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Archived Podcasts from:
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Featured Podcast:
Assessing and Predicting Health Risk in the Elderly
Dr. Marcia Wade
Length: 3:06
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Posted: January 26, 2010
Even though more than a third of the elderly are online, they're not necessarily using the Internet to seek health assistance, explains Marcia Wade, M.D., F.C.C.P., M.M.M., senior medical director at Aetna Medicare. That's why Aetna delivers its health risk assessment for the elderly in an alternate format while making available other Web-based tools to web-savvy boomer beneficiaries. Dr. Wade also describes Aetna's user-friendly strategy for heading off high-risk complications among its elderly and how this contributes to an overall reduction in hospital readmissions.
Dr. Wade will explain what to assess in the elderly population, how to match interventions based on risk score and the impact of this type of initiative during Assessing and Predicting Health Risk in the Elderly, a 45-minute webinar on February 10, 2010.
Most Recent Podcasts:
Multi-Payor Medical Home Programs: Addressing Funding and Organizational Challenges
Julie Schilz
Length: 6:29
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Posted: January 14, 2010
A year into the Colorado multi-payor medical home pilot whose practices provide care to 30,000 patients, Julie Schilz, B.S.N., M.B.A., prescribes a single tool that can help transform practices, improve quality and deliver evidence-based care. It's NOT an EHR, says the manager of the Improving Performance in Practice and Patient-Centered Medical Home (PCMH) initiatives for the Colorado Clinical Guidelines Collaborative, who lists this tool's four key functionalities. Also in this interview, Schilz describes the influence of other reimbursement models on the Colorado pilot and identifies two opportunities for NCQA to enhance its PCMH recognition process.
Schilz shared Colorado's experience to date in creating this multi-payor initiative — from the development of the program to the challenges of working with multiple payors — during the January 20, 2010 webinar, Multi-Payor Medical Home Programs: Addressing Funding and Organizational Challenges.
Health Coaching Evaluation: Measuring the ROI on Healthcare Utilization and Costs
Dr. Jim Reynolds
Length: 4:13
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Posted: December 29, 2009
The dismal economy of 2009 has been a bright spot for health coaching and other health improvement programs, notes Dr. Jim Reynolds, chief medical officer for Health Fitness Corporation. Dr. Reynolds also compares early results from a Massachusetts' smoking cessation program for Medicaid beneficiaries with outcomes in commercial populations, and describes what Year 1 of a coaching program for improved medication adherence might yield in the way of behavior change and cost impacts.
Dr. Reynolds and Dr. Elizabeth Rula, clinical research manager at the Center for Health Research at Healthways Inc., shared how their organizations respond to the challenges of evaluating and reporting on health coaching ROI during the January 13, 2010 webinar, Health Coaching Evaluation: Measuring the ROI on Healthcare Utilization and Costs.
Medication Therapy Management in the Patient-Centered Medical Home
Beth Chester
Length: 7:59
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Posted: December 21, 2009
The pharmacist has a natural and important role in patient medication reconciliation and review, explains Dr. Beth Chester, senior director of clinical pharmacy services and quality, Kaiser Permanente Colorado. She describes the dramatic impact that a pilot pharmacist intervention had on emergency department visits and mortality rates among patients just discharged from skilled nursing facilities (SNFs) once the health plan's pharmacists stepped in to monitor medication therapy in this population.
Dr. Chester detailed the roles of the physician practice’s staff and the pharmacist in medication management, the use of technology and how financial incentives and reimbursement can play a role in improving medication compliance during the January 6, 2010 webinar, Medication Therapy Management in the Patient-Centered Medical Home.
Risk Adjustment in the Medical Home: Building an Effective Reimbursement Strategy
Jeff Schiff
Length: 5:06
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Posted: December 11, 2009
Social and demographic factors such as chaos in the home or functional status can complicate care coordination for patients as much as clinical factors, explains Jeff Schiff, M.D., M.B.A., medical director of Minnesota Health Care Programs for the Minnesota Department of Human Services. He identifies two key social/demographic factors getting close attention in Minnesota's new primary care reimbursement model and explains how the engagement of patient and family at the clinical level is paying off in improved patient safety, satisfaction and health outcomes.
