An Introduction to HealthInfoNet s HIE Reporting & Analytics. 6th Annual APS Healthcare Maine Conference May 14, 2015

Size: px
Start display at page:

Download "An Introduction to HealthInfoNet s HIE Reporting & Analytics. 6th Annual APS Healthcare Maine Conference May 14, 2015"

Transcription

1 An Introduction to HealthInfoNet s HIE Reporting & Analytics 6th Annual APS Healthcare Maine Conference May 14, 2015

2 Presentation Outline HealthInfoNet Background Current Status of health information exchange Serving Mental and Behavioral Communities HealthInfoNet Analytic and Reporting Services

3 How does it work? HealthInfoNet s system combines information from separate health care sites to create a single electronic patient health record. Patient health information is automatically uploaded from a provider s electronic medical record system. The information is standardized and aggregated across care sites. HealthInfoNet automates reporting of certain illnesses and conditions like Lyme disease or food poisoning, to public health experts at the Maine CDC.

4 What is in the system? Patient Identifier and Demographics Encounter History Laboratory and Microbiology Results Vital signs Radiology Reports Adverse Reactions/Allergies Medication History Diagnosis/Conditions/Problems (primary and secondary) Immunizations Dictated/Transcribed Documents Continuity of Care Documents (CCD)

5 HIE Connections 35 of 37 hospitals (all hospitals under contract) 38 FQHC sites 400+ ambulatory sites including physician practices behavioral health and long term care facilities

6 HIE Penetration Of Maine Health Care Delivery Market By Segment Statewide HIN Enrollment HIE Status Hospitals Primary Providers Onboarding Goal 2015 Beginning of 2015 All 37 bidirectional 32 bidirectional Specialists 8 practices No defined target BH Orgs FQHC 20 No defined target LTC HHA 935 FTEs 490 FTEs Percent of Total (Estimates) 86% 83% 22% 10% 63% 9%

7 HIE Population Statistics As of May 1, ,506,781 lives in the HealthInfoNet database (this includes 97% of Maine s resident population) 198,173 Non-Maine residents have clinical data in the exchange 17,319 individuals have opted out (1.14%) 2,709 Maine clinicians and support staff are active users of the exchange 55% of active users accessed the exchange in April, 2015

8 Most recent HIE Usage Stats 8

9 Serving Mental & Behavioral Health Care Coordination 2011 change in Maine State law enabling licensed Maine mental health providers/organizations to exchange clinical data with HIN Maine s Opt In consent management process Initial pilot efforts with connecting mental/behavioral health providers to the statewide exchange States Innovation Models (SIM Grant) and bidirectional connection of mental/behavioral health providers 9

10 Reporting & Analytics Next generation of HIE Available to HIE bi-directional (sharing data) clients. Helps providers drive quality and cost improvements, manage risk and population health, and inform operational decision making. Uses real-time clinical data from the HIE to make a series of predictions. Offered in partnership with HBI Solutions (www.hbisolutions.com)

11 Benefits: Improved Quality Better target care for patients with chronic disease to prevent complications and hospitalizations. Identify your patients most at risk for future utilization and help them avoid unnecessary ER and hospital visits, tests and procedures. Use real time data to identify quality measure gaps to put performance improvement plans in place quicker.

12 Benefits: Lower Costs Determine if market share targets for key service lines are met. Better identify services lines that are not hitting key performance measures. Prevent unnecessary visits for high cost and repeat services. Lower out of pocket costs for patients Avoid penalties for readmissions and repeat tests and procedures. Identify and reduce higher than expected hospital lengths of stay.

13 Reporting and Analytics Modules Hospital Performance: Compare actual to target performance for key performance indicators (KPI) using case mix and severity adjusted targets, including statewide norms. Volume and Market Share: Track and trend volumes and market share by service area, disease, payer and patient demographics. Population Risk: Identify populations and individuals most at risk for future high costs, inpatient admissions, and emergency room visits. 30-Day Readmission Risk: Identify inpatient encounters most at risk for 30-day readmissions. Variation Management: Understand resource variation by disease and cost category (length of stay, laboratory, radiology, etc...) to reduce unnecessary practice variation.

14 Analytic Platform: Solution Road Map Available Today Population health application o Utilization monitoring and trending o Disease prevalence o Risk of emergency visit, risk of inpatient admission, cost risk o Risk of diabetes, stroke, and AMI o Risk of 30 day readmission, risk of 30 day ED return Variation management application Performance benchmarking application Market share and patient origin application Available in the Future Natural language processing data integration Claims data analysis Medicaid population New risk models - mortality, CHF, Coronary Artery Disease, COPD

15 Live Demonstration 15

16 Feedback from Users The greatest barrier to managing patients at high risk for readmission is identifying them quickly. It s easy to capture the patients that we know need a lot of help. My goal was to reach those patients that are doing OK but might be getting into trouble. Nurse care managers are a limited resource and we have to use our time wisely. Using HealthInfoNet s analytics tool, I can focus my time on the patients most at risk. Jessica Taylor, RN, St. Joseph Healthcare In today s health care market, everyone is working hard to reduce costs. Historically making cost predictions based on risk meant turning to outdated claims data. HealthInfoNet s analytics tool couples 837 claims data with real-time clinical data. This allows us to negotiate with payers, using data more current that what they re using. William Wood, MD, St. Joseph Healthcare

