Pushing the Envelope of Population Health
|
|
- Clinton Morgan
- 8 years ago
- Views:
Transcription
1 Pushing the Envelope of Population Health Timothy Ferris, MD, MPH Senior Vice President, Population Health Management, Partners HealthCare May 15, 2014 DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
2 Disclosure of Conflicts of Interest I have no conflicts of interest.
3 Population Health Management priority programs Primary Care Specialty Care Care Continuum Patient Engagement Infrastructure Patient Centered Medical Home (PCMH) High risk care management (palliative care) Mental health integration Virtual visits Active referral management (curbsides) Virtual visits Procedural decision support (appropriateness) Patient reported outcomes Episodes of care (bundles) SNF care improvement (network/waiver/snfist) Home care innovation (mobile observation/telemonitoring) Urgent care Shared decision making Customized decision aids and educational materials Single EHR platform with advanced decision support Data warehouse, analytics, performance metrics 3 V 2.1
4 3 phases of work for improving population health Phase 3 Phase 2 Phase 1 1 Primary care: The hub for managing populations: preventive services, chronic illness, high risk 2 3 Specialty care: Where a large fraction of costs are incurred, especially in commercial populations Care Continuum: Opportunities to track patients over time using new approaches and technology 5 Wellness promotion: Programs to prevent or delay the progression of illness 4 Patient engagement: Involving patients in better self-management of care Ongoing: IS, analytics and central infrastructure 4
5 Complex care management Care managers embedded in primary care practices Coordinate the care of patients at risk for poor outcomes, hospitalizations Supported by health IT (universal EHR, patient tracking, home monitoring) Adoption rapid and near universal among provider groups who are taking on financial risk populations MGH Experience Year Patients MDs CMS Demonstration Phase , Expansion Phase , Pioneer ACO , Ferris TG, et al; Cost Savings from Managing High-Risk Patients in The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington (DC): National Academies Press (US); , Care Culture and System Redesign. Available from: 5
6 6 Medicare Demonstration care team Healthcare & Community Services Non Acute Hospice VNAs Community Agencies Palliative Care and Hospice Community Resource Specialist Care Agencies Complex Care Team Substance Abuse Specialist PCP Care Manager Specialist Pharmacist Mental Health Team Financial Service Specialist Elder Service Network Transport Providers Civic Organizations
7 Medicare Demonstration results Patient Outcomes Hospitalization rate: 20% lower ED visit rate: 25% lower Mortality rate: 4% lower Savings 7.1% net savings (12.1% gross) Approximately 4% annual savings for the total population For every $1 spent, the program saved at least $2.65 Cohort Gross Savings % Net Savings % MGH (1) 10.4% 5.9% MGH (2) 19.8% 15.1% BWH 7.0% 2.9% NSMC 4.1% -0.7% Average 11.83% 7.28% Source: Lessons from Medicare s Demonstration Projects on Disease Management and Care Coordination, Lyle Nelson, Congressional Budget Office, January 2012, Working Paper Future Directions Specialty specific programs, palliative care RTI evaluation FullFTIreport.pdf 7
8 icmp identification process Goal: identify medically complex, chronically ill patients who would benefit from a primary care embedded, longitudinal, care management program Key features: Algorithm: 1. one year of claims data 2. threshold for prospective risk score 3. combination of clinical conditions and utilization triggers Automatic inclusion criteria for patients with a certain risk score or age regardless of the types of clinical conditions or utilization triggers Primary Care Physician makes the final decision about eligibility 25% of algorithm eligible patients removed by PCP decision (10% care needs are met and 15% patient doesn t need high touch program) Patients can refuse participation 8
9 icmp performance metrics Process measures Patients identified by algorithm Enrollment measures (reached and receptive, eligible, etc) Patient engagement (completed care plans) Patients declining enrollment and discharged Patient activities % of patients with post discharge assessment completed and documentation of communication between the inpatient care management and icmp care manager Patient survey measure % of patients who knew their care manager and could identify them by name New outcomes measures Medical admissions per 1,000 9
10 Virtual visits and technology tools Technology Pediatric Virtual Video Pilots 313 Video Conferencing Pedi ICU Burns Center Child and Adolescent Psychiatry Telephone Text Messaging 100% 80% 60% Active Referral Management Visits Avoided 16 Referrals Reviewed 100% 80% 60% Curbside* 54 Visits Avoided Visits Conducted Active Referral Management/ Electronic Curbside 40% 20% 0% Diabetes Endocrine Thyroid n=599 n=255 n=66 40% 20% 0% Cardiology n=602 *Expected results based on projected modeling for a 3 month period. Pilot in early stages. 10
