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Hospital admissions and readmissions among Medicare beneficiaries declined nearly twice as much in communities where Quality Improvement Organizations coordinated interventions that engaged the whole community to improve care than in comparison communities, according to a study in the Journal of the American Medical Association. The JAMA study shows how state-based QIOs, under the direction of national coordinator, the Colorado Foundation for Medical Care (CFMC), coordinated community-based efforts with hospitals and other medical and social service providers to improve care transitions and reduce readmissions.
The first step for any healthcare organization and community-based healthcare providers is to conduct a root cause analysis of readmission data, which can vary from community to community, says Alicia Goroski, MPH, senior project director for care transitions for CFMC.
During Patient Engagement and Provider Collaborations Across the Healthcare Continuum to Improve Care Transitions, a May 22nd, 2013 webinar at 1:30 p.m. Eastern, Goroski will share the lessons learned from the 14 communities that participated in the CMS care transition demonstration project and details on how the program is being rolled out in 400 communities and to over 12 million Medicare beneficiaries across the country.
By applying an "ACO magnifying glass" to high-risk patients and high-cost events, and using an organizational background in rapid cycle improvement, Atrius Health has developed focused interventions to hit Triple Aim goals within their Medicare's Pioneer ACO model.
During Medicare Pioneer ACO: Case Study on Atrius Health's Focus on the Triple Aim, a 45-minute webinar on May 9th, now available for replay, Emily Brower, executive director of accountable care programs at Atrius Health, shares the first year lessons from its experience as a Medicare Pioneer ACO and how the program is evolving in year two.
The convergence of social, mobile and cloud technologies is the driving trend behind the exploding growth of social healthcare. Healthcare organizations are increasingly using social strategies to manage content and facilitate collaboration among providers, patients and researcher communities.
To maximize the return on investment on social, healthcare organizations need to adopt an open and collaborative approach to increase productivity and better serve patients and member needs.
During Healthcare Social Business Strategy: Driving Adoption with Social, Mobile and Cloud Technologies, a May 1st webinar, now available for replay, Andrew Dixon, senior vice president of marketing and operations, Igloo Software, discusses the key factors in formulating an effective social strategy, along with implementation and best practice guidance from leading healthcare organizations with social strategies that are having a bottom line impact.
With focused attention on the patient handoff process, Regions Hospital has watched its readmission rates decrease from over 11 percent in 2009 to 9.5 percent for all patients and achieve readmission rates for 2012 that are better than its expected results, as predicted by modeling outside of the organization.
Cullman Regional Medical Center's award-winning "Good to Go" recorded hospital discharge instructions has resulted in a 15 percent decline in readmission rates for patients who received recorded discharge instructions and a 58 percent increase in HCAPS satisfaction scores.
During Care Transition Management: Strategies for Effective Patient Handoffs, a 60-minute webinar on April 24th, now available for replay, Joshua Brewster, director of care management at Regions Hospital, a HealthPartners hospital, and Cheryl Bailey, vice president of patient care services at Cullman Regional Medical Center, shared the key features of their care transition management programs.
With an additional star in CMS Star Quality Ratings worth about $50 per member per month (PMPM), according to L.E.K. Consulting (when moving from a three- to four-star MA plan), health plans are fine-tuning their operational processes to improve their ratings.
During A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings, a 45-minute webinar on April 16th, available for replay, Joseph Johnson, vice president, L.E.K. Consulting, shares how to stratify and prioritize strategies to improve quality ratings and insight into the future direction of the CMS Star Quality program.
With the recent announcement of 500 provider organizations selected to participate in the Bundled Payments for Care Improvement initiative, believed to be the largest demonstration project ever run by CMS, both payer and provider interest in the adoption of payment bundling is at an all-time high.
Moving Forward with Payment Bundling, a 45-minute webinar on March 13, 2013, now available for replay, features Jay Sultan, associate vice president and chief product portfolio architect for Trizetto, who provides perspectives on the emerging bundled payment trend.
With the continued expansion of patient-centered medical homes and accountable care organizations, case managers are taking on a more standardized, collaborative approach to care coordination.
During The Role of Case Managers in Emerging Care Delivery Models, a 45-minute webinar on February 21, 2013, now available for replay, Teresa Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, president, Ascent Care Management, provides perspectives of the changing healthcare landscape for case management and care coordination.
Outcome-based incentives are a valuable and important tool to encourage health behavior change and results among a defined population. However, with the growing trend toward outcome-based incentives, the incentive structure needs to balance this motivation with the sustainability of a program and regulatory requirements.
In its 2012 Health Care Changes Ahead Survey Report, Towers Watson reports growing interest in outcomes-based wellness plans. Some 25 percent of employers rewarded incentives based on biometric outcomes in 2011 and an additional 9 percent reported that they planned on rewarding incentives based on biometric outcomes in 2012. Moreover, 48 percent reported considering this approach for 2013 or 2014.
During Health and Wellness Incentives: Positioning for Outcome-Based Incentives, a February 4, 2013 webinar, now available for replay, John Riedel, president, Riedel & Associates Consultants, Inc., shares the key strategies in sustaining a health and wellness incentive program and moving toward outcome-based results.