Dr. Schiff examined the risk factors that need to be considered in a risk-adjusted medical home reimbursement strategy during the December 16, 2009 webinar, Risk Adjustment in the Medical Home: Building an Effective Reimbursement Strategy.
Aligning Reimbursement To Reduce Avoidable Hospital Readmissions
Dianne Feeney
Length: 5:03
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Dr. Randall Krakauer
Length: 5:06
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Posted: November 30, 2009
Maryland's Hospital Preventable Readmissions program rewards efforts that reduce hospital readmissions while improving care quality and decreasing cost. Dianne Feeney, associate director of quality initiatives for the Maryland Health Services Cost Review Commission (HSCRC), describes HSCRC's response to hospitals that claim they can't afford the empty beds that result from programs like these, as well as processes to help ensure that higher-risk patients are not refused admittance to hospitals. She also explains how partnerships with "siloed settings" — nursing homes and home health providers — can reduce common errors that occur during patient handoffs.
Case managers and advanced practice nurses in Aetna's Transitional Care pilot have also successfully partnered to reduce readmissions. Dr. Randall Krakauer, national medical director, Medicare at Aetna, describes the key focus and the complementary roles that reduced 90-day readmissions by 25 percent. Dr. Krakauer also weighs in on the pros and cons of bundled payments, and why incentives alone will not significantly impact avoidable readmissions.
Feeney and Dr. Krakauer examined how to structure programs to reduce avoidable hospital readmissions, including the alignment of financial incentives, during the December 2, 2009 webinar, Aligning Reimbursement To Reduce Avoidable Hospital Readmissions.
Reducing Avoidable Hospital Readmissions: A Case Study from Priority Health
Mary Cooley
Length: 7:23
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Posted: November 17, 2009
Priority Health members play an active role in keeping themselves out of the hospital, explains Mary Cooley, manager of case and disease management at Priority Health. She describes the four-point strategy that is reducing readmissions at Priority Health, the challenges that still exist and the essential tool that Priority supplies to help providers identify and close care gaps.
Cooley provided more details on the strategies that Priority Health is using to reduce avoidable hospital readmissions during Reducing Avoidable Hospital Readmissions: A Case Study from Priority Health, a 45-minute webinar on November 18, 2009.
Effective Case Management in the Medical Home
Geisinger Health Plan
Length: 8:52
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Posted: November 5, 2009
Case managers are the backbone of the Geisinger Health Plan (GHP) Health NavigatorSM program, a medical home partnership between primary care providers and GHP that has reduced 30-day hospital readmissions by 15 to 20 percent. Providing benchmarks for case manager caseloads and contact frequency, tools to support the case management effort, the key to smooth placement of case managers in the medical home and tips for better management of patients discharged to nursing facilities are Diane Littlewood, R.N., and Joann Sciandra, R.N., who are both regional managers of case management for health services at Geisinger Health Plan.
Littlewood and Sciandra provided more detail on the key components of a winning case management program during Effective Case Management in the Medical Home, a 45-minute webinar on November 11, 2009. The webinar is part of HIN's continuing Medical Home Open House webinar series.
Predicting Healthcare Reform's Biggest Losers and Winners
William DeMarco |
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Jim Knutson
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Length: 3:57
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Posted: November 4, 2009
A forecast of 2010 healthcare trends would not be complete without some prognostication on the fate of healthcare reform. The Healthcare Intelligence Network asked William DeMarco, president and CEO of DeMarco and Associates, and Jim Knutson, risk manager and human resources director, Aircraft Gear Corporation, to predict the winners and losers from the controversial legislation — as well as the delivery date of the much-debated package.
DeMarco and Knutson go beyond crystal-gazing to describe the implications for key healthcare stakeholders in the coming year with a special focus on payment reform in Healthcare Trends & Forecasts in 2010: Performance Expectations for the Healthcare Industry, a new special report from the Healthcare Intelligence Network.
Medical Home Open House Highlights Part 2: Physician Practice Innovations To Improve Care Delivery
Webinar Highlights
Length: 3:57
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Posted: October 27, 2009
Medical home innovators Group Health Cooperative, Greenhouse Internists and Grand Valley Health Plan describe practice level transformations that improve care delivery and move them along the path to NCQA medical home recognition in Part 2 of Medical Home Open House Highlights.
Click here to listen to Part 1: Focus on Care Continuity, Quality and Access.