Meeting Increasing Needs by Redesigning Care Delivery & Controlling Costs
Meeting Increasing Needs by Redesigning Care Delivery & Controlling Costs Timothy Ferris, MD, MPH Vice President for Population Health Management, Partners HealthCare Medical Director, Mass General Physicians
More informationNew York Presbyterian Innovations in Health Care Reform at Academic Medical Centers
New York Presbyterian Innovations in Health Care Reform at Academic Medical Centers October 28, 2011 Timothy G Ferris, MD, MPH Mass General Physicians Organization, Medical Director Associate Professor,
More informationCMS 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 informationMontefiore s Population Health Management Services. October 23, 2015
Montefiore s Population Health Management Services October 23, 2015 Integrated Delivery System Our Locations 3,092 Acute Beds Across 10 Hospitals Including 132 beds at the Children s Hospital at Montefiore
More informationBuilding an Accountable Care Organization. Jean Malouin, MD MPH University of Michigan Health System September 21, 2012
Building an Accountable Care Organization Jean Malouin, MD MPH University of Michigan Health System September 21, 2012 Agenda UMHS overview PGP demo ACO precursor Current efforts underway Role of primary
More informationThe Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM. Sue Thompson Chief Executive Officer
The Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM Sue Thompson Chief Executive Officer 2 UnityPoint Health: Organizational Profile 3 4 UnityPoint Health Fort Dodge: Organizational
More informationWhat is an Accountable Care Organization & Why is it Important to Your Home Infusion Company?
What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures
More informationAetna Medicare Advantage Embedded Case Management Program
Complex Care Management Program Overview Aetna Medicare Advantage Embedded Case Management Program Interviewee: Randall Krakauer, MD, FACP, FACR Summary Aetna has developed a Medicare Case Management Program
More informationWhat is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015
What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures
More informationKim Olmedo, LCSW, CCM CSW-G Social Work Manager, Silverback Care Management
Kim Olmedo, LCSW, CCM CSW-G Social Work Manager, Silverback Care Management According to AARP, about 8000 people turn 65 every day The Medicare Trustees have estimated that Medicare will run out of money
More information8/5/2013. Partners Approach to Managing the Economics of Population Health Management. What do you know about US health care?
Partners Approach to Managing the Economics of Population Health Management Creagh Milford, DO, MPH Associate Medical Director, Population Health Management Partners HealthCare Assistant Medical Director,
More informationAtrius 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 informationJohns 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 informationBridging the IT Functionality Divide in Care Coordination
Bridging the IT Functionality Divide in Care Coordination April 15, 2015 Anne Meara AVP, Network Care Management Dave Kim Strategy Advisory Service Line Executive DISCLAIMER: The views and opinions expressed
More information#Aim2Innovate. Share session insights and questions socially. UCLA Primary Care Innovation Model 6/13/2015. Mark S. Grossman, MD, MBA, FAAP, FACP
UCLA Primary Care Innovation Model Mark S. Grossman, MD, MBA, FAAP, FACP Chief Medical Office, UCLA Community Physicians & Specialty Care Networks June 16, 2015 DISCLAIMER: The views and opinions expressed
More informationThe Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary http://www.nap.edu/catalog/12750.html
CARE CULTURE AND SYSTEM REDESIGN 301 Healthcare information technology (IT) Although significant investment is being directed toward clinical IT, we should not lose sight of what can be achieved by focusing
More informationGaidaid Medicaid - A Great Initiative to Improve Performance and Provide Disease
69 th Annual Meeting of the Southern Legislative Conference Medicaid Behavioral Health Homes Integrating Services- Overview and Implementation Advice Savannah, GA July 19, 2015 Michael S. Varadian, JD,
More informationProven Innovations in Primary Care Practice
Proven Innovations in Primary Care Practice October 14, 2014 The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2014 Society for Healthcare
More informationPIONEER 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 informationPIONEER 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 informationSharp HealthCare ACO. Pioneer Introduction to the FSSB November 8, 2012
