Brief environmental scan Ti Triple AIM?...key elements Why the Plus One? How do we get there? What will be the advantage for us?
|
|
- Wilfrid McCormick
- 8 years ago
- Views:
Transcription
1 The Current Environment Requires Progress On All Four Simultaneously! Bruce Bagley, MD President and CEO TransforMED Brief environmental scan Ti Triple AIM?...key elements Why the Plus One? How do we get there? What will be the advantage for us? 2 1
2 The Problem 3 People/Organizations/Integration/Work Technology and Connectedness Patient Engagement and Self-management Support Payment Reform and Incentives Community Involvement in design and execution of new models of care Patient Centered Medical Home Medical Neighborhood Accountable Care Organizations 4 2
3 1. The current path of medical cost growth and societal expenditure is not sustainable 2. How providers are paid makes a difference 3. Fee for service payment is one of the root causes of the problem and most now realize it must go 4. Clinical, financial and information technology integration is essential for efficiency 5. Value based purchasing requires performance data on metrics for service, cost and clinical quality 6. Distribution of resources will mirror value contribution More emphasis on wellness and prevention The importance of the community of care Access redefined as addressing patient s needs when and where they have the need rather than a conversation about appointment availability Strategic distribution of the work (team care) Consolidation, integration and market forces for greater efficiency and effectiveness Many practices and systems are already successful in making transformational change 6 3
4 Health care providers will work together with a true team approach and a focus on the best results for patients They will work in organizations that provide the required infrastructure support for optimal outcomes for patients Integration, coordinated care and seamless transitions from one point of care to another will be the norm There needs to be a strategic distribution of the work 7 We must apply the great technology we already enjoy in our everyday lives to health care delivery Knowledge management, communication and information exchange Electronic health records Patient portals Community wide Health Information Exchange (HIE) with patients and e-visits Video visits Systems for tracking, care management and care coordination Registries (chronic illness care, high risk patients, preventive services etc.) 8 4
5 Gretchen Hoyle, MD, Twin City Pediatrics, Winston Salem, NC 9 Eliminate non-compliant patient from our vocabulary Patient/Family/Caregiver engagement g Patient Self-management Support Patient activation Motivational interviewing Health coaching Shared goal setting Informed Medical Decision Making Home monitoring and between visit contact Care coordination across the medical neighborhood Home care as needed 10 5
6 11 Better individual care Quality of care-clinical performance measures Satisfaction with the experience of care Better population health Defined population within the practice Ability to aggregate individuals for quality assessment Lower per capita cost of care Total cost of care on a PMPM basis Proxies such as ER utilization, bed days/1000, ALOS 12 6
7 The Happy Triple Aim Providers need support and systems to help them provide excellent care to individuals and populations They must feel that their work is helping patients and they are not doing things that matter less. Staff satisfaction Rewarding and meaningful work that is valued Sense of team and contribution by all Positive work environment 13 Quality of care delivered as measured by the available clinical performance measures (starting place) Systems, protocols, reminders, registries, home monitoring and between visit follow up are necessary to do this well (required processes and infrastructure) Care management and care coordination, ideally risk stratified by need and complexity (pro-active approach) Patient self-management support to assist them in managing chronic conditions in their daily lives 14 7
8 Service orientation to build patient trust and loyalty Patient/family and care giver engagement g in helping to manage chronic conditions Access, broadly defined as the ability for patients to get what they need, when they need it without barriers, waits and delays Input from patients to help define and redesign what great service looks like (patient advisory panels) Patient satisfaction surveys to identify opportunities for improvement 15 Population management of a sub-group of patients in the practice vs. the health of the community Required to assess the quality of care delivered d to that t sub-group of patients ( N of 1 vs. valid assessment of systems and approach) Allows evaluation of systems for performance and outcomes for patients Provides useful information for comparison data and identification of optimal performance (best practices) Requires processes and systems such as registries, out-reach, between visit follow up and active care management 16 8
9 Reduce waste by eliminating tests and treatments that add no benefit to patients or have no chance of improving the outcomes of their care Pro-active care management and care coordination in the medical neighborhood Conversations and service agreements among providers to build a shared sense of responsibility for service, cost and quality Alignment, simplification and integration of finances, clinical quality and information technology 17 Better individual health Clinical performance measures based on EBM (IHA) Satisfaction surveys, retention, loyalty Better population health Aggregate of clinical performance measures for the subgroup that defines the population Must have levels, trends and comparison data Lower per capita cost of care Total cost of care calculated on a PMPM basis 18 9