Achieving NCQA's Patient-Centered Medical Home Recognition
Barbara Luskin
Length: 4:34
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Posted: October 12, 2009
Grand Valley Health Plan's (GVHP) workgroup approach helps the staff model HMO to successfully disseminate workflow changes resulting from its NCQA medical home recognition process, explains Barbara Luskin, GVHP quality manager, and also created location champions in the process. Luskin describes how GVHP demonstrates compliance with the most challenging NCQA "must-pass" elements and shares GVHP's early returns in patient satisfaction ratings, quality of care and healthcare utilization.
Luskin and Dr. James Kerby, GVHP vice president of medical affairs, shared the basics of preparing for and achieving recognition from NCQA's Physician Practice Connections® - Patient-Centered Medical Home™ during Achieving NCQA's Patient-Centered Medical Home Recognition, a 45-minute webinar on October 21, 2009. The webinar is part of HIN's continuing Medical Home Open House webinar series.
Applying Evidence-Based Guidelines in the Medical Home
Dr. Richard J. Baron
Length: 6:00
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Posted: September 24, 2009
Despite the challenges, cost and uncertain return of EHRs, practices should move quickly to adopt this tool, recommends Dr. Richard J. Baron, president and CEO of Greenhouse Internists, where the EHR is the backbone that supports the implementation of evidence-based practices.
Dr. Baron shared his practice’s evidence-based guidelines experience — from working with physicians on documentation, staff training and work flow redesign to using the data to improve practice performance — during the October 6, 2009 webinar, Adopting and Implementing Evidence-Based Guidelines in the Medical Home. The 45-minute session is part of HIN's continuing Medical Home Open House webinar series.
Tackling Healthcare Fragmentation with
Innovative Health Management Solutions
Steve Wiggington
Length: 11:27
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Posted: September 23, 2009
Through the implementation of innovative health management programs, we can improve the performance of our healthcare system, says Steve Wigginton, president of Health Integrated, a leading health management solutions company. This podcast discusses how Health plans that make investments in wellness, chronic condition management and technology can enjoy a healthy return on investment with improved health outcomes for their members. To download a case study of one health plan's successful use of health management solutions that improved outcomes and reduced costs, and for more information on Health Integrated, please visit: www.healthintegrated.com/HIN909A or call 800-323-0286.
Successful Models of Care for the Medical Home: Staffing and Roles of the Care Team
Michael Erikson
Length: 4:45
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Posted: September 1, 2009
Although Group Health Cooperative's increased their primary care staff, patients are still successful in connecting with their caregivers, says Michael Erikson, vice president of primary care services for Group Health Cooperative. In fact, the key to a patient's understanding of his care team lies in the physician's hands. In this podcast, Erikson discusses the effect Group Health's staff expansion has had on its patients, as well as the many benefits of contacting patients via phone and e-mail in lieu of in-person office visits.
Erikson described the staffing strategies it implemented to reduce downstream utilization costs — from the skill sets required by the staff to the workflow changes needed to accommodate this model of care during a September 9, 2009 webinar, Successful Models of Care for the Medical Home: Staffing and Roles of the Care Team. The 45-minute session is part of HIN's continuing Medical Home Open House webinar series.
Medical Home Reimbursement: Exploring Bundled Payment Options
Michael Zucker
Length: 5:03
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Posted: August 19, 2009
Healthcare reform partially fueled Baptist Health System's desire to participate in the CMS Acute Care Episode (ACE) pilot that is testing bundled or episodic payments for selected orthopedic and cardiac procedures, explains Michael Zucker, Baptist's chief development officer. He describes some early returns from the experience, highlights the provider's role in Baptist's multi-pronged awareness campaign for Medicare beneficiaries and explains the committee-based approach to quality change and cost savings that has already improved communications among participating providers.
Zucker shared Baptist Health System's experience thus far in the CMS bundled payment pilot and early feedback during a September 16, 2009 webinar, Medical Home Reimbursement: Exploring Bundled Payment Options. The 45-minute session is part of HIN's continuing Medical Home Open House webinar series.
