Use and Value of Data Analytics. Comparative Effectiveness Study Inpatient Rehab Hospital (IRH) vs. Skilled Nursing Facility (SNF)

Size: px
Start display at page:

Download "Use and Value of Data Analytics. Comparative Effectiveness Study Inpatient Rehab Hospital (IRH) vs. Skilled Nursing Facility (SNF)"

Transcription

1 Use and Value of Data Analytics Comparative Effectiveness Study Inpatient Rehab Hospital (IRH) vs. Skilled Nursing Facility (SNF) Ryan Wilson Vice President of Managed Care HealthSouth Corporation Gerry Smedinghoff Manager, Healthcare Actuarial KPMG

2 Today s Presentation HealthSouth and the Opportunity Data Journey Need for Data Analytics Lessons Learned Unique Characteristics of Study Design Final Thoughts Challenges Available Data Study Design and Value Proposition Study Findings Total Cost of Care Readmission Average Length of Stay 2

3 3

4 What Prompted HealthSouth s Interest in Data? 1. Attention to Post-Acute Care (PAC) Sector Federal cost-cutting interest 2. Confusion between segments of PAC sector Payers, patients and families and even referring physicians may not know or appreciate the distinctions between LTACH, IRH & SNF. 3. Desire to differentiate our sector: Inpatient Rehabilitation Facilities (IRFs) 4

5 Medicare Spending on PAC Services 1.8% 2.1% 2.2% 2.1% 1.9% 1.5% 1.4% 1.3% 1.2% 1.2% 1.2% 1.2% Inpatient rehabilitation spending (% of total Medicare spending) Total Medicare Spending on Post-Acute Services $62 billion in 2012 $40 $30 $20 $10 $ Skilled nursing facilities Home health agencies Inpatient rehabilitation facilities Long-term acute care hospitals Sources: Center for Medicare & Medicaid Services, Medicare Trustees Report May 2013 Page 10, MedPAC Report to the Congress March 2013 pages 158, 188, 216, 238; MedPAC Databook, Healthcare Spending and the Medicare program, June 2013 page 122 5

6 How to Tell an IRF from a SNF Average Length of Stay (1) Rehab Hospital = 13.0 days Discharge to Home (percent) (2) = 81.1% Requirements: Rehab hospitals must also satisfy regulatory/policy requirements for hospitals, including Medicare hospital conditions of participation All patients must be admitted by a rehab physician. Rehab physicians must re-confirm each admission w/n 24 hours. All patients, regardless of diagnoses/condition, must demonstrate need and receive at least 3 hours of daily intensive therapy. All patients must see a rehabilitation physician in person at least 3 times weekly. Rehab hospitals required to provide 24 hour, 7 days per week nursing care; many nurses are RNs and rehab nurses. Rehab hospitals are required to use a coordinated interdisciplinary team approach led by a rehab physician, includes a rehab nurse, a case manager, and a licensed therapist from each therapy discipline who must meet weekly to evaluate/discuss each patient s case. Rehab hospitals are required to follow stringent admission/coverage policies and must carefully document justification for each admission; further restricted in number/type of patients (60% Rule) Average Length of Stay (2) Covered Days per Admission (1) Nursing Home = 30 days = 27.2 days Discharge to Home (percent) (2) = 45.5% Requirements: No similar requirement; Nursing homes are regulated as nursing homes only No similar requirement No similar requirement No similar requirement No similar requirement. SNF patients must be seen once a month by a physician (not necessarily a rehabilitation physician) No similar requirement No similar requirement; Nursing homes are not required to provide care on a interdisciplinary basis and are not required to hold regular meetings for each patient. Nursing homes have comparatively few policies governing the number or types of patients they treat. (1) MedPAC, Report to the Congress: Medicare Payment Policy, March 2013 Pages 218 and 167 (2) Centers for Medicare and Medicaid Services, FY 2012 SNF-PPS Final Rule, 76 Fed. Reg , 48525, and (August 8, 2011); March 2005 report in the Archives of Physical Medicine and Rehabilitation (http://www.archives-pmr.org/article/piis /abstract) 6

7 The Challenge/Opportunity How do we connect the dots?? Numerous clinical journals have documented the superiority of clinical and functional outcomes achieved by IRH compared to SNFs for appropriate patients Do superior clinical outcomes translate into lower cost on a Total Cost of Care basis?? 7

8 The Journey 1 Select a third party/parties to objectively quantify the Inpatient Rehabilitation Hospital total cost of care advantage 2 RFP Process and interviews 3 Consulting expertise coupled with actuarial expertise 4 Industry recognized and respected experts 5 Outcomes were not guaranteed 6 Big commitment in resources, both time and financial with significant risk/reward potential 8

9 The Journey (continued) 1 Step-by-step process: a. Establishing goals b. Choosing a partner c. Identifying data source d. Developing methodology e. Analyzing results f. Communicating the findings 9

10 Research Hypothesis Hypothesis Compared to SNFs, IRH s focus on rehabilitative care results in patients: Being discharged from the acute care setting earlier Show higher functional improvement during rehab Have a shorter length of stay in rehab Have lower acute care hospital readmission rates Have a lower average total cost of care 10

11 Obstacles-Challenges for HealthSouth There are no valid industry-wide metrics (e.g., JD Power) to evaluate cost and quality of post-acute rehabilitative care Most current research is at facility (i.e., SNF vs. IRH), not the patient, level Stand-alone metrics of ALOS, cost per day and readmissions are meaningless Most valid quality metric FIM Gain is not on standard health care claim 11

12 Obstacles-Challenges for HealthSouth Need to create valid metrics that avoid the two most common quality control (QC) definitional errors Assuming that Use = Value e.g., does longer LOS = better/worse level of care Failing to control for inputs e.g., higher hospital mortality rates often reflect A focus on older Medicare patients more likely to die Higher quality centers of excellence that attract the most severe cases Need to create homogeneous categories for proper comparison 12

13 From Traditional Data Analysis to Modern Data Analytics Traditional Data Analysis Modern Data Analytics Digitize handwritten data Merge multiple datasets Process by computer instead of humans Across business and technology platforms Answer familiar questions Provide new views Mathematical calculations Accounting and payroll applications Data organization and retrieval What do customers look like before they come to us? What do customers do after they leave us? What does the entire customer look like? 13

