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ClinOps I.M.P.A.C.T. Summaries: Trends in Value-Based Healthcare - April 2019

 

April 2019 Issue - In this issue, learn about the following Trends, Entrants, and Developments that I.M.P.A.C.T. and Contribute to VBHC:

 

1.    INFRASTRUCTURE:

 

How AI, Blockchain Combine to Fuel Healthcare Big Data Analytics

Artificial intelligence and blockchain are powerful individually, but combining the two may be the key to truly impactful big data analytics. Learn More.

 

AHRQ Announces Predictive Analytics, Inpatient Data Challenge

Competitors will apply predictive analytics to hospital inpatient data and forecast healthcare utilization trends. Learn More.

 

How telemedicine is evolving to support variety in care

What is new is how telemedicine has grown exponentially in the past five years. Simply put, more sophisticated and cheaper telecommunications, mobile device and remote monitoring technologies are empowering telemedicine to substantially bridge the gap, quite literally, between the physical locations of doctors and patients, anywhere in the world. Learn More.

 

BCBSA Data Analytics Reveal Shifts in Behavioral, Mental Health

The nation’s behavioral and mental health patterns are changing rapidly as patients and providers change their responses to issues such as depression, ADHD, and pain management, reveals large-scale data analytics from the Blue Cross Blue Shield Association (BCBSA). Learn More.

 

 

2.    MEMBER EXPERIENCE:

 

Patient Control Over Health Data

Two proposed rules from the Office of the National Coordinator for Health IT (ONC) and CMS will allow patients complete access to their electronic health records (EHR) from both care providers and insurers. Learn More.

 

The Caregiver Gap

Caregivers are often an integral part of the care team and are involved in everything from medication choice to adherence. But there is a growing gap between the number of caregivers and those who will be needed to address the needs of the aging baby boomer generation. Learn More.

 

 

3.    PEOPLE:

 

How to Run a Brainstorming Meeting that Actually WorksTry these tips to run a successful idea session that people will remember and that could actually get you to your next big idea. Learn More.

 

Employee engagement crucial for patient-centered care, says Press Ganey

Employee alignment and engagement is crucial for health systems seeking to build an organizational structure that supports patient-centered care, according to Press Ganey's 2019 Strategic Insights report, titled "Accelerating Transformation: Translating Strategy Into Action." Learn More.

 

Looking to make big changes? Here are 4 places for healthcare leaders should start

Healthcare leaders looking to drive a big change in their organization need to start by articulating their strategic vision—and doing their homework to make sure their workforce is able to carry out that vision, according to the annual Strategic Insights report from Press Ganey. Learn More.

 

 

As Your Team Gets Bigger, Your Leadership Style Has to Adapt

Back when our Facebook design team still fit around a conference table, a new designer joining our merry band was a momentous event. A few months later, another person would join. And another. And another. Each time, new faces were introduced to the current team and our existing processes.

Everything seemed to be going smoothly. Then one day, seemingly out of the blue, I realized that the old way of doing things was no longer working. Learn More

 

 

4.    POLICY:

 

With Medicare-for-all unlikely to pass, is Medicare buy-in option a realistic alternative?

With the most expensive medical care in the world and shorter life expectancies, the U.S. is in what the authors call a healthcare crisis. A commentary appearing in the American Journal of Medicine, proposes another approach that the authors believe would achieve wider access to care without triggering widespread opposition: a Medicare buy-in option for individuals under 65 years of age. Learn More.

 

Medicare for All Would Abolish Private Insurance. ‘There’s No Precedent in American History.’

Unlike Obamacare, emerging plans would sweep away the private health insurance system. What would that mean for the companies’ workers, the stock market and the cost of care? Learn More.

 

 

5.  PERFORMANCE:

 

MIPS Final Score Calculation in 2019: What You Need To Know

MIPS is scored across four performance categories: Quality, Promoting Interoperability (PI), Improvement Activities (IA), and Cost. If a group or individual reports only one performance category, then their MIPS final score is capped at the performance threshold. In 2019, CMS is emphasizing encouraging MIPS Eligible Clinicians (ECs) to reach data completeness requirements. Learn More.

 

Several states in CMMI model made 'significant strides' in pop health integration

States that received funding from the Center for Medicare and Medicaid Innovation's State Innovation Model (SIM) Round 2 Model Test have begun aligning stakeholders toward payment reform, advanced behavioral health integration and established infrastructure for population health. Learn More.

