TTM Informer. Fourth Quarter Issue 1 WELCOME TO THE TTM INFORMER

Size: px
Start display at page:

Download "TTM Informer. Fourth Quarter 2012 - Issue 1 WELCOME TO THE TTM INFORMER"

Transcription

1 TTM Informer Fourth Quarter Issue 1 In This Issue: Provider Outreach within Accountable Care Organizations...1 What are Heathcare Leaders Saying?...2 PROVIDER OUTREACH WITHIN ACCOUNTABLE CARE ORGANIZATIONS Upcoming Events...3 Recent News...4 As the fog lifts over the landscape of healthcare reform, one thing is certain - the growth of future healthcare delivery will be through a more accountable care model. Accountable Care Organizations (ACOs) hold great promise of aligning the interests of healthcare payers, providers and patients through a more coordinated care delivery model with appropriately allied incentives. Some may compare the current ACO movement with the Health Maintenance Organization (HMO) model growth seen in the 1980s and 1990s. The comparison is somewhat unfair, to begin with HMO s were plagued by objections and confusion of patients regarding the HMOs role in patient care decisions, an overemphasis on cost control, and either a real or imagined loss of intimate control over care decisions by the primary care provider. Ultimately these and other concerns caused HMOs to back off from some of their earlier approaches and eventually fall out of favor. The major difference, which must be kept in the fore with the ACO model, is the proper alignment among healthcare providers to achieve quality and outcome targets that lead to financial success among all stakeholders, providers and ACO s alike. For such a model to be successful and not suffer the same fate of the HMO, continuous communication between ACO leadership and healthcare providers is paramount. An effective provider educational outreach strategy that is based on data, medical evidence and financial transparency is critical. (Continued on page 2) WELCOME TO THE TTM INFORMER It is our distinct pleasure to welcome you to the inaugural issue of the TTM Informer. As our healthcare landscape continues to evolve, it is our goal to keep our friends, partners and clients informed about the many changes that may impact their business. In addition, we look forward to sharing all the great things we have going on at TTM to help organizations best respond and thrive in this changing environment. We hope you enjoy this first issue that focuses on accountable care organizations and look forward to continued communications in the future. Barry Patel, Pharm.D. President and Co-Founder Fourth Quarter Issue 1 p. 1

2 What are Healthcare Leaders Saying? Steps to Effective Provider Educational Outreach Considering that each ACO will have their own challenges based on their specific structure and provider relationships, here are some general steps to overcome challenges and develop a successful provider outreach and education program Break down the barriers; work to understand the perceptions of your physician networks and how those may have affected education efforts in the past. Review current procedures being used for education within the organization. Some organizations use newsletters or stuff monthly billing checks with updates on research and studies. This approach may work for some, but measuring effectiveness and determining if the data even gets into the hands of providers is difficult at best. Target and segment your providers avoid adopting a one-size fits all approach to education. Some physicians need more intensive, face-toface outreach, some respond well to virtual programs, and some are already incorporating best practices and need only passive interventions. 4. Consider outsourcing as education is sometimes perceived better coming from an outside credible source, rather than the ACO leadership itself. To ensure you receive optimal value from new educational initiatives, be sure to incorporate analytics to measure and report results. Share the information with providers and among organizational leadership so that successful programs can be expanded and those not producing desired results altered. TTM Informer: How can primary care physicians thrive within an ACO system? Ernest Cook, MD: PCPs are faced with an increasing workload with diminishing reimbursements and since the ACO model is based on accountability that provides rewards for providing better care as opposed to providing more care. TTM Informer: Are PCPs open to this new focus on accountability and how should they be approached to discuss it? Ernest Cook, MD: PCPs respond very well to open discussions that are based on quality and outcomes, but details have to be clearly explained based on a foundation of better outcomes with the knowledge that tools and resources will be available to help them to support this goal. Ernest Cook, MD Florida Physicians Trust (ACO) There are certain inherent challenges to provider outreach that need to be considered when developing an effective strategy in this area: 1. ACOs need to communicate a large amount of information a. b. c. d. CHALLENGES TO PROVIDER EDUCATIONAL OUTREACH: ACO quality metrics being measured Current performance compared to benchmarks Clinical guidelines based on medical evidence Latest literature that supports clinical guidelines Financial incentives and contract related specifications e. Lack of time by busy providers Lack of buy-in by providers Shear amount of information being communicated to providers from sometimes competing sources Lack of efficient and convenient methods of communication by ACO leadership Fourth Quarter Issue 1 p. 2