10 Better individual health Registries, protocols, reminders and pro-active outreach People and training to do patient engagement, selfmanagement support, care coordination etc. Better population health Disease registries, ability to analyze data in near real time Quality improvement strategy Comparison data and awareness of optimal performance Lower per capita costs Must have reliable cost data from payers for all care in the community (at least a valid sample) 19 Increasing quality and cost transparency will allow much better assessment of relative performance on the Triple Aim Even before you have all the numbers there are some systems that are known to work better for patients and should be installed Payers must begin to recognize and reward all aspects of the Triple Aim Your entire team will realize that the redesigned practice works better than the old way and that patients are getting better care and better service 20 10
11 Primary care infrastructure cannot be solely funded from visit based fee for service revenue Care management fees (transition strategy) Community wide support for IT and care coordination Global payments, bundled payments and capitation Resources must flow to the people and practices in relation to the value added for patients and measured by the progress on the Triple Aim 21 NCQA is useful but not sufficient Real organizational development required Leadership and decision making Systems thinking Metrics and improvement strategies built in Team approach to care Strategic distribution of the work Cost data needed down to the NPI Remove barriers to change 22 11
12 PCMH-Nothing less than an extreme make-over for primary care practices to make them: More Service Oriented for patients More Effective for better patient outcomes More Efficient for better profit More Fun to go to work for all 23 True team approach to care and change Quality measures and a culture of improvement Patient and family engagement with patient selfmanagement support Care management and care coordination IT enabled for the core business, clinical, education and communication functions 24 12
13 Practice and Payment Redesign in the CPC initiative Creating a Shared Sense of Responsibility for Service, Cost and Quality 26 13
14 Care Plan Home Care PCMH Mental Health Clinical Information Specialist Patient Hospital Facilitated Access Imaging Center Surgery Center Family and Caregiver Support Pharmacy 27 Shared responsibility for service, cost and quality Willingness to discuss process and interactions Efficient transfer of clinical information Multi-level accessibility Commit to a high level of service The patient is always the central focus 28 14
15 A three-year project funded by a CMS, Center for Medicare and Medicaid Innovation (CMMI) - Health Care Innovation Award (HCIA) Expands the Patient-Centered Medical Home to a Medical Neighborhood connecting Primary Care to: acute-care hospitals specialists community health resources increasingly assists patients manage their health proactively Avera Health, O'Neill, Neb. Charleston Area Medical Center, Charleston, W.Va. Columbus Regional, Columbus, Ind. Greater Baltimore Medical Center, Baltimore, Md. Huntsville Hospital, Huntsville, Ala. INTEGRIS Health, Oklahoma City, Okla. Marquette General Health, Marquette, Mich. Northeast Georgia Health System, Gainesville, Ga. North Mississippi Health Services, Tupelo, Miss. North Shore Physicians Group, Salem, Mass. Novant Health, Winston Salem, NC Ol Orlando Health, Orlando, Fla. Owensboro Medical Health System, Owensboro, Ky. Via Christi Health, Wichita, Kan. Western Connecticut Health Network, Danbury, Conn. **90 total primary care practices 15
16 Phytel offers Insight and Coordinate solutions for automating population health management delivering advanced care coordination, patient engagement, and quality-based analytical tools for PCMH-N. VHA Inc. is a network of not-for-profit hospitals that work together to improve their clinical and economic performance. VHA includes more than 1,400 not-for-profit hospitals and 25,500+ nonacute health care organizations. Provides consultation ti and 12 blueprints around PCMH-N leading practices. Cobalt Talon helps healthcare companies transform data into a strategic asset by providing high-performance analytic and data management products and services designed to solve the complex issues facing the industry. Reduce the Total Cost of Health Care for Medicare and Medicaid Beneficiaries by $49.5 Million Improve Health of Eligible Population Demonstrated by an Average of 15% with at least 3% Improvement in Each Selected Quality Measure A 25% Improvement in Patient Experience Demonstrate Ability to Scale to Additional Practices within Each Community 16
17 High needs/high cost patients require special attention Risk stratified care management and care coordination Care plan, registry, team approach, clinical integration Patient/family/care giver engagement and support The community footprint is real and requires leadership and comparison data to change Quality data Cost of care data, down to the NPI level Shared sense of responsibility for service, cost and quality New tools required Population health management and RSCM support Collaborative agreements or service contracts Development of a supportive community of care 33 If We Build It They Will Come Field of Dreams -Christine Bechtel National Partnership for Women and Families 34 17
