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Telephonic case management among behavioral health patients at Carolina Behavioral Health Alliance is targeting high-volume users of the emergency room and inpatient hospital stays for behavioral health concerns. During Telephonic Case Management: Protocols for Behavioral Healthcare Patients, a 45-minute webinar on March 7th, 2012 at 1:30 p.m. Eastern time, Jay Hale, director of quality improvement and clinical operations at Carolina Behavioral Health Alliance, will share the case management protocol developed by his organization, including using scripts and surveys to assess patients engagement in the treatment process and identify patients at-risk
Hudson River HealthCare (HRHC)'s Diabetes Collaborative program, in place for over 12 years, combines attributes from both the Institute for Health Improvement and the Wagner Chronic Care Model, to manage diabetic care for more than 3,400 adult patients. During Diabetes Management in the Medical Home, a 45-minute webinar on January 26, 2012 at 1:30 p.m. Eastern time, Kathy Brieger, R.D., C.D.E., chief operations officer at HRHC, will share the inside details on the diabetes management program and the program's impact on its diabetic patients.
A three-step process for resolving discrepancies between ICD-9 and ICD-10 codes has allowed Blue Cross Blue Shield of Michigan to complete its version of the General Equivalence Mappings (GEMs) and move closer toward ICD-10 compliance readiness. During Mapping the Way to ICD-10 Readiness: Blue Cross Blue Shield of Michigan's Approach, a 45-minute webinar on January 18, 2012, Dennis Winkler, ICD-10 technical program director at Blue Cross Blue Shield of Michigan, shared the health plan's mapping strategy along with other organizational readiness tactics.
With an aggressive expansion plan set for its embedded case management program, Aetna has clearly demonstrated the value of embedded case managers working side-by-side with physicians serving Aetna's Medicare members. Aetna began placing case managers in primary care practices in 2007 after its telephonic case management program showed significant reductions in the number of acute care days. During Demonstrating the Value of the Embedded Case Manager for the Medicare Population, Dr. Randall Krakauer, Aetna's Medicare medical director, shared the strategy supporting its embedded case management initiative, along with results from the program in terms of healthcare utilization and member satisfaction.
Each year, healthcare executives rely on the strategic advice they receive during the annual Healthcare Trends & Forecasts webinar sponsored by the Healthcare Intelligence Network. This annual, must-attend event provides a first look analysis at the key trends and opportunities for healthcare organizations in the coming year. With unprecedented economic conditions continuing to impact the industry, new healthcare payment and delivery options available for healthcare providers and the ongoing implementation of the Patient Protection and Affordable Care Act, healthcare organizations have much to monitor in the year ahead. This year's session, Healthcare Trends in 2012: A Strategic Industry Forecast, a 45-minute webinar on November 2nd, featured Steven Valentine, president, The Camden Group.
Determining how much risk your organization is willing to take, along with the key characteristics of your organization are two factors that will help you determine whether your organization should participate in CMS' Bundled Payments for Care Improvement (BPCI) and which model is the best fit for your organization. And with CMS' recent extension of the deadline to file the BPCI program application due to high levels of interest, healthcare organizations have even more time to determine if their organization should participate and if so, which model to select. During Evaluating CMS Bundled Payment Initiative: Legal, Financial and Clinical Considerations, a 45-minute webinar on October 19th, James Reilly, managing partner with TRG Health Care Solutions, examined the key distinctions between each of CMS four bundled payment models and share his expertise on the organizational criteria that is most effective in bundled payment programs.
As part of the clinical transformation program to a patient-centered medical home CDPHP has placed health plan embedded case managers in physician practices to better facilitate medical, behavioral and pharmaceutical services for high risk patients. During The Role of Embedded Case Managers in Clinical Transformation, a 60-minute webinar on September 20, 2011, available for On Demand replay on the web, DVD or CD, Lisa Sasko MA, MBA, director of clinical transformation and Charlene Schlude, director of case management, at CDPHP, shares the business reason for an embedded case management program to bring your healthcare organization to the new level of care required in today's healthcare system, as well as the day-to-day interactions of embedded case managers with providers in a practice.