3 Upcoming Events: October 3-5, 2012 Katie Stringer presenting at AMCP in Cincinnati on Working Together to Improve Patient Adherence to Antidepressant Medication through Physician Education Getting Started with Provider Engagement The first place to start is with the data. Analyze and understand your provider performance data. Educational strategies based upon specific areas of need will be more topical, timely and poignant. Educational content built on the foundation of medical evidence then bridged to impacts on quality measurements and cost is more effective and measurable than a more generic content. By conducting a thorough data analysis, an ACO can also target and tier their provider education audience. Based on the data, some providers may need intensive and continuous educational support whereas some may need more reaffirmation and maintenance education. Once target audiences have been identified and categorized, an effective educational platform that suits the ACO should be implemented based on several factors including budget, internal personnel to support education, geography needing to be covered and finally the timing. Education and engagement with providers is an ongoing process. Emphasis on continually evolving to meet the latest outcomes-based study findings, the needs of the organization, and the learning needs of providers will help maintain an effective initiative. Effectively managing the outreach, content and delivery of the quality initiatives will keep your program well-suited to your plan, your providers and most importantly, the continued quality outcomes for your patients. October 25, 2012 As the healthcare landscape continues to rapidly evolve, pharmacy and medical directors are increasingly challenged to demonstrate improvement in quality and outcomes to reap the rewards that come with these changes. TTM Complimentary Webinar Series: Part II, Medicare Part D Star Ratings Improvement, register at November 12-14, 2012 TTM to exhibit at HEDIS Measures and Quality Management Conference in Nashville Fourth Quarter Issue 1 p. 3

4 RECENT NEWS Total Therapeutic Management Introduces First Live Web-Based Academic Detailing Program iclin-engager offers a highly targeted, patientcentric approach to provider education while also accommodating busy clinicians schedules Kennesaw, GA -- July 19, 2012 As healthcare organizations struggle to find ways to engage providers in the use of more outcomes-focused data, Total Therapeutic Management (TTM) introduces iclin-engager, the nation s first virtual, interactive, peer-to-peer academic detailing program. TTM is a healthcare quality improvement company that has been providing one-on-one clinical education and outreach through academic detailing to clinicians since TTM physicians, nurses and pharmacists are using iclin-engager to disseminate clinical and quality information to healthcare providers in an interactive virtual environment via a live, web-based application. Sessions are scheduled when and where it is most convenient for the provider, ensuring higher levels of participation in educational initiatives. What really sets this virtual academic detailing program apart from typical provider education programs is that we can provide meaningful peer-reviewed best practice information and guidance down to the individual patient level, said Ed Perez, Pharm. D., CEO of TTM. Providers who have gone through the program are highly enthusiastic about the presentations and have noted that they will begin integrating the provider tools and patient tools into their practice to improve patient outcomes. Clinical and quality information can be customized based on specific conditions among a clinician s patient population, such as diabetes or heart disease. Reports can be presented that show providers how they can use this clinical and quality information immediately for their own patients. For example, the program can show providers which patients need certain tests or other follow-up care. Virtual academic detailing through iclin-engager TM provides a solution that meets the needs of clinicians in virtually every setting especially those in rural markets where over 25% of Americans receive their healthcare notes Barry Patel, Pharm.D, president of TTM. We are continuing to lead the way in physician education and engagement by embracing technology to create solutions for health systems that need better ways to engage and educate busy providers in these rural settings. This feature ensures providers have access to the most recent, and relevant data, and helps health plans seeking to improve quality and outcomes among individual patients as well as within targeted populations. The program also helps organizations to improve quality indicators such as Healthcare Effectiveness Data and Information Set (HEDIS ), and Medicare Star ratings. iclin-engager is being offered to health plans and other organizations seeking to share the kind of patient-specific data, as well as evidence-based, peer-reviewed research, that will better inform and engage providers in optimal patient management. Already several organizations, including a major national health plan completing a program mid-summer, have launched pilot programs using iclin-engager TM. Virtual academic detailing through iclin-engager TM provides a solution that meets the needs of clinicians in virtually every setting especially those in rural markets where over 25% of Americans receive their healthcare notes Barry Patel, Pharm.D, president of TTM. We are continuing to lead the way in physician education and engagement by embracing technology to create solutions for health systems that need better ways to engage and educate busy providers in these rural settings. Fourth Quarter Issue 1 p. 4