17 Analytic Platform: Current Adoption General Acute Care Hospitals Budgeting and volume forecasting Throughput management - high risk ED patients / over utilizers 30-day readmission management ACO Pioneer CMS, State Employees, Commercial Population management risk stratification and proactive care management Medical Group with Insurance Product Population management risk stratification and proactive care management

18 Early Assessment of Impact Subjective Findings Analytic findings are believable Outperforms existing manual risk assessment tools Risk trending over set time frames very powerful Near real time data access fills huge patient management needs Clinical and encounter data can generate reliable predictive analytics Empirical Findings (now in process) Impact on resource consumption (ED Visits, Inpatient Admissions, Readmissions Clinical Performance (decline in population risk)

19 Discussion/Questions Devore Culver Executive Director & CEO, HealthInfoNet

HealthInfoNet s Clinical Portal Supports PCMH Goals

HealthInfoNet s Clinical Portal Supports PCMH Goals HealthInfoNet s Clinical Portal Supports PCMH Goals Sharon Bearor, RN, BSN, Clinical Program Coordinator Katie Sendze, MBA, Program Director Trudy Iams, RN, Lead Nurse/Care Coordinator, Franklin Health

More information

Empowering Value-Based Healthcare

Empowering Value-Based Healthcare Empowering Value-Based Healthcare Episode Connect, Remedy s proprietary suite of software applications, is a powerful platform for managing value-based payment programs. Delivered via the web or mobile

More information

Population Health Solutions for Employers MEDIA RESOURCES

Population Health Solutions for Employers MEDIA RESOURCES Population Health Solutions for Employers MEDIA RESOURCES ABOUT MISSIONPOINT MissionPoint s mission is to make healthcare more affordable, accessible and improve the quality of care for our members. MissionPoint

More information

Health Home Performance Enhancement through Novel Reuse of Syndromic Surveillance Data

Health Home Performance Enhancement through Novel Reuse of Syndromic Surveillance Data Health Home Performance Enhancement through Novel Reuse of Syndromic Surveillance Data Category: Fast Track Solutions Contact: Tim Robyn Chief Information Officer Office of Administration Information Technology

More information

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company?

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures

More information

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015 What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures

More information

The Value Quadrant of Healthcare Reform. 2008 Pharos Innovations, LLC. All Rights Reserved.

The Value Quadrant of Healthcare Reform. 2008 Pharos Innovations, LLC. All Rights Reserved. The Value Quadrant of Healthcare Reform ACOs in PPACA Provider Organizations or networked groups Accountable for quality, cost and overall care of defined population of Medicare FFS benes Key metrics to

More information

E. Christopher Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences

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

More information

ACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT

ACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT ACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT Accountable Care Analytics: Developing a Trusted 360 Degree View of the Patient Introduction Recent federal regulations have

More information

Empowering Value-Based Healthcare

Empowering Value-Based Healthcare Empowering Value-Based Healthcare Episode Connect, Remedy s proprietary suite of software applications, is a powerful platform for managing value based payment programs. Delivered via the web or mobile

More information

A. John Blair, III, MD, CEO MedAllies Susan Stuard, Executive Director THINC, Inc.

A. John Blair, III, MD, CEO MedAllies Susan Stuard, Executive Director THINC, Inc. ACO Accelerated Development Learning Session Baltimore, MD September 15-16, 2011 Learning Module 3: HIT and Connecting Providers A. John Blair, III, MD, CEO MedAllies Susan Stuard, Executive Director THINC,

More information

The Promise of Regional Data Aggregation

The Promise of Regional Data Aggregation The Promise of Regional Data Aggregation Lessons Learned by the Robert Wood Johnson Foundation s National Program Office for Aligning Forces for Quality 1 Background Measuring and reporting the quality

More information

Using EHRs, HIE, & Data Analytics to Support Accountable Care. Jonathan Shoemaker June 2014

Using EHRs, HIE, & Data Analytics to Support Accountable Care. Jonathan Shoemaker June 2014 Using EHRs, HIE, & Data Analytics to Support Accountable Care Jonathan Shoemaker June 2014 Agenda Allina Health overview ACO framework- setting the stage Health Information Technology and ACOs Role of

More information

Health Information Exchange in Minnesota & North Dakota

Health Information Exchange in Minnesota & North Dakota Health Information Exchange in Minnesota & North Dakota April 16, 2014 Objectives Learn basic HIE concepts Understand key success factors for HIE Gain an understanding of Minnesota and North Dakota s approach

More information

Introduction to the GLPTN Program. Provider Office & Physician Organization Briefing

Introduction to the GLPTN Program. Provider Office & Physician Organization Briefing Introduction to the GLPTN Program Provider Office & Physician Organization Briefing What is the GLPTN? The GLPTN is one of 29 Practice Transformation Networks (PTNs) funded under the brand new CMS Transforming

More information

Disease Management Identifications and Stratification Health Risk Assessment Level 1: Level 2: Level 3: Stratification

Disease Management Identifications and Stratification Health Risk Assessment Level 1: Level 2: Level 3: Stratification Disease Management UnitedHealthcare Disease Management (DM) programs are part of our innovative Care Management Program. Our Disease Management (DM) program is guided by the principles of the UnitedHealthcare