Closing Gaps in Care for Chronic Conditions
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Steve Wiggington
Length: 5:58
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Posted: August 12, 2009
The fragmentation in the U.S. healthcare system for the care of chronic conditions, like diabetes, asthma, heart disease, and depression, causes the health of individuals with these chronic conditions to deteriorate while driving up expenses in emergency room visits and inpatient stays, says Steve Wigginton, president of Health Integrated, a health management solutions company. In this podcast, Wigginton describes how by closing gaps in care, addressing the interplay between medical and psychosocial health and providing day-to-day support for these patients, organizations can avoid costly emergency room visits and inpatient stays.
Medical Home Open House Highlights Part 1: Focus on Care Continuity, Quality and Access
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Webinar Highlights
Length: 4:24
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Posted: July 31, 2009
The opening sessions of the Medical Home Open House webinar series delivered tips for improving care continuity, quality and access for patients assigned to a medical home.
Click here to listen to Part 2: Physician Practice Innovations To Improve Care Delivery.
Constructing Care Transitions to Reduce Hospital Admissions
Doreen Salek
Length: 10:29
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Posted: July 23, 2009
Geisinger Health Plan's successful Transitions of Care program is the health plan's response to rising rehospitalization rates among Medicare patients, a major concern of both CMS and private payors. Geisinger Health Plan's Doreen Salek defines the transition teams' key area of focus when providing a "clean and clear handoff" of a patient from one care site to another, with the goal of avoiding readmission to the hospital. The health plan's director of business operations of health services also defines the plan's ideal home health partner, its blueprint for a universal plan of care to improve care coordination and expectations for patients and their families and caregivers.
Salek, along with Janet Tomcavage, R.N., M.S.N., vice president of health services for Geisinger Health Plan, explained how a focus on transitions of care across the continuum can enhance care quality and reduce readmissions during the August 26, 2009 webinar, Constructing Care Transitions to Reduce Hospital Admissions. The 45-minute session is part of HIN's continuing Medical Home Open House webinar series.
Patient Engagement and Education in the Medical Home: Perspectives from Several Pilots
Barbara Wall
Length: 3:43
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Posted: July 16, 2009
Looking to jump-start patient outreach in the medical home? The appointment calendar is a great place to start, recommends Barbara Wall, a healthcare consultant who advises organizations on adoption of the patient-centered model of care. She describes the simple steps that medical home staff can follow to turn the appointment calendar into a patient teaching, recall and outreach tool.
A featured presenter during HIN's Medical Home Open House webinar series, Wall explained the essential process changes that improve patient outreach and keep the patient at the center of the medical home during the August 5, 2009 webinar, Patient Engagement and Education in the Medical Home: Perspectives from Several Pilots.
Meet the Medical Home Neighbor: Accountable Care Organizations
Dr. Craig Samitt
Length: 6:46
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Posted: July 14, 2009
The accountable care organization (ACO) — a network of primary care physicians, one or more hospitals, and subspecialists that provide patient-centered care — is receiving increasing attention as healthcare reform unfolds. Not only do ACOs complement the medical home model, but they are inextricably linked, says Dr. Craig Samitt, M.B.A., president and CEO of Dean Health System. Dr. Samitt discusses how ACOs complement the medical home model, the pros and cons of mandatory and voluntary ACOs and creating reimbursement strategies for ACOs.
Dr. Samitt shared how Dean Health System uses its best practices to create an accountable care organization that provides a high-value patient-centered care experience during the July 29, 2009 webinar, Meet the Medical Home Neighbor: Accountable Care Organizations, part of the Medical Home Open House webinar series.
Reducing Uncompensated Care Costs for the Chronically Ill Through a Medical Home Approach: A Health System Case Study
Dr. Ricardo Guggenheim
Length: 6:42
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Robin Barca
Length: 5:48
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Posted: July 9, 2009
Increasingly, uninsured patients are seeking chronic care via the ER, where they are stabilized, possibly admitted and eventually discharged. However, this cycle is not conducive to managing chronic diseases, and, in the end, will result in high costs and poor quality of care for these individuals, says Dr. Ricardo Guggenheim, vice president of care management services at McKesson Health Solutions. Dr. Guggenheim discusses what areas stand to see improvements as a result of managed uncompensated care, why it is essential to invest in managing uninsured care costs and future plans for McKesson's Care Advisor program.
