Executive Reports

Preparing for MACRA: A Comprehensive FAQ for Physicians (Executive Report)

The Medicare Access and CHIP Reauthorization Act (MACRA) overhauls the payment system for Medicare providers. It’s a complex program that requires careful study so physicians can make the best choice for how they want to report. This choice ultimately impacts reimbursement and the potential bonuses or penalties associated with each reporting option.

This FAQ covers both tracks of the new rule, the Merit-based Incentive Payment System (MIPS), and the Advanced Alternative Payment Model (APM), with a background review and a comprehensive list of questions and answers.

It’s a practical guide complete with next steps for strategic and tactical planning.

The Best Way to Maximize Healthcare Analytics ROI (White Paper)

When it comes to maximizing analytics ROI in a healthcare organization, the more domains, the merrier. Texas Children’s Hospital started their outcomes improvement journey by using an EDW and analytics to improve a single process of care. It quickly realized the potential for more savings and improvement by applying analytics to additional domains, including:

  • Analytics efficiencies
  • Operations/Finance
  • Organization-wide clinical improvement

The competencies required to launch and sustain such an organizational sea change are all part of a single, defining characteristic: the data-driven culture. This allows fulfillment of the analytics strategy, ensures data quality and governance, encourages data and analytics literacy, standardizes data definitions, and opens access to data from multiple sources.

This article highlights the specifics of how Texas Children’s has evolved into an outcomes improvement leader, with stories about its successes in multiple domains.

Hadoop in Healthcare: Getting More from Analytics (White Paper)

Healthcare data is positioned for momentous growth as it approaches the parameters of big data. While more data can translate into more informed medical decisions, our ability to leverage this mounting knowledge is only as strong as our data strategy. Hadoop offers the capacity and versatility to meet growing data demands and turn information into actionable insight.

Specific use cases where Hadoop adds value data strategy include:

  1. Archiving
  2. Streaming
  3. Machine learning

When Healthcare Data Analysts Fulfill the Data Detective Role (White Paper)

There’s a new way to think about healthcare data analysts. Give them the responsibilities of a data detective. If ever there were a Sherlock Holmes of healthcare analytics, it’s the analyst who thinks like a detective. Part scientist, part bloodhound, part magician, the healthcare data detective thrives on discovery, extracting pearls of insight where others have previously returned emptyhanded. This valuable role comprises critical thinkers, story engineers, and sleuths who look at healthcare data in a different way. Three attributes define the data detective:

  1. They are inquisitive and relentless with their questions.
  2. They let the data inform.
  3. They drive to the heart of what matters.

Innovative analytics leaders understand the importance of supporting the data analyst through the data detective career track, and the need to start developing this role right away in the pursuit of outcomes improvement in all healthcare domains.

The Four Balancing Acts Involved with Healthcare Data Security Frameworks (White Paper)

There’s a lot at stake for healthcare organizations when it comes to securing data. A primary concern is to protect privacy and avoid costly breaches or leaks, but at the same time, data must be accessible if it’s to be used for actionable insights. This executive report introduces four balancing acts that organizations must maintain to build an ideal data security framework:

  1. Monitoring
  2. Data de-identification
  3. Cloud environments
  4. User access

This can be a tug-of-war between IT and security, two groups that often have divergent interests, however well-meaning they may be. Healthcare systems that build bridges between these interests and strike the crucial balance between data utilization and security can dial in on long-term goals, like better care at a lower cost and overall outcomes improvement.

The Who, What, and How of Health Outcome Measures (Executive Report)

Even though thousands of health outcome measures have the potential to impact the work we do every day, how well do we really understand them? In this article, we take a close look at the definitions, origins, and characteristics of health outcome measures. We break down the financial relevance of certain measures, the relationship between outcome measures and ACOs, and which measures impede, rather than enhance, a typical healthcare system. We review the role of an enterprise data warehouse and analytics, and we touch on the future of health outcome measures, all in an effort to provide deeper insight into some of the mechanics behind outcomes improvement.

The 7 Best Ways to Prepare for MACRA Today (Executive Report)

The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law in 2015, with major impacts starting in 2019. MACRA attempts to prioritize quality over quantity by letting providers choose between two value-based payment tracks: MIPs and APMs. Providers won’t have to choose until 2019; until then, they will receive a .5 percent annual increase.

The industry is conflicted about MACRA. On the one hand, many believe it is part of the overall shift to value-based healthcare. On the other hand, many say the administrative burden will overwhelm providers. Another area of MACRA controversy has to do with meaningful use which, contrary to what the CMS Acting Administrator said in 2016, isn’t going away with the introduction of MACRA.

Although it seems a ways away, MACRA’s base year will likely be 2017. Armed with the seven best ways to start preparing for MACRA today, and an EDW that provides clinicians with the self-service tools to monitor their performance, health systems can be ready to tackle MACRA when it finally goes into effect.

Population Health in Three Paragraphs (Executive Report)

Population health strategy can borrow a lot from public health. However, health systems haven’t had to deal with patient socioeconomic issues and need to build new skills and use new data. The skills can be adapted from the public health sphere, with hospitals developing health interventions alongside law enforcement, community-based social support, etc. The most important data are patient-reported outcomes data, social determinants of health data, and activity-based costing data. With this approach, the fundamental equation for population health would be Return on Engagement, that is the clinical outcome achieved divided by the total patient investment.

The Top Five Recommendations for Improving the Patient Experience (Executive Report)

Improving patient satisfaction scores and the overall patient experience of care is a top priority for health systems. It’s a key quality domain in the CMS Hospital Value-Based Purchasing (VBP) Program (25 percent) and it’s an integral part of the IHI Triple Aim.

But, despite the fact that health systems realize the importance of improving the patient experience of care, they often use patient satisfaction as a driver for outcomes. This article challenges this notion, instead recommending that they use patient satisfaction as a balance measure; one of five key recommendations for improving the patient experience:

  1. Use patient satisfaction as a balance measure—not a driver for outcomes.
  2. Evaluate entire care teams—not individual providers.
  3. Use healthcare analytics to understand and act on data.
  4. Leverage innovative technology.
  5. Improve employee engagement.

This article also explains why patient experience is so closely tied to quality of care, and why it’s a prime indicator of a healthcare organization’s overall health.

9 Ways Your Outcomes Improvement Program Could Be Delayed (Executive Report)

A health system’s outcomes improvement program is an expensive undertaking. It’s worth the results, but there’s no need to make it even more expensive through unforeseen and unnecessary delays. We outline the three phases of managing outcomes improvement programs, from hardware and software acquisition and configuration to resource management to sustaining and scaling the gains. We also examine the nine potential pitfalls that can undermine success in each of these phases:

  • Hardware and software acquisition delays
  • Environment readiness
  • Source system access
  • Lack of resource capacity
  • Lack of analytic and technical skills
  • Data quality paralysis
  • Lack of clinical or operational engagement
  • Punitive culture: data used as a weapon
  • No CEO, no go