 

MIPS participation in year 1 nets 95% of eligible cliniciansData CMS released Wednesday shows 95% of eligible clinicians participated in the first year of the Merit-based Incentive Payment System. Of those, 54% did so as groups, 12% as individuals and 34% through MIPS Advanced Alternative Payment Models. Learn More.

 

Healthcare in The Age Of Personalization Part 2: Identifying The Real Metrics Of Inclusion

This is Part 2 of a six-part series on Healthcare in the Age of Personalization. Measuring diversity takes us further away from inclusion. Unless we proactively interrupt that process. That’s why we need new metrics. Learn More.

 

 

6.    AFFORDABILITY AND VALUE:

 

Express Scripts: Value-based programs increasing adherence, lowering drug costs

A new analysis from Express Scripts reveals that value-based programs are keeping costs down while also improving care and outcomes for patients. The goal is to combine reimbursement strategies with clinical initiatives to help insurance plans and patients to get the best value out of high-cost therapy treatments and drugs. Learn More.

 

Prescriptions for healthy foods could save healthcare billionsThe novel approach could cut down on adverse cardiovascular events for Medicare and Medicaid beneficiaries, decreasing utilization. Learn More.

 

Pharmacy sticker shock: Surescripts working to lessen the pain

CEO Tom Skelton says Surescripts' product allows doctors to tell the patient at the point of care the price of prescriptions along with alternatives. Learn More.

 

How Addressing Social Determinants of Health Cuts Healthcare Costs

Nutrition programs, housing initiatives, and ridesharing partnerships are some of the ways providers are reducing healthcare costs by addressing social determinants of health. Learn More.

 

 

7.    COMMUNITY:

 

AMA, UnitedHealthcare Tackling Social Determinants of Health

UnitedHealthcare and AMA are launching a collaborative effort to more effectively identify and address social determinants of health. Learn More.

 

Health Care in America — How Doctors Can Make Life Easier for Patients

When a homeless person gets discharged from the hospital, he needs a safe place to recover. When a poor patient faces a high copay for a medicine, she may not fill the prescription. Doctors don’t typically try to address such social needs. But some are looking for ways to do so and improve their patients’ lives beyond the exam room. Learn More.

 

Social Determinants of Health Impact Hospital Readmission Rates

Safety-net hospitals could receive fewer penalties if value-based purchasing programs adjusted hospital readmission rates for social determinants of health. Learn More.

 

Better strategy needed to get ROI from social determinants initiatives

Health systems are increasingly investing in programs to address "social determinants" in healthcare like food and housing insecurity. But too often those efforts are still too fragmented to make the intended impact. There needs to be a strategic shift in thinking in order to leverage the full impact of these programs. Learn More.

 

 

8.    TRANSFORMATION:

 

How Employers Are Fixing Health Care

Walmart has embraced a new approach to improve the quality of care and lower costs. The results have been dramatic. Learn More

 

Hospital Patient Volumes Are Sliding As Amazon, CVS And Walgreens Threaten To Make Matters Worse

The report is the latest to show trouble for U.S. hospitals as new competitors emerge like Amazon, CVS Health, Walgreens Boots Alliance and Wal-Mart. These retailers are looking to establish themselves as a destination for low-cost outpatient care and give patients less reason to go to a hospital. Learn More.

 

Medicare Advantage Value-Based Insurance Design Model

Through the Value-Based Insurance Design (VBID) Model, CMS is testing a broad array of complementary Medicare Advantage health plan innovations designed to reduce Medicare program expenditures, enhance the quality of care for Medicare beneficiaries, and improve the coordination and efficiency of health care service delivery. Learn More.

 

117 hospitals drop out of BPCI Advanced: 5 things to know

The number of healthcare providers participating in Bundled Payments for Care Improvement Advanced has dropped 16 percent since the payment model launched Oct. 1. Five things to know. Learn More.

 

UPS looks to ring healthcare’s doorbell

United Parcel Service is preparing to enter the healthcare industry by dispatching nurses to vaccinate adults in their homes. Learn More.

 

Watch what Jeff Bezos is doing in health careFormer Aetna CEO Mark Bertolini says folks should spend more time watching Amazon specifically than Haven when it comes to health care. Learn More.

 

Telehealth, Urgent Care, Retail Clinics Getting

The use of alternative places of health service, such as telehealth, retail clinics, urgent care clinics, and emergency rooms, has grown rapidly over the past decade, but a very low percentage of the care delivered in the US healthcare system is provided in these venues. Learn More.

 

 

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