18 For more information:
Medical Home in the Context of ACOs, Healthcare Reform and the New Payment Environment
Medical Home in the Context of ACOs, Healthcare Reform and the New Payment Environment Six Simple Rules For Successful Organizations In The New Payment Environment Bruce Bagley, M.D. Session Objectives
More informationAccountable 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 informationProven 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 informationPopulation Health Management Primer
Population Health Management Primer A White Paper October 2014 Impact Advisors LLC 400 E. Diehl Road Suite 190 Naperville IL 60563 1-800- 680-7570 Impact- Advisors.com Table of Contents What Is Population
More informationRon Stock MD MA Oregon Rural Health Conference October 24, 2013
Ron Stock MD MA Oregon Rural Health Conference October 24, 2013 Provide a historical context for healthcare reform including the 2010 Patient Protection & Accountable Care Act Connect what is known to
More informationACOs: Six Things Specialty Practices Should Know
ACOs: Six Things Specialty Practices Should Know =TOS Newsletter, July/August 2014= Authors: John P. Schmitt, Ph.D. and J. Garrett Schmitt, MBA, PCMH CCE INTRODUCTION Do you remember the analogy of four
More informationEnhanced Personal Health Care Program
Enhanced Personal Health Care Program Documents included in the Recruitment Packet: Program Summary FAQ Checklist List of Program Information Form Questions Member Medical History Plus (MMH+) access form
More information6/12/2015. Dignity Health Population Health Management and Compliance Programs. Moving Towards Accountable Care. Dignity Health Poised for Innovation
Dignity Health Population Health Management and Compliance Programs Julie Bietsch, VP Population Health Management Dawnese Kindelt, Senior Compliance Director, Clinical Integration June 8, 2015 Moving
More informationRE: Medicare Program; Request for Information Regarding Accountable Care Organizations and the Medicare Shared Saving Program
Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS 1345 NC P.O. Box 8013 Baltimore, MD 21244 8013 RE: Medicare Program; Request for Information Regarding Accountable
More informationAnalytic-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 informationIdaho Health Home State Plan Amendment Matrix: Summary Overview. Overview of Approved Health Home SPAs
Idaho Health Home State Plan Amendment Matrix: Summary Overview This matrix outlines key program design features from health home State Plan Amendments (SPAs) approved by the Centers for Medicare & Medicaid
More informationPatient Centered Medical Homes
Patient Centered Medical Homes Paul Kleeberg, MD, FAAFP, FHIMSS CMIO Stratis Health North Dakota e-health Summit November 20, 2013 REACH - Achieving - Achieving meaningful meaningful use of your use EHR
More informationPatient 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 informationHow 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 informationPopulation Health Management Helps Utica Park Clinic Ease the Transition to Value-Based Care
CASE STUDY Utica Park Clinic Population Health Management Helps Utica Park Clinic Ease the Transition to Value-Based Care The transition from fee-for-service to value-based reimbursement has been a challenge
More informationTerry McGeeney, MD MBA, President, CEO of TransforMED
Terry McGeeney, MD MBA, President, CEO of TransforMED Terry McGeeney, MD MBA, President, CEO of TransforMED According to the Future of Family Medicine Report: unless there are changes in the broader healthcare
More informationBest Practices and Lessons Learned about EHR Adoption. Anthony Rodgers Deputy Administrator, Center for Strategic Planning
Best Practices and Lessons Learned about EHR Adoption Anthony Rodgers Deputy Administrator, Center for Strategic Planning Presentation Topics Value proposition for EHR adoption Medicaid Strategic Health
More informationCPR-PBGH Toolkit for Purchasers on Accountable Care Organizations. June 26, 2014
CPR-PBGH Toolkit for Purchasers on Accountable Care Organizations June 26, 2014 Overview Introductions The Current ACO Landscape ACO Options Available to Employers Today Features of the Ideal ACO CPR-PBGH
More informationGuidelines for Patient-Centered Medical Home (PCMH) Recognition and Accreditation Programs. February 2011
American Academy of Family Physicians (AAFP) American Academy of Pediatrics (AAP) American College of Physicians (ACP) American Osteopathic Association (AOA) Guidelines for Patient-Centered Medical Home
More informationHealthPartners: Triple Aim Approach to ACO Development
HealthPartners: Triple Aim Approach to ACO Development Brian Rank, MD Medical Director, HealthPartners Medical Group October 27, 2010 HealthPartners Integrated Care and Financing System 10,300 employees
More informationPremier ACO Collaboratives Driving to a Patient-Centered Health System
Premier ACO Collaboratives Driving to a Patient-Centered Health System As a nation we all must work to rein in spiraling U.S. healthcare costs, expand access, promote wellness and improve the consistency
More informationE. 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 informationBeyond the EHR: What s Next?
