Creating a state-of-the-art clinical documentation improvement (CDI) program isn?t just about boosting coding accuracy. It?s a key strategy in managing the transition from volume-based to value-based care, say healthcare leaders. That transition is a risky endeavor that is putting hospital and physician financial performance to the test. As hospitals participate in new care and business models aimed at improving value, leaders must ensure that their organizations are able to maintain reimbursement levels, effectively treat the chronically ill?especially in outpatient settings?and gather accurate data that will allow them to assess performance and segment their varying populations. While some organizations often believe they are leaving revenue on the table because of documentation and coding issues, CDI offers numerous opportunities for improving financial performance, finds a recent HealthLeaders Media survey of 149 healthcare executives at provider organizations.
A recent HealthLeaders Media Intelligence survey asked respondents to rank their top challenges impacting financial performance and to identify specific areas of concern within each of those issues. Their top three issues were system implementation and interoperability, recruiting and retaining talent, and reengineering the revenue cycle. On the surface, it's tempting to think these findings aren't surprising. Yet emerging external factors, including the cumulative effects of the HITECH Act (meaningful use), the Affordable Care Act, and an aging U.S. population, are creating new frameworks in which to view and solve these traditional problems.
Financial stability is top of mind for every healthcare organization. Recent industry activity, such as announcements from the Centers for Medicare & Medicaid Services (CMS) and large payer organizations earlier this year, show a definite shift away from traditional fee-for-service reimbursement models. Provider organizations looking to position themselves to thrive in the emerging value-based healthcare system must make decisions around taking on risk, and the extent of that risk, in their reimbursement arrangements. Here, Elena White, Optum’s vice president of risk, quality, and network solutions, discusses how providers are approaching decisions around risk-based contracts in the new healthcare economy.
As healthcare organizations ramp up the battle for specialized workers, human resources leaders are developing a new rulebook for hiring and engaging top-of-the-line talent. Advances in big data, EMR technology, and nursing practices are enabling healthcare organizations to take important steps forward with clinical and business goals, but for talent management leaders, finding qualified candidates has gotten that much harder. In addition to dealing with perpetual shortages in key areas like nursing, organizations are hustling to find and develop the next generation of employees who can perform not only increasingly complex roles but also jobs that are facility-specific. Sponsored material.
Even as the move to electronic health records (EHR) progresses in earnest, there are a myriad of challenges involving legacy data systems. Chief among these challenges is the cost of maintaining obsolete systems solely for the patient information they contain. When up to 70% of a typical IT budget is spent on maintaining the current IT infrastructure and application portfolio, organizations have little left to invest in much-needed innovation. According to a recent HealthLeaders Media Survey, many organizations are still adjusting after their migration to a new EHR system. Hospitals need to get a better grasp on all forms and sources of data that they have?and the data they don?t yet have?so that the right information can be delivered to the right individual, and in the right context, at the point of care.
As healthcare organizations become more adept at collaboration, data mining, and understanding the unique populations they serve, they are designing innovative care programs that involve higher risks and rewards.
From Ebola preparedness to leading large-scale changes, today's master's degree programs are producing leaders eager to tackle this generation's most pressing challenges.
Rahul Anand, MD, is chief epidemiologist at Middlesex Hospital in Middletown, Connecticut, where he heads up all infectious disease prevention activities for the nonprofit integrated delivery network, from Ebola preparedness to hand washing. He's also adjunct assistant professor in the department of medicine at the University of Utah, where he worked full time prior to moving to the East Coast. On top of that, he is one-third of the way through an MBA program at the University of Massachusetts Isenberg School of Management. It will take him another two years to finish the online program.
Results from a recent HealthLeaders Media Council survey of 126 senior leaders indicate a shift taking place as workforce management initiatives are expected to deliver more than reduced labor costs. Now, hospitals and health systems are seeking to find ways to better develop and deploy their workforce to improve the patient experience, including both clinical outcomes and patient satisfaction.
Join executives from Anderson Regional Medical Center and an industry acuity-based staffing expert as they discuss the shift toward strategies that improve patient outcomes and the success factors necessary to achieve this.