Baptist's Health's referral of patients to its family medicine residency program has given residents a greater understanding of the fiscal impact of the uninsured on the healthcare system, and the benefits don't end there. Robin Barca discusses the residents' experience with the medical home model, details of patient contracts and just how much of Baptist's uncompensated care falls into charity care.
Dr. Guggenheim and Barca described how, with a small up-front investment, Baptist was able to manage its health system costs more effectively and provide care for chronic diseases in more appropriate settings during the July 16, 2009 webinar, Reducing Uncompensated Care Costs for the Chronically Ill Through a Medical Home Approach: A Health System Case Study.
Medical Home Contracting: Building a Solid Framework
Dr. Barbara Walters
Length: 3:21
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Posted: July 7, 2009
There are several ways a healthcare organization can bring clinical credibility to the medical home contract negotiating table, explains Dr. Barbara Walters, senior medical director for Dartmouth-Hitchcock Medical Center. She describes the ways in which the medical home contracting process differs from the standard payor contracting experience and highlights some typical performance guarantees to include in a medical home contract.
In a July 8, 2009 webinar, Medical Home Contracting: Building a Solid Framework, Dr. Walters shared how to effectively prepare, negotiate and contract with payors for the medical home model of care to better prepare organizations for a seat at the negotiating table. The 45-minute session is part of HIN's continuing Medical Home Open House webinar series.
Finding Success in Health Behavior Change
Kate Larsen
Length: 9:39
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Posted: June 29, 2009
A move backward in readiness to change should not be perceived as a failure on the client's part but rather as an opportunity to readjust behavior goals, observes Kate Larsen, president of Winning LifeStyles, Inc., an ICF-certified professional coach and a WellCoaches® faculty member and mentor coach. There's value in reminding clients that health coaching is a journey and in checking coaching egos at the door to improve listening skills and allow clients to own their behavior change goals, notes the author of "Progress, Not Perfection."
Larsen and Claudine Reilly, wellness manager at CVS Caremark, a Certified Intrinsic Coach, and a Certified Health Education Specialist, provided different scenarios that coaches might encounter with patients and examples of how coaches can and should respond to assist clients in achieving the health behavior change they need during the July 15, 2009 webinar, Finding Success in Health Behavior Change.
Healthcare Trends in 2009: A Mid-Year Financial and Legislative Update
Paul Keckley
Length: 5:32
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Posted: June 23, 2009
Early and costly proposals for healthcare reform are creating clouds of uncertainty on the healthcare horizon, providing scant relief for organizations stymied by the economy, patient safety issues and internal budget restraints, observes Paul Keckley, Ph.D., executive director of the Deloitte Center for Health Solutions. As he prepares a mid-year review of financial and legislative trends shaping the healthcare industry, Keckley anticipates a slow and bumpy road to EHR adoption and defines the three key elements of the platform for a new generation of care-giving and care consumption at a community level.
Keckley examined how the industry is faring in 2009, including the impact of stimulus funding on the industry, the potential and expected shape for reform and other industry trends during the June 25, 2009 webinar, Healthcare Trends in 2009: A Mid-Year Financial and Legislative Update.
Under One Roof: Integrating Primary Care and Behavioral Healthcare in the Medical Home
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Liz Reardon
Length: 5:01
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Posted: June 17, 2009
Individuals with severe and persistent mental illnesses are likely to die 20 years earlier than people without such conditions, says Liz Reardon, president of Reardon Consulting and a member of the National Council for Community Behavioral Healthcare (NCCBH) Integration Consulting Team. Putting the right medical home services in place for adults with chronic mental illness can help to reduce this disparity, suggests Reardon, explaining why the earliest medical homes for children with complex health needs are great models for behavioral healthcare organizations.
Reardon and Laura Galbreath, NCCBH Director of Policy and Advocacy, kicked off HIN's Medical Home Open House webinar series when they presented current developments in the patient-centered medical home model with evidence-based approaches to integration of primary care and behavioral health during the July 1, 2009 webinar, Under One Roof: Integrating Primary Care & Behavioral Health in the Medical Home.
Patient Activation Measure™: Assessing the Engaged Healthcare Consumer for Self-Efficacy
Dr. Judith Hibbard
Length: 4:16
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Diane Bellard
Length: 5:31
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Posted: May 27, 2009
There are many ways to administer the Patient Activation Measure™ (PAM) and many socioeconomic factors that influence its outcomes, explains Dr. Judith Hibbard, developer of the PAM and professor of health policy at the University of Oregon. Dr. Hibbard identifies the PAM scores that signal a behavior change and the value of adding patient activation assessment to a health improvement initiative.
