelemedicine: Solving the Root Causes for Preventable 30-day Readmissions in SNF Settings
For Immediate Release: 05/11/18 Written By: Scott Whitaker Telemedicine: Solving the Root Causes for Preventable 30-day Readmissions in SNF Settings Outlining the Problem: Reducing preventable 30-day hospital
More informationThe Future of Healthcare Delivery; Are we ready?
The Future of Healthcare Delivery; Are we ready? Lisa K. Saladin, PT, PhD, FAPTA Dean and Professor Medical University of South Carolina copyright LisaSaladin 2016 Objectives 1. Discuss 5 of the projected
More informationFACT SHEET Congressional Bill
HR 3306 - Telehealth Enhancement Act of 2013 Rep. Gregg Harper (R-MS) Purpose: To promote and expand the application of telehealth under Medicare and other Federal health care programs. Positive Incentives
More informationQuality and Health Care Reform: How Do We Proceed?
Quality and Health Care Reform: How Do We Proceed? Susan D. Moffatt-Bruce, MD, PhD Chief Quality and Patient Safety Officer Associate Dean of Clinical Affairs Quality and Patient Safety Associate Professor
More informationPRISM Collaborative: Transforming the Future of Pharmacy PeRformance Improvement for Safe Medication Management
PRISM Collaborative: Transforming the Future of Pharmacy PeRformance Improvement for Safe Medication Management Mission: To improve the health of the people of Connecticut through safe and effective medication
More informationBundled 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 informationThe Pain or the Gain?
The Pain or the Gain? Comprehensive Care Joint Replacement (CJR) Model DRG 469 (Major joint replacement with major complications) DRG 470 (Major joint without major complications or comorbidities) Actual
More informationcoming from the Affordable Care Act?
What are you doing to prepare for the changes What are you doing to prepare for the changes coming from the Affordable Care Act? The Affordable Care Act seeks to accomplish the following: Reduce the number
More informationTRANSFORMING HEALTH CARE WITH CONNECTED HEALTH TECHNOLOGY
TRANSFORMING CARE WITH CONNECTED TECHNOLOGY TELE STATE TRENDS Florida Telehealth Advisory Council April 21, 2017 877-707-7172 cchpca.org Mario Gutierrez We are part of the Public Health Institute, an independent,
More informationthequalitypost in this issue Get Out of Your Comfort Zone Edward Tufte s Principles for Effective Presentations Get Out of Your Comfort Zone
thequalitypost Edward Tufte s Principles for Effective Presentations Get Out of Your Comfort Zone Multidiciplinary Care for COPD Going Above and Beyond Division Incentive Metrics Monthly Quality Improvement
More informationBeachey W (3 rd Ed.) Mosby (2012). ISBN:
RSPT-1050 - Clinical Cardiorespiratory Physiologic Anatomy 4.00 credits Prerequisite: Admission into the Respiratory Therapy program and BIOL-2710. Corequisite: RSPT-1060 (formerly RSP 105) This course
More informationSTATE PLAN FOR ADRESSING COPD IN ILLINOIS. Executive Summary
STATE PLAN FOR ADRESSING COPD IN ILLINOIS Executive Summary ! "!! # $! "! % & ' ' ' ( ) * ( +, ) -. / ) ) 0 * - - 1 * 1 + ). ' 0 2-1 * 3 ) 2 3 ) 4 ) ( ) ) * 5. / 2 ) )6 1 ( + ( 1 * ) ) 0 0 + 7) 8 ) 7.
More informationNational Readmissions Summit Safe and Reliable Transitions: An Integrated Approach Reducing Heart Failure Readmissions
National Readmissions Summit Safe and Reliable Transitions: An Integrated Approach Reducing Heart Failure Readmissions Michael Kanter, MD, Medical Director Quality and Clinical Analysis Patti Harvey, RN,
More informationReimbursement Policy. Subject: Inpatient Readmissions Committee Approval Obtained: Effective Date: 10/01/13
Reimbursement Policy Subject: Inpatient Readmissions Committee Approval Obtained: Effective Date: 10/01/13 Section: Facilities 04/03/17 *****The most current version of the Reimbursement Policies can be
More informationMedicare Hospital Inpatient Prospective Payment System for Acute Care Hospitals Final 2016 Rates & Policies 1
Medicare Hospital Inpatient Prospective Payment System for Acute Care Hospitals Final 2016 Rates & Policies 1 Cardiac Rhythm Management (CRM) Market Impacts Introduction On August 3, 2015, the Centers
More informationTELECOMMUNICATION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL
TELECOMMUNICATION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL NOVEMBER 2017 CSHCN PROVIDER PROCEDURES MANUAL NOVEMBER 2017 TELECOMMUNICATION SERVICES Table of Contents 38.1 Enrollment......................................................................