More information

The Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM. Sue Thompson Chief Executive Officer

The Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM. Sue Thompson Chief Executive Officer The Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM Sue Thompson Chief Executive Officer 2 UnityPoint Health: Organizational Profile 3 4 UnityPoint Health Fort Dodge: Organizational

More information

Dual RFI Response Summary

Dual RFI Response Summary Dual RFI Response Summary Improving Care through Integrated Medicare and Medi- Cal Delivery Models Stuart Levine, MD., MHA. Keith Wilson, MD Robert Margolis, MD. Stakeholder Meeting August 30, 2011 1 Organization

More information

HealthCare Partners of Nevada. Heart Failure

HealthCare Partners of Nevada. Heart Failure HealthCare Partners of Nevada Heart Failure Disease Management Program 2010 HF DISEASE MANAGEMENT PROGRAM The HealthCare Partners of Nevada (HCPNV) offers a Disease Management program for members with

More information

INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS. Karen Unholz, RN, BSN

INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS. Karen Unholz, RN, BSN INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS Karen Unholz, RN, BSN Origins of the Accountable Care Organization ACOs originated from the Patient Protection and Affordable Care Act (Healthcare Reform)

More information

Accountable Care Fundamentals for Medical Practice Executives

Accountable Care Fundamentals for Medical Practice Executives Accountable Care Fundamentals for Medical Practice Executives Nathan Anspach, FACMPE Senior Vice President and Chief Executive Officer John C. Lincoln Accountable Care Organization and John C. Lincoln

More information

Table 1 Performance Measures. Quality Monitoring P4P Yr1 Yr2 Yr3. Specification Source. # Category Performance Measure

Table 1 Performance Measures. Quality Monitoring P4P Yr1 Yr2 Yr3. Specification Source. # Category Performance Measure Table 1 Performance Measures # Category Performance Measure 1 Behavioral Health Risk Assessment and Follow-up 1) Behavioral Screening/ Assessment within 60 days of enrollment New Enrollees who completed

More information

CMS Innovation Center Improving Care for Complex Patients

CMS Innovation Center Improving Care for Complex Patients CMS Innovation Center Improving Care for Complex Patients ECRI Institute Dr. Patrick Conway, M.D., MSc CMS Chief Medical Officer and Deputy Administrator for Innovation and Quality Director, Center for

More information

Anthony Rodgers Deputy Administrator Centers for Innovation and Strategic Planning

Anthony Rodgers Deputy Administrator Centers for Innovation and Strategic Planning Anthony Rodgers Deputy Administrator Centers for Innovation and Strategic Planning Importance of establishing the value proposition for EHR adoption in Medicaid Reengineering the Medicaid Health Information

More information

1a-b. Title: Clinical Decision Support Helps Memorial Healthcare System Achieve 97 Percent Compliance With Pediatric Asthma Core Quality Measures

1a-b. Title: Clinical Decision Support Helps Memorial Healthcare System Achieve 97 Percent Compliance With Pediatric Asthma Core Quality Measures 1a-b. Title: Clinical Decision Support Helps Memorial Healthcare System Achieve 97 Percent Compliance With Pediatric Asthma Core Quality Measures 2. Background Knowledge: Asthma is one of the most prevalent

More information

Note: This is an authorized excerpt from 57 Population Health Management Metrics. To download the entire report, go to

Note: This is an authorized excerpt from 57 Population Health Management Metrics. To download the entire report, go to Note: This is an authorized excerpt from 57 Population Health Management Metrics. To download the entire report, go to http://store.hin.com/product.asp?itemid=4817 or call 888-446-3530. 57 Population Health

More information

Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION

Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION At the end of this session, you will be able to: Identify ways RT skills can be utilized for

More information

Atrius Health ACO Initiative. Agenda

Atrius Health ACO Initiative. Agenda Atrius Health ACO Initiative November 9, 2012 Mark Yurkofsky MD Mark_yurkofsky@vmed.org 11/13/2012 1 Agenda Why the interest in the Pioneer ACO? What actually is Pioneer ACO anyway? What is Atrius Health?

More information

Game Changer at the Primary Care Practice Embedded Care Management. Ruth Clark, RN, BSN, MPA Integrated Health Partners October 30, 2012

Game Changer at the Primary Care Practice Embedded Care Management. Ruth Clark, RN, BSN, MPA Integrated Health Partners October 30, 2012 Game Changer at the Primary Care Practice Embedded Care Management Ruth Clark, RN, BSN, MPA Integrated Health Partners October 30, 2012 Objectives To describe the recent evolution of care management at

More information

ACO Project Overview and Key Elements. Presented to FSSA September 3, 2013. 2013 Franciscan Alliance, Inc.