5 The benefits of virtual academic detailing education include: Lower costs compared with traditional live face-to-face academic detailing programs. Greater participation and engagement when done at a time and place that accommodates busy clinicians, such as before or after office hours. No geographic or time limitations programs scheduled when/where convenient for providers. Consistent delivery of content based on scripted messages. Customized data presentations specific to each clinician s patients. For additional information on iclin-engager, and to request a video demonstration, visit About TTM Based in Kennesaw, GA, Total Therapeutic Management (TTM) is a physician-focused quality improvement company that provides health information management, research and education support services to some of the nation s largest healthcare, pharmaceutical and research companies. TTM s services have helped ensure patients ultimately achieve treatment goals based on national guidelines for chronic conditions such as diabetes, hypertension and heart disease. Since 1995, healthcare organizations have relied on TTM to deliver clinical information that ultimately leads to better health outcomes. Fourth Quarter Issue 1 Contact TTM To learn more about TTM, please contact business development at , or at Utilizing our vast experience we will provide you with consultation related to your needs and help fit a solution that best fits your specific goals. General Inquires: Career Opportunity Inquires: Corporate Headquarters: 300 Townpark Drive Bldg 1, Suite 100 Kennesaw, GA Tel Fax Academic Detailing Operations Office: 386 Lawrence Street Marietta, GA Tel Fax p. 5

Embracing Accountable Care: 10 Key Steps

Embracing Accountable Care: 10 Key Steps Embracing Accountable Care: 10 Key Steps Sivakumar Nandiwada and Vijay Sylvestine Abstract For quite some time now, the U.S. healthcare market has been grappling with issues of spiraling costs and disparities

More information

Population 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 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 information

10 Key Concepts for Higher Sales into ACOs

10 Key Concepts for Higher Sales into ACOs By Michelle O Connor President and CEO By Michelle O Connor President and CEO CMR Institute Healthcare providers are under significant pressure from government payers, commercial health plans, and patients

More information

Engaging the Community: Involving Patients and their Providers in ACOs

Engaging the Community: Involving Patients and their Providers in ACOs Taconic Health Information Network and Community w w w. t h I n c. o r g Engaging the Community: Involving Patients and their Providers in ACOs THINC ACO Insights Program Webinar Three: September 27, 2011

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

Delivery System Innovation

Delivery 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 information

Pushing 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 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 information

Pharmaceutical Company Driven Disease Management in Medicare Part D: Opportunities and Threats

Pharmaceutical Company Driven Disease Management in Medicare Part D: Opportunities and Threats Pharmaceutical Company Driven Disease Management in Medicare Part D: Opportunities and Threats Barry Patel, Pharm.D. President and Co-Founder Total Therapeutic Management, Inc. Objectives Discuss the opportunities

More information

The Cornerstones of Accountable Care ACO

The Cornerstones of Accountable Care ACO The Cornerstones of Accountable Care Clinical Integration Care Coordination ACO Information Technology Financial Management The Accountable Care Organization is emerging as an important care delivery and

More information

The Impact Of Employer Contribution Policy On Premium Rate Setting. Group-Specific Experience: Financial And Utilization Performance

The Impact Of Employer Contribution Policy On Premium Rate Setting. Group-Specific Experience: Financial And Utilization Performance Premiums: HMO Premium Rate Calculations Setting Group Renewal Premium Rates The Impact Of Employer Contribution Policy On Premium Rate Setting Group-Specific Experience: Financial And Utilization Performance

More information

Capital District Physicians Health Plan, Inc. Nonprofit Health Plan Albany, New York

Capital District Physicians Health Plan, Inc. Nonprofit Health Plan Albany, New York Capital District Physicians Health Plan, Inc. Nonprofit Health Plan Albany, New York Capital District Physicians Health Plan, Inc. (CDPHP ) is featured as a high performer in cardiovascular care, identified

More information

Chapter 2. Developing a Marketing and Promotion Plan

Chapter 2. Developing a Marketing and Promotion Plan Chapter 2 Developing a Marketing and Promotion Plan 11 2. DEVELOPING A MARKETING AND PROMOTION PLAN In This Section This section covers how to lay the groundwork for implementing your approach to marketing

More information

DRIVING VALUE IN HEALTHCARE: PERSPECTIVES FROM TWO ACO EXECUTIVES, PART I

DRIVING 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 information

Accountable Care: Clinical Integration is the Foundation

Accountable Care: Clinical Integration is the Foundation Solutions for Value-Based Care Accountable Care: Clinical Integration is the Foundation Clinical Integration Care CoordinatioN ACO Information Technology Financial Management The Accountable Care Organization

