Tag Archives: Care Coordination

Changing reimbursement models requires changes to physician compensation models – basics

The public and private markets are moving to outcomes-based reimbursement and while many provider organizations are signing risk-based contracts, they have not realigned the physician compensation model. The conundrum – the organization is reimbursed to manage costs and utilization but the physicians are compensated based on volume (production). Currently, only 3% of physician compensation models […]
Read More »

Physician relations: A key to managing patient risk

In our last blog, we introduced AppleCare Medical Group, an independent practice association in California that has successfully managed risk since its inception in 1996. The IPA has done so by following a number of guiding principles, including carefully analyzing its new contracts to make sure the opportunities and risks each one presents is clear.

Information transparency is vital to population health management, yet difficult to achieve

You’d think providing up-to-date, relevant information to physicians in your accountable care organization (ACO) would be easy. Share files, email data, and voila! Transparency! But it’s not that simple. Data transparency is critical for population health management (PHM) success; without it, physicians won’t trust data that shows sub-optimal care patterns or outlier behavior. Transparency requires […]
Read More »

Engagement: The top fundamental to successful population health management

Accountable Care Organizations (ACOs) are in a unique position to engage patients faster and closer to the point of care than traditional models. This is true because of its reliance on population health management (PHM). Over the next few posts, we’ll discuss the five fundamental principles that drive PHM.

Risky business for providers: Planning for financial realities and capacity downturns

Ultimately, the financial side and the clinical side of the ACO equation need to be in balance. Adjusting to the financial realities of value-based contracting is essential. Therefore, our fourth risk-bearing action for provider organizations is financial and capacity planning.

Risky business for providers: Population-based planning in provider risk-bearing arrangements

Provider organizations that want to bear patient risk need to be informed by their local markets and the attending health care concerns that come with that market. That’s why our third action that leads to bearing risk is population-based planning.

Navigating the value transformation journey: Data and analytics to provide actionable information

In a value-based reimbursement setting, your most important technology assets may be your data. That’s because data, coupled with the right analytics capabilities, can help you focus on the patients and the conditions that have the most potential for cost savings and care quality improvement. And isn’t savings and care improvement what this “value transformation […]
Read More »

Navigating the value transformation journey: Managing population health yields cost and quality improvement

The premise of value-based contracting is that by changing incentives, health care organizations will help unhealthy people get healthy and healthy people stay that way. The change most value-based organizations are undertaking that stands to make the most difference in the health of patients is population health management (PHM). Population health management is a proactive, […]
Read More »

Handling the Handoff: The Key to Care Transitions

In this guest post, Judy Rich, president and CEO of Tucson Medical Center, shares the innovative ways her teams are leveraging technology to support improvements in care transitions. Tucson Medical Center is also part of Arizona Connected Care, which was recently selected to participate in the Medicare Shared Savings Program (Shared Savings Program) Accountable Care […]
Read More »