Beyond the EHR: What s Next? Trudi Matthews Senior Policy Advisor Kentucky REC What s the Problem? U.S. health care system is the most expensive in the world and has mediocre health outcomes. Spending
More informationCase Studies Patient Centered Medical Home
Case Studies Patient Centered Medical Home A 360 Degree View of the Medical Home in Action Presented by: Jackie Hayes, RN Executive Director of Clinical Services WellStar Healthcare Systems Lora Baker
More informationA white paper. Collaborative Accountable Care. CIGNA s Approach to Accountable Care Organizations. 841282 a 11/11
A white paper Collaborative Accountable Care CIGNA s Approach to Accountable Care Organizations 841282 a 11/11 Transforming the Health Care System Successfully transforming the U.S. health care system
More informationRealizing 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 informationDRIVING VALUE IN HEALTHCARE: PERSPECTIVES FROM TWO ACO EXECUTIVES, PART I
DRIVING VALUE IN HEALTHCARE: PERSPECTIVES FROM TWO ACO EXECUTIVES, PART I A firm understanding of the key components and drivers of healthcare reform is increasingly important within the pharmaceutical,
More informationPhysician Discovery Services Provide a Full Range of Physician Practice Solutions
Physician Discovery Services OUR SOLUTION Truven Health Physician Discovery Services experts provide insights into a hospital or health system s physician enterprise. With experience in physician assessment,
More informationNuts and Bolts of. Frank G. Opelka, MD FACS American College of Surgeons. Vice Chancellor for Clinical Affairs Professor of Surgery LSU New Orleans
Nuts and Bolts of Accountable Care Organizations Frank G. Opelka, MD FACS American College of Surgeons ACS Advocacy & Health Policy, Vice Chancellor for Clinical Affairs Professor of Surgery LSU New Orleans
More informationPOPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk
POPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk Julia Andrieni, MD, FACP Vice President, Population Health and Primary
More informationMedical Homes- Understanding the Model Bob Perna, MBA, FACMPE WSMA Practice Resource Center
Bob Perna, MBA, FACMPE WSMA Practice Resource Center Bob Perna, MBA, FACMPE Senior Director, WSMA Practice Resource Center E-mail: rjp@wsma.org Phone: 206.441.9762 1.800.552.0612 2 Program Objectives:
More informationPopulation Health Management: Banner Health Network s Perspective. Neta Faynboym, Medical Director Banner Health Network
Population Health Management: Banner Health Network s Perspective Neta Faynboym, Medical Director Banner Health Network 29 Acute Care Hospitals BANNER AT A GLANCE Banner Health Network with 400K lives
More informationAccountable Care Organizations: An old idea with new potential. Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010
Accountable Care Organizations: An old idea with new potential Stephen E. Whitney, MD, MBA Testimony to Senate State Affairs September 22, 2010 Impetus for ACO Formation Increased health care cost From
More informationOhio s strategy to enroll primary care practices in the federal Comprehensive Primary Care Plus (CPC+) Program
Ohio s strategy to enroll primary care practices in the federal Comprehensive Primary Care Plus (CPC+) Program Greg Moody, Director Governor s Office of Health Transformation Webinar for Primary Care Practices
More informationCrosswalk: CMS Shared Savings Rules & NCQA ACO Accreditation Standards 12/1/2011
Crosswalk: CMS Shared Savings Rules & NCQA ACO Accreditation Standards 12/1/2011 The table below details areas where NCQA s ACO Accreditation standards overlap with the CMS Final Rule CMS Pioneer ACO CMS
More informationDevelopment of a Vermont Pilot Community Health System To Achieve the Triple Aims
Development of a Vermont Pilot Community Health System To Achieve the Triple Aims Webinar February 23, 2010 Jim Hester PhD Director Vermont Health Care Reform Commission Outline Context: Vermont Health
More informationApplying ACO Principles to a Pediatric Population UH Rainbow Care Connection: Transforming Pediatric Ambulatory Care with a Physician Extension Team