More information

Population Health Management: Leveraging Data and Analytics to Achieve Value. White Paper. A Special Report

Population Health Management: Leveraging Data and Analytics to Achieve Value. White Paper. A Special Report Authors Carol Cassell CTG Health Solutions John Kontor, MD Clinovations Lisa Shah, MD, MAPP Clinovations Contributors Marla Roberts, DrPH, RN CTG Health Solutions Katie Stevenson Clinovations : Leveraging

More information

Introduction to Medication Management Systems, Inc. Comprehensive Medication Therapy Management Solutions

Introduction to Medication Management Systems, Inc. Comprehensive Medication Therapy Management Solutions Introduction to Medication Management Systems, Inc. Comprehensive Medication Therapy Management Solutions Vision Medication Management Systems, Inc. (MMS) envisions a health care system in which all patients

More information

Kaiser Permanente Southern California Depression Care Program

Kaiser Permanente Southern California Depression Care Program Kaiser Permanente Southern California Depression Care Program Abstract In 2001, Kaiser Permanente of Southern California (KPSC) adopted the IMPACT model of collaborative care for depression, developed

More information

HOW CARE MANAGEMENT EVOLVES WITH POPULATION MANAGEMENT

HOW CARE MANAGEMENT EVOLVES WITH POPULATION MANAGEMENT Reform and rising costs continue to push the importance of care management systems to the forefront. With the growing prominence of population health for provider organizations, provider-based care management

More information

Quality and Performance Improvement Program Description 2016

Quality and Performance Improvement Program Description 2016 Quality and Performance Improvement Program Description 2016 Introduction and Purpose Contra Costa Health Plan (CCHP) is a federally qualified, state licensed, county sponsored Health Maintenance Organization

More information

Second Annual Florida 2008 Electronic Prescribing Report

Second Annual Florida 2008 Electronic Prescribing Report Second Annual Florida 2008 Electronic Prescribing Report FLORIDA CENTER FOR HEALTH INFORMATION AND POLICY ANALYSIS AGENCY FOR HEALTH CARE ADMINISTRATION JANUARY 2009 Better Health Care for All Floridians

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

August 12, 2010. Dear Dr. Berwick:

August 12, 2010. Dear Dr. Berwick: Donald M. Berwick, MD Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services 200 Independence Avenue, SW Room 314G Washington, DC 20201 Dear Dr. Berwick: I am

More information

New Business and Investment Opportunities Emerging from Population Health Management (PHM)

New Business and Investment Opportunities Emerging from Population Health Management (PHM) Stax s Perspective on Changes Driven by PHM New Business and Investment Opportunities Emerging from Population Health Management (PHM) By Natalie De Fazio, Director, Stax Inc. November 2014 New Business

More information

Pediatric Alliance: A New Solution Built on Familiar Values. Empowering physicians with an innovative pediatric Accountable Care Organization

Pediatric Alliance: A New Solution Built on Familiar Values. Empowering physicians with an innovative pediatric Accountable Care Organization Pediatric Alliance: A New Solution Built on Familiar Values Empowering physicians with an innovative pediatric Accountable Care Organization BEYOND THE TRADITIONAL MODEL OF CARE Children s Health SM Pediatric

More information

THE ACCOUNTABLE CARE ORGANIZATION (ACO) TRAIN IS LEAVING THE STATION: ARE YOU ON BOARD?

THE ACCOUNTABLE CARE ORGANIZATION (ACO) TRAIN IS LEAVING THE STATION: ARE YOU ON BOARD? UNDER THE MICROSCOPE NOVEMBER 5, 2013 THE ACCOUNTABLE CARE ORGANIZATION (ACO) TRAIN IS LEAVING THE STATION: ARE YOU ON BOARD? ISSUE. A 2006 Institute of Medicine report ( Performance measurement: Accelerating

More information

Primary Care, ACOs, and Payment Reform

Primary Care, ACOs, and Payment Reform Primary Care, ACOs, and Payment Reform Mark McClellan, MD, PhD Director, Initiatives on Value and Innovation in Health Care Engelberg Center for Healthcare Reform Senior Fellow, Economic Studies The Brookings

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

A First Look at Attitudes Surrounding Telehealth:

A First Look at Attitudes Surrounding Telehealth: A First Look at Attitudes Surrounding Telehealth: Findings from a national survey taking a first look at attitudes, usage, and beliefs of family physicians in the U.S. towards telehealth. OVERVIEW Telehealth