ACO Project Overview and Key Elements. Presented to FSSA September 3, 2013. 2013 Franciscan Alliance, Inc. ACO Project Overview and Key Elements Presented to FSSA September 3, 2013 2013 Franciscan Alliance, Inc. Background of Presentation House Enrolled Act 1328 requires the Indiana Family and Social Services

More information

Imagining Seamless Information Flow: Bridging the HIE Gap and Making Care Coordination Reality AJ Peterson: GM, CareConnect Larry Seltzer: GM,

Imagining Seamless Information Flow: Bridging the HIE Gap and Making Care Coordination Reality AJ Peterson: GM, CareConnect Larry Seltzer: GM, Imagining Seamless Information Flow: Bridging the HIE Gap and Making Care Coordination Reality AJ Peterson: GM, CareConnect Larry Seltzer: GM, CareManager Jerry Dolezal: CIO, Optum BH-Pierce County Agenda

More information

A STRATIFIED APPROACH TO PATIENT SAFETY THROUGH HEALTH INFORMATION TECHNOLOGY

A STRATIFIED APPROACH TO PATIENT SAFETY THROUGH HEALTH INFORMATION TECHNOLOGY A STRATIFIED APPROACH TO PATIENT SAFETY THROUGH HEALTH INFORMATION TECHNOLOGY Table of Contents I. Introduction... 2 II. Background... 2 III. Patient Safety... 3 IV. A Comprehensive Approach to Reducing

More information

NYS Landscape. 9 RHIOs cover state. RHIOs will be interconnected by State Health Information Network of NY (SHIN-NY) - funded by state and CMS

NYS Landscape. 9 RHIOs cover state. RHIOs will be interconnected by State Health Information Network of NY (SHIN-NY) - funded by state and CMS NYS Landscape 9 RHIOs cover state RHIOs will be interconnected by State Health Information Network of NY (SHIN-NY) - funded by state and CMS SHIN-NY will enable each RHIO to access records of any other

More information

OBJECTIVES AGING POPULATION AGING POPULATION AGING IMPACT ON MEDICARE AGING POPULATION

OBJECTIVES AGING POPULATION AGING POPULATION AGING IMPACT ON MEDICARE AGING POPULATION OBJECTIVES Kimberly S. Hodge, PhDc, MSN, RN, ACNS-BC, CCRN- K Director, ACO Care Management & Clinical Nurse Specialist Franciscan ACO, Inc. Central Indiana Region Indianapolis, IN By the end of this session

More information

Home Health Care Today: Higher Acuity Level of Patients Highly skilled Professionals Costeffective Uses of Technology Innovative Care Techniques

Home Health Care Today: Higher Acuity Level of Patients Highly skilled Professionals Costeffective Uses of Technology Innovative Care Techniques Comprehensive EHR Infrastructure Across the Health Care System The goal of the Administration and the Department of Health and Human Services to achieve an infrastructure for interoperable electronic health

More information

Pediatricians Implement Office-based Care Management Guided by Meaningful and Actionable Population Health Management

Pediatricians Implement Office-based Care Management Guided by Meaningful and Actionable Population Health Management Pediatricians Implement Office-based Care Management Guided by Meaningful and Actionable Population Health Management Changing needs of technology and data for successful coordinated care transformation

More information

Proven Innovations in Primary Care Practice

Proven Innovations in Primary Care Practice Proven Innovations in Primary Care Practice October 14, 2014 The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2014 Society for Healthcare

More information

How Health Reform Will Affect Health Care Quality and the Delivery of Services

How Health Reform Will Affect Health Care Quality and the Delivery of Services Fact Sheet AARP Public Policy Institute How Health Reform Will Affect Health Care Quality and the Delivery of Services The recently enacted Affordable Care Act contains provisions to improve health care

More information

Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida

Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida Medicare Quality Management Program Overview Quality Improvement (QI) Overview At Coventry, we

More information

Enterprise Analytics Strategic Planning

Enterprise Analytics Strategic Planning Enterprise Analytics Strategic Planning June 5, 2013 1 "The first question a data driven organization needs to ask itself is not "what do we think?" but rather "what do we know? Big Data: The Management

More information

It Takes Two to ACO A Unique Management Partnership

It Takes Two to ACO A Unique Management Partnership AMGA 2014 Annual Conference, April 4, 2014 It Takes Two to ACO A Unique Management Partnership Scott Hayworth MD, President & CEO Mount Kisco Medical Group Alan Bernstein MD, Senior Medical Director Mount

More information

Be Careful What You Ask For A Predictive Model That Really Works

Be Careful What You Ask For A Predictive Model That Really Works Be Careful What You Ask For A Predictive Model That Really Works Rod Christensen, MD President, Allina Health Clinics Cheryl Hermann, RN, MBA Vice President, Clinic Operations & Patient Care Services Karen

More information

Health Information Exchange for Long-Term Care May 19,2011

Health Information Exchange for Long-Term Care May 19,2011 Health Information Exchange for Long-Term Care May 19,2011 Jim Younkin IT Director, Geisinger Health System Director, Keystone Health Information Exchange GEISINGER Facilities Care Team 2 Acute Care Hospitals

More information

Accountable Care Organizations and Behavioral Health. Indiana Council of Community Mental Health Centers October 11, 2012

Accountable Care Organizations and Behavioral Health. Indiana Council of Community Mental Health Centers October 11, 2012 Accountable Care Organizations and Behavioral Health Indiana Council of Community Mental Health Centers October 11, 2012 What is an ACO? An accountable care organization is a group of providers or suppliers

More information

Analytic-Driven Quality Keys Success in Risk-Based Contracts. Ross Gustafson, Vice President Allina Performance Resources, Health Catalyst