Sharp HealthCare ACO Pioneer Introduction to the FSSB November 8, 2012 Sharp HealthCare Not-for-profit serving 3.1 million residents of San Diego County Grew from one hospital in 1955 to an integrated
More informationImplementing Care Management for Complex Patients in Primary Care Best Practices from Successful Programs
Implementing Care Management for Complex Patients in Primary Care Best Practices from Successful Programs Clemens Hong MD, MPH California Association of Public Hospitals December 5, 2014 Sources: Cohen,
More informationHealth Homes in Medicaid
Health Homes in Medicaid Melissa Cuerdon, MSW, LCSW-C and Christa Speicher, MPH Disabled and Elderly Health Programs Group Centers for Medicaid & CHIP Services Centers for Medicare and Medicaid Services
More informationMAKING THE TRANSITION TO POPULATION HEALTH MANAGEMENT
MAKING THE TRANSITION TO POPULATION HEALTH MANAGEMENT H O W T O E F F E C T I V E L Y N E G O T I A T E V A L U E - B A S E D C O N T R A C T S I N T H E N E W R E T A I L M A R K E T P I O N E E R I N
More informationBe Careful What You Ask For A Predictive Model That Really Works
Be Careful What You Ask For A Predictive Model That Really Works Rod Christensen, MD President, Allina Health Clinics Cheryl Hermann, RN, MBA Vice President, Clinic Operations & Patient Care Services Karen
More informationLeveraging EHR to Improve Patient Safety: A Davies Story
Leveraging EHR to Improve Patient Safety: A Davies Story Claudia Colgan, Vice President of Quality Initiatives Bruce Darrow, MD, PhD, Interim Chief Medical Information Officer Jill Kalman, MD, Director
More informationPopulation Health Management: Advancing Your Position in the Journey to Value-Based Care
Population Health Management: Advancing Your Position in the Journey to Value-Based Care Webcast Session One: An Integrated Approach to Population Health Management 11 August 2015 Welcome & Introductions
More informationInsight Into Evolving Payment and Delivery Models
Insight Into Evolving Payment and Delivery Models Overview Objectives Provide an overview of Accountable Care Organization (ACO)-like payment and delivery models Demonstrate Genentech s commitment to patient
More informationFinal Report. September 2010. Prepared for
September 2010 Evaluation of Medicare Care Management for High Cost Beneficiaries (CMHCB) Demonstration: Massachusetts General Hospital and Massachusetts General Physicians Organization (MGH) Final Report
More informationCare Coordination. The Embedded Care Manager. Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed
Care Coordination The Embedded Care Manager Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed Goals of Care Management The goals of care Management are consistent with the Triple Aim: Improve population
More informationA. John Blair, III, MD, CEO MedAllies Susan Stuard, Executive Director THINC, Inc.
ACO Accelerated Development Learning Session Baltimore, MD September 15-16, 2011 Learning Module 3: HIT and Connecting Providers A. John Blair, III, MD, CEO MedAllies Susan Stuard, Executive Director THINC,
More informationDual Eligible and High Risk Populations: A Case for Integrated Care and Redesign
Dual Eligible and High Risk Populations: A Case for Integrated Care and Redesign Peggy Johnson, MD Chief of Psychiatry, Commonwealth Care Alliance Twitter Handle CCABoston May 15, 2014 DISCLAIMER: The
More informationThe Patient Centered Medical Home (PCMH): Overview of the Model and Movement Part I. July 2010
The Patient Centered Medical Home (PCMH): Overview of the Model and Movement Part I July 2010 Shari M. Erickson, MPH Senior Associate, Center for Practice Improvement & Innovation American College of Physicians
More informationNew Models of Care and Approaches to Payment
New Models of Care and Approaches to Payment Richard Lopez, MD Chief Medical Officer Richard_Lopez@AtriusHealth.org September 30, 2014 Atrius Health Non-profit alliance of six leading independent medical
More informationProposed 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 informationTHE LANDSCAPE OF MEDICAID ALTERNATIVE PAYMENT MODELS
POLICY BRIEF September 2014 THE LANDSCAPE OF MEDICAID ALTERNATIVE PAYMENT MODELS Authored by: America s Essential Hospitals staff KEY FINDINGS States have increasingly sought to establish alternative payment
More informationImplementing Care Management for Complex Patients in Primary Care Best Practices from Successful Programs
Implementing Care Management for Complex Patients in Primary Care Best Practices from Successful Programs Clemens Hong MD, MPH Maine Community Care Teams Summit November 14, 2013 Health Care Costs Concentrated
More informationAtrius Health ACO Initiative. Agenda
Atrius Health ACO Initiative November 9, 2012 Mark Yurkofsky MD Mark_yurkofsky@vmed.org 11/13/2012 1 Agenda Why the interest in the Pioneer ACO? What actually is Pioneer ACO anyway? What is Atrius Health?
More informationMERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D.
MERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D. November, 2012 Accountable Care Organization An ACO is a group of health care providers who agree to take on a shared
More informationPopulation Health Management: Banner Health Network s Perspective. Neta Faynboym, Medical Director Banner Health Network
Population Health Management: Banner Health Network s Perspective Neta Faynboym, Medical Director Banner Health Network 29 Acute Care Hospitals BANNER AT A GLANCE Banner Health Network with 400K lives
More informationMaineCare Value Based Purchasing Initiative
MaineCare Value Based Purchasing Initiative The Accountable Communities Strategy Jim Leonard, Deputy Director, MaineCare Peter Kraut, Acting Accountable Communities Program Manager Why Value-Based Purchasing
More informationImplementing Care Management for Complex Patients
Implementing Care Management for Complex Patients Timothy Ferris, MD, MPH SVP, Population Health Management, MGH, MGPO and Partners HealthCare Ohio Perinatal Quality Collaborative September 28, 2015 Thinking
More informationcaresy caresync Chronic Care Management
caresy Chronic Care Management THE PROBLEM Chronic diseases and conditions, including heart disease, diabetes, COPD and obesity, are among the most common, expensive, and preventable health problems in
More informationRealizing ACO Success with ICW Solutions
Realizing ACO Success with ICW Solutions A Pathway to Collaborative Care Coordination and Care Management Decrease Healthcare Costs Improve Population Health Enhance Care for the Individual connect. manage.
More informationCHAPTER 535 HEALTH HOMES. Background... 2. Policy... 2. 535.1 Member Eligibility and Enrollment... 2. 535.2 Health Home Required Functions...
TABLE OF CONTENTS SECTION PAGE NUMBER Background... 2 Policy... 2 535.1 Member Eligibility and Enrollment... 2 535.2 Health Home Required Functions... 3 535.3 Health Home Coordination Role... 4 535.4 Health
More informationPopulation 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 informationAccountable Care Organizations: Forging Stakeholder Partnerships for Health Care Performance and Efficiency
Accountable Care Organizations: Forging Stakeholder Partnerships for Health Care Performance and Efficiency Julie Lewis Director of Health Policy Dartmouth Institute for Health Policy and Clinical Practice
More informationHealth Care and Political Polarization. Northeast Business Group on Health April 2012
Health Care and Political Polarization Northeast Business Group on Health April 2012 Peter R. Orszag Citigroup, Council on Foreign Relations, and Bloomberg What is driving the recent deceleration in health
More informationApplying ACO Principles to a Pediatric Population UH Rainbow Care Connection: Transforming Pediatric Ambulatory Care with a Physician Extension Team
Applying ACO Principles to a Pediatric Population UH Rainbow Care Connection: Transforming Pediatric Ambulatory Care with a Physician Extension Team Ethan Chernin, MBA Director 1 Objectives Understand
More informationCommunity Care Collaborative Integrated Behavioral Health Intervention for Chronic Disease Management 307459301.2.3 Pass 3
Community Care Collaborative Integrated Behavioral Health Intervention for Chronic Disease Management 307459301.2.3 Pass 3 Provider: The Community Care Collaborative (CCC) is a new multi-institution, multi-provider,