As payors and large employers aggressively look to hospitals and physicians to move from volume to value of healthcare services, the industry is seeing a resurgence in physician hospital organizations (PHOs).
With an eye toward shared savings agreements, PHOs provide a collaboration tool for physicians and hospitals to organize and participate in these evolving healthcare payment and delivery models.
During Physician Hospital Organizations: Developing a Collaborative Structure for Shared Savings Agreements, a 45-minute webinar on January 23rd, 2013, Greg Mertz, director, Healthcare Strategy Group and Travis Ansel, manager of strategic services, Healthcare Strategy Group, explore the key contractual elements to consider when creating a PHO for the purpose of participating in value-based payment models.
The approximately 9 million low-income elderly and disabled individuals who are Medicare and Medicaid dual eligibles are poorer and sicker than Medicare and Medicaid beneficiaries as a whole, and consequently account for disproportionate shares of Medicaid and Medicare spending, according to a study by the Kaiser Commission on Medicaid and the Uninsured. Dual eligibles make up 15 percent of Medicaid beneficiaries but account for 39 percent of Medicaid spending; they make up 21 percent of Medicare beneficiaries but account for 36 percent of Medicare spending.
With a long history in serving Medicare beneficiaries, Scan Health Plan has a multi-pronged, strategic approach to reaching dual eligibles based on the specific needs of the member. This unique care management model emphasizes prevention and early intervention, with a focus on medication management.
Recent analyses by Avalere Health of Scan Health Plan's care management model demonstrate its effectiveness in reducing readmission rates and inpatient hospital admissions and producing significant cost savings tied to the improvement in health status of members.
During Care Coordination for Dual Eligibles: A Results-Oriented Approach, a December 6th, 2012 webinar, now available for replay, Dr. Timothy Schwab, chief medical officer, Scan Health Plan, shares his organization's strategic approach to serving the dual eligible market.
CMS readmission penalty rolled out this month with hospitals facing a penalty cap of 1 percent of their Medicare revenue this fiscal year. The penalty will increase to 2 percent in FY 14 and 3 percent in FY 15. Hospitals may also be subject to additional conditions for the penalty beyond the initial heart attack, heart failure and pneumonia DRGs.
Hospitals are making the transition from the mindset that every readmission is revenue to every readmission is a penalty and developing collaborative strategies with the post-acute providers in their communities to ensure the transition out of the hospital and the reception into the next site of care is a successful one.
During Readmission Penalties in 2013: A Cross-Continuum Approach To Lessen The Financial Impact, a November 14th, 2012 webinar, now available for replay, Amy Boutwell, MD, MPP, president of Collaborative Healthcare Strategies, co-founder of the STAAR (State Action on Avoidable Rehospitalizations) Initiative of the Institute for Healthcare Improvement (IHI) and senior physician consultant to the National Coordinating Center for the CMS QIO Care Transitions Theme, shared cross-continuum strategies and tactics to reduce readmissions and lessen the financial impact of the Readmission Penalty program.
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 the industry moving ahead to implement the upcoming requirements of the Affordable Care Act following the Supreme Court decision to uphold the law, a noticeable jump in the formation of accountable care organizations and new healthcare delivery models, including the patient-centered medical home and bundled payment programs, healthcare organizations have much to monitor in the year ahead.
This year's session, Healthcare Trends & Forecast in 2013: A Strategic Planning Session, a 60-minute webinar on October 17, 2012 at 1:30 p.m. Eastern time, will feature Steven Valentine, president, The Camden Group, Hank Osowski, managing director of Strategic Health Group and Dennis Eder, also a managing director at Strategic Health Group.
As part of its clinical transformation project, Bon Secours Health System has watched the progression of its data collection efforts mature into usable knowledge and wisdom to better manage the health of its population.
Using custom builds in its EPIC electronic health record system, Bon Secours has developed sophisticated reporting, patient registries and a predictive model to identify high-risk patients.
During Improving Population Health Management Through Effective, Efficient Data Analytics, an October 3rd, 2012 webinar, now available for replay, Robert Fortini, vice president, chief clinical officer at Bon Secours Health System drills down on Bon Secours' tools and protocols.
Employers, health plans and physician practices are being charged with managing the health of the population they serve under an increasingly value-based healthcare system. From low-risk patients to chronic, acute-risk patients, healthcare organizations must develop strategies for stratifying, communicating and engaging patients in population health management programs.
During Population Health Management: Achieving Results in a Value-Based Healthcare System, a September 26th, 2012 webinar, now available for replay, Patricia Curran, director, Buck Consultants National Health Management Practice, shared the types of population health management programs and how these programs can produce tangible results in terms of improved outcomes and costs savings.
An integrated health coaching approach that addresses the needs of those with lifestyle and health behavior changes, along with those with chronic conditions, provides a coaching model that address participants' needs across the continuum while delivering results in a reduction of healthcare utilization, improvements in clinical and HEDIS measures and a return on investment.