Analytic-Driven Quality Keys Success in Risk-Based Contracts. Ross Gustafson, Vice President Allina Performance Resources, Health Catalyst Analytic-Driven Quality Keys Success in Risk-Based Contracts March 2 nd, 2016 Ross Gustafson, Vice President Allina Performance Resources, Health Catalyst Brian Rice, Vice President Network/ACO Integration,

More information

Value-Based Programs. Blue Plans Improving Healthcare Quality and Affordability through Innovative Partnerships with Clinicians

Value-Based Programs. Blue Plans Improving Healthcare Quality and Affordability through Innovative Partnerships with Clinicians Value-Based Programs Blue Plans Improving Healthcare Quality and Affordability through Innovative Partnerships with Clinicians Issue: U.S. healthcare spending exceeds $2.8 trillion annually. 1 With studies

More information

Employee Population Health Management:

Employee Population Health Management: Employee Population Health Management: a stepping stone for accountable care Richard Boehler, MD, MBA, FACPE President and Chief Executive Officer St. Joseph Hospital, Nashua N.H. Learning to Manage Populations

More information

A Population Health Management Approach in the Home and Community-based Settings

A Population Health Management Approach in the Home and Community-based Settings A Population Health Management Approach in the Home and Community-based Settings Mark Emery Linda Schertzer Kyle Vice Charles Lagor Philips Home Monitoring Philips Healthcare 2 Executive Summary Philips

More information

Implementing a Patient Centered Medical Home and ACO to Improve Health Outcomes and Reduce Medicare Costs

Implementing a Patient Centered Medical Home and ACO to Improve Health Outcomes and Reduce Medicare Costs Implementing a Patient Centered Medical Home and ACO to Improve Health Outcomes and Reduce Medicare Costs Medicare Market Innovations Forum July 14, 2014 Donna Zimmerman Senior Vice President, Government

More information

Presented by: DV-NJ HIMSS Fall Event 10/22/2009. Colleen Woods, Chief Information Officer, State of NJ Department of Human Services

Presented by: DV-NJ HIMSS Fall Event 10/22/2009. Colleen Woods, Chief Information Officer, State of NJ Department of Human Services Overcoming the interoperability challenges between a health plan and a provider as payers have been reluctant to participate in traditional clinical exchanges DV-NJ HIMSS Fall Event 10/22/2009 Presented

More information

Program Description and FAQ s 2016 Medicare Shared Savings Program Year

Program Description and FAQ s 2016 Medicare Shared Savings Program Year and FAQ s 2016 Medicare Shared Savings Program Year Who is the National Rural Accountable Care Consortium? The National Rural Accountable Care Consortium was formed in 2013 to pool knowledge, patients,

More information

Innovations@Home. Home Health Initiatives Reduce Avoidable Readmissions by Leveraging Innovation

Innovations@Home. Home Health Initiatives Reduce Avoidable Readmissions by Leveraging Innovation How Does CMS Measure the Rate of Acute Care Hospitalization (ACH)? Until January 2013, CMS measured Acute Care Hospitalization (ACH) through the Outcomes Assessment and Information Set (OASIS) reporting

More information

ACCOUNTABLE CARE ORGANIZATION (ACO): SUPPLYING DATA AND ANALYTICS TO DRIVE CARE COORDINATION, ACCOUNTABILITY AND CONSUMER ENGAGEMENT

ACCOUNTABLE CARE ORGANIZATION (ACO): SUPPLYING DATA AND ANALYTICS TO DRIVE CARE COORDINATION, ACCOUNTABILITY AND CONSUMER ENGAGEMENT ACCOUNTABLE CARE ORGANIZATION (ACO): SUPPLYING DATA AND ANALYTICS TO DRIVE CARE COORDINATION, ACCOUNTABILITY AND CONSUMER ENGAGEMENT MESC 2013 STEPHEN B. WALKER, M.D. CHIEF MEDICAL OFFICER METRICS-DRIVEN

More information

Practice and Transformation Taskforce: CCIP. Design Group 3, Session 2: Technology Enablers & Monitoring Performance August 20 th, 2015

Practice and Transformation Taskforce: CCIP. Design Group 3, Session 2: Technology Enablers & Monitoring Performance August 20 th, 2015 Practice and Transformation Taskforce: CCIP Design Group 3, Session 2: Technology Enablers & Monitoring Performance August 20 th, 2015 1 Meeting Agenda Item 1. Meeting Objectives Allotted Time 5 min 2.