More informationNancy L. Wilson Department of Medicine-Geriatrics Houston Center for Quality of Care& Utilization Studies Texas Consortium of Geriatric Education
1 Nancy L. Wilson Department of Medicine-Geriatrics Houston Center for Quality of Care& Utilization Studies Texas Consortium of Geriatric Education Centers Care for Elders Governing Council Acknowledge
More informationIt Takes Two to ACO A Unique Management Partnership
AMGA 2014 Annual Conference, April 4, 2014 It Takes Two to ACO A Unique Management Partnership Scott Hayworth MD, President & CEO Mount Kisco Medical Group Alan Bernstein MD, Senior Medical Director Mount
More informationINTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS. Karen Unholz, RN, BSN
INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS Karen Unholz, RN, BSN Origins of the Accountable Care Organization ACOs originated from the Patient Protection and Affordable Care Act (Healthcare Reform)
More informationPartnerships in Primary and Behavioral Health Care ACO Survival Integrated Care
Partnerships in Primary and Behavioral Health Care ACO Survival Integrated Care Ensuring Success for ACOs September 22 23 Joyce Wale LCSW Vice President, Institute for Behavioral Healthcare Improvement
More informationUpdate on New Coordination of Care and Transition of Care Coding
Update on New Coordination of Care and Transition of Care Coding Michele Olivier ACP Colorado Chapter February 5, 2015 (303) 801-0123 Agenda Introduction Chronic Care Management Coding Advanced Care Planning
More informationThe Promise of Regional Data Aggregation
The Promise of Regional Data Aggregation Lessons Learned by the Robert Wood Johnson Foundation s National Program Office for Aligning Forces for Quality 1 Background Measuring and reporting the quality
More informationPatient-Centered Medical Home and Meaningful Use
Health Home Series: Patient-Centered Medical Home and Meaningful Use Presenters: Christine Stroebel, MPH, PCIP/NYC REACH Natalie Fuentes, MPH, PCIP/NYC REACH Alan Silver, MD, MPH/IPRO March 27, 2012, 2:00
More informationDual RFI Response Summary
Dual RFI Response Summary Improving Care through Integrated Medicare and Medi- Cal Delivery Models Stuart Levine, MD., MHA. Keith Wilson, MD Robert Margolis, MD. Stakeholder Meeting August 30, 2011 1 Organization
More informationHow Models Work: Care Coordination from an IT Perspective
How Models Work: Care Coordination from an IT Perspective Steve Davis, DO Roberta Sniderman DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily
More informationApplying Lessons from Two Years of a Commercial ACO to a Medicare Shared Savings Program
Applying Lessons from Two Years of a Commercial ACO to a Medicare Shared Savings Program Lee B. Sacks, MD, CEO Mark Shields MD, MBA, FACP, Senior Medical Director AMGA 2013 Annual Conference Orlando, FL
More informationFacilitating the Palliative Care Discussion: Using the Universal Patient Score to Simplify Clinician-Family Collaboration
Facilitating the Palliative Care Discussion: Using the Universal Patient Score to Simplify Clinician-Family Collaboration www.perahealth.com Agenda Introduction to the Rothman Index and PeraTrend Jonathan
More informationThe New Health Care Model. Axel Arroyo, MD MPH
The New Health Care Model Axel Arroyo, MD MPH Past Learning Objectives Which are the reasons behind these changes? To review the reasons of this transformation. To review Legislative initiatives (ARRA,
More informationWhat Really Works for High- Risk, High-Cost Patients?