14 Available Datasets HealthSouth Internal Patient Records 72,000 admissions for 58,000 stroke patients from January 1, 2010 June 30, 2013 Detailed metrics such as Functional Improvement Measure (FIM) gains Only show cost and quality of HealthSouth care, not Total Cost of Care or competitor comparisons CMS National Medicare Fee For Service (FFS) Claim Data 62% of HealthSouth patients are Medicare CMS restrictions prevent release of Professional and Rx data required for this analysis 14

15 Available Datasets (continued) BHI Dataset Nationwide in coverage with total cost of all care 202,650 de-identified members with stroke diagnosis from January 1, 2010 June 30, 2013 Consecutive years increases sample size and allow patient level durational analysis 15

16 Study Design Focus on one specific condition (stroke) to control for inputs Target patients defined as admitted to a rehabilitation facility (IRH or SNF) following discharge from an acute care hospital for stroke Define Quality/Total Cost of Care of all health plan expenses in three periods, combined with LOS and readmission metrics: Pre-stroke: 90 days prior to hospitalization for stroke Stroke: from hospital admission for stroke thru rehab facility discharge Post-stroke: 90 days following rehab facility discharge 16

17 Key Unknowns of Data Analytics Studies You don t know what to look for until you know how to look for it You don t know how to look for it until you find out what data you have You don t know what s in the data you have until you look for the opposite of what you expect to find Exponentially declining trends: airline and auto fatality rates Steady state (flat) trends: skydiving fatality rates Increasing trends: motorcycle fatality rates Disease/condition (stroke): treatable or subject to improvement Aging/disease (retina): untreatable or managing a process to failure 17

18 Data Challenges and Problems Causing Delays and Requiring Rework Definition issues in claim data Identifying facility type: hospital vs. SNF vs. IRH Defining an inpatient stay Consecutive billings of single extended stay Series of therapy sessions with start/end dates that resemble inpatient Professional claims coded as inpatient Category of service: conversion of emergency room costs to inpatient Bundling of services as inpatient vs. subcontracted professional and outpatient 18

19 Lessons Learned From Data Validation Data Validation Findings Some rehab facility claims could not be classified and were categorized as Undefined Minor anomalies and errors affecting < 1.0% of cases are inevitable Research results and conclusions are relative, not absolute 19

20 Value Proposition Data Analysis: Revised Study Design The study design was revised based on the data available, the validation results, the provider landscape and observed patient behaviors: Patient Cohorts HealthSouth (HLS) Non-HLS IRH SNF Undefined Severity Moderate DRGs 65 & 66 Severe DRGs Stroke with complications Continuum of Care Pre-Stroke Stroke Post-Stroke 90 days claims data prior to stroke Days of Acute and Post Acute Hospitalization 3 30/60/90 days claims data after stroke Cost Category Home Health Acute Care Outpatient Pharmacy Professional Post-Acute (Rehab) Other Step 1: Three Continuum of Care periods were defined to assign key insights to relative periods and enable segment comparisons Step 2: Four Cohorts of Place of Service (POS) were identifiable Step 3: Seven relevant Categories Of Service (COS) were defined to analyze the costs incurred across the continuum of care Step 4: Stroke patients were sub-divided into three categories by industry standard DRG categories, Moderate, Severe and Other 20

21 Total Cost of Care Analysis Results IRF costs are comparatively lower in each of the three care continuum phases DRG's Total Averages Across Phases $73.K $97.9K $100.7K $83.6K $7.2K $15.7K $7.7K $8.9K $15.1K $24.6K $20.7K $18.1K Pre Stroke Stroke Post Stroke IRF SNF Undefined Rehab All Targeted Stroke Patients in Data Set Patient Volume 1,068 2,181 8,885 IRF SNF Undefined Rehab All 12,134 stroke Target Members IRF s had the lowest cost of care in each three stroke phases 21

22 Readmissions Key Findings IRF patients have the lowest total costs in each of the three 30 day segments of the 90 day post-stroke period With an average post-stroke readmission rate half of Skilled Nursing Facilities, significant savings can be realized by utilizing IRF s. IRF patients have the lowest total costs in each of the three 30 day segments of the 90 day post-stroke period IRF patients have the lowest Acute Inpatient readmission costs in each of the three 30 day segments of the 90 day post-stroke period Average Percentage of patients readmitted (during the 90 day post-stroke phase) Post-Stroke (90 days after discharge from postacute) IRF 13.3% SNF 24.2% SNF readmission rate is about 2X greater than IRF ~10.9% More SNF Patients Readmitted x $32,372 = $352,855 Average Readmissions Rate Advantage of IRF over SNFs per 100 Stroke Patients Average acute readmission cost during Post-Stroke period for Target Members Average Readmission Savings Generated from IRF over SNF per 100 Stroke Patients 22

23 Average Length of Stay (ALOS) Analysis Average Acute Care Inpatient Days by Cohort by Phase Pre-Stroke Stroke Post-Stroke Overall All 12,134 Members IRF SNF Undefined Average Rehab Care Days by Cohort by Phase Pre-Stroke Stroke Post-Stroke Overall All 12,134 Members Highlighted cells -significant data points IRF SNF Undefined

24 Study Refinements to Normalize Patient Cohorts IRH cohort patient advantages Average age six years younger Pre-Stroke phase Cost 50% less 64% less inpatient days 88% less rehab days Stroke phase 50% less acute inpatient days Cohort refinements Stroke severity Moderate DRGs Severe DRGs Co-morbidities Other DRGs Age bands < 65 vs. > 65 < 55 vs Readmitted vs. not readmitted 24

25 Unexpected Study Findings 01 More than two-thirds of patients hospitalized for a stroke are discharged to the home and never enter a rehab facility 02 Original definition of stroke did not produce desired level of target patient homogeneity 03 Measured IRF advantages for all metrics were both large and consistent, regardless of level of refinement 04 30, 60 and 90 day post-discharge readmission rates declined consistently for all post-acute facility types 25