More informationFor Vanderbilt Medical Center Carolyn Buppert, NP, JD Law Office of Carolyn Buppert
For Vanderbilt Medical Center Carolyn Buppert, NP, JD Law Office of Carolyn Buppert www.buppert.com Describe the services in critical care that nurse practitioners perform that are billable Discuss what
More informationTest bank PowerPoint slides for each chapter Instructor guides for each chapter (with answers for discussion questions and case studies)
This is a sample of the instructor materials for Dimensions of Long-Term Care Management: An Introduction, second edition, edited by Mary Helen McSweeney-Feld, Carol Molinari, and Reid Oetjen. The complete
More informationManaging Congestive Heart Failure as a Business September 13, 2010 Session M30 Society for Healthcare Strategy and Market Development annual meeting
Managing Congestive Heart Failure as a Business September 13, 2010 Session M30 Society for Healthcare Strategy and Market Development annual meeting Chris Kane SVP, Strategic Business Development WellStar
More informationHOSPITALS & 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 informationQuality 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 informationReimbursement for Non-Invasive Respiratory Support in Hospital Inpatient, Emergency Department and Other Outpatient Settings 1
2400 Beacon St., #203, Chestnut Hill, MA 02467 617-645-8452 Reimbursement for Non-Invasive Respiratory Support in Hospital Inpatient, Emergency Department and Other Outpatient Settings 1 The purpose of
More informationPartner with Health Services Advisory Group
Partner with Health Services Advisory Group Bonnie Hollopeter, LPN, CPHQ, CPEHR Health Services Advisory Group (HSAG) Quality Improvement Lead Rosalie McGinnis, MS, RN HSAG Quality Improvement Lead November
More informationChronic Care Management. Sharon A. Shover, CPC, CEMC 2650 Eastpoint Parkway, Suite 300 Louisville, Kentucky
Chronic Care Management Sharon A. Shover, CPC, CEMC 2650 Eastpoint Parkway, Suite 300 Louisville, Kentucky 40223 502.992.3511 sshover@blueandco.com Agenda Chronic Care Management (CCM) History Define Requirements
More informationThe 5 W s of the CMS Core Quality Process and Outcome Measures
The 5 W s of the CMS Core Quality Process and Outcome Measures Understanding the process and the expectations Developed by Kathy Wonderly RN,BSPA, CPHQ Performance Improvement Coordinator Developed : September
More informationSession Objectives 10/27/2014. How Can I get Beyond the Basics of Hospital Readmission and Become a Preferred Provider? Kim Barrows RN BSN
How Can I get Beyond the Basics of Hospital Readmission and Become a Preferred Provider? Kim Barrows RN BSN Session Objectives At the end of the session the learner will be able to: 1. Discuss the history
More informationThe 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 informationManaging Healthcare Payment Opportunity Fundamentals CENTER FOR INDUSTRY TRANSFORMATION
Managing Healthcare Payment Opportunity Fundamentals dhgllp.com/healthcare 4510 Cox Road, Suite 200 Glen Allen, VA 23060 Melinda Hancock PARTNER Melinda.Hancock@dhgllp.com 804.474.1249 Michael Strilesky
More informationPartnering with the Care Management Department. Medical Staff and Allied Health Practitioner Orientation
Partnering with the Care Management Department Medical Staff and Allied Health Practitioner Orientation 10/2015 Department of Care Management Medical Directors of Care Coordination Inpatient Case Managers
More informationHEALTH CARE REFORM IN THE U.S.
