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Value-Based Purchasing / Risk-Based Contracting

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.

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Pairing HIE Data with an Analytics Platform: Four Key Improvement Categories

Population health and value-based payment demand data from multiple sources and multiple organizations. Health systems must access information from across the continuum of care to accurately understand their patients’ healthcare needs beyond the acute-care setting (e.g., reports and results from primary care and specialists). While health system EHRs have a wealth of big-picture data about healthcare delivery (e.g., patient satisfaction, cost, and outcomes), HIEs add the clinical data (e.g., records and transactions) to round out the bigger picture of patient care, as well as the data sharing capabilities needed to disseminate the information.

By pairing HIE capability with an advanced analytics platform, a health system can leverage data to improve processes in four important outcomes improvement areas:

  1. Workflow
  2. Machine learning
  3. Professional services
  4. Data governance

Value-Based Care: Four Key Competencies for Success (Executive Report)

How prepared are healthcare organizations to enter into value-based care? Many may not be ready. While early value-based care adopters have focused on improving and measuring quality, they’ve often overlooked steps to bear the associated financial risk. Now that health systems can enter into alternative payment models and risk-based contracts, they need to ensure that cost is as much a priority as quality.

Health systems can achieve sustainable value-based care success by optimizing the five core competencies of population health management:

  1. Governance that educates, engages, and energizes.
  2. Data transformation that addresses clinical, financial, and operational questions.
  3. Analytic transformation that aligns information and identifies populations.
  4. Payment transformation that drives long-term sustainability.
  5. Care transformation as a key intervention in value-based contracts.

How to Drive ROI in Your Healthcare Improvement Projects (Executive Report)

Hospitals and healthcare systems need a systematic approach and tools to demonstrate ROI from their healthcare improvement projects. Bobbi Brown, VP of Financial Engagement, shares a four-step process for demonstrating ROI: 1) define the project and business need, 2) begin to quantify ROI, 3) recruit, train and plan, and 4) evaluate costs, revenue and direct benefits. Download the Health Catalyst Clinical Improvement Financial and Executive Communications tools for estimating, calculating and communicating your ROI results.

Surviving Value-Based Purchasing in Healthcare: Connecting Your Clinical and Financial Data for the Best ROI

Reducing healthcare costs is a major driving force in bundled payments, home-centered medical care, and accountable care organizations. But each new delivery model is built on the premise of reducing revenue per patient. So how can a health system win? Find out what you can do financially survive in today’s environment.