Delivering Value-based Healthcare
August 31, 2016
8:30 am – 12:30 pm
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A Positive Payment Experience is Critical: How Healthcare Organizations Deliver Consumer Engagement (8:30-9:20 am)
The application of new payment technologies can help healthcare providers enhance consumer engagement and collect more payments. New payment technologies, especially mobile options, improve the speed and increase the amount of patient collections. The growing use of mobile devices has enabled 24/7 consumer access to email and online services – 63 percent of consumers use their mobile devices exclusively to go online. Consumers now have the ability to manage their healthcare payments through a website or portal anywhere, at any time. Accordingly, the number of healthcare payments made from a mobile device through an online portal are increasing. Referencing data from Aite, Coalfire and InstaMed’s proprietary research, this presentation will analyze how NFC, EMV, online and mobile payments, including Apple Pay, enhance the consumer payment experience and help providers streamline their processes and collect more. The goal will be to validate that the healthcare industry needs to focus on meeting the demands of consumerism and will outline key trends affecting the way healthcare organizations approach payments. However, delivering consumer engagement does not come without challenges. The proliferation of new payment channels is setting the stage for payment and personal data to be at greater risk of compromise through breaches and cyberattacks. This presentation will discuss enhanced data security options that protect consumer privacy, prevent fraud and proactively defend critical payment data from falling into the wrong hands.
- Discuss the importance of consumer engagement in improving patient payment collections
- Evaluate best practices for improving the consumer payment experience and achieving financial stability
- Identify security risks associated with the expansion of payment channels and illustrate options to best protect payment data
Noah Dermer (InstaMed)
The healthcare industry is transitioning from a physician- and facility-centric fee-for-service model to a consumer-centric and value-based population health services model. This combined with dramatic shifts in demand, new financial realities, government reform and the changing nature of the consumer and competition creates a powerful set of business drivers that will continue to compel major industry change for years to come and challenge the most seasoned CIOs at healthcare organizations. This session analyzes the U.S. healthcare industry using the Value Chain framework to identify key players, regulatory bodies and processes, and the nature of their interaction. For example, how does Risk stratification fits into the changing strategy? What impact does it have on the organization’s bottom line and patient value? The presenter will offer recommendations on making a strategic shift to a value-based healthcare system using Applied Analytics.
- Explain how to make a strategic shift to a value-based healthcare system using Applied Analytics.
- Identify the key players, regulatory bodies and processes, the nature of their interaction, and the transformative forces impacting the healthcare industry .
- Describe the strategic benefits of a shift to a value-based healthcare system using Applied Analytics.
Jay Paulson (SAS)
Attend this session to learn why episode management is the fastest path to success under value-based reimbursement for hospitals, health systems, ACOs, and clinically-integrated networks. The session will arm you with the tools and strategies needed for great episode management. Episode management, particularly the 30-90 days post-discharge, is incredibly important for all types of healthcare entities seeking to succeed under value-based reimbursement. Millions of dollars in revenue, shared savings, and bundled payment contracts are at risk when hospitals, ACOs, bundled payment conveners, and others don’t have visibility into their patient’s care after hospital discharge. Leading health care organizations are realizing the solution is not simply to hire an army of care managers, but rather to supplement a care management team with focused automation to double or triple their productivity by sharing workflow and care management with the patient’s community providers, including independent physician offices, skilled nursing facilities, home health agencies, and others. Having the right solutions in place is critical to ensuring successful episode management.
- Describe post-discharge care coordination best practices and benefit impact
- Identify the obstacles to care coordination automation across diverse providers, including the attitude “We don’t want another system!”
- Discuss how a multi-state ACO succeeded with episode management across independent providers, their early results and long-term plans
Cheryl Dieterle (Experian Health)
Automate This! How Standardization & Automation will Solve Your Population Health Challenges (9:30-10:20 am)
The evolution of population health initiatives is still ongoing, and for the majority of health systems identifying and improving the outcomes of a population is extremely challenging. Efforts to organize and take action on billions of data points, in the context of ever-changing policies and requirements, can make even the most experienced data scientist’s head spin. In order to make significant progress in outcomes, we must “flip the switch” on our approach to handling patient data. We must transition from using technology to react to data, to exploiting technology to proactively pull, manage and take action based on data. Moving from a reactive to a fully proactive approach to population health management represents an innovative shift in thinking. We also need to move away from “patchwork” solutions that: utilize disparate technologies that don’t integrate with the EMR; require manual processes to identify and act on patient care gaps; and only manage the top 10-15 DRGS, at best. Recently the Institute for Health Technology Transformation published a case study entitled, A Roadmap for Provider-Based Automation in a New Era of Healthcare, in which the following is recommended: “At an operational level organizations must change their structure as well as workflows to implement PHM and adopt new types of automation tools and reporting.”