Applying ACO Principles to a Pediatric Population UH Rainbow Care Connection: Transforming Pediatric Ambulatory Care with a Physician Extension Team Ethan Chernin, MBA Director 1 Objectives Understand
More informationOHIO CONSUMERS FOR HEALTH COVERAGE POLICY PRIORITIES FY 2012-13. Medicaid Make Improvements to Improve Care and Lower Costs
OHIO CONSUMERS FOR HEALTH COVERAGE POLICY PRIORITIES FY 2012-13 Ohio Consumers for Health Coverage supports robust implementation of the Patient Protection and Affordable Care Act (ACA) in Ohio, making
More informationNew York Presbyterian Innovations in Health Care Reform at Academic Medical Centers
New York Presbyterian Innovations in Health Care Reform at Academic Medical Centers October 28, 2011 Timothy G Ferris, MD, MPH Mass General Physicians Organization, Medical Director Associate Professor,
More information1900 K St. NW Washington, DC 20006 c/o McKenna Long
1900 K St. NW Washington, DC 20006 c/o McKenna Long Centers for Medicare & Medicaid Services U. S. Department of Health and Human Services Attention CMS 1345 P P.O. Box 8013, Baltimore, MD 21244 8013 Re:
More informationMedical Home: Next Steps in the Neighborhood. David Kelley MD, MPH Chief Medical Officer Office of Medical Assistance Programs
Medical Home: Next Steps in the Neighborhood David Kelley MD, MPH Chief Medical Officer Office of Medical Assistance Programs Outline Pennsylvania s medical home initiatives RDPS Care Collaboration for
More informationDelivery System Innovation
Healthcare Transformation Concepts and Definitions Our healthcare transformation process is invigorated by many stakeholders with differing backgrounds. To help them with new terms and all of us to use
More informationAccountable Care Platform
The shift toward increased collaboration, outcome-based payment and new benefit design is transforming how we pay for health care and how health care is delivered. UnitedHealthcare is taking an industry
More informationESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION)
ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION) Hello and welcome. Thank you for taking part in this presentation entitled "Essentia Health as an ACO or Accountable Care Organization -- What
More informationRE: CMS 1461-P; Medicare Shared Savings Program: Accountable Care Organizations
221 MAIN STREET, SUITE 1500 SAN FRANCISCO, CA 94105 PBGH.ORG OFFICE 415.281.8660 FACSIMILE 415.520.0927 February 6, 2015 Marilyn Tavenner Administrator Centers for Medicare and Medicaid Services 7500 Security
More informationMichael J. Tronolone, MD, MMM, Chief Medical Officer Michelle Matin, MD, FAAFP Associate Medical Director for Quality The Polyclinic Seattle, WA
Succeed with Population Health Management in a Fee-for-Service Environment and Improve Clinical Quality Measures While Transitioning to Value- Based Care Michael J. Tronolone, MD, MMM, Chief Medical Officer
More informationPiloting an ACO: A Community Provider Network Which Achieves the Triple Aims
Piloting an ACO: A Community Provider Network Which Achieves the Triple Aims December 1, 2008 Jim Hester PhD Director VT Health Care Reform Commission Outline Pilot goals The context: Vermont Health care
More informationEarly Lessons learned from strong revenue cycle performers
Healthcare Informatics June 2012 Accountable Care Organizations Early Lessons learned from strong revenue cycle performers Healthcare Informatics Accountable Care Organizations Early Lessons learned from
More informationRELIANCE CONSULTING GROUP ACCOUNTABLE CARE ORGANIZATIONS: GETTING READY FOR ACO PARTICIPATION
RELIANCE CONSULTING GROUP ACCOUNTABLE CARE ORGANIZATIONS: GETTING READY FOR ACO PARTICIPATION Ohio MGMA State Conference 8-23-13 Presented by : John P. Schmitt, Ph.D. RCG Managing Director The healthcare
More informationPROVIDER ATTITUDES TOWARD VALUE-BASED PAYMENT MODELS
PROVIDER ATTITUDES TOWARD VALUE-BASED PAYMENT MODELS An Availity Research Study April, 2014 TABLE OF CONTENTS 1 Introduction 2 Definitions 3 Key Findings 5 Survey Results 6 Revenue sources and experience
More informationPopulation Health Management: Advancing Your Position in the Journey to Value-Based Care