HEALTH CARE REFORM IN THE U.S. A LOOK AT THE PAST, PRESENT AND FUTURE Carolyn Belk January 11, 2016 0 HEALTH CARE REFORM BIRTH OF THE AFFORDABLE CARE ACT Health care reform in the U.S. has been an ongoing
More informationStatement of the American Academy of Physician Assistants. for the Hearing Record of the Senate Finance Committee
Statement of the American Academy of Physician Assistants for the Hearing Record of the Senate Finance Committee on Chronic Illness: Addressing Patients Unmet Needs July 15, 2014 On behalf of the more
More informationLa Rabida Inpatient Rotation PL2 Residents
PL2 Residents Residents rotate through the inpatient service at La Rabida Children s Hospital and Research Center over 1-2 months during the second year of residency. The inpatient service is separated
More informationRedesigning 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 informationQuality and Safe Respiratory Care: Does it Work in a Productivity Model?
Quality and Safe Respiratory Care: Does it Work in a Productivity Model? Timothy R. Myers MBA, RRT-NPS, FAARC Associate Executive Director, Brands Management American Association for Respiratory Care Adjunct
More informationReducing Readmissions: Potential Measurements
Reducing Readmissions: Potential Measurements Avoid Readmissions Through Collaboration October 27, 2010 Denise Remus, PhD, RN Chief Quality Officer BayCare Health System Overview Why Focus on Readmissions?
More informationFramework for Post-Acute Care: Current and Future Issues for Providers
Framework for Post-Acute Care: Current and Future Issues for Providers Alan G. Rosenbloom Alliance for Quality Nursing Home Care March 2012 Overview of Presentation Post-Acute Care: Background and Trends
More informationHenry Ford Medical Group
Henry Ford Medical Group Radical Convenience: A New Wave of Patient Care Presented by: Diane George, DO HFMG Associate Chief Medical Officer Thomas S. Nantais HFMG Chief Operating Officer The Henry Ford
More informationCollaborative Activation of Resources and Empowerment Services Building Programs to Fit Patients vs. Bending Patients to Fit Programs
Organization: Solution Title: Calvert Memorial Hospital Calvert CARES: Collaborative Activation of Resources and Empowerment Services Building Programs to Fit Patients vs. Bending Patients to Fit Programs
More informationUnderstanding Insurance Models For Risk Adjustment
Understanding Insurance Models For Risk Adjustment For Healthcare Professionals Education provided by: Brian Boyce, BSHS, CPC, CPC-I CEO, Proprietor & Managing Consultant, ionhealthcare, LLC 1 No part
More informationTelehealth: Overcoming the challenges of implementing innovative health care solutions
Telehealth: Overcoming the challenges of implementing innovative health care solutions NRTRC 5 TH ANNUAL CONFERENCE MARCH 22, 2016 ROKI CHAUHAN, MD, FAAFP Disclaimer 2 The material presented here is being
More informationQuality Based Impacts to Medicare Inpatient Payments
Quality Based Impacts to Medicare Inpatient Payments Overview New Developments in Quality Based Reimbursement Recap of programs Hospital acquired conditions Readmission reduction program Value based purchasing
More informationJob Description. Job Title: (Respiratory Specialist)
Job Title: (Respiratory Specialist) Reports to: Annette Moser Responsibility Level: Staff Direct Supervision: Respiratory Manager Job Location: UI Health Department: Respiratory Care Services Job Category:
More informationPROVIDER POLICIES & PROCEDURES
PROVIDER POLICIES & PROCEDURES EXTENDED NURSING SERVICES The purpose of this document is to provide guidance to providers enrolled in the Connecticut Medical Assistance Program (CMAP) on the requirements
More informationMediServe. More than 25 Years Serving the Rehab and Respiratory Communities
MediServe More than 25 Years Serving the Rehab and Respiratory Communities Who We Are Respiratory Rehabilitation 250+ Clients Chandler, Arizona 26+ yrs of business CORE Focus (Compliance, Outcomes, Revenue,
More informationIntroduction 4/7/2015