American Health Holding relies on the Patient Activation Measure™ to assess a patient’s level of engagement in their own overall disease management (DM), but it does more than just that. PAM scores are also used to gauge the success of the DM program and its coaches. Director of DM and wellness services Diane Bellard discusses PAM — who is using it, how to deal with a decrease in PAM levels, how it fits with a patient's readiness to change and PAM's role in an organization's overall quality improvement.
Dr. Hibbard and Bellard shared the research behind the development of the PAM, its potential for improving a patient's healthcare self-efficacy and examples of its use in a DM setting during the June 18, 2009 webinar, Patient Activation Measure™: Assessing the Engaged Healthcare Consumer for Self-Efficacy.
Wiring the Medical Home: Healthcare IT to Power a Patient-Centered Model
Dr. James Crawford
Length: 7:16
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Ewa Matuszewski
Length: 5:32
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Posted: May 20, 2009
Implementing an EHR into your organization is not the same as implementing a patient-centered medical home (PCMH) model of care, according to Dr. James Crawford, senior vice president for laboratory services and chair of the department of pathology and laboratory medicine at North Shore-Long Island Jewish Health System. To be a PCMH, the practice workflow has to change as well. In this podcast, Dr. Crawford discusses the key process change that has to accompany the adoption of health IT by a medical home as well as health IT's impacts on care coordination and findings from the PCPCC's survey of physician practices on their use of health IT in support of the medical home model.
Health IT is extremely important in improving an organization's communication and prevention strategies, says Ewa Matuszewski, CEO of Medical Network One. In this podcast, Matuszewski also comments on how health IT supports the joint principles of the PCMH and describes how her health IT tool of choice can be a stepping stone to further implement IT within an organization.
Dr. Crawford and Matuszewski presented case studies on the use of health IT in the medical home and its impact on care access, quality and cost in a May 28, 2009 webinar, Wiring the Medical Home: Healthcare IT to Power a Patient-Centered Model.
Reducing Acute and Chronic Care Costs Through an Effective Health Risk Stratification Model
Dr. William Vennart
Length: 4:30
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John Harris
Length: 4:25
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Posted: April 29, 2009
Predictive modeling and health risk stratification can help providers identify members for case management and disease management interventions, says Dr. William Vennart, vice president of medical management and national medical director with CareAdvantage Inc. These methods ensure that patients receive treatment for their chronic conditions early on and, in turn, reduce unnecessary utilization and lower acute and chronic care costs.
Health claims are still scrutinized during risk stratification, but today's analysts examine these data points through a slightly different lens, explains John Harris, chief wellness officer and senior vice president for Healthways. Harris explains why the focus has shifted from ICD-9 coding patterns to the financial trends evident in the claims, and what accelerating or decelerating costs reveal about an individual's health status.
Dr. Vennart and Harris described how their organizations have approached health risk stratification, from how individuals are identified for stratification purposes to the effectiveness of risk stratification programs during a May 6, 2009 webinar, Reducing Acute and Chronic Care Costs Through an Effective Health Risk Stratification Model.
The Strategic Ongoing Role of Disease Management in the Healthcare Continuum: Achieving the ROI
Dr. Dexter Shurney
Length: 10:42
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Posted: April 13, 2009
Nightly data mining has helped Vanderbilt University and Medical Center identify and make contact with high-risk high-volume patients, explains Dr. Dexter Shurney, which has vastly improved patient outcomes and closed care gaps. But the medical director of Vanderbilt's Employee Health and Care Plan would like to see even more data put in front of physicians at the point of care — especially regarding certain patients with no claims history. Dr. Shurney describes these "bombs waiting to explode," as well as the impact of the patient-centered medical home (PCMH) model of care on disease management and why wellness and prevention services may be the best responses to individuals with comorbidities.
Dr. Shurney, along with Dr. Ariel Linden, Dr.P.H., M.S., president of Linden Consulting Group, examined how disease management programs can continue to prove their worth and new developments in disease management that are netting results during The Strategic Ongoing Role of Disease Management in the Healthcare Continuum: Achieving the ROI.