Population Health Management: Advancing Your Position in the Journey to Value-Based Care Webcast Session One: An Integrated Approach to Population Health Management 11 August 2015 Welcome & Introductions
More informationPushing the Boundaries of Population Health Management: How University Hospitals Launched Three ACOs July 26, 2013 American Hospital Association
Pushing the Boundaries of Population Health Management: How University Hospitals Launched Three ACOs July 26, 2013 American Hospital Association Eric J. Bieber, M.D. Chief Medical Officer, University Hospitals
More informationHealth Literacy & Health Reform Opportunities and Challenges
Health Literacy & Health Reform Opportunities and Challenges Frank Funderburk Director, Division of Research Office of Communications Centers for Medicare & Medicaid Services November 10, 2010 CMS Perspective
More informationAccountable Care Organization Workgroup Glossary
Accountable Care Organization Workgroup Glossary Accountable care organization (ACO) a group of coordinated health care providers that care for all or some of the health care needs of a defined population.
More informationTACKLING POPULATION HEALTH MANAGEMENT with Worksite Wellness & Community Outreach
TACKLING POPULATION HEALTH MANAGEMENT with Worksite Wellness & Community Outreach APRIL 2015 THE PRESIDENT S MESSAGE Daniel T. Yunker Why do we need population health management in the health care delivery
More informationFederal Health Care Reform: Implications for Hospital and Physician partnerships. Walter Kopp Medical Management Services
Federal Health Care Reform: Implications for Hospital and Physician partnerships Walter Kopp Medical Management Services Outline Overview of federal health reform legislation Implications for Care delivery
More informationAutomating Population Health Management to Deliver Sustainable, High-Quality Care. Michael Matthews, CEO MedVirginia / inhealth
Automating Population Health Management to Deliver Sustainable, High-Quality Care Michael Matthews, CEO MedVirginia / inhealth Objectives Describe how to use technology to meet the challenges of population
More informationThe New Health Care Model. Axel Arroyo, MD MPH
The New Health Care Model Axel Arroyo, MD MPH Past Learning Objectives Which are the reasons behind these changes? To review the reasons of this transformation. To review Legislative initiatives (ARRA,
More informationPatient-Centered Medical Home and Meaningful Use
Health Home Series: Patient-Centered Medical Home and Meaningful Use Presenters: Christine Stroebel, MPH, PCIP/NYC REACH Natalie Fuentes, MPH, PCIP/NYC REACH Alan Silver, MD, MPH/IPRO March 27, 2012, 2:00
More informationImproving Quality And Bending the Cost Curve: Strategies That Work
Improving Quality And Bending the Cost Curve: Strategies That Work Lewis G. Sandy MD SVP, Clinical Advancement, UnitedHealth Group UnitedHealth Center for Health Reform and Modernization AcademyHealth
More informationMedicare Shared Savings Program (ASN) and the kidney Disease Prevention Project
December 3, 2010 Donald Berwick, MD Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Room 445-G, Hubert H. Humphrey Building 200 Independence Avenue, SW
More informationCommunity Health Centers and Health Reform: Issues and Ideas for States
Community Health Centers and Health Reform: Issues and Ideas for States Ann S. Torregrossa, Esq. Deputy Director & Director of Policy Governor s Office of Health Care Reform Commonwealth of Pennsylvania
More informationHow To Prepare For A Patient Care System
Preparing for Online Communication with Your Patients A Guide for Providers This easy-to-use, time-saving guide is designed to help medical practices and community clinics prepare for communicating with
More informationAnalytics 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 informationOur Patient-Centered Medical Home a Process, not a Click
Our Patient-Centered Medical Home a Process, not a Click Richard Johnston, M.D. President, Medical Clinic of North Texas, P.A. Medical Clinic of North Texas, P.A. MCNT Physician Owned Primary Care Medical
More informationWho are Parent Navigators?