More information

Understanding Health Information Technology and Health Information Exchange

Understanding Health Information Technology and Health Information Exchange Understanding Health Information Technology and Health Information Exchange 1 What you will learn How the Connecticut (DSS) works About the benefits of health information exchange (HIE) Questions to ask

More information

1. Introduction - Nevada E-Health Survey

1. Introduction - Nevada E-Health Survey 1. Introduction - Nevada E-Health Survey Welcome to the Nevada E-Health Survey for health care professional providers and hospitals. The Office of Health Information Technology (OHIT) for the State of

More information

Decision Support & Business Intelligence. The Next Generation. Derek Morkel, CEO GAFFEY Healthcare

Decision Support & Business Intelligence. The Next Generation. Derek Morkel, CEO GAFFEY Healthcare Decision Support & Business Intelligence The Next Generation Derek Morkel, CEO GAFFEY Healthcare Measurement is the core of any process ---------------------------------------------------------------------------

More information

HEAL NY Phase 5 Health IT RGA Section 7.1: HEAL NY Phase 5 Health IT Candidate Use Cases Interoperable EHR Use Case for Medicaid

HEAL NY Phase 5 Health IT RGA Section 7.1: HEAL NY Phase 5 Health IT Candidate Use Cases Interoperable EHR Use Case for Medicaid HEAL NY Phase 5 Health IT RGA Section 7.1: HEAL NY Phase 5 Health IT Candidate Use Cases Interoperable EHR Use Case for Medicaid Interoperable Electronic Health Records (EHRs) Use Case for Medicaid (Medication

More information

CHAPTER 535 HEALTH HOMES. Background... 2. Policy... 2. 535.1 Member Eligibility and Enrollment... 2. 535.2 Health Home Required Functions...

CHAPTER 535 HEALTH HOMES. Background... 2. Policy... 2. 535.1 Member Eligibility and Enrollment... 2. 535.2 Health Home Required Functions... TABLE OF CONTENTS SECTION PAGE NUMBER Background... 2 Policy... 2 535.1 Member Eligibility and Enrollment... 2 535.2 Health Home Required Functions... 3 535.3 Health Home Coordination Role... 4 535.4 Health

More information

RE: Advancing Interoperability and Health Information Exchange

RE: Advancing Interoperability and Health Information Exchange April 21, 2013 Ms. Marilyn Tavenner Acting Administrator, Chief Operating Officer Centers for Medicare and Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, MD

More information

Frequently Asked Questions: Electronic Health Records (EHR) Incentive Payment Program

Frequently Asked Questions: Electronic Health Records (EHR) Incentive Payment Program 1. Where did the Electronic Health Records (EHR) Incentive Program originate? The American Recovery and Reinvestment Act (ARRA) was signed into law on February 17, 2009, and established a framework of

More information

ACO s as Private Label Insurance Products

ACO s as Private Label Insurance Products ACO s as Private Label Insurance Products Creating Value for Plan Sponsors Continuing Education: November 19, 2013 Clarence Williams Vice President Client Strategy Accountable Care Solutions Today s discussion

More information

Guide to Population Health Management

Guide to Population Health Management Guide to Population Health Management presented by the Healthcare Intelligence Network Note: This is an authorized excerpt from the Guide to Population Health Management. To download the entire guide,

More information

Program Description and FAQ s 2016 Medicare Shared Savings Program Year

Program Description and FAQ s 2016 Medicare Shared Savings Program Year and FAQ s 2016 Medicare Shared Savings Program Year Who is the National Rural ACO? The National Rural ACO was formed in 2013 to pool knowledge, patients, and resources so that independent community health

More information

2013 NYeC / HealtheConnections Spring Summit

2013 NYeC / HealtheConnections Spring Summit 2013 NYeC / HealtheConnections Spring Summit Rob Hack Executive Director 109 S. Warren Street Suite 500, State Tower Building Syracuse, NY 13202 315-671-2241 x100 rhack@healtheconnections.org Agenda Welcome

More information

Reducing Readmissions with Predictive Analytics

Reducing Readmissions with Predictive Analytics Reducing Readmissions with Predictive Analytics Conway Regional Health System uses analytics and the LACE Index from Medisolv s RAPID business intelligence software to identify patients poised for early

More information

Accountable Care Organizations and Shared Savings Programs (What are they and how do they differ)

Accountable Care Organizations and Shared Savings Programs (What are they and how do they differ) Accountable Care Organizations and Shared Savings Programs (What are they and how do they differ) Presentation to: House Health Care Committee January 30, 2015 Georgia Maheras, Esq. Director, Vermont Health

More information

Ann Hablitzel, RN, BSN, MBA Hospice Care of California

Ann Hablitzel, RN, BSN, MBA Hospice Care of California Ann Hablitzel, RN, BSN, MBA Hospice Care of California Objectives Describe the creations of new community based palliative care programs Identify criteria for admission Discuss philosophy and goals Analyze

More information

Realizing ACO Success with ICW Solutions

Realizing ACO Success with ICW Solutions Realizing ACO Success with ICW Solutions A Pathway to Collaborative Care Coordination and Care Management Decrease Healthcare Costs Improve Population Health Enhance Care for the Individual connect. manage.