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

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

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

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

MODULE 11: Developing Care Management Support

MODULE 11: Developing Care Management Support MODULE 11: Developing Care Management Support In this module, we will describe the essential role local care managers play in health care delivery improvement programs and review some of the tools and

More information

4 Trends Driving New Opportunities for Engaging Physicians in Organized Provider Systems

4 Trends Driving New Opportunities for Engaging Physicians in Organized Provider Systems Working the System 4 Trends Driving New Opportunities for Engaging Physicians in Organized Provider Systems Key findings from Capgemini Consulting and Quantia study (N=2,996) October 2014 page 2 of 9 Trend

More information

The Accountable Care Organization: An Introduction

The 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 information

Medicare Value Partners

Medicare Value Partners Medicare Value Partners Medicare Shared Savings ACO Program Frequently Asked Questions (FAQ) Q: What exactly is a Medicare Shared Savings Program ACO? A: Medicare Shared Savings Program accountable care

More information

c. determine the factors that will facilitate/limit physician utilization of pharmacists for medication management services.

c. determine the factors that will facilitate/limit physician utilization of pharmacists for medication management services. Consumer, Physician, and Payer Perspectives on Primary Care Medication Management Services with a Shared Resource Pharmacists Network Marie Smith, PharmD and Michlle Breland, PhD University of Connecticut,

More information

Early Lessons learned from strong revenue cycle performers

Early 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 information

Accountable Care Organizations: Good in Theory, Slow to Catch On

Accountable Care Organizations: Good in Theory, Slow to Catch On Accountable Care Organizations: Good in Theory, Slow to Catch On The phrase "accountable care organization" (ACO) was coined in 2006. But it didn't really start gaining currency until three years later

More information

A 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 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 information

Enhanced Personal Health Care Program

Enhanced 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 information

THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION. 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams

THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION. 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams Agenda Overview Impact of HIT on Patient-Centered Care (PCC)

More information

October 15, 2010. Re: National Health Care Quality Strategy and Plan. Dear Dr. Wilson,

October 15, 2010. Re: National Health Care Quality Strategy and Plan. Dear Dr. Wilson, October 15, 2010 Dr. Nancy Wilson, R.N., M.D., M.P.H. Senior Advisor to the Director Agency for Healthcare Research and Quality (AHRQ) 540 Gaither Road Room 3216 Rockville, MD 20850 Re: National Health

More information

Advancing Accountable Care

Advancing Accountable Care Advancing Accountable Care Sean McBride Project Manager, Engelberg Center for Health Care Reform; Project Manager, ACO Learning Network Agenda 2. 4. Overview of national ACO Implementation: growing private

More information

2015 ASHP STRATEGIC PLAN

2015 ASHP STRATEGIC PLAN 2015 ASHP STRATEGIC PLAN ASHP Vision ASHP s vision is that medication use will be optimal, safe, and effective for all people all of the time. ASHP Mission The mission of pharmacists is to help people

More information

MERCY-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. 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 information

The 4 Pillars of Clinical Integration: A Flexible Model for Hospital- Physician Collaboration

The 4 Pillars of Clinical Integration: A Flexible Model for Hospital- Physician Collaboration The 4 Pillars of Clinical Integration: A Flexible Model for Hospital- Physician Collaboration Written by Daniel J. Marino, President & CEO, Health Directions November 14, 2012 Originally published by Becker

More information

PROVIDER ATTITUDES TOWARD VALUE-BASED PAYMENT MODELS

PROVIDER 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 information

Will Your Accountable Care Organization Pilot Succeed? Predict Success with Just Four Numbers.

Will Your Accountable Care Organization Pilot Succeed? Predict Success with Just Four Numbers. White Paper Will Your Accountable Care Organization Pilot Succeed? Predict Success with Just Four Numbers. Bob Kelley Senior Vice President, Healthcare Analytics Truven Health Analytics SM February 2012

More information

Leveraging Technology to Power Transformation in Today's Healthcare Environment

Leveraging Technology to Power Transformation in Today's Healthcare Environment Leveraging Technology to Power Transformation in Today's Healthcare Environment Healthcare executives, staff and clinicians consistently say they are both surprised and impressed at how new technology

More information

Benefit Design and ACOs: How Will Private Employers and Health Plans Proceed?