Parent Navigators: A New Care Team Member in Your Medical Home or Specialty Practice Faculty Disclosure: We have no financial relationships to disclose relating to the subject matter of this presentation.
More informationPhysicians at Baptist Health System will
Clinical Integration and the Baptist Physician Alliance Physicians at Baptist Health System will soon have the opportunity to decide whether to participate in the development of a clinically integrated
More informationStrengthening Medicare: Better Health, Better Care, Lower Costs Efforts Will Save Nearly $120 Billion for Medicare Over Five Years.
Strengthening Medicare: Better Health, Better Care, Lower Costs Efforts Will Save Nearly $120 Billion for Medicare Over Five Years Introduction The Centers for Medicare and Medicaid Services (CMS) and
More informationMaineHealth ACO in. Context W 5
MaineHealth ACO in Who? Context W 5 What? Why? When? HoW? 1 Who? 2 The MaineHealth ACO is all of the MaineHealth member hospitals plus St. Mary s Regional Medical Center and all of the physicians in Community
More informationAppendix 2. PCMH 2014 and CMS Stage 2 Meaningful Use Requirements
Appendix 2 PCMH 2014 and CMS Stage 2 Meaningful Use Requirements Appendix 2 PCMH 2014 and CMS Stage 2 Meaningful Use Requirements 2-1 APPENDIX 2 PCMH 2014 AND CMS STAGE 2 MEANINGFUL USE REQUIREMENTS Medicare
More informationFinancial and Population Analytics for Accountable Care Organizations SEPTEMBER 20, 2012
Financial and Population Analytics for Accountable Care Organizations Valence Biographies Lori Fox Ward is Senior Vice President of Clinical Integration for Valence Health where her primary role involves
More informationCo-management (Service Line Agreement 2007)
Co-management (Service Line Agreement 2007) Orthopedics Neuroscience Cardiology Cardiovascular Surgery Collaboration on a different level Tactical method of increasing alignment and collaboration Agreement
More informationBest Practices and Strategies to Engage ACOs, Incentive Programs and Emerging Payment Models JUSTIN T. BARNES
Best Practices and Strategies to Engage ACOs, Incentive Programs and Emerging Payment Models JUSTIN T. BARNES CHAIRMAN EMERITUS, EHR ASSOCIATION CO-CHAIR, ACCOUNTABLE CARE COMMUNITY OF PRACTICE About Justin
More informationAssociate Chief Financial Officer Commonwealth Care Alliance Boston, MA
Associate Chief Financial Officer Commonwealth Care Alliance Boston, MA Position Specification July 2014 The Summary Commonwealth Care Alliance is seeking an Associate Chief Financial Officer (ACFO) for
More informationCMS Initiatives Involving Patient Experience Surveying FAQs
CMS Initiatives Involving Patient Experience Surveying FAQs Updated October 2013 Prepared by: DSS Research CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). The
More informationACOs: Impacting the Past, Present and Future State of Healthcare
ACOs: Impacting the Past, Present and Future State of Healthcare Article By Alan Cudney, RN, CPHQ, PMP, FACHE, Executive Consultant October 2012 What are Accountable Care Organizations? Can they help us
More informationElke Shaw-Tulloch, Administrator Division of Public Health Idaho Department of Health and Welfare
Elke Shaw-Tulloch, Administrator Division of Public Health Idaho Department of Health and Welfare IDAHO STATE HEALTHCARE INNOVATION PLAN HOW DID WE GET HERE? Idaho has been engaged in efforts to redesign
More informationOutcomes-based payment for population health management
Outcomes-based payment for population health management February 10, 2016 Introduction PURPOSE OF THIS PAPER Since July 2014, the Delaware Center for Health Innovation (DCHI) has been convening stakeholders
More informationMERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D.
MERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D. November, 2012 Accountable Care Organization An ACO is a group of health care providers who agree to take on a shared
More informationRe: Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations
February 6, 2015 Marilyn Tavenner, Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-1461-P P.O. Box 8013 Baltimore, Md. 21244-8013 Re: Medicare
More informationPatient Centered Medical Home: An Approach for the Health Plan
: An Approach for the Health Plan By Marissa A. Harper and JoAnn E. Balara Excellence in healthcare consulting The Medical Home Concept Works Recent Medicare demonstration projects on Patient Centered
More informationACCOUNTABLE 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 informationMontefiore s Population Health Management Services. October 23, 2015
Montefiore s Population Health Management Services October 23, 2015 Integrated Delivery System Our Locations 3,092 Acute Beds Across 10 Hospitals Including 132 beds at the Children s Hospital at Montefiore
More informationHOW CAN INFORMATION TECHNOLOGY HELP ADVANCE THE AIM OF VALUE BASED HEALTH CARE?