Modeled after Geisinger Health System's Patient Care Navigator program, Bon Secours Health System launched an embedded case management program in 2009. Adapting the Geisinger model to fit its unique needs, Bon Secours' embedded case managers have been placed in eight physician practices and will be expanded system-wide over the next two years. During Embedded Case Management in the Primary Care Practice: Program Design and Results, a 45-minute webinar on August 10, 2011, Robert Fortini, vice president and chief clinical officer at Bon Secours Health System, shares the program's development and roll-out strategy.
With CMS moving toward a value-based purchasing system effective October 2012, hospitals are struggling to improve their core measurement scores before their reimbursement levels are impacted.
Healthcare Performance Improvement: Exceeding Core Measure Targets for Value-Based Reimbursement, a 45-minute minute webinar on July 20, 2011 now available for replay, features Dr. Steve Berkowitz, president at SMB Health Consulting and former chief medical officer for the central and west Texas division of HCA at St. David's HealthCare, who shares practical strategies for improving core measures, as well as modeling techniques to illustrate the impact of a hospital's failure to meet the measures. Dr. Berkowitz draws upon his quality improvement experience at St. David's HealthCare, which has among the best CMS core measures in the country.
Improving Medication Adherence Benchmarks Through Community Pharmacist Interventions, a 45-minute on May 25, 2011. A patient-centered approach to pharmacy visits combined with motivational interviewing by community pharmacists is improving medication adherence rates for members of Highmark Blue Cross Blue Shield.
The pilot program, a collaborative between Highmark, the University of Pittsburgh School of Pharmacy, and Rite Aid pharmacies, is training pharmacists to use motivational interviewing techniques with patients at-risk of medication non-adherence.
During this 45-minute webinar, Janice Pringle, Ph.D., director of program evaluation research unit at the University of Pittsburgh School of Medicine, describes how patients are identified for the intervention and the tools and strategies that pharmacists are using to improve adherence benchmark levels.
Reducing Readmissions Through Multi-Disciplinary Post-Discharge Support, a 45-minute recorded program from May 18, 2011. By risk-stratifying patients at high risk for hospitalizations and re-hospitalizations into a coordinated, multi-disciplinarian program, HealthCare Partners Medical Group of California has significantly reduced readmissions for its patients, including Medicare Advantage members, commercially insured individuals and dual eligibles.
During this 45-minute webinar, you'll hear from HealthCare Partners Medical Group of California's corporate medical director Dr. Stuart Levine on HCP's approach to hospital readmissions, which is responsible for achieving the lowest readmission rates in the organization's history.
Improving Medication Adherence Benchmarks Through Community Pharmacist Interventions, a 45-minute on May 25, 2011. A patient-centered approach to pharmacy visits combined with motivational interviewing by community pharmacists is improving medication adherence rates for members of Highmark Blue Cross Blue Shield.
The pilot program, a collaborative between Highmark, the University of Pittsburgh School of Pharmacy, and Rite Aid pharmacies, is training pharmacists to use motivational interviewing techniques with patients at-risk of medication non-adherence.
During this 45-minute webinar, Janice Pringle, Ph.D., director of program evaluation research unit at the University of Pittsburgh School of Medicine, describes how patients are identified for the intervention and the tools and strategies that pharmacists are using to improve adherence benchmark levels.
Patient Registries: A Cornerstone in Creating and Delivering Accountable Care, a 45-minute archive version program on April 28, 2011. Improving the quality of care and outcomes of a defined population for which healthcare organizations are accountable requires a true understanding of the patient population being served. An effective patient registry will ensure that a healthcare organization is delivering recommended care and identifying ways to improve outcomes.
Whether pulled from an electronic health record or from a stand-alone patient registry solution, healthcare organizations need usable, actionable data from their patient registries.
During this 45-minute archive version webinar, Dr. Gregory Spencer, chief medical officer, Crystal Run Healthcare shares the best practices of patient registries.
Identifying Functional Decline in Chronic Care Patients To Reduce Preventable Healthcare Utilization, a 45-minute archive version program on April 27, 2011. By identifying changes in functional status, which lead to decline among the elderly population who have various chronic illnesses, healthcare organizations can intervene to prevent emergency room visits and hospital inpatient stays.
Fallon Community Health Plan (FCHP), along with the Fallon Clinic are not only reducing healthcare utilization through this strategy, but also maintaining optimal function and preventing or delaying further decline for these patients and reporting a healthy return on investment on program costs.
