The Landscape is Changing. Survival in the Rapidly Changing Health Care Industry 9/14/2016. LeadingAge Iowa Board Meeting September 20, 2016
|
|
- Clarissa McKinney
- 5 years ago
- Views:
Transcription
1 Survival in the Rapidly Changing Health Care Industry LeadingAge Iowa Board Meeting September 20, 2016 The Landscape is Changing The Affordable Care Act Medicaid Expansion Balancing Incentive Program Center for Medicare and Medicaid Innovation CMMI Medicare ACOs Medicare Value based Purchasing Medicare Bundled Payment Program 1
2 The Changing Landscape: Iowa Medicaid Expansion 1115 waiver 138% FPL IA Health Link Balancing Incentive Program 1915 waiver for HCBS Federal Health Insurance Exchange Money Follows the Person Challenges for Providers in New Care and Payment Models Assessing the current service delivery model and how it fits with the value based systems of ACOs, Bundled Payments, PCMH, etc. What outcomes are being achieved? Where are the areas for improvement? What is the core business and what can be done through partnerships? 2
3 The Triple Aim 3
4 How Health Care will be Delivered Regional Approach Fewer hospital systems Affiliations and partnerships Risk Sharing becomes important Producing data and outcomes is imperative What does this mean for Health Care Providers? Payment reforms will challenge service delivery reform. Reducing readmissions and length of stay imperative! Reduced hospital and nursing stays, more home care P4P, Bundled payments, capitation PCMH If I keep doing what I m doing I ll be fine This mindset will not work and you may find yourself out of business. 4
5 Payors will Change Too Quality verses Efficiency Paying for outcomes Providers must take advantage of opportunities to engage with payors to determine what those outcomes are and how they will be paid. Don t assume payors know your business, be ready and willing to educate them how you deliver services and the outcomes you are trying to achieve. It s All About Data Collecting and analyzing data will be imperative for providers. Presenting that data in a meaningful format for your partners whether they be hospitals or payors shows your value to them. Readmissions and Length of Stay the low hanging fruit. 5
6 The Benefits of a Network Greater visibility and attention by government and commercial payors. We are their priority. Access to state government Medicaid. Ability to identify key quality measures, collect data on those measures, aggregate information and present it in a meaningful way to payors and partners. Network Development Separate LLC each member of the network is an equal partner of the network. The network develops the parameters as to membership. Committees: Finance, Contracting, Quality and Membership Requirements for data collection of quality measures. Dues structure can be based on a variety of factors; unduplicated client numbers, size and type of services, etc. 6
7 Leading Age Ohio Facilitates Managed Care Networks LeadingAge Ohio had a managed care task force that worked over two years to explore the feasibility of long term care managed care networks to negotiate contracts with payors for commercial, Medicaid, Medicare and ICDS contracts. Ohio Aging Services Network: The first year, OASN had 37 members and about 71 facilities. Currently, Ohio Aging Services Network is made up of 62 LAO members representing 131 facilities across Ohio. OASN Has contracts with all MyCare Ohio plan providers, Medicaid only contracts and contracts with many commercial plans. The network has developed a quality program collecting data on 21 quality measures. Each member reports their data through cpmt so data can be aggregated. OASN has a contract with Discern Health to develop dashboards for each member showing their quality. 7
8 OASN Budget First Year Total = $200,000 Expenses: Network Administration $84,000 D&O Insurance $ 3,500 Data Collection (cpmt) $55,000 Quality program $20,000 Estimated Taxes $ 3,500 Marketing $ 5,000 Board Meetings $ 3,000 Website $10,000 TOTAL $184,000 OASN Dues Structure Based on type and size of facility. SNF = $1,000 per facility + $35.00/bed AL = No facility fee + $7.00/bed Medicare Certified Home Health Program = $1,000 Adult Day Program = $7.00/licensed capacity 8