- Explain how automation is the foundation for comprehensive population health management
- Describe a 3-step strategy for automation-enabled population health management
- Discuss the importance of shifting to a new, proactive model
Jonathan Baran (healthfinch)
Understanding your patient experience has always been important, but the degree and dimensions of understanding have changed dramatically. You have to move beyond an occasional post-encounter survey to truly gauge how your patients view your providers and services. Patients have “free-range” choice. Patients have immediate feedback from social sources. Patients are expecting more than an appointment and a bill. Keeping patients with you will require more frequent and more personal feedback to ensure the level of service is what they expect. What if you were able to question your patients based on their type of encounter with you? You’d achieve a response level that more closely matches the patient’s experience level. If the encounter is an office visit, ask office visit questions. If what you’re looking for is outcomes, ask outcome related questions. Static, one-size-fits-all surveys can’t fulfill the specificity required for an in-depth understanding of your relationship. If you could analyze patient input in real-time and recognize positive or negative trends as they happen, would that change how you respond to patient incidents? The era of capturing survey responses and getting results in three months is over. All it takes is one bad incident to cause a negative effect to the practice. By compressing the time from patient input to patient action, you can effectively respond to incidents before it’s too late. Today’s technology and the seamless integration between healthcare systems can enable your practice to question, analyze and act on patient feedback and incidences like never before.
- Discuss the transition from static, encounter-based surveys to dynamic, context-based questionnaires.
- Describe tactics for using continual response data for practice and provider key performance indicators.
- Explain how to expand survey tactics to include retention, marketing and revenue opportunities.
David Olson (Clinect Healthcare)
Developing the Staff & Resource Infrastructure to Support Value-based Reimbursement (10:30-11:20 am)
This session will help participants strategically develop the staff and resource infrastructure necessary to support a successful transition from fee-for-service to value-based reimbursement. Value-based incentives and penalties continue to rely heavily on capture, management, and reporting of quality measures. University Physicians, in partnership with the University of Colorado School of Medicine, recently created an “Office of Value-Based Performance” to promote alignment of quality reporting and quality innovation activities across a large enterprise consisting of 2,500+ providers. By bringing together expertise in population and care management, quality and performance measurement, analytics, and clinical informatics, the new office is able to look into what we’re doing well and where we can improve. Traditionally, organizations silo this expertise but the Office of Value-Based Performance is aligning it to enhance efficiency and impact.
- Describe the infrastructure needed to successfully manage a transition from fee-for-service to value-based reimbursement.
- Provide compelling arguments for investment in staff and resources to successfully capture, manage and report quality metrics impacting reimbursement.
- Project value-based emergence into commercial payor modeling.
Aaron Van Artsen & John Steffen (University Physicians)
Utilizing Data Analytics to Improve Patient Care & System Risk Management (11:30 am – 12:20 pm)
Several of CMS’ Medicare initiatives are targeted to reducing the 30-day readmission rates among Medicare beneficiaries. Most hospitals and health systems have recognized that reducing readmission rates is vital and have started readmission reduction initiatives to work with patients to address needs that may cause them to return to the hospital. However, the BOOST, LACE and PARR predictive models, which are typically used to identify the patients with the greatest need, provide limited help in determining those priorities and do nothing to help the case managers understand what unique challenges each patient may be facing to avoid readmission.
- Describe how readmission rates can impact a hospital or system’s Medicare revenue
- Review the standard predictive models and their alternatives
- Explain how predictive models and their identified risk drivers can be used to make readmission reduction programs more effective
Norm Storwick (Forecast Health)
Finding the Right Balance: Anesthesia Post-procedure Handover (11:30 am – 12:20 pm)
The Joint Commission has recognized the communicative patient safety value in a formal, standardized patient handover between care teams as a patient transitions from anesthesia to nursing/post-procedure care. Historically, this process has been quite fragmented at my organization. All manner of patients (Peds, cardiac, etc.) going to all manner of postprocedure care areas (PACU, ICU, PICU, etc.) all have had their own handoff tool. This tool could be a photocopied piece of paper, a Word or PDF-based semi-electronic tool, or just colloquial “this is what we cover” handover. With the advent of a consistent enterprise-wide documentation tool, the opportunity presented itself to consider standardizing this handover process. First steps involved reviewing existing tools with key operational stakeholders. Once common elements were decided upon, the next step was to determine the best “source of truth” for the information. Adoption of the tool would be improved if it would present information that had already been documented as opposed to having users re-enter information. This would also reduce the risk of transcription errors or conveying incorrect information. Understanding that the tool should represent what had already been documented, the decision to go with a report was made. Configuration of print groups inside this report would be the representative bits from the patient’s record. Operational stakeholders provided information and opinion as to the content and layout for this report. A preliminary/phase I report was rolled out to anesthesia and PACU nurse users. Once the ‘proof of concept’ was established, the handover process was more formalized and ready to roll out to a larger audience. The surgical team and downstream ICU user groups were now included. The establishment of a one-stop, single-source for consistent and representative information has proven very effective in facilitating the SBAR-based handover of care.
- Describe the inherent patient safety risks in a non-standard handover model
- Identify some “source-of-truth” based data points/areas in their medical record and how they can be configured/exploited to provide critical handover information
- Discuss the value in engaging operational stakeholders as partners in a successful handover program
Tim Crittenden (Duke Health Technology Solutions)
The registration fee is $99 NCHICA members/$149 non-members.
Click below to find out more about the workshop presenters.