Medical Home Metrics and Measurements for Achieving ROI
George Chedraoui
Length: 9:12
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Dr. Don Liss
Length: 11:49
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Posted: March 24, 2009
IBM spends about $2 billion a year on healthcare for its 500,000 employees but doesn't believe it's getting its money's worth from the current system, explains George Chedraoui, healthcare leader with IBM and immediate past president of Bridges to Excellence. Chedraoui explains why IBM is banking on the patient-centered medical home (PCMH) — with its focus on disease prevention and wellness — to deliver this value, what impact $19 billion in health IT incentives will have on physician practices, and why it will take more than technology to transform a physician practice into a medical home.
Aetna's practice of sending its providers periodic "care considerations" — detailed clinical data that identify opportunities to improve care — has been formalized in its patient-centered medical home (PCMH) pilot with Partners in Care (PIC), explains Dr. Don Liss, the regional medical director of Aetna's mid-Atlantic region. PIC providers' engagement with the care considerations is now a factor in the pay for performance aspect of the pilot. Dr. Liss shares some short-term indicators that demonstrate that the PCMH is working as well as the long-term view for medical home ROI, which can vary greatly for payors and providers.
Chedraoui and Dr. Liss shared different viewpoints — the healthcare payor and purchaser — and their strategies for achieving an ROI from the medical home during, Medical Home Metrics and Measurements for Achieving ROI.
Calculating the Health Coaching ROI: Models and Results
Paul Terry
Length: 7:12
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Posted: March 18, 2009
According to Paul Terry, Ph.D., president and CEO of StayWell Health Management, when evaluating health coaching and population health programs, it is rare to see a return on investment in a program's first year, but generally by the second and third years, ROI begins to build. In addition to discussing ROI trends, Terry evaluates the value of self-reported data and the impact health coaching can have on an organization's productivity, presenteeism and absenteeism, and also gives some benchmarks for ROI in health coaching.
Terry, along with Dr. Craig Nelson, director of health services research for American Specialty Health, described the measures to look at when evaluating health coaching and population health programs and provided case studies of how they are actually using these measures to demonstrate a health management ROI during a March 25, 2009 webinar, Calculating the Health Coaching ROI: Models and Results.
Physician Quality Reporting Initiative in 2009: How To Avoid Submission Errors and Improve Reimbursement
Dr. Bruce Bagley
Length: 5:05
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Posted: February 27, 2009
According to Dr. Bruce Bagley, the cornerstone of PQRI is quality improvement, and any bonus payments physicians receive for reporting efforts are just that — by-products of the process. Dr. Bagley, medical director of quality improvement for the American Academy of Family Physicians, also shares his views on the value of patient registries and other healthcare IT for PQRI, and advises physicians who may be frustrated by their PQRI experiences.
Dr. Bagley, along with Betsy Nicoletti, consultant, Medical Practice Consulting, LLC, described how PQRI can provide physician practices with a great start on registries and measurement and reporting and provided practical hands-on PQRI coding and auditing strategies during a March 18, 2009 webinar, Physician Quality Reporting Initiative in 2009: How To Avoid Submission Errors and Improve Reimbursement.
New Approach to Chronic Pain: Focus on Patient, Not Condition
Dr. Agostino Villani
Part 1: 14:04
Part 2: 13:49
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Posted: February 26, 2009
Too often, pain management tends to focus on the conditions rather than the people experiencing the pain, says Dr. Agostino Villani, internationally recognized expert
on chronic pain, CEO of Triad Healthcare, Inc., and author of Pain Is Not A Disease. According to Dr. Villani, this way of thinking depersonalizes the experience of pain and treats it as a disease instead of the complex, personal event that it really is. In Part 1 of this interview with Dr. Villani, he discusses his new book as well as pain management programs, pain level reduction strategies and side effects of pain medications. In Part 2, Dr. Villani discusses the importance of the physician-patient relationship, measuring the outcomes of pain management and med school curricula surrounding the topic of pain management.