9 OASN Dues Structure Ohio Aging Services Network Membership Fee Calculator Facility Name: Service Type Number Facility Fee Bed Fee Do you have a skilled nursing facility? If yes, enter the number of facilities in Column B If no, enter 0 1 $1, How many SNF beds do you have? Enter number of beds for all in Column B 100 $ 3,500 Do you have Assisted Living? If yes, enter the number of beds in Column B 50 $ 350 Do you have a Medicare Certified Home Health program? If yes, enter 1,000 in Column C. If not, enter 0 in Column C $1, Do you have an Adult Daycare Center? If yes, enter the licensed capacity for each facility in Column B If not, enter 0 0 $0.00 TOTAL Annual Fee for OASN Membership > $5, OASN Value Survey of members after three years showed three consistent values of OASN by the members: Access to payors they could never get to previously. Increase in reimbursement with payors already under contract with (one payor $15/bed day increase). Increase in revenue. One member share that due to getting a payor contract they had never been able to get yielded over $100,000 in new revenue. More than covered their dues of around $10,000/year. 9
10 Size and Scope of a Network There is no required size of a network. A network should have adequate market presence in major population areas to ensure access of payors members to facilities and services. OASN has good market presence in the Cincinnati, Columbus, Cleveland, Toledo, Dayton, Akron/Canton, Youngstown markets which are the seven major metropolitan markets in Ohio. OASN has members outside of these areas as well. The Indiana Health Services Network has good representation in the Indianapolis, Fort Wayne, South Bend, Evansville and Terra Haute. OASN Quality Program 30 day unplanned readmissions Observation stays ER Visits Return to Community Pressure Ulcers UTIs Falls with Major Injury Flu and Pneumonia vaccines Staffing hours 10
11 Who are Your Partners? You will do business with others that you never thought you d do business with in the past.just to survive. Faith based communities Social Service Agencies DME Agencies Hospitals Nursing Homes Tear down the silos!! Find those partners who recognize the right time to start care right care, right place, right time. This may take some education 11
12 Achieving Success Know your costs not your charges!! Know your quality collect data and analyze it. Identifying those services you do best and find partners for other services you don t have to own it all. Know who your partners are and the value the bring to you. Looking Ahead We need to continue challenging ourselves to assess the way we are providing services so we can improve overall health and collect data that is meaningful to our patients and payors. Identify our partners who can help us achieve desired outcomes and develop those relationships. Data, data, data.. 12
13 Questions?? 13
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 informationMedicare, Managed Care & Emerging Trends
Medicare, Managed Care & Emerging Trends LeadingAge Michigan 2015 Annual Leadership Institute August 12, 2015 Jon Lanczak, Manager Beth Sullivan, Senior Manager Plante Moran, PLLC Overall Theme Healthcare
More informationGetting Started in a Medicare Shared Savings Program Accountable Care Organization
1 Getting Started in a Medicare Shared Savings Program Accountable Care Organization Tuesday, September 16 th Pam Maxwell, Chief Growth Officer What is an ACO? Accountable Care Organizations (ACOs) are
More informationThe Impact of Health Care Reform on Long- Term Care
The Impact of Health Care Reform on Long- Term Care AMY RUNGE, CPA Moss Adams LLP Partner & National Practice Leader, Long-Term Care MARCY BOYD, CPA Moss Adams LLP Partner September 22, 2014 1 The material
More informationPerson-Centered Accountable Care
Person-Centered Accountable Care Nelly Ganesan, MPH, Senior Director, Avalere s Evidence, Translation and Implementation Practice October 12, 2017 avalere.com @NGanesanAvalere @avalerehealth Despite Potential
More informationAdopting a Care Coordination Strategy
Adopting a Care Coordination Strategy Authors: Henna Zaidi, Manager, and Catherine Castillo, Senior Consultant Current state of health care The traditional approach to health care delivery is quickly becoming
More informationPREPARING FOR RISK-BASED OUTCOMES OF BUNDLED CARE
CPAs & ADVISORS experience support // PREPARING FOR RISK-BASED OUTCOMES OF BUNDLED CARE Jackie Nussbaum MHA, CPC, CHFP, FHFMA Director Eric Rogers M.Ed. RT Managing Consultant THE CHANGING HEALTH CARE
More informationLTCH Payment Reform & Patient Criteria
LTCH Payment Reform & Patient Criteria Mary Dalrymple Managing Director, LTRAX Kristen Smith, MHA, PT Senior Consultant, Fleming-AOD Overview Objectives What happened? Describe new LTACH payment system
More informationTo successfully submit a full application, hospitals must complete both the online application and the Self-assessment.