What Really Works for High- Risk, High-Cost Patients? National Academy of Medicine Workshop Models of Care for High-Need Patients Washington, DC January 19, 2016 Randall Brown, Ph.D. Mathematica Policy
More informationPopulation Health Management Helps Utica Park Clinic Ease the Transition to Value-Based Care
CASE STUDY Utica Park Clinic Population Health Management Helps Utica Park Clinic Ease the Transition to Value-Based Care The transition from fee-for-service to value-based reimbursement has been a challenge
More informationMaximizing Limited Care Management Resources to Improve Clinical Quality and Ensure Safe Transitions
Maximizing Limited Care Management Resources to Improve Clinical Quality and Ensure Safe Transitions Scott Flinn MD Deborah Schutz RN JD Fritz Steen RN Arch Health Partners A medical foundation formed
More informationCPCA California Primary Care Association
CPCA California Primary Care Association Accountable Care Organizations: Next Generation Systems for Community Health Centers? CPCA Annual Conference Sacramento, California October 10, 2014 Larry Garcia,
More informationHealth Care Reform. Jim Smith American Continental Group 900 19 th Street, NW, #800 Washington, DC 20006 202-327-8100
Health Care Reform Jim Smith American Continental Group 900 19 th Street, NW, #800 Washington, DC 20006 202-327-8100 *Tobacco-related disease *Poor diet *Lack of exercise *Excessive use of alcohol *American
More informationUCare provides case management for all UCare members not affiliated with one of the above listed care systems. 2011 UCare for Seniors
Case Requirements Updated 3/16/2011 According to the Case Society of America (CMSA), Case Model Act of 2009, Case management is a collaborative process of assessment, planning, facilitation, care coordination,
More informationHow Health Reform Will Affect Health Care Quality and the Delivery of Services
Fact Sheet AARP Public Policy Institute How Health Reform Will Affect Health Care Quality and the Delivery of Services The recently enacted Affordable Care Act contains provisions to improve health care
More informationOctober 22, 2014 Jill M. Gregoire RN, MSN Quality Assurance/Clinical Operations Director Indian Stream Health Center Colebrook, NH
October 22, 2014 Jill M. Gregoire RN, MSN Quality Assurance/Clinical Operations Director Indian Stream Health Center Colebrook, NH Why Stratify Risk for Your Patients? NCQA s Patient-Centered Medical Home
More informationBest Principles for Integration of Child Psychiatry into the Pediatric Health Home
Best Principles for Integration of Child Psychiatry into the Pediatric Health Home Approved by AACAP Council June 2012 These guidelines were developed by: Richard Martini, M.D., co-chair, Committee on
More informationAccountable Care and Value Based Payments 101: Government Programs Update
1 Accountable Care and Value Based Payments 101: Government Programs Update June 24 th, 2014 Dave Neiman, FSA, MAAA Senior Consulting Actuary DaveN@Wakely.com (720) 226-9806 2 Caveats Opinions expressed
More informationCare Coordination among DSRIP Partners
Care Coordination among DSRIP Partners John F. Skip Williams, Jr., MD, EdD, MPH Maureen Fahey, RN, MBA Thursday, June 25, 2015 3:00-3:30 pm OVERVIEW OF PRESENTATION New York State DSRIP Overview Brooklyn
More informationLow-Hanging Fruit: Analytic Best Practices for Physician-Led ACOs
Low-Hanging Fruit: Analytic Best Practices for Physician-Led ACOs MY BACKGROUND Practicing General Internal Medicine Physician Hospitalist at Newton-Wellesley Hospital Researcher at Brigham and Women s
More information1900 K St. NW Washington, DC 20006 c/o McKenna Long
1900 K St. NW Washington, DC 20006 c/o McKenna Long Centers for Medicare & Medicaid Services U. S. Department of Health and Human Services Attention CMS 1345 P P.O. Box 8013, Baltimore, MD 21244 8013 Re:
More informationBilling and Coding Update in the Nursing Home 2015
Billing and Coding Update in the Nursing Home 2015 Charles Crecelius MD PhD FACP CMD Agenda Review of nursing home basic coding requirements Use of NPP New Transition of Care code Ancillary CPT codes,
More informationPerformance Measurement in CMS Programs Kate Goodrich, MD MHS Director, Quality Measurement and Health Assessment Group, CMS
Performance Measurement in CMS Programs Kate Goodrich, MD MHS Director, Quality Measurement and Health Assessment Group, CMS Mind the Gap: Improving Quality Measures in Accountable Care Systems October
More informationChallenges with Meaningful Use EHR Satisfaction & Usability Diminishing
Challenges with Meaningful Use EHR Satisfaction & Usability Diminishing Will Underwood, MPH Alan Brookstone, MD DISCLAIMER: The views and opinions expressed in this presentation are those of the author
More informationPOPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk
POPULATION HEALTH MANAGEMENT The Lynchpin of Emerging Healthcare Delivery Improve Patient Outcomes, Engage Physicians, and Manage Risk Julia Andrieni, MD, FACP Vice President, Population Health and Primary
More informationPL 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 informationMODULE 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 informationProject Objective: Integration of mental health and substance abuse with primary care services to ensure coordination of care for both services.