26 Unique Characteristics of Study Design 1 Patient-Focused Cost, quality and outcomes measured at patient level, not provider level 2 Controls for inputs Homogeneous patients with specific profile of hospitalization for stroke, followed by inpatient rehab 3 Longitudinal study period From 90 days prior to stroke thru stroke incident to 90 days after completion of rehab 4 Total cost of care Measure all categories of care delivered to patients, not just for a specific provider category, care setting or incident 5 Measure interactions of all available variables and metrics Age, cost, acute and rehab LOS, acute and rehab readmissions (return to work not available in dataset) 26

27 Findings Summary Study clearly demonstrated that IRF s have a cost advantage over SNF s: In every phase of care For every sub-category of patients Regardless of efforts to control for inputs 1: SNFs have much higher readmission rates (24%) than IRFs (13%) 2: IRFs have much lower ALOS than SNFs 3: IRFs have a lower total cost of care for stroke patients. 27

28 Bringing the Pieces of Care Together Age Inpatient Rehab LOS Cost & Utilization during a stroke Cost & Utilization >90 days to stroke Pharmacy Cost 28

29 Bringing the Pieces of Care Together (continued) Stroke Diagnosis: Moderate, Severe, Other Acute Hospital cost Inpatient Rehab Costs Outpatient Cost Readmissions Professional Cost Cost & Utilization during a stroke Age FIM Gain Total Cost of Care Inpatient Rehab Admissions Acute LOS Home Health Cost 29

30 Final Thoughts: These Findings Can 1 Reorient provider s understanding of rehab options 2 Assist patients and families in medical decision-making 3 Improve payor s decision-making algorithms for IRF s and SNF s 4 Promote wise use of limited health resources 5 Fulfill the promise of patient access to appropriate care 30

31 General Lessons Applicable to Future Studies Key Considerations for Future Studies Requiring Significant Rework to Define: Disease or condition to study (diagnosis codes and priority: primary vs. secondary) Study period(s): pre-treatment, treatment and post-treatment Target patients Classification of claims and costs (chemotherapy drugs) Study baseline and competitors 31

32 General Lessons Applicable to Future Studies (continued) Not treated or non-customers Stroke patients discharged home (healthier or have home support?) Cancer patients that choose not to be treated (terminal or change carriers?) Censoring impacts of mortality and coverage 85% of target patients covered thru 90 day pre-admission and post-discharge windows Relative results did not change when partial coverage patients removed Continued coverage rate deteriorates to 50% after 12 months 32

33 Total Reimbursement for Care Patient Distribution 33

34 Total Reimbursement for Care Category: Surgery 34

35 Total Reimbursement for Care Comparison 35

36 Future of Health Care Data Analytics Aggregation of data sets opens field with limitless potential for new research HIPAA concerns restrict patient-level analysis Sub-groups must be greater than ten patients Four or five organized data elements can identify an individual Most important developments Shift from provider cost and utilization metrics to patient recovery and health Potential to combine claim payment data with patient clinical data such as FIM Increased pricing and clinical transparency will favor the best platforms of specialized focused care 36

BUNDLING ARE INPATIENT REHABILITATION FACILITIES PREPARED FOR THIS PAYMENT REFORM?

BUNDLING ARE INPATIENT REHABILITATION FACILITIES PREPARED FOR THIS PAYMENT REFORM? BUNDLING ARE INPATIENT REHABILITATION FACILITIES PREPARED FOR THIS PAYMENT REFORM? Uniform Data System for Medical Rehabilitation Annual Conference August 10, 2012 Presented by: Donna Cameron Rich Bajner

More information

Lowering Costs and Improving Outcomes. Patient Engagement Issues. Nancy Davenport-Ennis President & CEO. September 8 th, 2009

Lowering Costs and Improving Outcomes. Patient Engagement Issues. Nancy Davenport-Ennis President & CEO. September 8 th, 2009 The Healthcare Imperative: Lowering Costs and Improving Outcomes Patient Engagement Issues Nancy Davenport-Ennis President & CEO National Patient Advocate Foundation September 8 th, 2009 Institute of Medicine

More information

PL 111-148 and Amendments: Impact on Post-Acute Care for Health Care Systems

PL 111-148 and Amendments: Impact on Post-Acute Care for Health Care Systems PL 111-148 and Amendments: Impact on Post-Acute Care for Health Care Systems By Kathleen M. Griffin, PhD. There are three key provisions of the law that will have direct impact on post-acute care needs

More information

What do ACO s and Hospitals want from SNF s and CCRC s

What do ACO s and Hospitals want from SNF s and CCRC s What do ACO s and Hospitals want from SNF s and CCRC s Presented to the Institute of Senior Living, April 11, 2013 A Division of Kindred Healthcare 1 Assessing the match: What hospitals and ACO s currently

More information

Blueprint for Post-Acute

Blueprint for Post-Acute Blueprint for Post-Acute Care Reform Post-acute care is a critical component within our nation s healthcare system and an essential aspect of care for many patients making a full recovery possible after

More information

Medicare Savings and Reductions in Rehospitalizations Associated with Home Health Use

Medicare Savings and Reductions in Rehospitalizations Associated with Home Health Use Medicare Savings and Reductions in Rehospitalizations Associated with Home Health Use June 23, 2011 Avalere Health LLC Avalere Health LLC The intersection of business strategy and public policy Table of

More information

2014: Volume 4, Number 1. A publication of the Centers for Medicare & Medicaid Services, Office of Information Products & Data Analytics

2014: Volume 4, Number 1. A publication of the Centers for Medicare & Medicaid Services, Office of Information Products & Data Analytics 2014: Volume 4, Number 1 A publication of the Centers for Medicare & Medicaid Services, Office of Information Products & Data Analytics Medicare Post-Acute Care Episodes and Payment Bundling Melissa Morley,¹

More information

3M s unique solution for value-based health care

3M s unique solution for value-based health care A quick guide to 3M s unique solution for value-based health care Part 2: The era of and Current trends industry changes Volume-based health care Value-based health care ICD-9 ICD-10 Inpatient care Outpatient

More information

Using Medicare Hospitalization Information and the MedPAR. Beth Virnig, Ph.D. Associate Dean for Research and Professor University of Minnesota

