Population health is the phrase of the week. In this week's roundup: a lesson from precision medicine that helps inform healthcare leaders on improving population health; three ways healthcare professionals can use social media to improve population health; an introduction to a data- and analytics-first approach to population health management; and how academic medical centers can boost population health management.
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Introducing the Health Catalyst Population Health Foundations Solution: A Data- and Analytics-first Approach to PHM
Introducing the Health Catalyst Population Health Foundations solution, which draws on integrated claims and clinical data, and provides essential, extensible tools and machine-learning capabilities for optimizing results in value-based risk arrangements. Accompanying solution services ensure that the strategic value of data is maximized to improve performance in risk contracts—and provide side-by-side subject matter expert partnership for establishing short- and long-term goals for population health management.
The Health Catalyst Population Builder: Stratification Module allows healthcare organizations to identify the right patient populations in order to deliver the right care at the right time. The solution provides a seamless process for stratifying populations from multiple sources (EMR, claims, and clinical), using pre-defined, easily customized populations as building blocks. With a comprehensive view of the patients they manage, organizations can map populations along their continuum of care and confidently transition appropriate populations to population health interventions.
A health system's board of trustees plays a critical role in decision-making and governance but often lacks oversight. In this week's news roundup: six guidelines for engaging the board in quality and safety; AHA study shows that hospital boards see low turnover but lack diversity and succession planning; an assessment tool allows health system boards to track their performance; and, why all hospital boards deserve greater scrutiny
Utah HIMSS (UHIMSS) recognized Health Catalyst for its innovative leadership with the 2019 UHIMSS Healthcare IT Corporate Innovator award. Dale Sanders, Health Catalyst President of Technology, accepted the honor on behalf of his organization at the UHIMSS 2019 spring conference on May 17. He shared some key insights into what makes a great environment for ongoing innovation, including these valuable sources for invention and originality:
- Pen and paper
- Pattern recognition
The quality and patient safety movement of the early 21st century called for greater board of trustee involvement in improvement. However, too many health systems still don’t have the resources in place to effectively engage their boards around quality and safety measures. Six guidelines describe how organizations can better leverage data to inform their boards:
- Emphasize quality and patient safety goals.
- Leverage National Quality Forum-endorsed measures.
- Use benchmarking and risk adjustment to select targets.
- Access data beyond the EHR.
- Provide data and information for multiple organizational levels.
- Develop a board-specific measurement and presentation strategy.
Healthcare payer models are changing rapidly. This week's roundup features new and emerging healthcare payment models: the top five financial opportunities for payers; healthcare experts weigh in on the five new CMS Primary Care payment models; why some healthcare executives are calling for Stark Law reform; and what payment looks like in social determinants of health programs.
Healthcare payers today must develop new business models to address the industry’s mounting challenges around cost, access, and quality. The best emerging models are simple and aligned, accommodate all stakeholders’ needs, and center on the patients/members. Five key payer opportunities provide a framework for new models that will support the healthcare transformation goals of lower cost, better quality, and increased access:
- Understand the impact of the Affordable Care Act.
- Be ready for potential shifts due to regulatory impacts.
- Understand how social determinants of health impact members.
- Focus on provider relations.
- Prepare for future trends.
With the right evidence, analytics, and methods, providers and improvement teams can transform healthcare, improving the quality of patient care and the bottom line. This week's news roundup focuses on healthcare quality improvement projects: top examples, battling prolonged lengths of stay with data, closing care gaps with technology, and streamlining data for health plan quality reporting.
So far, the EHR hasn’t delivered on its original intent to improve patient care with more efficiency and personalization and lower cost. Instead, physician users blame the systems for worsening their experience and the quality of their care in significant ways:
- Less time for patient interaction and worsened quality of interaction.
- An extended workday.
- Poor design (difficult to use).
- Demands of quality measures.
- Cost and maintenance.
This week's news roundup is all about ACOs: the past, present, and future of ACOs and CINs; why some provider groups want to make the next generation of ACOs permanent; the reason some ACOs stay in the MSSP; and why half of ACOs are likely to exit MSSP due to new downside risk requirements.
Accountable Care Organizations (ACOs) and clinically integrated networks (CINs) are two types of organizations working to address the problem of rising costs. As ACOs and CINs continue to evolve, organizations moving into value-based care (VBC) face an ever-changing landscape. This article looks at the evolution of the ACO and CIN models, what new tools ACOs employ today to promote success, and lessons learned from organizations that have succeeded in alternative payment models. It also explores what healthcare experts believe the future of alternative payment models will look like and competencies to develop to meet those changing demands.
This week’s news roundup focuses on improvement opportunities and digital solutions for payers: how healthcare analytics is helping payers thrive with increased financial risk; trends in healthcare payments; how health insurers and pharmacy benefit managers are falling short when it comes to medication access for autoimmune diseases; why communication is key for out-of-pocket patient costs; and more.
To stay in sync with healthcare’s transition to value-based care, payers today must develop the analytics capability to support alternative payment models and drive more value to their members. Payers can follow an analytics roadmap to develop a strategy that extends their data, analytics, and risk management expertise to meet growing demands. The analytics roadmap helps the payer meet these common challenges of establishing a data-driven culture:
- Recruiting and retaining high-quality providers in a competitive market.
- Managing increasing numbers of high-risk/high-cost members with limited resources.
- Efficiently reacting to federal and state legislative and payment changes.
- Controlling the rising costs of healthcare services and pharmaceuticals.
In order to thrive in an increasingly challenging healthcare environment, undertaking quality improvement projects is more important than ever for healthcare systems’ continued survival. However, health systems need to tackle the right projects at the right time to maximize the impact to their organization. This article shares both clinical and financial and operational examples of quality improvement in healthcare that may help others as they tackle improvement projects. Some examples shared include:
- Pharmacist-led Medication Therapy Management (MTM) reduces total cost of care.
- Optimizing sepsis care improves early recognition and outcomes.
- Boosting readiness and change competencies successfully reduces clinical variation.
- New generation Activity-Based Costing (ABC) accelerates timeliness of decision support.
- Systematic, data-driven approach lowers length of stay (LOS) and improves care coordination.
- Clinical and financial partnership reduces denials and write-offs by more than $3 million.
Patient safety is always an important and timely topic. In this week's news roundup: a CMS proposed rule to strengthen oversight of accrediting organizations; using event reporting and predictive analytics to make patients safer; EHRs as the cause of treatment delays and safety and communication issues between patients and providers; and, using data to improve quality and patient safety.