Benefit Design and ACOs: How Will Private Employers and Health Plans Proceed? Benefit Design and ACOs: How Will Private Employers and Health Plans Proceed? Accountable Care Organizations: Implications for Consumers October 14, 2010 Washington, DC Sam Nussbaum, M.D. Executive Vice

More information

The Rising Tide of Pharmacy Benefit Cost and Complexity: A health plans roadmap to optimizing pharmacy services relationships

The Rising Tide of Pharmacy Benefit Cost and Complexity: A health plans roadmap to optimizing pharmacy services relationships The Rising Tide of Pharmacy Benefit Cost and Complexity: A health plans roadmap to optimizing pharmacy services relationships New pharmacy benefit challenges After several years of manageable pharmacy

More information

About NEHI: NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs.

About NEHI: NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs. 1 Aaron McKethan PhD (amckethan@rxante.com) About NEHI: NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs. In partnership

More information

The importance of Program Management and Change Management in ehealth

The importance of Program Management and Change Management in ehealth Bart de Witte 09.11.2010 ITAPA Bratislave - Slovakia Let s Build A Smarter Planet: The importance of Program Management and Change Management in ehealth Bart de Witte CEE Healthcare Industry Leader IBM

More information

Formulary Management

Formulary Management Formulary Management Formulary management is an integrated patient care process which enables physicians, pharmacists and other health care professionals to work together to promote clinically sound, cost-effective

More information

Provider Satisfaction Survey: Research and Best Practices

Provider Satisfaction Survey: Research and Best Practices Provider Satisfaction Survey: Research and Best Practices Provider Satisfaction Survey Revamp Provider Satisfaction with the health plan has been one of the most popular proprietary survey tools that TMG

More information

Helping You Achieve Better Clinical and Financial Health

Helping You Achieve Better Clinical and Financial Health McKesson Business Performance Services Accountable Care Services Helping You Achieve Better Clinical and Financial Health 1 We recognized that fee-for-service would decrease and value-based care would

More information

Tennessee Payment Reform Initiative

Tennessee Payment Reform Initiative Tennessee Payment Reform Initiative State Innovation Model Public Roundtable Meeting July 31, 2013 PRELIMINARY WORKING DRAFT, SUBJECT TO CHANGE Agenda for State Innovation Model Public Roundtable meeting

More information

Introduction and Invitation for Public Comment

Introduction and Invitation for Public Comment 2 of 22 Introduction and Invitation for Public Comment The Patient-Centered Outcomes Research Institute (PCORI) is an independent, non-profit health research organization. Its mission is to fund research

More information

ACOs: Impacting the Past, Present and Future State of Healthcare

ACOs: 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 information

STRATEGIC INNOVATIONS FOR AFFORDABLE, SUSTAINABLE HEALTH CARE:

STRATEGIC INNOVATIONS FOR AFFORDABLE, SUSTAINABLE HEALTH CARE: January 2011 STRATEGIC INNOVATIONS FOR AFFORDABLE, SUSTAINABLE HEALTH CARE: A Model for Health System Reform Environmental Scan Accountable Care Organizations Table of Contents ACCOUNTABLE CARE ORGANIZATIONS...

More information

Are Delegated Model Physician Groups Being Crowded Out of the Exchange? s4. Making the move from volume to value-based models-- strategies for success

Are Delegated Model Physician Groups Being Crowded Out of the Exchange? s4. Making the move from volume to value-based models-- strategies for success learn Informative Sessions General Session IT Managers Clinical Staff HCIM ICD-10, Presented by Platinum Sponsor Michael Wilson & Co-Presented by Peggy Honts With a little room to breathe until the October

More information

LTC Division Webinar Accountable Care Organizations and LTC Pharmacy - The New Era in Health Care Delivery

LTC Division Webinar Accountable Care Organizations and LTC Pharmacy - The New Era in Health Care Delivery LTC Division Webinar Accountable Care Organizations and LTC Pharmacy - The New Era in Health Care Delivery 1 The Pioneer ACO Model James Vasquenza Jr. Vice President, Preferred Provider Network, Innovatix

More information

Health Care System. Troyen Brennan, M.D., M.P.H. Executive Vice President & Chief Medical Officer

Health Care System. Troyen Brennan, M.D., M.P.H. Executive Vice President & Chief Medical Officer Creating a More Connected Health Care System Troyen Brennan, M.D., M.P.H. Executive Vice President & Chief Medical Officer Agenda Our Role in the Changing Health Care System CVS/minuteclinic: Growth and

More information

Care Management Strategies Require Better Tools

Care Management Strategies Require Better Tools Care Management Strategies Require Better Tools The ripple effect of healthcare reform is beginning to impact care delivery strategies as care management now falls increasingly to providers. According