Using Medicare Hospitalization Information and the MedPAR. Beth Virnig, Ph.D. Associate Dean for Research and Professor University of Minnesota Using Medicare Hospitalization Information and the MedPAR Beth Virnig, Ph.D. Associate Dean for Research and Professor University of Minnesota MedPAR Medicare Provider Analysis and Review Includes information

More information

CURRENT AND FUTURE TRENDS IN POST ACUTE CARE The Value and Role of Acute Inpatient Rehab

CURRENT AND FUTURE TRENDS IN POST ACUTE CARE The Value and Role of Acute Inpatient Rehab CURRENT AND FUTURE TRENDS IN POST ACUTE CARE The Value and Role of Acute Inpatient Rehab Robert S. Djergaian, M.D. Medical Director Banner Good Samaritan Rehabilitation Institute Stewardship Profitability

More information

Inpatient rehabilitation facility services

Inpatient rehabilitation facility services Inpatient rehabilitation facility services C H A P T E R9 R E C O M M E N D A T I O N 9 The Congress should eliminate the update to the Medicare payment rates for inpatient rehabilitation facilities in

More information

Maximizing Post-Acute Value by Leveraging the Physician's Role Susan Quirk, MBA, president, Susan Douglass and Associates, Colorado Springs, Colo.

Maximizing Post-Acute Value by Leveraging the Physician's Role Susan Quirk, MBA, president, Susan Douglass and Associates, Colorado Springs, Colo. Maximizing Post-Acute Value by Leveraging the Physician's Role Susan Quirk, MBA, president, Susan Douglass and Associates, Colorado Springs, Colo.; and Mike Soisson, senior vice president, Vibra Healthcare,

More information

Inpatient Transfers, Discharges and Readmissions July 19, 2012

Inpatient Transfers, Discharges and Readmissions July 19, 2012 Inpatient Transfers, Discharges and Readmissions July 19, 2012 Discharge Status Codes Two-digit code Identifies where the patient is at conclusion of encounter Visit Inpatient stay End of billing cycle

More information

HOSPITAL INPATIENT AND OUTPATIENT UPDATE RECOMMENDATIONS

HOSPITAL INPATIENT AND OUTPATIENT UPDATE RECOMMENDATIONS Glenn M. Hackbarth, J.D. 64275 Hunnell Road Bend, OR 97701 Dear Mr.Hackbarth: The Medicare Payment Advisory Commission (MedPAC) will vote next week on payment recommendations for fiscal year (FY) 2014.

More information

Inpatient rehabilitation facility services

Inpatient rehabilitation facility services C h a p t e r10 Inpatient rehabilitation facility services R E C O M M E N D A T I O N 10 The Congress should eliminate the update to the Medicare payment rates for inpatient rehabilitation facilities

More information

Jane Snecinski, FACHE Post Acute Advisors, LLC P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com

Jane Snecinski, FACHE Post Acute Advisors, LLC P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com Jane Snecinski, FACHE P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com RAC Demonstration Project 3 year demonstration project Greatest impact to IRF from California Issue with greatest impact

More information

Moving Towards Bundled Payment

Moving Towards Bundled Payment ISSUE BRIEF Moving Towards Bundled Payment Introduction The fee-for-service system of payment for health care services is widely thought to be one of the major culprits in driving up U.S. health care costs.

More information

Creating Strategic Alliances for Post-Acute Coordination of Care

Creating Strategic Alliances for Post-Acute Coordination of Care Creating Strategic Alliances for Post-Acute Coordination of Care Kathleen Yosko, PhD President/CEO Wheaton Franciscan Health Care Sole Illinois property Free-standing facility 101 IRF beds 27 SNF beds

More information

Rehabilitation Reimbursement Update By: Cherilyn G. Murer, JD, CRA

Rehabilitation Reimbursement Update By: Cherilyn G. Murer, JD, CRA Rehabilitation Reimbursement Update By: Cherilyn G. Murer, JD, CRA Introduction The Centers for Medicare & Medicaid Services (CMS) and legislators in this country remain dedicated to ensuring that beneficiaries

More information

Reducing Hospital Readmissions & The Affordable Care Act

Reducing Hospital Readmissions & The Affordable Care Act Reducing Hospital Readmissions & The Affordable Care Act The Game Has Changed Drastically Reducing MSPB Measures Chuck Bongiovanni, MSW, MBA, NCRP, CSA, CFE Chuck Bongiovanni, MSW, MBA, NCRP, CSA, CFE

More information

Clarification of Patient Discharge Status Codes and Hospital Transfer Policies

Clarification of Patient Discharge Status Codes and Hospital Transfer Policies The Acute Inpatient Prospective Payment System Fact Sheet (revised November 2007), which provides general information about the Acute Inpatient Prospective Payment System (IPPS) and how IPPS rates are

More information

Population 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 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 information

Discharge or Episode of Care? CMS Redefines the Interrupted Stay Rule for LTACHS. Cherilyn G. Murer, J.D., C.R.A.

Discharge or Episode of Care? CMS Redefines the Interrupted Stay Rule for LTACHS. Cherilyn G. Murer, J.D., C.R.A. Introduction Discharge or Episode of Care? CMS Redefines the Interrupted Stay Rule for LTACHS By Cherilyn G. Murer, J.D., C.R.A. When CMS first implemented the prospective payment system for long term

More information

Site-neutral payments for select conditions treated in inpatient rehabilitation facilities and skilled nursing facilities

Site-neutral payments for select conditions treated in inpatient rehabilitation facilities and skilled nursing facilities C h a p t e r6 Site-neutral payments for select conditions treated in inpatient rehabilitation facilities and skilled nursing facilities C H A P T E R 6 Site-neutral payments for select conditions treated

More information

Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015

Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015 Leveraging the Continuum to Avoid Unnecessary Utilization While Improving Quality Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015 Karim A. Habibi, FHFMA, MPH, MS Senior

More information

September 4, 2012. Submitted Electronically

September 4, 2012. Submitted Electronically September 4, 2012 Ms. Marilyn Tavenner Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1589-P P.O. Box 8016 Baltimore, MD 21244-8016

More information

June 2, 2014. RE: File Code CMS-1608-P. Dear Ms. Tavenner:

June 2, 2014. RE: File Code CMS-1608-P. Dear Ms. Tavenner: . June 2, 2014 Marilyn Tavenner Centers for Medicare & Medicaid Services Room 445-G, Hubert H. Humphrey Building 200 Independence Avenue SW Washington, DC RE: File Code CMS-1608-P Dear Ms. Tavenner: The

More information

Inpatient rehabilitation facility services

Inpatient rehabilitation facility services C h a p t e r10 Inpatient rehabilitation facility services R E C O M M E N D A T I O N 10 The Congress should eliminate the update to the Medicare payment rates for inpatient rehabilitation facilities

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

4/27/2015. LeadingAge Michigan 2015 Annual Conference Dearborn, MI Monday May 18th, 2015. Jon Golm, President

4/27/2015. LeadingAge Michigan 2015 Annual Conference Dearborn, MI Monday May 18th, 2015. Jon Golm, President LeadingAge Michigan 2015 Annual Conference Dearborn, MI Monday May 18th, 2015 Jon Golm, President Aging Improving Enriched Post Discharge Services, LLC Outcomes Mike Logan, SVP/COO Wellspring Lutheran

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

Integrating Post-Acute Providers with Health System Strategies

Integrating Post-Acute Providers with Health System Strategies Integrating Post-Acute Providers with Health System Strategies Bridging the Acute and Post-Acute Worlds The opinions expressed are those of the presenter and do not necessarily state or reflect the views

More information

High Rehospitalization Rates: Evaluation and Impact

High Rehospitalization Rates: Evaluation and Impact High Rehospitalization Rates: Evaluation and Impact May 29, 2009 Denise Remus, PhD, RN Chief Quality Officer, BayCare Health System BayCare Health System BayCare is the largest full-service, community-based

More information

What Providers Need To Know Before Adopting Bundling Payments

What Providers Need To Know Before Adopting Bundling Payments What Providers Need To Know Before Adopting Bundling Payments Dan Mirakhor Master of Health Administration University of Southern California Dan Mirakhor is a Master of Health Administration student at

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

Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge

Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities (IRFs) and After Discharge PREPARED FOR: ARA Research Institute PRESENTED BY: Al Dobson, Ph.D. PREPARED

More information

Regulatory Compliance Policy No. COMP-RCC 4.32 Title:

Regulatory Compliance Policy No. COMP-RCC 4.32 Title: I. SCOPE: Regulatory Compliance Policy No. COMP-RCC 4.32 Page: 1 of 4 This policy applies to (1) Tenet Healthcare Corporation and its wholly-owned subsidiaries and affiliates (each, an Affiliate ); (2)

More information

Deciphering the Details:

Deciphering the Details: Deciphering the Details: An update on implementing PPS for inpatient rehabilitation facilities. By: Cherilyn G. Murer, J.D., C.R.A. President & CEO - The Murer Group Reimbursement for operating costs of

More information

Last January, the parent organization of CMS, the Department of Health and

Last January, the parent organization of CMS, the Department of Health and Executive White Paper Series April 2015 In Cooperation With: This white paper series is produced by the LINK Conference, whose mission is to accelerate productivity and innovation in long term care and

More information

Inpatient rehabilitation facility services

Inpatient rehabilitation facility services C h a p t e r10 Inpatient rehabilitation facility services R E C O M M E N D A T I O N 10 The Congress should eliminate the update to the Medicare payment rates for inpatient rehabilitation facilities

More information

Glossary. Adults: Individuals ages 19 through 64. Allowed amounts: See prices paid. Allowed costs: See prices paid.

Glossary. Adults: Individuals ages 19 through 64. Allowed amounts: See prices paid. Allowed costs: See prices paid. Glossary Acute inpatient: A subservice category of the inpatient facility clams that have excluded skilled nursing facilities (SNF), hospice, and ungroupable claims. This subcategory was previously known

More information

Post-acute care providers: Shortcomings in Medicare s fee-for-service highlight the need for broad reforms

Post-acute care providers: Shortcomings in Medicare s fee-for-service highlight the need for broad reforms C h a p t e r7 Post-acute care providers: Shortcomings in Medicare s fee-for-service highlight the need for broad reforms C H A P T E R 7 Post-acute care providers: Shortcomings in Medicare s fee-for-service

More information

EnduraCare. We are committed to exceeding our customers expectations.

EnduraCare. We are committed to exceeding our customers expectations. AmEriCA s leading provider of hospital therapy services We are committed to exceeding our customers expectations. We re not just out to change the world of therapy, we re actually changing it. services

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 Organizations: What Are They and Why Should I Care?

Accountable 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 information

Medicare Skilled Nursing Facility Prospective Payment System

Medicare Skilled Nursing Facility Prospective Payment System Medicare Skilled Nursing Facility Prospective Payment System Payment Rule Brief FINAL RULE Program Year: FFY 2016 Overview and Resources On August 4, 2015, the Centers for Medicare and Medicaid Services

More information

ST JOHN S LUTHERAN MINISTRIES. Kent Burgess President & CEO

ST JOHN S LUTHERAN MINISTRIES. Kent Burgess President & CEO ST JOHN S LUTHERAN MINISTRIES Kent Burgess President & CEO WHAT S CHANGING MAYBE? -The way we get paid (Reduce Cost) -The way we get measured (Better Care) -What will be required of us (More) -Partnerships/Affiliations

More information

TRENDWATCH. Medicare, Medicaid and most states. Addendum: Background On Post-Acute Care. PAC Provider Snapshot and Overlap of Patient Characteristics

TRENDWATCH. Medicare, Medicaid and most states. Addendum: Background On Post-Acute Care. PAC Provider Snapshot and Overlap of Patient Characteristics AMERICAN HOSPITAL ASSOCIATION DECEMBER 2015 TRENDWATCH Addendum: Background On Post-Acute Care Medicare, Medicaid and most states recognize four types of post-acute care (PAC) settings: long-term acute-care

More information

The Big Data Dividend

The Big Data Dividend The Big Data Dividend Enhancing Revenue in an Era of Change May 7, 2015 Agenda Big Data Sample Healthcare Big Data Sets Healthcare Applications of Big Data Revenue Enhancement Opportunities Rate Benchmarking/Rate

More information

DELIVERING VALUE THROUGH POST-ACUTE CARE

DELIVERING VALUE THROUGH POST-ACUTE CARE OCTOBER 2014 DELIVERING VALUE THROUGH POST-ACUTE CARE WHAT IT MEANS FOR HEALTH SYSTEMS About The Chartis Group The Chartis Group is an advisory services firm that provides management consulting and applied

More information

1. Clarification regarding whether an admission order must be completed before any therapy evaluations are initiated.

1. Clarification regarding whether an admission order must be completed before any therapy evaluations are initiated. Follow-up information from the November 12 provider training call I. Admission Orders 1. Clarification regarding whether an admission order must be completed before any therapy evaluations are initiated.

