Tag Archives: healthcare reform

3 categories of non-clinical factors lead to readmissions

Failure to follow up with a physician or follow a medication regimen can cause a recently released patient to end up right back in the hospital. But there are other, non-clinical factors that also lead to readmissions. The causes can be grouped into three main categories: Patients’ medical literacy According to the National Network of Libraries […]
Read More »

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 […]
Read More »

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 […]
Read More »

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 […]
Read More »

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 […]
Read More »

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 […]
Read More »

Benchmarking Clinical, Financial Goals Key for ACO Performance and Care Delivery

This post is the fifth 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. It is important for accountable care partners to understand their financial, clinical and quality performance on a macro […]
Read More »

Upside and Downside Risk Should Be Part and Parcel of ACO Financial Arrangements

This post is the fourth 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. Most provider organizations today are not built to manage risk. In many of the current fragmented payment models, […]
Read More »