During this 45-minute archive version webinar, Patricia Zinkus, director of case management, and Susan Legacy, senior manager of case management at FCHP sharees how they identify Medicare Advantage members at risk of high utilization, the strategies they've implemented to reduce this utilization and the outcomes and cost savings achieved by FCHP.
Assessing ACO Business Opportunities in the Medicare and Commercial Markets, a 45-minute archive version program on April 21, 2011. With CMS' long-awaited proposed rule governing the Medicare Shared Savings (ACO) program now on the table, healthcare organizations will begin to analyze the opportunities that exist with the program and will continue to move forward to take advantage of the commercial ACO opportunity.
During this 45-minute archive version webinar, Greg Mertz, senior project director with the Healthcare Strategy Group provides a critical analysis of CMS's final rule on Medicare Shared Savings and how they will impact commercial ACOs.
Improving Transitions of Care Between Hospital and SNF: A Collaboration Supporting the Accountable Care Vision, a 60-minute archive version webinar on April 6, 2011. Through a growing number of community partnerships with skilled nursing facilities, the Care Coordination Network created by Summa Health System has been able to reduce hospital readmission rates and average length of stay for patients transferred to these SNFs...and has them well-positioned as they work toward development of an accountable care organization (ACO).
By identifying three key areas to improve care transitions between the hospital discharge and a SNF admission, Summa Health System developed a collaborative model of care for this next level of care among a network of privately owned, competing SNFs.
During this 60-minute archive version webinar, Carolyn Holder, manager of transitional care for Summa Health System and Michael Demagall, administrator, Bath Manor & Windsong Care Center, shares how to create a win-win for SNFs and hospitals to reduce readmission rates; strategies implemented by Summa to address the key hospital-to-SNF transition challenges and how the partnership is being developed and enhanced as the hospital system works toward development of an ACO.
Aligning Physician Incentives for Shared Risk and Reward Across the Healthcare Continuum, a 45-minute archive version webinar on March 2, 2011. The alignment of incentives for both physicians and hospitals to share risk and reap rewards for coordinating care across the healthcare continuum is continuing to increase in preparation of accountable care organizations and bundled payment pilots.
With a rich history in pay-for-performance programs, HealthPartners is developing new measures and incentives to move from driving volume in healthcare services to driving value.
During this 45-minute archive version webinar, Babette Apland, senior vice president of health and care management for HealthPartners, shares how HealthPartners is aligning physician incentives and shared savings with pay-for-performance programs and a total cost of care initiative.
Rewarding Primary Care Practice Reform with Physician Payment Reform: A Medical Home's Experience, a 45-minute archive version webinar on February 23, 2011, part of the Medical Home Open House series. With the dual goal of improving the value of healthcare and enhancing the compensation to primary care physicians, Capital District Physicians' Health Plan Inc., (CDPHP), a network model health plan, launched a two-phase pilot in 2008 to reform both the practice of primary care in its network and the payment to these physicians.
During this 45-minute archive version webinar, Bruce Nash, MD, MBA, senior VP of medical affairs and CMO for CDPHP, describes how CDPHP met the challenge of developing a novel risk adjustment methodology that would drive a global payment combined with a significant bonus structure to attract physician participation and encourage future growth by medical students to enter primary care.
Evaluating Health and Wellness Incentive Programs for Behavior Change, a 45-minute archive version webinar on February 10, 2011. At Premera Blue Cross, a constant evaluation is being conducted to understand how changes to incentives for member participation and engagement in health and wellness programs impact behavior change.
During this 45-minute archive version webinar, Neal Sofian, MSPH, director of member engagement at Premera, shares his organization's techniques and strategies to increase engagement in and results from health and wellness programs.
Physician-Owned ACOs: Overcoming the Legal and Regulatory Compliance Challenges, a 45-minute archive version webinar on January 19, 2011. Poised to succeed under the Medicare Shared Savings Program in the Patient Protection and Affordable Care Act, the Medical Society of Queens County, Inc. is facilitating the creation of one of New York State's largest physician ACOs.
With a January 2012 expected launch date, physicians and healthcare providers must begin the organizational process now to participate in the Medicare Shared Savings Program, even while waiting for final program details from CMS and formal guidance from the FTC.