More information

Using Data to Understand the Medicare Spending Per Beneficiary Measure

Using Data to Understand the Medicare Spending Per Beneficiary Measure Using Data to Understand the Medicare Spending Per Beneficiary Measure Mary Wheatley, AAMC Jacqueline Matthews, Cleveland Clinic Keely Macmillan, Partners Healthcare December 17, 2013 Webinar Details The

More information

Stroke Rehabilitation Triage Severe Strokes

Stroke Rehabilitation Triage Severe Strokes The London Stroke Rehab Data Base Project Robert Teasell MD FRCPC Professor and Chair-Chief Department of Phys Med Rehab London Ontario Retrospective Data Bases In stroke rehab limited funding for clinical

More information

Follow-up information from the November 12 provider training call

Follow-up information from the November 12 provider training call Follow-up information from the November 12 provider training call Criteria I. Multiple Therapy Disciplines 1. Clarification regarding the use of group therapies in IRFs. Answer: CMS has not yet established

More information

Leveraging Predictive Analytic and Artificial Intelligence Technology for Financial and Clinical Performance

Leveraging Predictive Analytic and Artificial Intelligence Technology for Financial and Clinical Performance Leveraging Predictive Analytic and Artificial Intelligence Technology for Financial and Clinical Performance Matt Seefeld CEO & Co-Founder mseefeld@interpointpartners.com www.interpointpartners.com (404)446-0051

More information

Comparison of Discharge Functional Status Rehabilitation: Hip Fracture Repair. Trudy Mallinson, PhD, OTR/L

Comparison of Discharge Functional Status Rehabilitation: Hip Fracture Repair. Trudy Mallinson, PhD, OTR/L Comparison of Discharge Functional Status Rehabilitation: Hip Fracture Repair Trudy Mallinson, PhD, OTR/L Acknowledgements Co-authors Anne Deutsch, PhD, CRRN Jillian Bateman, OTD, OTR/L Hsiang-Yi Tseng,

More information

PATTERNS OF POST-ACUTE UTILIZATION IN RURAL AND URBAN COMMUNITIES: HOME HEALTH, SKILLED NURSING, AND INPATIENT MEDICAL REHABILITATION.

PATTERNS OF POST-ACUTE UTILIZATION IN RURAL AND URBAN COMMUNITIES: HOME HEALTH, SKILLED NURSING, AND INPATIENT MEDICAL REHABILITATION. PATTERNS OF POST-ACUTE UTILIZATION IN RURAL AND URBAN COMMUNITIES: HOME HEALTH, SKILLED NURSING, AND INPATIENT MEDICAL REHABILITATION Final Report March 2005 Janet P. Sutton, Ph.D. NORC Walsh Center for

More information

Figuring Out the Codes: Inpatient Rehabilitation Facilities and the Transfer Policy

Figuring Out the Codes: Inpatient Rehabilitation Facilities and the Transfer Policy Figuring Out the Codes: Inpatient Rehabilitation Facilities and the Transfer Policy Inpatient rehabilitation facilities (IRFs) are hospitals (or subunits of a hospital) that offer intensive rehabilitation

More information

PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT. Norris Vivatrat, MD Associate Medical Director Monarch HealthCare

PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT. Norris Vivatrat, MD Associate Medical Director Monarch HealthCare PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT Norris Vivatrat, MD Associate Medical Director Monarch HealthCare 2 Agenda Pioneer ACO basics, performance and challenges Monarch HealthCare Post-acute network

More information

PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT

PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT Norris Vivatrat, MD Associate Medical Director Monarch HealthCare 2 Agenda Pioneer ACO basics, performance and challenges Monarch HealthCare Post-acute network

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

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services. Discharge Planning

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services. Discharge Planning DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services ICN 908184 October 2014 This booklet was current at the time it was published or uploaded onto the web. Medicare policy

More information

Rehabilitation Regulatory Compliance Risks

Rehabilitation Regulatory Compliance Risks Rehabilitation Regulatory Compliance Risks Christine Bachrach Vice President & Chief Compliance Officer University of Maryland Medical System 2011 AHIA Annual Conference Agenda - Rehabilitation Compliance

More information

Get With The Guidelines - Stroke PMT Special Initiatives Tab for Ohio Coverdell Stroke Program CODING INSTRUCTIONS Effective 10-24-15

Get With The Guidelines - Stroke PMT Special Initiatives Tab for Ohio Coverdell Stroke Program CODING INSTRUCTIONS Effective 10-24-15 Get With The Guidelines - Stroke PMT Special Initiatives Tab for Ohio Coverdell Stroke Program CODING INSTRUCTIONS Effective 10-24-15 Date and time first seen by ED MD: The time entered should be the earliest

More information

The Promise of Healthcare Analytics with FTI Catalyst. By Prof. Asha Saxena, Columbia Business School CEO, FTI Catalyst

The Promise of Healthcare Analytics with FTI Catalyst. By Prof. Asha Saxena, Columbia Business School CEO, FTI Catalyst The Promise of Healthcare Analytics with FTI Catalyst By Prof. Asha Saxena, Columbia Business School CEO, FTI Catalyst Asha Saxena, President & CEO, fticorporate.com, fticatalyst.com President and CEO

More information

Care Transformation and the Journey to Population Health Management

Care Transformation and the Journey to Population Health Management Care Transformation and the Journey to Population Health Management Richard A Bankowitz, MD MBA FACP Chief Medical Officer, Premier healthcare alliance AMGA Institute for Quality September 26, 2013 Premier:

More information

Acute Inpatient Rehabilitation Level of Care

Acute Inpatient Rehabilitation Level of Care Printer-Friendly Page Acute Inpatient Rehabilitation Level of Care EFFECTIVE DATE 07/06/2010 LAST UPDATED 07/06/2010 Prospective review is recommended/required. Please check the member agreement for preauthorization

More information

Managing Population Health: Equity through Person- Centered Care

Managing Population Health: Equity through Person- Centered Care Managing Population Health: Equity through Person- Centered Care Linda Alexander, RN, MBA, CCM Total Health Care Chief Clinical Officer Plante Moran Healthcare Consulting Detroit Medical Center - Clinical

More information

The Solution to your Rehab Needs

The Solution to your Rehab Needs The Solution to your Rehab Needs E R G O S O L U T I O N S N E W S L E T T E R Visit our website goergorehab.com June 2011 Volume 1 The Solution to your Rehab Needs ERGO SOLUTIONS NEWSLETTER Volume 1 Ergo

More information

Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and payment changes (CMS-1632-P)

Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and payment changes (CMS-1632-P) Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and payment changes (CMS-1632-P) Date 2015-04-17 Title Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and

More information

CMS National Dry Run: All-Cause Unplanned Readmission Measure for 30 Days Post Discharge from Inpatient Rehabilitation Facilities

CMS National Dry Run: All-Cause Unplanned Readmission Measure for 30 Days Post Discharge from Inpatient Rehabilitation Facilities CMS National Dry Run: All-Cause Unplanned Readmission Measure for 30 Days Post Discharge from Inpatient Rehabilitation Facilities Special Open Door Forum October 20, 2015 2-3 PM ET RTI International is

More information

in LOVE with LIFE CaroMont Health s Path to Accountable Care: A Pathway to Health

in LOVE with LIFE CaroMont Health s Path to Accountable Care: A Pathway to Health CaroMont Health s Path to Accountable Care: A Pathway to Health Betty Herbert, Director Managed Care May 17, 2011 CaroMont Health System Gaston Memorial Hospital, with 435 beds Courtland Terrace, a 96-bed

More information

Plenary Session 1. Health Dimensions Group. 2010 Health Dimensions Group

Plenary Session 1. Health Dimensions Group. 2010 Health Dimensions Group Plenary Session 1 Kathleen M. Griffin, PhD Health Dimensions Group March 31, 2011 Hospital, Post Acute and Long-Term Care Collaboration in Health Care Reform: Critical Success Factors National Summit:

More information

O N L I N E A P P E N D I X E S. Hospital inpatient and outpatient services

O N L I N E A P P E N D I X E S. Hospital inpatient and outpatient services 2A O N L I N E A P P E N D I X E S Hospital inpatient and outpatient services 2A-A O N L I N E A P P E N D I X Documentation and coding improvements What are documentation and coding improvements and how

More information

THE ROLE OF LONG TERM ACUTE CARE HOSPITALS IN THE ACUTE CARE CONTINUUM. Wednesday, June 02, 2010

THE ROLE OF LONG TERM ACUTE CARE HOSPITALS IN THE ACUTE CARE CONTINUUM. Wednesday, June 02, 2010 THE ROLE OF LONG TERM ACUTE CARE HOSPITALS IN THE ACUTE CARE CONTINUUM Wednesday, June 02, 2010 As A Provider Of Continuing Nursing Education, Triumph Healthcare Is Required By Texas Nurses Association

More information

Proposed Rule: Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations (CMS-1461-P)

Proposed Rule: Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations (CMS-1461-P) Via online submission to http://www.regulations.gov February 6, 2015 Sylvia M. Burwell Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS 1461

More information

RE: CMS-1455-P Medicare Program; Part B Inpatient Billing in Hospitals

RE: CMS-1455-P Medicare Program; Part B Inpatient Billing in Hospitals Marilyn Tavenner Acting Administrator and Chief Operating Officer Centers for Medicare and Medicaid Services Department of Health and Human Services Room 445-G Hubert H. Humphrey Building 200 Independence

More information

Where Should Rehabilitation Take Place?!

Where Should Rehabilitation Take Place?! Where Should Rehabilitation Take Place?! Three Basic Questions! 1. Is rehabilitation effective in improving a patient s functional abilities?!yes" yes" 2. Is rehabilitation cost effective?!yes" where"

More information

Quality Credentialing or Why Should a Long Term Care Facility Pay Attention to Health Care Reform?

Quality Credentialing or Why Should a Long Term Care Facility Pay Attention to Health Care Reform? Quality Credentialing or Why Should a Long Term Care Facility Pay Attention to Health Care Reform? Richard J. Brockman, Esq. Susan D. Doughton, Esq. I. Introduction The Patient Protection and Affordable

More information

Background. Does the Organization of Post- Acute Stroke Care Really Matter? Changes in Provider Supply. Sites for Post-Acute Care.

Background. Does the Organization of Post- Acute Stroke Care Really Matter? Changes in Provider Supply. Sites for Post-Acute Care. Does the Organization of Post- Acute Stroke Care Really Matter? Pamela W. Duncan, PhD, FAPTA University of Florida Brooks Center for Rehabilitation Studies Department of Veteran Affairs Rehabilitation

More information

OVERVIEW This policy is to document the criteria for coverage of services at the acute inpatient rehabilitation level of care.

OVERVIEW This policy is to document the criteria for coverage of services at the acute inpatient rehabilitation level of care. Medical Coverage Policy Acute Inpatient Rehabilitation Level of Care EFFECTIVE DATE: 07 06 2010 POLICY LAST UPDATED: 06 04 2013 sad OVERVIEW This policy is to document the criteria for coverage of services

More information

For trauma, there are some additional attributes that are unique and complex:

For trauma, there are some additional attributes that are unique and complex: Saving Lives, Reducing Costs of Trauma Care Trauma Center Association of America Model of Value Based Trauma Care to Evaluate, Test and Pilot July 25, 2013 Unique Nature of Trauma Injury and Treatment:

More information

1900 K St. NW Washington, DC 20006 c/o McKenna Long

1900 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 information

Outcomes Report through June 30, 2014

Outcomes Report through June 30, 2014 Outcomes Report through June 0, 0 Contents Introduction... Haag Pavilion (Sub-Acute Unit)... Rehabilitation Outcomes... Rehospitalization Outcomes of Sub-Acute Patients... Center for Heart Health Outcomes...

