Join leaders from UniNetHealthcare Network, St. Vincent's Health Partners, and McKesson as they discuss the evolution of care management as organizations increase their focus on population health. They will expound upon survey results drawn from HealthLeaders Media's 7,400-member executive Council and reflect on experiences at their own organizations.
As chief transformation officer at MemorialCare Health System in Los Angeles and Orange counties, CA, it’s Helen Macfie’s job to rethink the future of healthcare delivery. Lately, she’s been thinking a lot about healthcare reform and care redesign as the six-hospital integrated delivery system, with more than 200 care sites, focuses on growth across the Southern California region. In addition to consistently adding to its network of outpatient health, imaging, and surgery centers, MemorialCare Health System has nearly doubled the size of its MemorialCare Medical Foundation physician organization over the last three years from 980 to 1,570 employed and contracted physicians. It has also partnered with physicians over the last several years to create best practices and convert them into useable tools that are distributed throughout its EHR. Additionally, MemorialCare is aggressively pursuing population health strategies, most recently partnering in a pay-for-performance program called Vivity with Anthem Blue Cross and six other hospitals. Having a robust data analytics strategy is central to this level of growth, change, and innovation.
A decade ago, hospital leaders viewed cost containment as a distant option to that of building topline revenue through increased volumes and
rates. But with the road to profitability choked off by a recession, the ACA, and double-digit increases in healthcare inflation, most have been left pursuing a flurry of initiatives to cut operational costs and maintain
Hospitals and healthcare organizations of all sizes and structures are quickly elevating analytics to the enterprise level. But according to a recent HealthLeaders Intelligence survey, some might still be lacking the expertise to perform predictive or prescriptive analytics. Despite any potential infrastructure differences, the general consensus of surveyed health systems suggests they will face similar challenges in order to thrive in an analytics-driven future. An overwhelming majority (89%) agreed that a transformational understanding of clinical and fiscal success requires the ability to analyze clinical and cost data from all settings of care, including acute, primary, and homecare. Healthcare analytics can be intimidating, so one of the associated challenges may be simply finding a place to start. According to Tina Foster, vice president of business advisor services at McKesson, it's critical that leaders not treat analytics as simply another project.
U.S. healthcare providers’ journey from “sick care” to “well care” will be significantly less rocky if they can effectively capture, analyze, and use information about the people they care for. Yet providers face formidable obstacles in integrating all the available information and inducing their clinicians to use information technology (IT) effectively, according to a survey conducted this summer by HealthLeaders Media. The aging of the U.S. population and the nation’s skyrocketing healthcare bill (the highest in the world, at almost 18% of GDP as of 2012) have prompted both the federal government and commercial insurers to move away from paying providers on a fee-for-service basis, and toward reimbursement based on providers’ ability to keep their patients healthy and use clinical resources to maximum efficiency.
In the rough-and-tumble world of community and rural hospitals, the phrase "innovate or get left behind" is no longer a scary suggestion thrown out by expensive consultants, but a daily reality for CEOs. Rocked by reform and big changes in areas including financing, care models, and population trends, chief executives are getting used to making bold leadership decisions on a regular basis.
The history of healthcare reform has been largely fragmented, with pockets of success but few sweeping changes. Current federal reform efforts primarily aim to change how healthcare providers get paid for the work they do. Today, shared risk is permeating healthcare like never before in an attempt to focus providers on finding models of care that deliver better care at lower costs. Many of these new models, like Medicare ACO gainsharing, require hospitals and healthcare organizations to implement strategies like population health management—a move born more out of necessity than choice. However, for those organizations willing to take on more risk, the end result will hopefully be healthier patients, greater efficiency, and more returns to the bottom line.
Hospital administrators are facing significant financial realities, increasingly challenged with evaluating new diagnostics and therapy technologies to ensure they are both effective and efficient in improving patient outcomes and limiting the burden of chronic diseases. Heart failure is particularly challenging because of hospitalization volume, frequency and variable margins.
From minimizing the risk of infection to keeping out intruders, healthcare organizations need to be hyper-vigilant about ensuring the safety of patients, staff, and visitors. To do this, industry leaders are striving to create a culture of safety within their organizations that extends to all employees, according to an Intelligence Buzz survey conducted recently by HealthLeaders Media. In this report, senior executives from Texas Health Resources, UC Health in Cincinnati, and Intellicentrics discuss the results of the survey as well as some of the key steps to establishing a safety culture in healthcare organizations.
The healthcare industry continues to debate the definition of population health, but for San Diego-based Scripps Health, it's pretty simple: Population health is the future of healthcare. Two years ago, the five-hospital nonprofit, bolstered by a strong financial track record and an extensive ambulatory network, publicly entered the population health arena. It brought on Anil Keswani, MD, as its first corporate vice president of ambulatory care and population health management. In this role, Keswani is working to integrate ambulatory and inpatient care, disease management activities, quality improvement, and clinical practice guidelines.
Using your own employees as a starting population builds confidence and credibility while cutting costs and creating efficiencies.
As hospitals face more market pressures than ever before and margins continue to shrink, financial performance remains one of the most pressing concerns for C-suite leaders. Since fiscally responsible patient care is the goal of nearly every provider going forward, partnerships with management service providers are increasingly playing a role in meeting that objective.
Focusing on ICD-10 implementation and reducing denials will set the stage for the next generation in healthcare
At Catholic Health Initiatives, one of the largest nonprofit health systems in the country, reform looms large. From buttoning down denials to implementing ICD-10 to tipping the scale of services from inpatient to outpatient, CHI aims to boost patient satisfaction, quality of care, and revenue. The ultimate goal: Set a foundation to migrate smoothly from a fee-for-service to a value-based purchasing model.
Have you considered the benefits of workforce management automation for patient care, employee engagement, and productivity?
Automation of workforce management is starting to move from the back office to the bedside, according to a recent HealthLeaders Media survey.
In the next three to five years, hospitals, health systems, and other patient service providers expect to augment their time-and-attendance and payroll systems with integrated applications that enable more sophisticated data crunching around labor analytics, acuity management, and staffing assignments.
Reform and rising costs continue to push the importance of care management systems to the forefront. With the growing prominence of population health for provider organizations, provider-based care management becomes a critical bridge that ties the analytics of the population to proactive care interventions. However, health systems face challenges in order to thrive amid changing payment models. For example, they will increasingly need to work toward developing integrated solutions to keep their patient population and surrounding communities healthy. Data, analytics and technology are critical and can positively impact workflow and help staff work smarter.
Healthcare is an intensely complex industry where innovations, regulations, and business models constantly morph and patient lives hang in the balance. To manage these intricacies, hospitals have been employing IT solutions for decades. But with the Patient Protection and Affordable Care Act in full swing, accountable care and pay-for-performance delivery and reimbursement models taking shape, and meaningful use stage 2 and ICD-10 on the horizon, never has it been more apropos for healthcare organizations to deploy truly transformational technologies.