More information

The Next Shiny Object: Understanding Accountable Care Organizations in the PCMH and Meaningful Use Context

The Next Shiny Object: Understanding Accountable Care Organizations in the PCMH and Meaningful Use Context The Next Shiny Object: Understanding Accountable Care Organizations in the PCMH and Meaningful Use Context 1 The Next Shiny Object: Understanding Accountable Care Organizations in the PCMH and Meaningful

More information

Bridging the Gap between Inpatient and Outpatient Worlds. MedPlus Solution Overview: Hospitals/IDNs

Bridging the Gap between Inpatient and Outpatient Worlds. MedPlus Solution Overview: Hospitals/IDNs Bridging the Gap between Inpatient and Outpatient Worlds MedPlus Solution Overview: Hospitals/IDNs Introduction As you look to develop your organization s health information technology (HIT) plans, selection

More information

Analytics: The Key Ingredient for the Success of ACOs

Analytics: The Key Ingredient for the Success of ACOs Analytics: The Key Ingredient for the Success of ACOs Author: Senthil Raja Velusamy Business Analyst Healthcare Center of Excellence Executive Summary Accountable Care Organizations (ACOs) are structured

More information

Supplemental Technical Information

Supplemental Technical Information An Introductory Analysis of Potentially Preventable Health Care Events in Minnesota Overview Supplemental Technical Information This document provides additional technical information on the 3M Health

More information

Big Data for the Small Practice Connectivity, Management and Exchange. OSMA Education Symposium April 1, 2016

Big Data for the Small Practice Connectivity, Management and Exchange. OSMA Education Symposium April 1, 2016 Big Data for the Small Practice Connectivity, Management and Exchange OSMA Education Symposium April 1, 2016 1 Big Data >> Describes the large volume of data both structured and unstructured that inundates

More information

Organizational and Financial Integration of Behavioral Health into Accountable Care Organizations

Organizational and Financial Integration of Behavioral Health into Accountable Care Organizations Organizational and Financial Integration of Behavioral Health into Accountable Care Organizations Aricca Van Citters, MS Valerie Lewis, PhD Karen Schoenherr, BA Stephen Bartels, MD, MS ACO adoption is

More information

Low-Hanging Fruit: Analytic Best Practices for Physician-Led ACOs

Low-Hanging Fruit: Analytic Best Practices for Physician-Led ACOs Low-Hanging Fruit: Analytic Best Practices for Physician-Led ACOs MY BACKGROUND Practicing General Internal Medicine Physician Hospitalist at Newton-Wellesley Hospital Researcher at Brigham and Women s

More information

Medicare Physician Reporting: Beyond PQRS. Mary Patton Wheatley Senior Specialist, AAMC August 17, 2011

Medicare Physician Reporting: Beyond PQRS. Mary Patton Wheatley Senior Specialist, AAMC August 17, 2011 Medicare Physician Reporting: Beyond PQRS Mary Patton Wheatley Senior Specialist, AAMC August 17, 2011 Who is the AAMC? The Association of American Medical Colleges (AAMC) serves and leads the academic

More information

Healthcare s Transformation Journey

Healthcare s Transformation Journey Healthcare s Transformation Journey Susan DeVore, president and CEO, Premier, Inc. November 21, 2014 2 Premier, Inc. Our Mission: To improve the health of communities. Uniting approximately 3,400 hospitals

More information

Patient Centered Health Home and Data Analytics. Amanda Stangis, Director of Programs, CPCA Andrew Principe, VP Strategy, Arcadia Solutions

Patient Centered Health Home and Data Analytics. Amanda Stangis, Director of Programs, CPCA Andrew Principe, VP Strategy, Arcadia Solutions Patient Centered Health Home and Data Analytics Amanda Stangis, Director of Programs, CPCA Andrew Principe, VP Strategy, Arcadia Solutions Agenda What is a Health Home? What is the connection between Health

More information

HealthInfoNet s. A) Technology Related Questions: Date of call: February 7, 2014. Questions are grouped in these categories:

HealthInfoNet s. A) Technology Related Questions: Date of call: February 7, 2014. Questions are grouped in these categories: HealthInfoNet s Maine State Innovation Model Testing Model Grant Request for Proposals (RFP) for Behavioral Health Information Technology (HIT) Reimbursement Date of call: February 7, 2014 Questions are

More information

POPULATION HEALTH ANALYTICS

POPULATION HEALTH ANALYTICS POPULATION HEALTH ANALYTICS ANALYTICALLY-DRIVEN INSIGHTS FOR POPULATION HEALTH LAURIE ROSE, PRINCIPAL CONSULTANT HEALTH CARE GLOBAL PRACTICE DISCUSSION TOPICS Population Health: What & Why Now? Population

More information

Henry Ford Health System Care Coordination and Readmissions Update

Henry Ford Health System Care Coordination and Readmissions Update Henry Ford Health System Care Coordination and Readmissions Update September 2013 BACKGROUND Most hospital readmissions are viewed as avoidable, costly, and in some cases as a potential marker of poor

More information

I n t e r S y S t e m S W h I t e P a P e r F O R H E A L T H C A R E IT E X E C U T I V E S. In accountable care

I n t e r S y S t e m S W h I t e P a P e r F O R H E A L T H C A R E IT E X E C U T I V E S. In accountable care I n t e r S y S t e m S W h I t e P a P e r F O R H E A L T H C A R E IT E X E C U T I V E S The Role of healthcare InfoRmaTIcs In accountable care I n t e r S y S t e m S W h I t e P a P e r F OR H E

More information

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Epidemiology Over 145 million people ( nearly half the population) - suffer from asthma, depression and other chronic

More information

69 th Annual Meeting of the Southern Legislative Conference

69 th Annual Meeting of the Southern Legislative Conference 69 th Annual Meeting of the Southern Legislative Conference Medicaid Behavioral Health Homes Integrating Services- Overview and Implementation Advice Savannah, GA July 19, 2015 Michael S. Varadian, JD,