HOW CAN INFORMATION TECHNOLOGY HELP ADVANCE THE AIM OF VALUE BASED HEALTH CARE? James Whitfill, MD President Lumetis, LLC Chief Medical Officer, Scottsdale Health Partners University of Arizona-Phoenix
More informationAccountable Care Organizations: What Are They and Why Should I Care?
Accountable Care Organizations: What Are They and Why Should I Care? Adrienne Green, MD Associate Chief Medical Officer, UCSF Medical Center Ami Parekh, MD, JD Med. Director, Health System Innovation,
More informationAccountable Care Communities 101. Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014
Accountable Care Communities 101 Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014 Premier is the largest healthcare alliance in the U.S. Our Mission:
More informationAHLA. Q. Medicaid ACOs: Coming to a Neighborhood Near You. Clifford E. Barnes Epstein Becker & Green PC Washington, DC
AHLA Q. Medicaid ACOs: Coming to a Neighborhood Near You Clifford E. Barnes Epstein Becker & Green PC Washington, DC Jennifer E. Gladieux Senior Health Policy Analyst Health Policy Source, Inc. Alexandria,
More informationMedical Home Overview May 6, 2014 Noon-1:00pm EST
Medical Home Overview May 6, 2014 Noon-1:00pm EST Paul Klintworth, Medical Home Lead Office of the National Coordinator for IT U.S. Department of & Human Services Meaningful Use as a Building Block Office
More informationWellSpan Health Care Management Strategy. October, 2013
WellSpan Health Care Management Strategy October, 2013 We will realize a fundamental, yet gradual, shift in how we deliver and receive payment for care From: A system that treats people mostly when they
More informationThe Accountable Care Organization: An Introduction
January 2011 The Accountable Care Organization: An Introduction The healthcare reform discussion introduced new terms and ideas and reintroduced many concepts explored in the past: value-based healthcare,
More informationAnalytics Tools for Population Health Management. Arumani Manisundaram Director - Center for Connected Health Adventist HealthCare
Analytics Tools for Population Health Management Arumani Manisundaram Director - Center for Connected Health Adventist HealthCare About Our Organization(s) Adventist HealthCare Five acute-care and specialty
More informationACO 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 informationAdding Value to. Provider Compensation. June 13, 2016. Healthcare Strategy Group OHA Presentation 2016. Adding Value to. Physician Compensation
Provider Compensation June 13, 2016 1 Who are We? About (HSG) Hospital-physician integration specialists since 1999 Strategic, best practice approach to employed physician networks and independent physician
More informationPopulation health management:
3M Health Information Systems Population health management: A bridge between fee for service and value-based care Balancing multiple payment models Although 85 percent of healthcare reimbursement is currently
More informationValue-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 informationNuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations
Nuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations Presented to The American College of Cardiology October 27, 2012 1 Franciscan Alliance Overview Franciscan
More informationContinuity of Care Guide for Ambulatory Medical Practices
Continuity of Care Guide for Ambulatory Medical Practices www.himss.org t ra n sf o r m i ng he a lth c a re th rou g h IT TM Table of Contents Introduction 3 Roles and Responsibilities 4 List of work/responsibilities
More informationDecember 3, 2010 SUBMITTED ELECTRONICALLY
December 3, 2010 SUBMITTED ELECTRONICALLY Donald M. Berwick, MD, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Room 445 G Hubert H. Humphrey Building 200
More informationHFMA Region 9 Webinar Are You on the Right Path to Value?
HFMA Region 9 Webinar Are You on the Right Path to Value? March 21, 2016 P. Todd DeWeese, MBA Vice President The Affordable Care Act s Path to Payment Reform and Corresponding Impact on the Health Care
More informationSummary of the Final Medicaid Redesign Team (MRT) Report A Plan to Transform The Empire State s Medicaid Program
Summary of the Final Medicaid Redesign Team (MRT) Report A Plan to Transform The Empire State s Medicaid Program May 2012 This document summarizes the key points contained in the MRT final report, A Plan
More information