During this 45-minute archive version webinar, Jeffrey R. Ruggiero, Esq., a Partner in the law firm of Arnold & Porter LLP, who is advising the Queens County Medical Society, shares the Medical Society's ACO development approach.
Maximizing the Nurse Advice Line To Ensure Appropriate Healthcare Utilization, a 45-minute archive version webinar on January 6, 2011. From reducing avoidable emergency room visits to reducing re-hospitalizations, a nurse advice line can have big pay-offs in terms of appropriate healthcare utilization. To accomplish these goals, nurse advice lines need to be effectively staffed and need to build relationships with local physicians and engage the consumer.
During this 45-minute archive version webinar, Patricia Curtis, director of operations, clinical care services, Optima Health, shares how Optima's nurse advice line has evolved from a call center that supported a staff model HMO to a critical component of the organization's effort to improve the efficiency of healthcare utilization.
Redesigning the Physician Practice for Improved Efficiency and Increased Revenue, a 45-minute archive version webinar on December 15, 2010. In an era of the patient-centered medical home and accountable care organizations, there has been a sea change of what is required for physicians to accomplish during a patient visit. Physicians need to learn how to work smarter, not harder, says Dr. David Eitrheim, a family physician with Mayo Clinic Health System-Menomonie.
During this 45-minute archive version webinar, Dr. Eitrheim shares how his practice made the transformation from a traditional practice to this team-based approach.
Health Plan Rate Setting: Balancing Premium Increases Against Regulatory Oversight, a 45-minute archive version webinar on December 8, 2010. With increased government oversight on healthcare premium rate increases and negative perceptions in the marketplace for increases, health plans are facing a tough environment to justify rate increases.
During this 45-minute archive version webinar, John Steele and Steve Young, both managing directors, HealthScape Advisors, share how health plans can develop a sound policy for premium rate increases that will meet with regulatory approval.
How To Create an ACO Framework Through Clinical Integration with Independent Physicians, a 45-minute archive version webinar on December 1, 2010. As healthcare organizations begin to align to create accountable care organizations and negotiate for bundled payment contracts, the clinical integration of providers allows for the coordination of services among the organizations required for shared accountability and reward.
During this 45-minute archive version webinar, Dr. Mark Shields, senior medical director with Advocate Physician Partners, shares Advocate's clinical integration strategy.
Embedded Case Managers in the Emergency Department, a 60-minute archive version webinar on November 3, 2010. An embedded case manager in the hospital emergency room is becoming a critical element in a hospital's case management program. The embedded case manager is the first line of defense in determining medical necessity and can be instrumental in reducing the number of claim denials for a hospital.
During this 60-minute archive version webinar, Toni Cesta, Ph.D., senior vice president of operational efficiency and capacity management at Lutheran Medical Center, explores how to effectively structure an ED-based case management program and the potential impacts of an embedded case manager in the ED.
Healthcare Trends in 2011: A Strategic Industry Forecast, a 60-minute archive version webinar on October 20, 2010. Each year, healthcare executives rely on the strategic advice they receive during the annual Healthcare Trends & Forecasts webinar sponsored by the Healthcare Intelligence Network. This annual, must-attend event provides a first look analysis of the trends and opportunities for healthcare organizations in the coming year.
During this 60-minute archive version webinar, William Shea, partner, health industry consulting for Cognizant Business Consulting and Steven T. Valentine, president, The Camden Group, cover how healthcare organizations can prepare for the health reform changes required in 2011; short and long-term reform ramifications for the coming year; the critical healthcare industry developments to monitor and much more.
The Colorado Accountable Care Collaborative: Practical Lessons from an ACO, a 45-minute archive version webinar on September 29, 2010, part of the Medical Home Open House series. With a January 2011 go-live date for an accountable care organization pilot, the Colorado Department of Health Care Policy and Financing is entering into the final stages of an RFP process to identify regional organizations that will function as ACOs, the medical homes that will serve as providers within the ACO and a state-wide data and analytics vendor that will provide real-time data to the providers within the ACO.
During this 45-minute archive version webinar, Laurel Karabatsos, deputy Medicaid director and Jerry Smallwood, Medicaid reform unit manager, at the Colorado Department of Health Care Policy and Financing, walk us through the ACO development process in Colorado from the practical challenges to the processes for addressing these challenges.
