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

January 21, 2020

Posted In: Financial Empowerment, Population Health

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.

Succeeding in Population Health Management: Why the Right Tools Matter

August 28, 2019

Posted In: Population Health

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.

Healthcare’s Next Revolution: Finding Success in the Medicare Shared Savings Program

June 19, 2019

Posted In: Financial Empowerment, Population Health

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.

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

March 19, 2019

Posted In: Population Health

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. Workflow2. Machine learning3. Professional services4. Data governance