During Integrated Health Coaching: The Next Generation in Health Behavior Change Management, Kelly Merriman, HealthFitness' vice president of service delivery and Dr. Dennis Richling, chief medical and wellness officer at HealthFitness, a September 20th, 2012 webinar, now available for replay, shares the key features of HealthFitness' integrated health coaching program, from how participants are assessed and assigned to coaches to the program's impact.
With increased patient accountability in the patient-centered medical home, accountable care organizations and other emerging healthcare delivery models, healthcare organizations need to engage members and patients to change their behaviors in ways that increase quality, reduce cost and improve their overall healthcare experience. The consumer engagement team at Horizon Blue Cross Blue Shield of New Jersey is targeting four key areas within its healthcare delivery models to engage consumers, including: consumer insight, technology, behavioral economics and outreach and communications.
During Patient Engagement in the Patient-Centered Medical Home: A Continuum Approach, a 45-minute webinar on Wednesday, August 22nd, now available for replay, Jay Driggers, director of consumer engagement at Horizon BCBS, shares how Horizon approaches engagement.
Aetna's Compassionate Care Program, a case management program that specifically targets patients with advanced illness, has had an enormous impact on the number of inpatient stays, average length of stay, emergency room visits, ICU days and hospice selection rate for the patients it serves, according to a study published in the Journal of Palliative Medicine.
During Advanced Illness Care Coordination: A Case Study on Aetna's Compassionate Care Program, a 45-minute webinar on June 13, 2012, now available for replay, Dr. Joseph Agostini, senior medical director, Aetna Medicare, shares the key features of the Compassionate Care Program at Aetna, along with the impact the program has had on healthcare utilization and quality outcomes.
A community-based approach that identifies and breaks down barriers to using the emergency room as a usual source of care among targeted populations is helping UPMC Health Plan reduce emergency department visits.
During Identifying, Engaging and Breaking Down Patient Barriers To Reduce Avoidable ED Use, a 45-minute webinar on June 6, 2012, now available for replay, Debra Smyers, senior director of program development at UPMC Health Plan, shared the inside details on the five-pronged approach UPMC developed to target avoidable ED visits.
A primary care focused pay-for-performance program at Blue Cross Blue Shield of Florida has been transitioned this year into a statewide patient-centered medical home initiative. While the Recognizing Physician Excellence program (RPE) program had moved the bar on quality metric performance, the move to the PCMH provides a look at both the quality and efficiency factors of a patients care. During The Patient-Centered Medical Home: Lessons from a Statewide Rollout, a 45-minute webinar on May 10th, now available for replay, Barbara Haasis, R.N., CCRN, senior clinical lead, quality reward and recognition programs at Blue Cross Blue Shield of Florida, shared how the health plan transitioned from the RPE program into a medical home model.
A statewide quality improvement project aimed at reducing avoidable emergency room visits among Medicaid patients in California created a unique partnership between L.A. Care Health Plan, the country's largest Medicaid managed care plan, and Children's Hospital Los Angeles. During Reducing Avoidable Medicaid ER Visits With a Community Partnership Approach, a 45-minute webinar on Wednesday, May 9th, now available for replay, Laura Linebach, director of quality improvement at L.A. Care Health Plan, shared the inside details on how the health plan worked with the hospital to target avoidable ER use and results from the initiative.
As part of the transformation of physician practices to patient-centered medical homes within Bon Secours Health System, embedded case managers are placed within practices to function as nurse navigators for patients with complex needs or for those experiencing transitions of care. During Recruiting, Training and Case Load Management Strategies for Embedded Case Managers, a 45-minute webinar on May 3rd at 1:30 p.m. Eastern, Irene Zolotorofe, administrative director of clinical operations at Bon Secours Health System, will share the process that Bon Secours has established for recruiting, selecting and placing an embedded case manager in their practices, along with details on case load management, tools used by case managers and benchmarks for measuring effectiveness.
At Arkansas Blue Cross and Blue Shield, case managers have access to an intranet repository that provides at their fingertips materials and tools to help them perform their job functions. Developed internally, the site provides access to policies and procedures, patient education materials and resources, evidence-based guidelines and documentation and coding information, as well as licensure information. During Leveraging Case Management Tools and Technology to Improve Outcomes, a 45-minute webinar on April 11, 2012 at 1:30 pm Eastern, Karen Black, RN, HIPAAP, quality improvement coordinator for Arkansas Blue Cross Blue Shield, will share how the tool was developed, how it fits into the case manager's workflow and the key features that are directly attributed to improvements in patient care delivery.
In existence for 15 years, the Highmark Inc. physician pay for performance program, Quality Blue, which continues to evolve, is providing its 6,300 enrolled primary care physicians the opportunity to earn bonus payments across six measure sets. Physicians are eligible for bonus payments across a broad spectrum of measures from clinical and quality measures to prescribing habits, access to care and level of technology use. In addition, practices can also qualify for a bonus payment based on their development and improvement of a Best Practice evidence-based quality improvement project. During Physician Pay-for-Performance: Refining the Bonus Structure To Meet Market Realities, a 45-minute webinar on March 22, 2012, now available for replay, Julie Hobson, R.N., B.S.N., manager of provider engagement, performance and partnership at Highmark Inc., describes how the program has evolved to meet todays healthcare market realities.
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.
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.