More information

Applying 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 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 information

csc WORLD WORLD HEALTHCARE: A Performance Improvement Maturity Model for the Healthcare Industry at Virgin Money AN ARTICLE FROM

csc WORLD WORLD HEALTHCARE: A Performance Improvement Maturity Model for the Healthcare Industry at Virgin Money AN ARTICLE FROM csc AN ARTICLE FROM WORLD HEALTHCARE: A Performance Improvement Maturity Model for the Healthcare Industry The Green IT Issue WORLD Building a Better Business June 2008 at Virgin Money JUNE 2008 A Performance

More information

February 2014 Patient Savings Program Use Analysis

February 2014 Patient Savings Program Use Analysis Providing key policy setters and decision makers in the global health sector with unique and transformational insights into healthcare dynamics derived from granular analysis of information. February 2014

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

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

CPR-PBGH Toolkit for Purchasers on Accountable Care Organizations. June 26, 2014

CPR-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 information

Are ACOs the Fix? The Latest Addition to the AHS Coding Corner

Are ACOs the Fix? The Latest Addition to the AHS Coding Corner Are ACOs the Fix? The Latest Addition to the AHS Coding Corner It has been some time since I have added to the seven contributions already on the AHS website Coding Corner. The reason is because there

More information

Colorado Choice Health Plans

Colorado Choice Health Plans Quality Overview Colorado Choice Health Plans Accreditation Exchange Product Accrediting Organization: Accreditation Status: URAC Health Plan Accreditation (Marketplace HMO) Provisional Accreditation Commercial

More information

Why Electronic Health Records are Ill-Suited for Population Health Management An InfoMC White Paper January 2016

Why Electronic Health Records are Ill-Suited for Population Health Management An InfoMC White Paper January 2016 Why Electronic Health Records are Ill-Suited for Population Health Management An InfoMC White Paper January 2016 Many studies have demonstrated that cost of care for patients with chronic illnesses is

More information

POPULATION 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 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 information

ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION)

ESSENTIA 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 information

ACO CASE STUDY METRO HEALTH: GRAND RAPIDS, MICHIGAN

ACO CASE STUDY METRO HEALTH: GRAND RAPIDS, MICHIGAN ACO CASE STUDY METRO HEALTH: GRAND RAPIDS, MICHIGAN January 2011 ACO CASE STUDY METRO HEALTH: GRAND RAPIDS, MICHIGAN Prepared by: Keith D. Moore / kmoore@mcmanisconsulting.com & Dean C. Coddington / dcoddington@mcmanisconsulting.com

More information

Premier ACO Collaboratives Driving to a Patient-Centered Health System

Premier 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 information

Health Insurance Exchanges: Tools for Success

Health Insurance Exchanges: Tools for Success Health Insurance Exchanges: Tools for Success Health insurance exchanges present a significant opportunity to coordinate and simplify access to affordable health insurance. By 2020, more than 27 million

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

ACOs ECONOMIC CREDENTIALING BUNDLING OF PAYMENTS

ACOs ECONOMIC CREDENTIALING BUNDLING OF PAYMENTS ACOs ECONOMIC CREDENTIALING BUNDLING OF PAYMENTS There are a number of medical economic issues Headache Medicine Physicians should be familiar with as we enter a new era of healthcare reform. Although

More information

WHITE PAPER. How a multi-tiered strategy can reduce readmission rates and significantly enhance patient experience

WHITE PAPER. How a multi-tiered strategy can reduce readmission rates and significantly enhance patient experience WHITE PAPER How a multi-tiered strategy can reduce readmission rates and significantly enhance patient experience Vocera Communications, Inc. June, 2014 SUMMARY Hospitals that reduce readmission rates

More information

The Progressive Journey Toward Population Health Management

The Progressive Journey Toward Population Health Management The Progressive Journey Toward Population Health Management Lee B. Sacks, MD CEO Advocate Physician Partners, Executive Vice President and Chief Medical Officer, Advocate Health Care Michael Udwin, MD

More information

Purchasers Efforts to Promote Better Information Technology

Purchasers Efforts to Promote Better Information Technology Purchasers Efforts to Promote Better Information Technology Peter V. Lee Pacific Business Group on Health The Health Information Technology Summit West March 7, 2005 Measuring Provider Quality and Cost-Efficiency

More information

RE: Medicare Program; Request for Information Regarding Accountable Care Organizations and the Medicare Shared Saving Program