Domain 3 Projects 3.a.i Integration of Primary Care and Behavioral Health Services Project Objective: Integration of mental health and substance abuse with primary care services to ensure coordination
More informationMeasure Information Form (MIF) #275, adapted for quality measurement in Medicare Accountable Care Organizations
ACO #9 Prevention Quality Indicator (PQI): Ambulatory Sensitive Conditions Admissions for Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Data Source Measure Information Form (MIF)
More informationImpact of VA Home Based Primary Care: Access, Quality and Cost National Health Policy Forum
Impact of VA Home Based Primary Care: Access, Quality and Cost National Health Policy Forum Thomas Edes, MD, MS Director, Geriatrics and Extended Care Office of Clinical Operations U.S. Department of Veterans
More informationCPR-PBGH Toolkit for Purchasers on Accountable Care Organizations. June 26, 2014
CPR-PBGH Toolkit for Purchasers on Accountable Care Organizations June 26, 2014 Overview Introductions The Current ACO Landscape ACO Options Available to Employers Today Features of the Ideal ACO CPR-PBGH
More informationWho are Parent Navigators?
Parent Navigators: A New Care Team Member in Your Medical Home or Specialty Practice Faculty Disclosure: We have no financial relationships to disclose relating to the subject matter of this presentation.
More informationAccountable Care Communities 101. Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014
Accountable Care Communities 101 Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014 Premier is the largest healthcare alliance in the U.S. Our Mission:
More informationOregon Standards for Certified Community Behavioral Health Clinics (CCBHCs)
Oregon Standards for Certified Community Behavioral Health Clinics (CCBHCs) Senate Bill 832 directed the Oregon Health Authority (OHA) to develop standards for achieving integration of behavioral health
More informationPremier ACO Collaboratives Driving to a Patient-Centered Health System
Premier ACO Collaboratives Driving to a Patient-Centered Health System As a nation we all must work to rein in spiraling U.S. healthcare costs, expand access, promote wellness and improve the consistency
More informationMONTANA. Downloaded January 2011
MONTANA Downloaded January 2011 37.40.202 PREADMISSION SCREENING, GENERAL REQUIREMENTS (1) This rule provides the preadmission screening requirements of the Montana Medicaid program for applicants to nursing
More informationDRIVING VALUE IN HEALTHCARE: PERSPECTIVES FROM TWO ACO EXECUTIVES, PART I
DRIVING VALUE IN HEALTHCARE: PERSPECTIVES FROM TWO ACO EXECUTIVES, PART I A firm understanding of the key components and drivers of healthcare reform is increasingly important within the pharmaceutical,
More informationSMD# 13-001 ACA #23. Re: Health Home Core Quality Measures. January 15, 2013. Dear State Medicaid Director:
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 SMD# 13-001 ACA #23 Re: Health Home Core Quality
More informationBUNDLING 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 informationNuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations
Nuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations Presented to The American College of Cardiology October 27, 2012 1 Franciscan Alliance Overview Franciscan
More informationAccountable Care Organizations: What Are They and Why Should I Care?
Accountable Care Organizations: What Are They and Why Should I Care? Adrienne Green, MD Associate Chief Medical Officer, UCSF Medical Center Ami Parekh, MD, JD Med. Director, Health System Innovation,
More informationHIPAA and Payment Reform ACOs, Medical Home & Bundled Payments
HIPAA and Payment Reform ACOs, Medical Home & Bundled Payments By: Paul T. Smith, Shareholder Hooper, Lundy & Bookman, P.C. psmith@health-law.com 21 st National HIPAA Summit Washington, D.C. February 20,
More informationWellmark s ACO Model and the Value Index Score. Tom Newton, Vice President Network Engagement
Wellmark s ACO Model and the Value Index Score Tom Newton, Vice President Network Engagement Wellmark s ACO Shared Savings Model 9/24/2014 Confidential and Proprietary Wellmark Blue Cross and Blue Shield
More informationAnn Hablitzel, RN, BSN, MBA Hospice Care of California
Ann Hablitzel, RN, BSN, MBA Hospice Care of California Objectives Describe the creations of new community based palliative care programs Identify criteria for admission Discuss philosophy and goals Analyze
More informationkaiser medicaid commission on and the uninsured May 2009 Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid
P O L I C Y B R I E F kaiser commission on medicaid SUMMARY and the uninsured Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid May 2009 Why is Community Care of North
More informationFive 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