SMALL RURAL HOSPITAL TRANSITION (SRHT) PROJECT To successfully submit a full application, hospitals must complete both the online application and the Self-assessment. Applications must be submitted online,
More informationUsing 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 informationMANAGED CARE IS HERE
MANAGED CARE IS HERE Survive or Thrive Susie Mix CEO/President Mix Solutions Inc. 1 Nursing Home (NH) Industry Transformation Senior Care Industry Trends & Strategies Why do we care about change? Finances
More informationValue Based Care in LTC: The Quality Connection- Phase 2
Value Based Care in LTC: The Quality Connection- Phase 2 Joseph J. Tomaino, M.S., R.N., Principal Healthcare Transformation Consulting ChemRx/PharmMerica Geriatric Skilled Nursing Seminar December 7, 2017
More informationWelcome to. Primary Care and Public Health: Linking Public Health and Advanced Primary Care to Improve Outcomes
Welcome to ASTHO s Delivery and Payment Reform Technical Assistance Call Series Primary Care and Public Health: Linking Public Health and Advanced Primary Care to Improve Outcomes Presented by ASTHO and
More informationInnovative 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 informationhfma Maryland Chapter New All-Payer Model for Maryland Maryland Health Services Cost Review Commission
hfma Maryland Chapter New All-Payer Model for Maryland Maryland Health Services Cost Review Commission October 2013 1 HSCRC Preparation for New All Payer Hospital Model Maryland prepared updated application
More information10/3/2014. Ohio Department of Medicaid
Ohio Health Care Association Fall 2014 John McCarthy Medicaid Director Balancing Ohio: More Opportunities in the Community 2 1 Balancing Incentive Program (BIP) Background The Jobs Budget(2011) set out
More informationReimbursement Models of the Future A Look at Proposed Models
Experience the Eide Bailly Difference Reimbursement Models of the Future A Look at Proposed Models Ralph J. Llewellyn, CPA, CHFP Partner rllewellyn@eidebailly.com 701.239.8594 Introduction CAH reimbursement
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 informationconferences & full day programs Spring Conference
catalogue of events conferences & full day programs Spring Conference May 2-3, 2016 The 2016 Spring Conference, Awards and Trade Show is all about making a difference, and that difference is you. You expand
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 informationThe Census Scene in 2018: Strategies to Optimize Occupancy During Change Census Scorecard. Ohio Overall Certified Occupancy
The Census Scene in 2018: Strategies to Optimize Occupancy During Change Linda L. Saunders, LNHA Founder, President 2016 Census Scorecard 1 84% 82% Ohio Overall Certified Occupancy Ohio Overall Licensed
More informationAccountable 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 informationPost-Acute Care Alignment Strategy Management & Operations Track Tuesday, July 29, 4:45 5:45 pm
Post-Acute Care Alignment Strategy Management & Operations Track Tuesday, July 29, 4:45 5:45 pm Lisa Lyons Executive Director St. Josephs John Knox John M. Hehn, Jr. Executive Director Florida Presbyterian
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 informationSucceeding 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 information4/9/2016. 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 informationGlobal Budget Revenue. October 8, 2015
Global Budget Revenue October 8, 2015 Goals Understand GBR s connection to the goals of Maryland s Demonstration Understand impact on budgeting and planning for RFP and future phases Answer questions that
More informationUsing Quality Data to Market to Referral Sources. Kim Hicks
Using Quality Data to Market to Referral Sources Kim Hicks Change as a Matter of Survival BUSINESS OF HEALTHCARE 3 What s Happening here? It costs Medicare about $26 billion a year, with about $17 billion
More informationBeyond the Hospital Walls: Impact of a SNFist Practice Model
Beyond the Hospital Walls: Impact of a SNFist Practice Model Aaron Snyder, MD Vice President, US Acute Care Solutions Kim Repac Chief Financial Officer, WMHS Aging Population 50 Million Distribution
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 informationRural Health Clinics
Rural Health Clinics * An Issue Paper of the National Rural Health Association originally issued in February 1997 This paper summarizes the history of the development and current status of Rural Health
More informationPresentation Objectives
Quality Improvement and Value-Based Purchasing (VBP) How your QI program can prepare you for transformation Paul Mulhausen, MD, AGSF, FACP Medical Director Telligen Quality Improvement Network Quality
More informationHealthy Aging Recommendations 2015 White House Conference on Aging
Healthy Aging Recommendations 2015 White House Conference on Aging Chronic diseases are the leading causes of death and disability in the U.S. and account for 75% of the nation s health care spending.