The Perfect Storm: A Distinguished Post-Acute Rehabilitation Program (Session # W25) Wednesday April 29 th, 2:30-4:30 Presented by: Hilary Forman PT, RAC-CT Senior Vice President of Clinical Strategies
More informationNHSGGC Respiratory Managed Clinical Network Annual Report 2010/11 Executive Summary and Table of Contents
NHSGGC Respiratory Managed Clinical Network Annual Report 2010/11 Executive Summary and Table of Contents The full report is available on the Respiratory MCN Website www.nhsggc.org.uk/respmcn 1. Executive
More informationProvider Handbooks. Telecommunication Services Handbook
Provider Handbooks December 2016 Telecommunication Services Handbook The Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid under contract with the Texas Health
More information(202) or CMS Proposals to Improve Quality of Care during Hospital Inpatient Stays
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE April 30, 2014 Contact: CMS Media
More informationNational Coalition on Care Coordination (N3C) Care Coordination and the Role of the Aging Network. Monday, September 12, 2011
National Coalition on Care Coordination (N3C) Care Coordination and the Role of the Aging Network Monday, September 12, 2011 Washington, DC Hyatt Regency on Capitol Hill Yellowstone/Everglades 4:00 PM
More informationAmbulatory Care Practice Trends and Opportunities in Pharmacy
Ambulatory Care Practice Trends and Opportunities in Pharmacy David Chen, R.Ph., M.B.A. Senior Director Section of Pharmacy Practice Managers ASHP Objectives Describe trends in health system pharmacy reported
More informationTelehealth: Using technology in the delivery of healthcare
Telehealth: Using technology in the delivery of healthcare Using Telemedicine to Treat Chronic Disease in Rural Communities "Rural Americans face a unique combination of factors that create disparities
More informationSubject: Skilled Nursing Facilities (Page 1 of 6)
Subject: Skilled Nursing Facilities (Page 1 of 6) Objective: I. To ensure that Tuality Health Alliance (THA) and delegated Providence Health Plan Medicare members are appropriately placed in skilled nursing
More informationHealth Reform and IRFs
American Medical Rehabilitation Providers Association 8 th Annual AMRPA Educational Conference New Orleans, LA Health Reform and IRFs Planning Today for Success Tomorrow October 14, 2010 Agenda Introduce
More informationPACE Performance on Post-Discharge Primary Care Evaluations from Jan-Jun 2012 PACE. By: Rocio Solano Padilla PCLP-NMF/GE Scholar Jul 23, 2012
PACE Performance on Post-Discharge Primary Care Evaluations from Jan-Jun 2012 PACE By: Rocio Solano Padilla PCLP-NMF/GE Scholar Jul 23, 2012 2 INTRODUCTION Who am I? Physician Assistant student Towson/CCBC
More informationPain: Facility Assessment Checklists
Pain: Facility Assessment Checklists This is a series of self-assessment checklists for nursing home staff to use to assess processes related to pain management in the facility, in order to identify areas
More informationHealthcare Leadership Council: John Perticone Golden Living 3/9/2016
Healthcare Leadership Council: Care Transitions in Post Acute Care John Perticone Golden Living 3/9/2016 Golden Living Profile Golden Living Centers and Communities 296 skilled nursing facilities 15 assisted
More informationThe Community Care Navigator Program At Lawrence Memorial Hospital
The Community Care Navigator Program At Lawrence Memorial Hospital Presented By: Linda Gall, MSN, RN, ACM Director of Care Coordination October 21, 2011 Learning Objectives: 1. Describe the vision and
More informationMassMedic Healthcare and Payment Reform: Impact on Value Demonstration
MassMedic Healthcare and Payment Reform: Impact on Value Demonstration November 2, 2012 David Martin, Senior Director, Health Policy COVIDIEN, COVIDIEN with logo, Covidien logo and positive results for
More informationFriday Health Plans of Colorado
QUALITY OVERVIEW Health Plans of Colorado (formerly Colorado Choice Health Plans) Serving Colorado for over 4 years, Health Plans utilizes a community-focused model. We work hand in hand with local providers
