Tag Archives: Healthcare IT

Who should make up the team that directs your move to accountable care?

As the U.S. health care system moves away from reimbursement models that reward volume and toward those that reward care coordination – traditional industry roles are blurring. • New #5in5 video: Fee for value requires revised relationships As this integration accelerates, organizations must build new governance structures that can provide strategic direction and accountability. That […]
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Payer IT paradigm shift needed to support customer-centric approach

With health plans focusing their organizations more on customers, it’s critically important that we ensure IT applications and infrastructure are modernized to better collect, store, analyze and produce more specific customer information. The IT implications are significant because plans’ administrative systems have historically focused on policy administration. While administrative systems are good at handling transactions, […]
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Navigating the Journey from Providing Care to Managing Health

Health care’s “Triple Aim”—the goal of simultaneously improving quality, lowering costs, increasing patient satisfaction—is not a passing fad. It’s good business. Focusing on the Triple Aim will give organizations strategic advantages in contracting and in marketing. It may also help them gain market share.

Leveraging technology to support the sharing of information and drive decision making

Integrating IT systems and aggregating data across multiple organizations will lead to higher quality, more effective and more efficient patient care. The components an ACO required to accomplish these goals include an electronic health record (EHR), a health information exchange (HIE), data management resources, a clinical analytics solution and patient registries.

Care management for high-risk patients

To manage high-risk members, a community-based, team-based approach provides the best balance of quality and patient care. Care management teams should include a physician, a care manager, a pharmacist, a behavioral specialist and a social worker. Payers typically have the most experience with care management, but a 2012 study[1] confirmed that providers who are part […]
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Improving overall population health starts at better care for individuals

Successfully improving population health begins with improving the health of people in the community. This begins with giving health care providers the means to identify and prioritize the individuals in need of help. The first step is to define a standard risk-stratification process by which providers will identify and at-risk populations and disease conditions. For […]
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Empowering patients to support population health initiatives

Both provider and payer organizations need to find ways to consistently and cost-effectively interact with and coordinate patient-centered prevention and care. But it’s not just engaging the providers—it’s also empowering the patient to make better health care choices to prevent or manage illness.

Care Integration Requires Re-thinking Care Delivery Processes-Part 2

This post is the seventh of an 11-part series that proposes structures and actions that characterize successful accountable care organizations. Click here to download A Model for Value-Based Provider/Payer Partnerships white paper that covers the subject more in-depth. To redesign care delivery processes and coordinate patient care services, a multi-organizational and multi-disciplinary operations and clinical team […]
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Care Integration Requires Re-thinking Care Delivery Processes-Part 1

This post is the sixth of an 11-part series that proposes structures and actions that characterize successful accountable care organizations. Click here to download A Model for Value-Based Provider/Payer Partnerships white paper that covers the subject more in-depth. The term clinical integration is commonly cited as a foundational enabler of accountable care and fee-for-value, but there […]
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How has the external roadmap to value changed over the last year for providers?

As the momentum to value-based health care progresses, the focus of physicians and hospitals has shifted.  Last year many providers were waiting to see if the Supreme Court would uphold the Patient Protection Affordable Care Act (PPACA), what the outcomes of the elections would hold and whether cadence of value-based public and commercial programs would […]
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