More informationThe Center for Medicare & Medicaid Innovations: Programs & Initiatives
The Center for Medicare & Medicaid Innovations: Programs & Initiatives Rob Stone, Esq. American Health Lawyers Association Institute on Medicare & Medicaid Payment Issues March 30-April 1, 2012 CMMI Mission
More informationQuality, 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 information5/26/2015. January 26, 2015 INCENTIVES AND PENALTIES. Medicare Readmission Penalties. CMS Bundled Payment Providers & ACOs in NE
Agenda ESTABLISHING SHARED EXPECTATIONS New tool of ACOs, Bundled Payments & Readmission Reduction Update on current market pressures driving a focus on care across settings & over time at lowest cost
More informationIowa Medicaid: Innovations & Initiatives
Iowa Medicaid: Innovations & Initiatives ICD-10 ACA Expansion Presumptive Eligibility Health Information Technology PERM DHS Initiatives Adult Quality Measures SIM CDAC Topics 2 ICD-10 3 1 ICD-10 Background
More informationExecutive Summary. Leadership Toolkit for Redefining the H: Engaging Trustees and Communities
Executive Summary Leadership Toolkit for Redefining the H: Engaging Trustees and Communities Report produced by the AHA Committee on Research and Committee on Performance Improvement 2015 Executive Summary
More informationReducing Preventable Hospital Readmissions in Post Acute Care Kim Barrows RN BSN
Reducing Preventable Hospital Readmissions in Post Acute Care Kim Barrows RN BSN Session Objectives At the end of the session the learner will be able to: 1. Discuss the history of hospital readmission
More informationSaint 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 informationHome Health Market Overview
Home Health Market Overview December 2013 Investment banking services are provided by Harris Williams LLC, a registered broker-dealer and member of FINRA and SIPC, and Harris Williams & Co. Ltd, which
More informationPresentation to the CAH Administrator Meeting January 23 24, 2013 Helena, MT
Presentation to the CAH Administrator Meeting January 23 24, 2013 Helena, MT Keith J. Mueller, Ph.D. Director, RUPRI Center for Rural Health Policy Analysis Head, Department of Health Management and Policy
More informationData-Driven Strategy for New Payment Models. Objectives. Common Acronyms
Data-Driven Strategy for New Payment Models Mark Sharp, CPA Partner msharp@bkd.com Objectives Understand new payment model reforms and bundling arrangements Learn how these new payment models can impact
More informationCPAs & 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 informationGoals & Challenges for Outpatient Quality Directors. Quality HealthCare Consulting, LLC CEO: Jennifer O'Donnell, MHA, PCMH-CCE
Goals & Challenges for Outpatient Quality Directors Quality HealthCare Consulting, LLC CEO: Jennifer O'Donnell, MHA, PCMH-CCE Objectives Learn a practical way for Quality Directors to align Quality Measures
More informationForces of Change- Seeing Stepping Stones Not Potholes
May 19, 2014 Forces of Change- Seeing Stepping Stones Not Potholes 2 3 4 Overview Demographics Long Term Care Financing Challenges Broad Health System Challenges Payment Reform Delivery System Reform Where
More informationLeadingAge Ohio. Achieving Alignment Between Hospitals & Post Acute Providers
LeadingAge Ohio Achieving Alignment Between Hospitals & Post Acute Providers Renee Cummings CEO, Access Companies Bryce Henson VP of Value Based Care www.accesselite.com Janine Stackhouse, BA LNHA Associate
More informationSWING BED (SWB) Rural Hospitals under 100 Beds and Critical Access Hospitals
SWING BED (SWB) Rural Hospitals under 100 Beds and Critical Access Hospitals Federal Regulations Hospitals under 100 Beds Critical Access Hospitals CMS State Operations Manual Appendix T Regulations and