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Hospitals seek clinical partners who will integrate into the fabric of their organizations as they make key transformations in anesthesia,
hospital medicine, and the ED.
Two years ago Saint Agnes Hospital set a new course for its emergency department: It was time to take patient satisfaction scores to the next level, as well as make critical changes to improve patient throughput. Admission and discharge times were too high, and too many patients were leaving without being seen. While the hospital had outsourced its ED for two decades with varying degrees of success, a strategic plan called for bringing on a brand-new national clinical partner to help revamp the department. "Our ED accounts for about 70% of our admissions," says Adrian Long, MD, CMO for the 276-bed teaching hospital in Baltimore. "The ED was the front door to the hospital, and it was important for us that we had providers who were going to improve these scores and our performance."
Workforce management and the pursuit of productivity have formed a consistent pain point for hospitals for several years. The Affordable Care Act has only exacerbated the problem, increasing the demand on providers as the number of insured grows and the bar continues to rise on quality of care. According to a recent HealthLeaders Media Council survey, workforce productivity and acuity-based staffing will continue to be top priorities this year. Karlene Kerfoot, PhD, chief clinical integration officer at API Healthcare, says the survey results indicate a shift taking place as workforce management initiatives are expected to deliver more than reduced labor costs.
Buzz Survey: Workforce Productivity Buzz Survey
From the cloud and mobile devices to the latest in robotics, healthcare’s renegades are riding a new wave of transformational technologies.
The University of California, San Francisco (UCSF) Medical Center, which sits on a steep hill in one of the city’s foggiest neighborhoods, may be only 30 miles north of Silicon Valley, but for its researchers and clinicians, technology disruption starts on the home turf. Unwilling to wait for others to develop the same slick apps and technologies that consumers have come to expect, UCSF is finding success forging its own innovative path. “When you are on your computer doing your work and you get a FaceTime message on your iPhone from your kid who’s 3,000 miles away, you ask, ‘Why can’t we do this in healthcare?’ ” says Robert Wachter, MD, chief of the division of hospital medicine and chief of medical service. “Here, when we see gaps like that, we have the inclination to develop a tool to fix it.”
For telemedicine trailblazer Robert Groves, MD, his first recollection of the technology is an illustration in a 1950s magazine article showing a little boy interacting with a physician over a video screen. Most of telemedicine's history, says Groves, "has been that model, that on-demand, limited time-frame interaction that facilitates both trust between the parties and the ability of the provider to assess the patient more than they would be able to by a telephone conversation." Today, however, Groves oversees a telemedicine program that is a "radical departure" from this early vision. As vice president of health management at Banner Health, a nonprofit healthcare delivery system based in Phoenix, Groves runs a teleICU program that enables physicians and other clinicians to remotely monitor critical care units hundreds of miles away. Introduced nine years ago, the technology has done more than just provide telemedicine consults between board-certified intensivists and providers in far-flung outposts: It has changed the way the system delivers critical care services.
The ripple effect of healthcare reform is beginning to impact care delivery strategies as care management now falls increasingly to providers.
According to a recent HealthLeaders Intelligence survey, hospital leaders are making progress with care management efforts, but more robust tools will be needed if hospitals want to scale up.
Courtesy of McKesson Corporation.
Eight years ago, executive and board leaders at Sentara Healthcare in Norfolk, Virginia, threw down a strategic gauntlet: It was time to make a big shift and focus on new growth. Since then, the nonprofit health system has been ramping up its presence in its home state of Virginia and continues to evaluate opportunities for partnerships in other states. ?Sentara?s evolution as an IDN is similar to many other health systems nationally in that our delivery system was largely centered in one geographic region,? says Megan Perry, corporate vice president of mergers and acquisitions. ?In 2006, as we looked at the national landscape, we realized that in order to meet the needs of the current communities we served, as well as make the necessary investments in technology and innovation, that we needed to continue to grow.? Between 2010 and 2014, Sentara merged with five hospitals and has entered into new partnerships with Ohio Health, in Columbus, Ohio, as well as with Huntsville Hospital Health System in Alabama. Today, Sentara encompasses more than 100 sites of care, including 12 acute care hospitals, five medical groups, and a health plan; it offers postacute, outpatient, and urgent care services, among others.