Reducing Heart Failure Admissions through Remote Health Monitoring
Dr. Randall Williams
Length: 11:29
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Updated: September 16, 2009
Remote monitoring of heart failure patients by Henry Ford Health System reduced expected all-cause hospital admissions for enrollees by 36 percent after six months of enrollment and a return of 2.3:1 vs. program costs, according to a September 2009 study. Dr. Randall Williams, CEO of Pharos Innovations, the developer of the Tel-Assurance® remote patient monitoring platform used in Henry Ford's medical home pilot, describes how the daily engagement of Medicaid beneficiaries in self-care health monitoring programs can help healthcare organizations avoid many of the challenges inherent in working with this frequently underserved population. Once participants are identified, they are very receptive to the daily contact, which has resulted in extremely high program engagement rates.
Dr. Williams, along with Dr. Thomas Kline, medical director, Iowa Medicaid Enterprise, and Katherine Scher, R.N., C.C.M., program manager for the Center for Clinical Care Design at Henry Ford Health System, describe the factors that can impact engagement in telephonic health management programs and present strategies to improve engagement rates in Health IT in Care Management to Improve Health and Effect Behavior Change.
Patient Assignment into the Medical Home: Building a Collaborative Patient-Centric Approach
Dr. Anita Murcko
Length: 10:47
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Dr. Charles DeShazer
Length: 5:49
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Posted: February 4, 2009
According to Dr. Anita Murcko, medical director of clinical informatics and provider adoption with the Arizona Health Care Cost Containment System (AHCCCS), patient involvement and collaboration with providers are the keys to any successful medical home assignment — not only understanding what a medical home can provide patients but also how this model of care can empower them.
There are so many benefits to implementing the medical home model, that they more than justify the initial investment needed, says Dr. Charles DeShazer, market medical officer at Humana. These benefits range from a decrease in fragmentation of care to an increase in quality care processes to even allowing physicians to manage their time more efficiently. DeShazer also discusses the importance of patient involvement, overcoming patient resistance and measuring the success of your medical home.
Dr. Murcko and Dr. DeShazer examined the various approaches to medical home assignment and the factors that can impact effective assignment in a February 12, 2009 webinar, Patient Assignment into the Medical Home: Building a Collaborative Patient-Centric Approach.
Improving Patient Collections in an Unhealthy Economy: Technologies and Processes to Speed Payments
Kevin Burchill, Sean McDonagh and Ben Tobin
Length: 13:50
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Posted: January 19, 2009
With a revenue cycle that is measured by claims denials, collaborative data mining by billing and IT can identify origins of financial "bleeding" and turn these problems into actionable items, explain Beacon Partner experts Kevin Burchill, director; Sean McDonagh, practice director; and Ben Tobin, management consultant. Patient-friendly IT can also improve the patient experience on the front end while obtaining data to improve collections on the back end. This is a practice frequently employed by more financially robust providers. The three experts also debate the merits of offering patient discounts for prompt payment and placing patient credit reports in providers' hands.
Burchill, McDonagh and Tobin, along with Beacon senior consultant Greg Adams and principal Phil Villacci, provided practical strategies, techniques and tools to improve patient collections without alienating patients during Improving Patient Collections in an Unhealthy Economy: Technologies and Processes to Speed Payments.
Emergency Room Utilization: Developing a Team Approach to Address Overcrowding Factors That Increase Wait Time
Cindy Rentsch
Length: 11:20
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Posted: January 6, 2009
Delaying of healthcare for economic reasons is causing volatility in hospital emergency room volumes that is expected to intensify. To handle staffing, equipment and treatment challenges posed by these census variations, hospital EDs must rethink processes and protocols. At Edward Hospital in Naperville, Il., a "culture of certification" that includes cash bonuses for certification and peer support during exam preparation helps to raise the caliber of the ER staff and maintain patient satisfaction levels. Cindy Rentsch, Edward Hospital's clinical director of emergency services, describes the culture of certification that has raised the caliber of Edward's ER staff, a marketing campaign to divert mental health patients from the ER and protocols for treatment of pediatric ER patients.
Rentsch will be joined by Joan Heater, director of nursing emergency services, Banner Gateway Medical Center and Kevin Roche, director of the management engineering program at Banner Health Corporation, during Emergency Room Utilization: Developing a Team Approach to Address Overcrowding Factors That Increase Wait Time, a January 14, 2009 webinar. The three presenters shared organizational strategies that improve throughput in the ER as well as increase efficiencies, reduce costs and improve patient outcomes and satisfaction.
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