Category: Uncategorized

Understanding Value-Based Purchasing

Mar 12, 2015

By THCB STAFFER

Value-based care is one of the most misunderstood and controversial areas in a rapidly evolving healthcare system. This helpful webinar introduces and clarifies many of the core concepts involved in the transition to the value-based model. You’ll get a walk through of programs offered by CMS. Learn how programs are measured. Hear about the success of programs to date. Find out what organizational changes are necessary for the transition.

Hosted by Bobbi Brown, Vice President, Financial Engagements at Health Catalyst this event will be held Wednesday, May 13th at 1 PM EST and is free of charge. Bobbi’s healthcare finance background includes high profile roles as an executive with Kaiser Permanente, Sutter Health and InterMountain. Register now to guarantee your spot.

Do Value-Based Payments Lead to Higher Doctor-Satisfaction Scores?

Mar 11, 2015• 19

By JACK COCHRAN, MD and CHARLES KENNEY

Recently we wrote a blog post promoting the benefits of shifting from fee-for-service to value-based payments. We praised the recent decision by leaders at the U.S. Department of Health and Human Services (HHS) to accelerate that shift, and we were then and remain convinced this shift paves the way for better, more affordable care.

There were some strong reactions to the post.

Some people think capitated payments have been discredited, others believe the change from fee-for-service will change little. One physician told John Irvine, editor at The Health Care Blog, that he got the impression from our post that we were saying value-based payments would make physicians lives easier. “Really?” Irvine’s doctor friend said. “You’re making my life easier? Prove it.”

How Will the Practice of Medicine Change?

We didn’t actually use the word easier in the post though we did say that “increasingly, physicians seek liberation from the constraints of fee-for-service in order to focus on the overall health of their patients. Value-based payments allow doctors to do exactly that.” So we definitely hear what Irvine’s friend is saying — and we understand his frustration. Has there ever been a time when so many physicians have been worn thin — angry with the direction of our health care system?

Irvine invited us to respond to his friend and we thought we would do so by soliciting the thoughts of Scott Young, MD, executive director of Kaiser Permanente’s Care Management Institute and associate executive director for Clinical Care and Innovation at The Permanente Federation.

“Easier?” said Dr. Young. “No, value-based payments don’t make doctors’ lives easier. But I think it does make the practice of medicine more rewarding and fulfilling.”

This isn’t what we meant when we said “Like Uber For Doctors”

Mar 11, 2015• 2

DEPARTMENT OF WHAT?

HAT TIP: Josh Gray

Value-Based Health

Mar 11, 2015• 36

By CYNDY NAYER

In recent weeks, the market has reacted to a few noteworthy headlines, all involved with or touching upon value-based discretionary actions, and many with the not-so-hidden question: What’s In It for Me or WIIFM?

CMS announced that by 2016 30% of fees in health care should be paid for through a value-based system, moving away from fee-for-service.
ACO results have shown ambivalent outcomes.
Outcomes-based contracts have permeated the Hepatitis C cost-nado (that’s a cost sharknado, the kind that fiercely defies cost controls and takes over all noise about payment reform and patient preferences).
Reference-based pricing is a good/bad troublemaker in the middle of the value-based travails.

The latest rampages have appeared on two national and highly-regarded blogs: The Health Care Blog [Value-Based Reform] and The Health Affairs Blog [Go Slow on Reference Pricing].

As one of the loudest proponents on value-based designs, I lift the curtain again to show the thinking behind the movement from fee for service to value-based designs. All of these items above discuss the message of payment reform, or system alignment, but they are intensely linked to the patient-consumer ability to make the right choices, choose the right sites for care, and pay the right amount for services rendered to achieve health security.

This last—health security—should be at the heart of the US health system.

▪      It’s the place where patient competency is built and tested over time, as the patient becomes aware of health risks and chooses to modify behaviors to lower the risk.
▪      It’s the place where, when there are acute or emergent symptoms, there is no question but that the patient will be able to access the appropriate and affordable care in the safest possible setting, hopefully receiving care that delivers the patient back to functional health.
▪      It’s the place where caregivers and administrators are paid a competitive wage for serving the needs of the patient and getting the patient back to the best health possible.

From Google to New Reimbursement Models, Digital Health Trends for 2015

Mar 10, 2015

By RYAN BECKLAND

There is no question that 2014 was an exciting and eventful year for digital health. Even with all of the advancements and innovations in 2014, this year promises to be even better. The growth in business cases for new models of healthcare delivery and integration of digital health technology is reaching the point of convergence — creating powerful synergies where there was once only data silos and skepticism.

Maybe we have not quite achieved this synergy yet, but the trends emerging in 2015 will move the industry much closer to the long-awaited initiatives in connected, value-based care.. To understand the convergence that is taking place in digital health, we need to examine the key emerging trends in technology, healthcare and business.

Technology

Connecting to Smart Clinical Devices

Technology has advanced to the point that we are constantly hyper-connected to a variety of networks and devices. We have handheld diagnostic tools on our person continuously generating an astounding amount of data.