More information

CCNC Care Management

CCNC Care Management CCNC Care Management Community Care of North Carolina (CCNC) is a statewide population management and care coordination infrastructure founded on the primary care medical home model. CCNC incorporates

More information

DATA DRIVEN HEALTH CARE TRANSFORMATION

DATA DRIVEN HEALTH CARE TRANSFORMATION DATA DRIVEN HEALTH CARE TRANSFORMATION Population Health Analytics as the Foundation for Primary Care Redesign Sylvia Meltzer, MD, LSSGBC Laura Spurr, MPS, PMP Learning Objectives Organization description

More information

HEALTH CARE ANALYTIC SERVICES CONTRACT TRUVEN HEALTH ANALYTICS AND BRANDEIS UNIVERSITY

HEALTH CARE ANALYTIC SERVICES CONTRACT TRUVEN HEALTH ANALYTICS AND BRANDEIS UNIVERSITY HEALTH CARE ANALYTIC SERVICES CONTRACT TRUVEN HEALTH ANALYTICS AND BRANDEIS UNIVERSITY DECEMBER 2013 Healthcare Analytic Services Contract - Status Overview of the contract Current status Preliminary descriptive

More information

Wasteful spending in the U.S. health care. Strategies for Changing Members Behavior to Reduce Unnecessary Health Care Costs

Wasteful spending in the U.S. health care. Strategies for Changing Members Behavior to Reduce Unnecessary Health Care Costs Strategies for Changing Members Behavior to Reduce Unnecessary Health Care Costs by Christopher J. Mathews Wasteful spending in the U.S. health care system costs an estimated $750 billion to $1.2 trillion

More information

Analytics for ACOs Integrated patient views

Analytics for ACOs Integrated patient views Analytics for ACOs Integrated patient views What s at stake? Level-setting Overview The healthcare environment is changing and healthcare organizations have challenging decisions to make. With the dramatic

More information

Beacon User Stories Version 1.0

Beacon User Stories Version 1.0 Table of Contents 1. Introduction... 2 2. User Stories... 2 2.1 Update Clinical Data Repository and Disease Registry... 2 2.1.1 Beacon Context... 2 2.1.2 Actors... 2 2.1.3 Preconditions... 3 2.1.4 Story

More information

Accountable Care Organizations

Accountable Care Organizations Accountable Care Organizations Myth, Reality, Facts Why =System Failure Low Quality - IOM report High Cost Quality Cost disconnect Low Value Problems Disconnect between Quality and Cost Care is fragmented

More information

2.b.vii Implementing the INTERACT Project (Inpatient Transfer Avoidance Program for SNF)

2.b.vii Implementing the INTERACT Project (Inpatient Transfer Avoidance Program for SNF) 2.b.vii Implementing the INTERACT Project (Inpatient Transfer Avoidance Program for SNF) Project Objective: Skilled nursing facilities (SNFs) will implement the evidence based INTERACT program developed

More information

Modern care management

Modern care management The care management challenge Health plans and care providers spend billions of dollars annually on care management with the expectation of better utilization management and cost control. That expectation

More information

Health Information Exchange in NYS

Health Information Exchange in NYS Health Information Exchange in NYS Roy Gomes, RHIT, CHPS Implementation Project Manager 1 Who is NYeC? 2 Agenda NYeC Background Overview and programs Assist providers transitioning from paper to electronic

More information

Patient to Person. Transitions of Care. Colby Bearch, MA-SF, MA-M, BA, RN, CDONA Sharyn King, RN, BSN, CCM

Patient to Person. Transitions of Care. Colby Bearch, MA-SF, MA-M, BA, RN, CDONA Sharyn King, RN, BSN, CCM Patient to Person Transitions of Care Colby Bearch, MA-SF, MA-M, BA, RN, CDONA Sharyn King, RN, BSN, CCM Transitions of Care Transitioning from school to adult services (vocational, medical day, etc.)

More information

Combining Case and Care Management for Population Health

Combining Case and Care Management for Population Health Combining Case and Care Management for Population Health Raena C. Akin-Deko, MHSA Assistant Vice President for Product Development, NCQA Karen Handmaker, MPP VP Population Health Strategies, Phytel August

More information

Population Health Management Systems

Population Health Management Systems Population Health Management Systems What are they and how can they help public health? August 18, 1:00 p.m. 2:30 p.m. EDT Presented by the Public Health Informatics Working Group Webinar sponsored by

More information

HOW TO PREPARE FOR THE FUTURE COMPLEX CARE MANAGEMENT

HOW TO PREPARE FOR THE FUTURE COMPLEX CARE MANAGEMENT HOW TO PREPARE FOR THE FUTURE COMPLEX CARE MANAGEMENT #607 Friday, October 30, 2015 MARY NEWBERRY, MSN RN, DIRECTOR, HOME BASED & TRANSITIONAL CARE DEBORAH BRADLEY, MSN RN, MANAGER HOME HEALTH CARE BETH

More information

Adirondack Region Medical Home Pilot

Adirondack Region Medical Home Pilot Adirondack Region Medical Home Pilot John Rugge, M.D Adirondack Health Institute Patient-Centered Primary Care Collaborative February 10, 2011 Demographics Population ~ 200,000 Micropolitan (2)/Rural/Frontier

More information