More informationShifting from Volume to Value-based Healthcare. November 2014 Briefing
Shifting from Volume to Value-based Healthcare November 2014 Briefing The Healthcare Collaborative of Greater Columbus is a non-profit, public-private partnership. We serve as a catalyst, convener, and
More informationJune 18, 2009 Page 1
Base Year Current LOC base rates calculated using: Wyoming Medicaid inpatient hospital claims data from July 1, 1994 through December 31, 1996 Most recently audited Medicare cost report with provider fiscal
More informationPatient-Centered Primary Care
Patient-Centered Primary Care Greg Moody, Director Office of Health Transformation July 30, 2014 www.healthtransformation.ohio.gov Agenda 1. Health System Challenges 2. Health System Trends in Primary
More informationA 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 informationAlternative 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 informationPayment and Delivery System Reform in Vermont: 2016 and Beyond
Payment and Delivery System Reform in Vermont: 2016 and Beyond Richard Slusky, Director of Reform Green Mountain Care Board Presentation to GMCB August 13, 2015 Transition Year 2016 1. Medicare Waiver
More informationBuilding 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 informationSucceeding 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 informationSucceeding 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 information9/10/2016. What is a Cycle? Learning Objectives
Keep the Cycle Going: Maintaining a Healthy Long Term Care Revenue Cycle and Key Strategies for Successful Reimbursement Management September 29, 2016 What is a Cycle? By law of periodical repetition,
More informationSample Exam Case Studies/Questions
Module II of the CHFP Program: HFMA's Operational Excellence exam Sample Exam Case Studies/Questions The intent of the Operational Excellence exam is for you to exhibit your mastery of the information
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 informationReforming 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 informationPrimary Care 101: A Glossary for Prevention Practitioners
PREVENTION COLLABORATION IN ACTION Engaging the Right Partners Primary Care 101: A Glossary for Prevention Practitioners As the U.S. healthcare landscape continues to change under the Affordable Care Act
More informationHealth Care Evolution
Health Care Evolution Patient-Centered Medical Home to Clinical Integration & Accountable Care Ken Bertka, MD bertka@mindspring.com 419-346-8719 Agenda Top 3 Challenges of Health Care Reform PCMH & ACO
More informationCritical Access Hospital Quality
Critical Access Hospital Quality Current Performance and the Development of Relevant Measures Ira Moscovice, PhD Mayo Professor & Head Division of Health Policy & Management School of Public Health, University
More informationTransitioning 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 informationMassHealth 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 informationSNC BRIEF. Safety Net Clinics of Greater Kansas City EXECUTIVE SUMMARY CHALLENGES FACING SAFETY NET PROVIDERS TOP ISSUES:
EXECUTIVE SUMMARY The Safety Net is a collection of health care providers and institutes that serve the uninsured and underinsured. Safety Net providers come in a variety of forms, including free health
More informationmbudsman Annual Report of the State Long-Term Care Ombudsman of Ohio FFY 2016 Expect Excellence in Your Care
Annual Report of the State Long-Term Care Ombudsman of Ohio FFY 2016 mbudsman Expect Excellence in Your Care BEVERLEY L. LAUBERT, Ohio s State Long-Term Care Ombudsman Message from the State Long-Term
More informationWhat Have we Learned from the Pioneer ACO Model?