More informationGet A Seat at the Table
Get A Seat at the Table Develop Cross-Continuum Networks in the Competitive, Performance-Driven Senior Living Industry Hilary Forman, PT, RAC-CT Senior VP, Clinical Strategies Division, HealthPRO Heritage
More informationCritical Access Hospitals and Cost-Based Reimbursement
Critical Access Hospitals and Cost-Based Reimbursement Jared Heim, CPA, Partner jheim@eidebailly.com 563.557.6169 Agenda for Today Overview of Critical Access Hospitals Overview of Health Care Reform Behavioral
More informationASSEMBLY BILL No. 214
AMENDED IN SENATE AUGUST, 00 AMENDED IN SENATE AUGUST, 00 AMENDED IN SENATE AUGUST, 00 AMENDED IN SENATE JULY, 00 AMENDED IN SENATE JUNE, 00 AMENDED IN SENATE JUNE, 00 AMENDED IN SENATE AUGUST 0, 00 california
More informationWinning at Care Coordination Using Data-Driven Partnerships
Idriz Limaj, LNHA, RN Chief Operating Officer Winning at Care Coordination Using Data-Driven Partnerships Session #166, February 22, 2017 1 Steven Littlehale, MS, GCNS-BC EVP & Chief Clinical Officer Speaker
More informationPaving the Way for. Health Homes
Paving the Way for Health Homes Paving the Way for Healthcare Homes Affordable Care Act The Affordable Care Act passed by Congress and signed into law by the president in March 2010, provides a variety
More informationTHE ALPHABET SOUP OF MEDICAL PAYMENTS: WHAT IS MACRA, VBP AND MORE! Lisa Scheppers MD FACP Margo Ferguson MT MSOM
THE ALPHABET SOUP OF MEDICAL PAYMENTS: WHAT IS MACRA, VBP AND MORE! Lisa Scheppers MD FACP Margo Ferguson MT MSOM THE REASON FOR CHANGE VOLUME TO VALUE Fee-for-service PAYMENT Bundled, Shared Patient FOCUS
More informationUsing Education Codes Effectively and Legally in Clinical Sleep Education
SOUTHERN SLEEP SOCIETY 39 TH ANNUAL MEETING SOUTHERN SLEEP SOCIETY TECHNOLOGIST COURSE - 2017 Using Education Codes Effectively and Legally in Clinical Sleep Education Jayme R. Matchinski March 23, 2017
More informationTelemedicine and Health Reform. Jonathan Neufeld, PhD Clinical Director Upper Midwest Telehealth Resource Center
Telemedicine and Health Reform Jonathan Neufeld, PhD Clinical Director Upper Midwest Telehealth Resource Center 1 telehealthresourcecenters.org Links to all TRCs National Webinar Series Reimbursement,
More informationThe Affordable Care Act
The Affordable Care Act Medical City, Dallas, TX October 26, 2012 Presented by Cheryl West, MPH Director, Government Affairs, AARC Affordable Care Act (ACA) 2 What I m Not Going to Talk About 3 What I
More informationHospital Readmissions Survival Guide
WHITE PAPER Hospital Readmissions Survival Guide The Long-Term Care Provider s Ultimate Survival Guide to Incorporating INTERACT into Health Information Technology (HIT) March 2017 In this survival guide,
More informationQUALITY AND COMPLIANCE
2015 HCCA SOUTHEAST CONFERENCE JANUARY 23, 2015 QUALITY AND COMPLIANCE Katie Fink Donna Lewis Susan Walberg Presenters Katie Fink Senior Counsel Office of Counsel to the Inspector General U.S. Department
More informationTELEHEALTH INDEX: 2015 PHYSICIAN SURVEY
TELEHEALTH INDEX: 2015 PHYSICIAN SURVEY Overview Telehealth is accelerating in 2015. As many as 37% of hospital systems have at least one type of telemedicine solution to meet a variety of objectives,
More informationQuestions 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 informationSpecial Needs Plan Provider Education
Special Needs Plan Provider Education Learning Goals What is a Special Needs Plan (SNPs) What differentiates a SNP from other MA plans What SNPs are offered by Freedom Health and Optimum Healthcare 2 Care
More informationHome Health. Improving Patient Outcomes & Reducing Readmissions. Home Health: Improving Outcomes & Reducing Readmissions
Home Health Improving Patient Outcomes & Reducing Readmissions Home Health: Improving Outcomes & Reducing Readmissions Benefits of Home Health Care Scientific evidence proves people heal more quickly,
More informationL8: 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