Tag Archives: care management

Revolutionizing traditional care management

Traditional care management is facing increased scrutiny under mounting expectations. Expectations of better utilization management and cost control. Expectations that the increasing number of members entering the market through exchanges will receive better quality care. But for care management services to achieve genuine success, there must be substantiated value in regard to improved health outcomes, […]
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Changing reimbursement models requires changes to physician compensation models – the value of unblinded performance metrics

In my final blog related to changing reimbursement models requiring changes to physician compensation models, I want to identify the value of sharing unblinded information once physicians have approved, digested and absorbed the compensation model. Many of the organizations I have talked to find unblinded incentives to be a very powerful tool. However, you need […]
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Changing reimbursement models requires changes to physician compensation models – A structured approach to implementation

My previous blog, “Changing reimbursement models requires changes to physician compensation models – Characteristics of value-based compensation model,” outlined that as provider organizations move to risk-bearing contracts there are characteristics that go beyond just measuring quality of care and patient outcomes. A structured approach to engaging physicians is required to ensure long-term adoption and ultimate […]
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Combining high-tech and high-touch with care guides

The previous blog post focused on how Minneapolis-based HealthEast applied data and analytics from Optum One to get great care management results. This final blog in the three-part series will show how care management is making a difference in patient lives. One relatively new element to care coordination that HealthEast put into practice was certified […]
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Changing reimbursement models requires changes to physician compensation models – characteristics of value-based compensation Model

My previous blog, “Changing Reimbursement Models Requires Changes to Physician Compensation Models – Fundamental Pillars to Building a Strong Physician Compensation Model,” outlined that there are five pillars that the model should incorporate. Value-based transformation requires incentivizing physicians and the care team on a variety of behaviors that go beyond productivity. Outlined below are a […]
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Podcast: Using predictive analytics to improve care quality

Being proactive about providing care for patients is an important strategy for quality improvement. Once a patient presents at the point of care, especially a high-risk patient, the time for prevention has passed. Reaching out to such patients before they feel like they need to go to the hospital is the key. In this edition […]
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Podcast: Create opportunities for actionable intelligence with patient registries

As the buzz around population health management increases, you’re going to hear more about registries. Registries are HIPAA-compliant lists of patients who share common attributes. When registries are used to focus on patients in need of targeted actions to prevent negative outcomes, registries can be the backbone of a good care management program. In this […]
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Consumer behavioral segmentation – the next frontier in population health stratification

In my previous blogs I have outlined the need for providers to develop customer relationship management and patient relationship management capabilities but a fundamental requirement for success is the ability to segment the consumer and patient. Currently, providers are focused on segmenting patients based on their predictive clinical risk. The challenge to only leveraging predictive […]
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Population health stratification – thinking beyond the standard clinical risk segments

In my previous blogs I have outlined the need for providers to develop customer relationship management and patient relationship management capabilities which includes understanding the consumer’s perspective on health and the healthcare system. Currently providers are focused on understanding an individual’s clinical risk profile but it is important to integrate an individual’s attitude and activation […]
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Integrated approach to customer relationship management and patient relationship management

As I have discussed in previous blogs, today’s health care trends challenge hospitals and physicians to think differently about how they engage the community and consumers. With new dynamics due to health care and market reforms and the retailization of health care, providers need to strategically and systematically think about how to engage the individual […]
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