What Have we Learned from the Pioneer ACO Model? Sherly Binu, CMMI December 7, 2016 Disclaimers 2 This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose
More informationEarly Insights From Ohio s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
Early Insights From Ohio s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries Molly O Malley Watts Ohio was the third state to launch a 3-year capitated financial alignment
More informationPolicy Does Matter: Continued Progress in Providing Long-Term Services and Supports for Ohio s Older Population
Policy Does Matter: Continued Progress in Providing Long-Term Services and Supports for Ohio s Older Population SHAHLA MEHDIZADEH, MATT NELSON, ROBERT APPLEBAUM, JANE K. STRAKER Scripps Gerontology Center
More informationChallenges and Opportunities for Improving Health and Healthcare in Ohio through Technology
Challenges and Opportunities for Improving Health and Healthcare in Ohio through Technology Ohio Health IT Advocacy Day Craig Brammer, CEO cbrammer@healthbridge.org @CraigABrammer Challenge #1: Information
More informationAssignment of Medicare Fee-for-Service Beneficiaries
February 6, 2015 Ms. Marilyn B. Tavenner, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1461-P Room 445-G, Hubert H. Humphrey Building 200
More informationAHCA NURSING HOME PROSPECTIVE PAYMENT SYSTEM STUDY
AHCA NURSING HOME PROSPECTIVE PAYMENT SYSTEM STUDY PUBLIC HEARING JUNE 30, 2016 1:00 P.M. 4:00 P.M. 1 AGENDA Welcome Project Overview Stakeholder Engagement Payment Methodology Options Quality Incentive
More informationAccelerating the Impact of Performance Measures: Role of Core Measures
Accelerating the Impact of Performance Measures: Role of Core Measures Mark McClellan, MD, PhD Director, Engelberg Center for Health Care Reform Senior Fellow, Economic Studies Leonard D. Schaeffer Chair
More information4/17/2017. Executive Breakfast: An Update on the Ever Changing Health Care Reform Landscape. American Health Care Act. Megatrends of Change
Executive Breakfast: An Update on the Ever Changing Health Care Reform Landscape LeadingAge Indiana May 9, 2017 Investment advisory services are offered through CliftonLarsonAllen Wealth Advisors, LLC,
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 informationLessons from Medicaid Pay-for- Performance in Nursing Homes
Lessons from Medicaid Pay-for- Performance in Nursing Homes R. Tamara Konetzka, PhD Based on work with Rachel M. Werner, Daniel Polsky, Meghan Skira Funded by National Institute of Aging (R01 AG034182,
More informationExecutive, Legislative & Regulatory 2017 AGENDA. unitypoint.org
Executive, Legislative & Regulatory 2017 AGENDA unitypoint.org PRESIDENT S LETTER Dear Policy Makers and Community Stakeholders, 2017 presents many opportunities to meet needs, lower costs and continue
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 informationValue-Based Care Contracting and Legal Issues
Session 4b Value-Based Care Contracting and Legal Issues Presented by: Janet Walker Farrer General Counsel and Insurance Legal Department Chair Ascension Health Leah Stewart Associate Vice President for
More informationACOs: 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 informationWHITE PAPER. The Shift to Value-Based Care: 9 Steps to Readiness.
