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Transformation toward value-based healthcare is reshaping the delivery of care, patient expectations, and payment structures.
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After this fall's disastrous flooding in Colorado, it's easy to forget that, like many areas in the West and Southwest, the Denver metro area is just coming out of one of the worst droughts in its history. Indeed, notwithstanding the recent historical rainfall, Denver's climate is basically semiarid, and the area's propensity for drought demands continued vigilance in protecting water resources.
Prior to the recent downpours, experts noted that to meet its water requirements, the Denver metro area needed to save at least 16 billion gallons of water in the next year, with no certainty of whether future precipitation will be sufficient to meet that need. The good news is, Denver is prepared.
About a decade ago, the Denver Water Department launched the "Use Only What You Need" program to reduce water waste. The department collaborated with area schools on educational programs and partnered with appliance manufacturers to provide incentives for the use of water-saving equipment. Penalties for improper water use were also implemented.
Advertisements on billboards and sidewalk benches featured phrases, such as "CNSRV" and "B STNGY," that omitted unneeded materials and letters.
And it worked. Water usage dropped 30 percent in just one year, and citizens consume 20 percent less water to this day, despite a 10 percent population increase.
Health care is facing its own drought. Provider margins are depleting at a time significant investments in technology, labor, and other resources are necessary to transition to new care delivery models. And our industry is enduring a shortage of physicians and other clinicians while an increasing number of the aged and people with multiple chronic conditions require additional care.
But like the Denver Water Department and its community, care providers have been preparing for this situation for years.
It started with collaboratives, such as the Centers for Medicare & Medicaid Services (CMS) Physician Group Practice demonstration and CMS’s collaboration with Premier healthcare alliance on the Hospital Quality Incentive Demonstration value-based purchasing program. More-recent efforts focused on accountable care include CMS's Medicare Shared Savings Program, Bundled Payments for Care Improvement Initiative, Partnership for Patients Program, and Pioneer Accountable Care Organization (ACO) Model Program.
Each of these collaboratives has documented cost and quality successes among its participants. Now, we're seeing the affect they’re having on the industry as a whole.
A recent report shows healthcare inflation rising at the slowest rate in nearly 50 years. It's premature to think this trend will continue, and clearly the recession and other economic factors played a role in this decline. But an article in Health Affairs argues the slowdown "preceded the recession," and that spending "slowed more than the drop in income in the most recent recession would predict." And Harvard researchers directly associate a portion of the slowdown with the implementation of value-based purchasing and accountable care organizations. I couldn't agree more.
University Hospitals (UH) Rainbow Babies & Children's Hospital created the UH Rainbow Care Connection—one of the country’s first pediatric ACOs—to improve care and overall health for children while lowering costs.
The program targets children with chronic and behavioral health problems. Focusing on patients who under- and over-utilize the care system, the ACO offers alternatives to high cost EDs, where about 70 percent of visits shouldn't require emergency care.
Nurses and physicians are available via phone 24/7 to prescribe medications, and provide care advice. Children and their families also have direct access to medical teams with their personal health information. And state-of-the-art telemedicine stations, monitored by a physician, consult on minor issues such as colds and earaches.
Though in its early stages, UH Rainbow Care Connection will impact 200,000 children in Northeast Ohio, one-third of them Medicaid enrollees.
Last year, in Chicago's inner city, Mount Sinai Hospital’s Sinai Urban Health Institute (SUHI) launched a program to educate citizens about preventing and managing diabetes.
Community health educators go door-to-door in area communities hit particularly hard by the disease, some having a diabetes rate three times the national average. Among the major reasons for the high rate of diabetes is a lack of access to healthy foods—the overall area covered by the program is known as a "food desert," with only one grocery store serving it.
SUHI partnered with that store to offer healthy shopping and food preparation classes, as well as free health and dental screenings. Opportunities now exist for parents to enroll their children in wellness programs at local schools, day-camps, and other youth programs.
Through 2012, health educators had canvassed well over 1,000 homes, working with 300 individuals with diabetes. They have increased their outreach in 2013, and plan to partner with Wal-Mart to expand their wellness program.
Publication Date: Tuesday, September 24, 2013
In this Business Profile, Bruce Haupt, president and CEO of ClearBalance, discusses how a patient loan program can increase patient collections, reduce bad debt, and speed cash flow.
In this Business Profile, Jerry Bruno, principal with Deloitte Consulting LLP, discusses the importance of choosing revenue cycle solutions that help an organization meet the challenges of a quickly evolving healthcare environment.
In this business profile, Lane Jackson, a partner in the Grant Thornton LLP Health Care Advisory Services practice, with extensive experience in overseeing system implementations and revenue cycle reorganizations, discusses best practices for elevating revenue cycle performance during an EMR implementation. Grant Thornton LLP is a sponsor of the Large System Controllers Council Affinity Group.
In this business profile, Amy Gross, senior vice president of Key Government Finance, discusses the benefits of private placement transactions to support large-scale financing projects.
In this business profile, Doug Polasky, executive vice president at Xtend Healthcare, explains the importance of having sound workflow processes in a consolidated business office to ensure optimal performance and reduce costs.
In this business profile, sponsored by SSI, Jay Colfer, vice president of sales and marketing, shares how patient access solutions are reversing the trend toward increased bad debt resulting from the rise in high-deductible consumer health plans.
In this business profile of Deloitte Consulting, Matthew Hitch and David Betts explore the potential benefits of elevating the customer experience and outline strategies to change service delivery.
TriMedx helps health systems control costs and uncover savings opportunities by optimizing the clinical engineering function.
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