The types of health devices that are connectable and disseminating data are rapidly changing. Tools are emerging like flash thermometers that do not require physical touch, which diminish contamination risks, and smart EpiPen casings that automatically alert medical professionals during an allergic reaction.

These devices are not only becoming less expensive, but they are also starting to be reimbursable by insurers. Thus, over time these devices will replace traditional, non-connected products. Clinical devices are increasingly designed as Bluetooth-enabled, allowing for the real time collection of patient data, and providing better access and outcomes for patients.

Livongo–update on the “new diabetes meter experience”

Mar 10, 2015• 2

By MATTHEW HOLT

I spent a day in Chicago last week and caught up with Stephanie Kowalski from Livongo. This is the company that has a very cool new blood glucose meter, with cloud communication, and a careteam and coaching function built in. The CEO is ex- Allscripts boss Glen Tullman (no stranger to building big companies) and the product launched at Health 2.0 last Fall. Take a look at the video to get a sense of the user experience and hear more about the company’s rapid evolution (and to hear me almost choke to death!)

[youtube width=”425″ height=”325″]https://www.youtube.com/watch?v=NUSNb0oxF4M[/youtube]

Make Your Organization a HIMSS15 Standout!

Mar 10, 2015

In MARKETPLACE

Don’t get lost amongst the 1,200+ exhibitors that will be fighting for the attention of 38,000 or so health IT professionals at next spring’s HIMSS conference. Make sure your brand is top-of-mind before the attendees descend on Chicago April 12-16.

THCB understands that exhibiting at HIMSS requires a significant financial and time commitment for participating vendors. Our goal is to help organizations maximize their marketing success by sharing their message with the 6,000 THCB readers who visit our site each day.

HIMSS exhibitors wishing to connect with our highly healthcare-centric audience are encouraged to take advantage of one of our HIMSS Specials.

Our sweet marketing packages include:

Unbeatable social media exposure on THCB and Twitter
Awesome THCB front page placement (logo, ad unit, guest blog post)
Networking access to THCB’s healthcare obsessed audience of 650,000 plus healthcare pros
Other slick advantages that will help you stand out during and after the event

A limited number of promotional opportunities remain. Contact Michelle Noteboom for details on options and to reserve your spot.

HIT Newser: What’s the ICD-10 Contingency Plan?

Mar 9, 2015• 3

By MICHELLE RONAN NOTEBOOM

AMA: What’s the ICD-10 Contingency Plan?

The AMA and about 100 other physician groups urge CMS to develop an ICD-10 contingency plan in the event of a “catastrophic” backlog following the October 1 transition. The organizations want CMS to make public its plans to make advanced payments or reimbursements for services already rendered, work with ONC to ensure EHR systems are ICD-10 ready, and confirm contractors won’t audit for the correct code.

The silver lining here is that these organizations are (finally) not asking for a delay in implementing ICD-10. CMS apparently has drafted a contingency plan in the event of claims process disruptions but does not plan to make it public. In this age of more transparency, CMS needs to make the plan public – even though provider groups will surely find fault with the plan. But, isn’t it better to continue moving the conversation forward, just in case of there is a catastrophe?

Why Data Handoffs Matter

Mar 9, 2015• 12

By JORDAN SHLAIN, MD

Chief information officers (CIOs) and chief medical information officers (CMIOs) have spent the better part of two decades on a quest for interoperability; yet, their Achilles heel lies in the “information” part of their titles. If information is the sole beacon of efficiency and value, the invaluable contours of human suffering, personal preferences and humanity itself are lost.

Information is the first step to developing knowledge and understanding, but what physicians and patients rely on in the real clinical setting, rife with changes, are knowledge, understanding and empathy. The cold, hard calculus of a=b does not always apply when dealing with people because they are much more complex and complicated than binary machines with screens. If it were so easy, there would be no problem reaching 100% compliance with medication or a plan of action.

Sadly, all data lives in a database; which might as well be called a wait-a-base; after all, the data just sits there and waits for someone to look at it.

The fundamental problem with today’s information architecture is that all data are not created equal. Data, information and knowledge degrade with each new doctor that becomes involved. In addition, systems design lacks an understanding of how the human computer works in the context of illness, anxiety or uncertainty. Healthcare is a people business in need of data, not a data business in need of people. Data are the means; people are the beginning and the end.

Open Sourcing What Works in Health & Wellness

Mar 9, 2015

By DAVID CHASE

Few argue that we have a fully optimized healthcare system. In fact, many argue the opposite. I have good news for you. All of the components of a high achieving health ecosystem have not only been created — they have been proven with solid evidence backing them up.

The future is here. It is just unevenly distributed. — William Gibson

Mr. Gibson could have been speaking about healthcare when he made this oft-cited quote. Unfortunately, while we have the components to fix health and healthcare, they are scattered all over the country and world. Healthcare, in it’s present state, is a design failure given the money, smarts and compassion that we invest. Put simply, it rewards the wrong activities. We pay for illness and treatment, and we get more illness and treatment. Even if we had a perfectly designed health ecosystem, the emerging convergence of new genomic insights, smartphones and mobile Internet, the Internet of Things, sensors, wearables and changed reimbursement models creates an enormous new challenge.