The Shift to Value-Based Care: Table of Contents Overview 1 Value Based Care Is it here to stay? 1 1. Determine your risk tolerance 2 2. Know your cost structure 3 3. Establish your care delivery network
More informationActivity Based Cost Accounting and Payment Bundling
Activity Based Cost Accounting and Payment Bundling 1 Agenda Introduction of Speakers Fast Facts about Jewish Senior Life/Jewish Home of Rochester Determining the need and uses for an Activity Based Cost
More informationKeeping Your Diabetes Education Program Stable In the Era Of Health Care Reform and Accountable Care Organizations
Keeping Your Diabetes Education Program Stable In the Era Of Health Care Reform and Accountable Care Organizations Nicole Downey, MBA, RD, CDE Program Director Diabetes Services The Polyclinic Seattle,
More informationCMS Bundled Payments Initiative
October 4, 2011 Practice Groups: Health Care Health Care Reform CMS Bundled Payments Initiative By Richard P. Church and Irene B. Nsiah The Patient Protection and Affordable Care Act ( PPACA ), Pub. Law
More informationAugust 25, Dear Ms. Verma:
Seema Verma Administrator Centers for Medicare & Medicaid Services Hubert H. Humphrey Building 200 Independence Avenue, S.W. Room 445-G Washington, DC 20201 CMS 1686 ANPRM, Medicare Program; Prospective
More informationHealth 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 informationWound Care Reimbursement. Things Are A-Changing!
Wound Care Reimbursement Things Are A-Changing! Kathleen D. Schaum, MS President Kathleen D. Schaum & Assoc., Inc. kathleendschaum@bellsouth.net 561-964-2470 Disclosure No relevant financial relationships
More informationAccountable Care Organizations: Process and Applications. Presentation to South Carolina Hospital Association CO CFO Forum.
Accountable Care Organizations: Lessons Learned from the ACO Process and Applications Presentation to South Carolina Hospital Association CO CFO Forum TheSea PinesResort Hilton Head, SC August 28, 2013
More informationNextGen Population Health TEN TEN TEN TEN TE. Prevent Patients from Falling Through the Cracks in 10 Easy Steps
NextGen Population Health TEN TEN TEN TEN TE Prevent Patients from Falling Through the Cracks in 10 Easy Steps Proactive, automated patient engagement anytime, anywhere. Automate care management to improve
More informationTen Tips for Accountable Care Success TEN TEN TEN TEN TE. Retooling for the Shifting Healthcare Landscape
Ten Tips for Accountable Care Success TEN TEN TEN TEN TE Retooling for the Shifting Healthcare Landscape That s right. It s time to retool. To prepare. Healthcare is changing and it s changing fast. A
More informationValue-Based Reimbursements are Here: Are you Ready?
Value-Based Reimbursements are Here: Are you Ready? White Paper ELLIS MAC KNIGHT, MD Senior Vice President/CMO Published by Becker s Hospital Review April 2016 White Paper Value-Based Reimbursements are
More informationQuality Outcomes and Data Collection
Quality Outcomes and Data Collection Presented By: Joanne Jones Director, Clinical Consulting Services August 30, 2016 Quality Measurement in LTC CMS Nursing Home Compare 5 Star Rating System New measures
More informationPhysician Leadership Training Meeting the CIO/ACO Healthcare Challenge
Physician Leadership Training Meeting the CIO/ACO Healthcare Challenge Brian E. Condit MD, MSHA Director, Physician Leadership Institute NMMC Tupelo (tertiary, 650 beds) 6 Community Hospitals 35 Clinics
More informationMedicaid Payment Reform at Scale: The New York State Roadmap
Medicaid Payment Reform at Scale: The New York State Roadmap ASTHO Technical Assistance Call June 22 nd 2015 Greg Allen Policy Director New York State Medicaid Overview Background and Brief History Delivery
More informationFinancial and Data Analytics to Support Risk Based Models of Care
Financial and Data Analytics to Support Risk Based Models of Care 2014 LEADING AGE OF MICHIGAN LEADERSHIP INSTITUTE Betsy Rust, CPA, Partner and Beth Sullivan, Senior Manager www.plantemoran.com 0 1 Session
More informationConnected 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 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 informationProposed CMMI Rural Shared Savings Demonstration Project: Frontier/Rural Community Care Organizations
Proposed CMMI Rural Shared Savings Demonstration Project: Frontier/Rural Community Care Organizations Executive Summary Rural networks across the nation have been working with rural providers to assist
More information