More information

Long-Term and Post-Acute Care Financing Reform Proposal

Long-Term and Post-Acute Care Financing Reform Proposal Long-Term and Post-Acute Care Financing Reform Proposal Section 1: Reforming and Rationalizing Medicare Post-Acute Care Benefits Overview. The proposal will reform and rationalize Medicare post-acute care

More information

Stroke Rehabilitation

Stroke Rehabilitation Stroke Rehabilitation Robert Teasell MD FRCPC Professor and Chair-Chief Dept Physical Medicine and Rehabilitation Schulich School of Medicine University of Western Ontario Lawson Health Research Institute

More information

Readmissions as an Enterprise Priority. Presenters 4/17/2014

Readmissions as an Enterprise Priority. Presenters 4/17/2014 Readmissions as an Enterprise Priority April 24, 2014 Presenters Vincent A. Maniscalco, MPA, LNHA Administrator Middletown Park Rehabilitation and Health Care Center Vmaniscalco@parkmanorrehab.com Eileen

More information

Five Myths Surrounding the Business of Population Health Management

Five Myths Surrounding the Business of Population Health Management Five Myths Surrounding the Business of Population Health Management Joan Moss, RN, MSN Robert Sehring Chief Nursing Officer and Chief Ministry Services Officer, Senior Vice President, Sg2 OSF HealthCare

More information

Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights

Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Emily Brower Executive Director Accountable Care Programs Emily_Brower@AtriusHealth.org November 2013 1 Contents Overview of

More information

A DATA BOOK. Health Care Spending and the Medicare Program

A DATA BOOK. Health Care Spending and the Medicare Program J U N E 2 0 1 5 A DATA BOOK Health Care Spending and the Medicare Program J U N E 2 0 1 5 A DATA BOOK Health Care Spending and the Medicare Program The MedPAC Data Book provides information on national

More information

Health care trend: Developing ACOs

Health care trend: Developing ACOs Health care trend: Health care trend: Accountable Care Organizations (ACOs) have been a significant topic within health care. While many organizations have embarked on a quest to embrace ACOs as quickly

More information

Transforming Patient Flow, Improving Patient Care

Transforming Patient Flow, Improving Patient Care Transforming Patient Flow, Improving Patient Care Transformation by Design (TbyD) Dr. Peter Nord, VP, CMO, Chief of Staff Thelma Horwitz, Director, Quality and Process Improvement Heidi Hunter, Quality

More information

Value Based Insurance Design Key concepts & their application at HealthPartners Health Insurance Plan

Value Based Insurance Design Key concepts & their application at HealthPartners Health Insurance Plan Value Based Insurance Design Key concepts & their application at HealthPartners Health Insurance Plan Shaun Frost, MD Associate Medical Director for Care Delivery Systems HealthPartners Health Plan Minneapolis,

More information

7/31/2014. Medicare Advantage: Time to Re-examine Your Engagement Strategy. Avalere Health. Eric Hammelman, CFA. Overview

7/31/2014. Medicare Advantage: Time to Re-examine Your Engagement Strategy. Avalere Health. Eric Hammelman, CFA. Overview Medicare Advantage: Time to Re-examine Your Engagement Strategy July 2014 avalerehealth.net Avalere Health Avalere Health delivers research, analysis, insight & strategy to leaders in healthcare policy

More information

Using analytics to get started with population health. The 3M 360 Encompass Health Analytics Suite

Using analytics to get started with population health. The 3M 360 Encompass Health Analytics Suite Using analytics to get started with population health The 3M 360 Encompass Health Analytics Suite The need for analytics in health care The global healthcare analytics market is expected to reach $21 billion

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

HEALTH DATA ANALYTICS OPTIMIZED CLINICAL AND FINANCIAL OUTCOMES DELIVERED FOR YOUR POPULATION HEALTH MANAGEMENT PROGRAMS

HEALTH DATA ANALYTICS OPTIMIZED CLINICAL AND FINANCIAL OUTCOMES DELIVERED FOR YOUR POPULATION HEALTH MANAGEMENT PROGRAMS HEALTH DATA ANALYTICS OPTIMIZED CLINICAL AND FINANCIAL OUTCOMES DELIVERED FOR YOUR POPULATION HEALTH MANAGEMENT PROGRAMS HOW WE HELP YOU MAXIMIZE THE VALUE OF YOUR POPULATION HEALTH INITIATIVES Indegene

More information

Post-Acute Opportunities in Population Health Management

Post-Acute Opportunities in Population Health Management Post-Acute Opportunities in Population Health Management Opening Questions Types of facilities Roles Parts of a Pioneer, Medicare Shared Savings Program (MSSP) or Commercial ACO network In a bundled payment

More information

DRIVING VALUE THROUGH CLINICAL PRACTICE VARIATION REDUCTION

DRIVING VALUE THROUGH CLINICAL PRACTICE VARIATION REDUCTION DRIVING VALUE THROUGH CLINICAL PRACTICE VARIATION REDUCTION Dr. Phil Oravetz, MD, MPH, MBA Adam J. Kelchlin, MEIE, MBA, PMP, LSSBB Abstract Rising costs, coupled with declining Medicare reimbursements

More information

UNIVERSITY OF VIRGINIA BOARD OF VISITORS MEETING OF THE MEDICAL CENTER OPERATING BOARD FOR THE UNIVERSITY OF VIRGINIA TRANSITIONAL CARE HOSPITAL

UNIVERSITY OF VIRGINIA BOARD OF VISITORS MEETING OF THE MEDICAL CENTER OPERATING BOARD FOR THE UNIVERSITY OF VIRGINIA TRANSITIONAL CARE HOSPITAL UNIVERSITY OF VIRGINIA BOARD OF VISITORS MEETING OF THE MEDICAL CENTER OPERATING BOARD FOR THE UNIVERSITY OF VIRGINIA TRANSITIONAL CARE HOSPITAL FEBRUARY 18, 2016 UNIVERSITY OF VIRGINIA MEDICAL CENTER

More information