RE: 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 information

BRAVE NEW WORLD: OVERCOMING NEW HEALTHCARE CHALLENGES WITH TOP IT TALENT

BRAVE NEW WORLD: OVERCOMING NEW HEALTHCARE CHALLENGES WITH TOP IT TALENT HEALTHCARE CHALLENGES WITH TOP IT TALENT Massive change is on the horizon for your healthcare organization in fact, it has probably already started. For years, industry organizations have departmentalized

More information

EMDEON INTERACTIVE CARE MANAGEMENT

EMDEON INTERACTIVE CARE MANAGEMENT EMDEON INTERACTIVE CARE MANAGEMENT Innovative Care Management Strategies for Payers Simplifying the Business of Healthcare Emdeon Interactive Care Management Innovative Care Management Strategies for Payers

More information

Value Based Purchasing: A Definition (Adapted from the National Business Coalition on Health)

Value Based Purchasing: A Definition (Adapted from the National Business Coalition on Health) Value Based Purchasing: A Definition (Adapted from the National Business Coalition on Health) As major purchasers of health care services, employers have the clout to insist on change. Unfortunately, they

More information

Population health management:

Population 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 information

TRUVEN HEALTH UNIFY. Population Health Management Enterprise Solution

TRUVEN HEALTH UNIFY. Population Health Management Enterprise Solution TRUVEN HEALTH UNIFY Population Health Enterprise Solution A Comprehensive Suite of Solutions for Improving Care and Managing Population Health With Truven Health Unify, you can achieve: Clinical data integration

More information

Understanding and preparing for the impact of the Affordable Care Act

Understanding and preparing for the impact of the Affordable Care Act Understanding and preparing for the impact of the Affordable Care Act Care Management / P. 1 The Affordable Care Act is expected to impact access to care, change the way accountable care organizations

More information

DRAFT Health Home Concept Paper

DRAFT Health Home Concept Paper DRAFT Health Home Concept Paper 1. How are health home services provided? Illinois Medicaid has been primarily a fee-for-service system, involving thousands of healthcare providers who have provided invaluable

More information

Financial and Population Analytics for Accountable Care Organizations SEPTEMBER 20, 2012

Financial 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 information

Pennsylvania s Chronic Care/ Medical Home Initiative: Transforming Primary Care

Pennsylvania s Chronic Care/ Medical Home Initiative: Transforming Primary Care Pennsylvania s Chronic Care/ Medical Home Initiative: Transforming Primary Care Ann S. Torregrossa, Esq. Director Governor s Office of Health Care Reform Commonwealth of Pennsylvania WORKING TO ACHIEVE

More information

5 pillars of clinical integration

5 pillars of clinical integration REPRINT AUGUST 2012 Daniel M. Grauman Carole J. Graham Molly Martha Johnson healthcare financial management association hfma.org 5 pillars of clinical integration A healthcare organization s ability to

More information

Translating to the language of payers

Translating to the language of payers Translating to the language of payers Actuarial analyses of new drug therapies Gregory Warren, FSA, MAAA Vice President, Pharmacy Actuarial Consulting 303-714-1022 gregory.warren@optum.com 1 Why are actuaries

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

Doctor of Nursing Practice (DNP) Programs Frequently Asked Questions

Doctor of Nursing Practice (DNP) Programs Frequently Asked Questions Doctor of Nursing Practice (DNP) Programs Frequently Asked Questions On October 25, 2004, the members of the American Association of Colleges of Nursing (AACN) endorsed the Position Statement on the Practice

More information

Technician Learning Objectives 3/25/2014. Pharmacy Practice Changes in ACA Accountable Care Organizations

Technician Learning Objectives 3/25/2014. Pharmacy Practice Changes in ACA Accountable Care Organizations Pharmacy Practice Changes in ACA Accountable Care Organizations Avani S. Desai, PharmD & Emory S. Martin PharmD Sunday, April 12, 2014 9:05 10:05 am Pharmacist Learning Objectives At the conclusion of

More information

PIPC: Hepatitis Roundtable Summary and Recommendations on Dissemination and Implementation of Clinical Evidence

PIPC: Hepatitis Roundtable Summary and Recommendations on Dissemination and Implementation of Clinical Evidence PIPC: Hepatitis Roundtable Summary and Recommendations on Dissemination and Implementation of Clinical Evidence On May 8, 2014, the Partnership to Improve Patient Care (PIPC) convened a Roundtable of experts

More information