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Latest Executive Reports

A Sustainable Healthcare Emergency Management Framework: COVID-19 and Beyond (White Paper)

With an ever-changing understanding of COVID-19 and a continually fluctuating disease impact, health systems can’t rely on a single, rigid plan to guide their response and recovery efforts. An effective solution is likely a flexible framework that steers hospitals and other providers through four critical phases of a communitywide healthcare emergency:

  1. Prepare for an outbreak.
  2. Prevent transmission.
  3. Recover from an outbreak.
  4. Plan for the future.

The framework must include data-supported surveillance and containment strategies to enhance detection, reduce transmission, and manage capacity and supplies, providing a roadmap to respond to immediate demands and also support a sustainable long-term pandemic response.

Interoperability in Healthcare: Making the Most of FHIR

With the CMS and ONC March 2020 endorsement of HL7 FHIR R4, FHIR is positioned to grow from a niche application programming interface (API) standard to a common API framework. With broader adoption, FHIR promises to support expanding healthcare interoperability and prepare the industry for complex use cases by addressing significant challenges:

  1. Engaging consumers.
  2. Sharing data with modern standards.
  3. Building a solid foundation for healthcare interoperability.

What Health Systems Need to Know About COVID-19 Relief Funding

During the emergency phase of the COVID-19 pandemic, almost half of all U.S. healthcare consumers postponed routine and non-emergent care, leaving organization with significant revenue loss across all care settings. In response to the widespread financial strain on the healthcare industry, Congress has allocated $100 billion in relief funding for hospitals and other healthcare providers. But while providers clearly need the financial relief, using it (including navigating terms and conditions and eligibility) has been less straightforward. Better understanding of these relief programs and compliance requirements will help organizations confidently optimize this assistance.

The Healthcare Analytics Adoption Model: A Roadmap to Analytic Maturity (Executive Report)

The focus on analytics is contributing to the “EHR problem”—doctors prioritizing the EHR over patients. The Healthcare Analytics Adoption Model (HAAM) walks healthcare organizations through nine levels that lay the framework to fully leverage analytic capabilities to improve patient outcomes:

Level 1. Enterprise Data Operating System
Level 2. Standardized Vocabulary & Patient Registries
Level 3. Automated Internal Reporting
Level 4. Automated External Reporting
Level 5. Waste and Care Variability Reduction
Level 6. Population Health Management & Suggestive Analytics
Level 7. Clinical Risk Intervention & Predictive Analytics
Level 8. Personalized Medicine & Prescriptive Analytics
Level 9. Direct-To-Patient Analytics & Artificial Intelligence

Analytics are crucial to becoming a data-driven organization, but providers and administrators can’t forget about the why behind the data—to improve outcomes. Following the HAAM enables organizations to build a sustainable, analytic platform and empower patients to become data-driven when it comes to their own care.

Value-Based Purchasing 2020: A 10-Year Progress Report (Executive Report)

The year 2020 marks a decade since the passage of the Affordable Care Act in 2010 and healthcare’s first transitional steps from volume to value. The 10-year progress report is mixed. On one hand, CMS’s emphasis on quality and cost is driving an upward trend for patients and providers, with substantial improvement in readmissions; on the other hand, organizations still need to simplify and consolidate value-based programs for more widespread positive impact. As the industry enters into another decade of value, it’s time for health systems to consider the impacts of these programs so far and make sure they have the processes and tools in place to succeed in an increasingly value-driven industry.

The Medicare Shared Savings Program: Four Tools for Better Profit Margins and High-Quality Care (White Paper)

Medicare patients make up the majority of health systems’ revenue; yet, organizations earn only a one percent profit while caring for this population. Despite historically low profit margins, Medicare can be lucrative for health systems, and through the Medicare Shared Savings Program, healthcare organizations can increase revenue with four tools:

  1. The ability to aggregate and analyze data.
  2. The ability to align financial incentives between payers and providers.
  3. The ability to engage patients in behavior or lifestyle modifications.
  4. The ability to garner support from clinicians and encourage them to lead the shift to VBC.

As the shift from fee-for-service to value-based care continues, health systems can leverage MSSP to deliver the highest level of care while also increasing profit margins.

Survey Points to Major Burnout Concerns Among Clinicians (Executive Report)

According to a November 2019 survey, 62 percent of clinicians and other healthcare professionals view burnout as a major problem industrywide. When asked for the best way to address clinician burnout problems, the most popular solution was less-complex workflows, which is the aim of emerging point-of-care analytics solutions.

Responses to additional questions reveal more about clinician burnout experience and views on the technology designed to help:

  1. At your organization, how big of a problem is clinician burnout?
  2. What is the best way to solve clinician burnout problems?
  3. What are the biggest barriers to adopting closed-loop, point-of-care analytics capabilities at your organization
  4. What are the biggest problems arising from a lack of adopting closed-loop, point-of-care analytics capabilities?

Succeeding in Population Health Management: Why the Right Tools Matter (Executive Report)

The U.S. healthcare market projects that by 2022 90 million Americans will be in an ACO. The upward trend in population health management (PHM) makes the move towards risk-based contracts increasingly urgent for health systems. The industry has been largely unprepared for the shift, as it hasn’t established a clear definition of population health or solid guidelines on transitioning from volume to value. Organizations can, however, prepare for the demands of PHM by adopting a solution that manages comprehensive population health data, provides advanced analytics from new and complex challenges, and connects them with the deep expertise to thrive in a value-based landscape.

Continuity of Care Documents: Today’s Top Solution for Healthcare Interoperability Demands (Executive Report)

While healthcare waits for the expanded data interoperability that FHIR promises, the industry needs an immediate solution for accessing and using disparate data from across the continuum of care. With FHIR potentially several years away, continuity of care documents (CCDs) are the best option for acquiring the ambulatory clinical care data health systems need to close quality gaps today. Because organizations that rely only on claims data to drive quality improvement risk missing out on more that 80 percent of patient information, CCDs are the current must-have answer to interoperability for successful quality improvement.

Healthcare’s Next Revolution: Finding Success in the Medicare Shared Savings Program (Executive Report)

A series of revolutions has driven the development of the U.S. healthcare system, enabling dramatic improvements in all aspects of healthcare quality and outcomes over the past century. Although healthcare organizations have focused on moving towards value-based care for decades, the data shows that the shift is indeed taking place and fee-for-service models are declining.

New changes to the Medicare Shared Savings Program (MSSP) will help drive this change as revisions to MSSP require ACOs to take on more financial risk earlier. This article covers the following topics:

  1. Important moments in history that led to today’s current challenges.
  2. Why financial imperatives drive cultural change in our economic model.
  3. Ways MSSP can help healthcare organizations achieve financial success.
  4. How to utilize data to develop better healthcare delivery systems.