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Partnering Around Value-Based PaymentFive case studies illustrate how payers, hospitals, and physicians are successfully partnering to gain experience with alternative payment structures, including capitation, shared savings, bundled payment, and reference pricing.
Communitywide Approaches to AgingEnterprising healthcare and community leaders are testing new ways to ensure that seniors get all the services they need—including health care, support care, and transportation—in a coordinated manner so they can remain in their communities as long as possible. But major challenges remain before these pockets of excellence become the status quo for all elders.
Sidebar: Funding New Innovations for Aging at Home
Audio: A Cincinnati Partnership to Reduce Readmissions
Web Extra: Creating Care Plans for Patients with Complex
Tool: Sample Ambulatory Care Plan for Frail, Older
When to Outsource Versus InsourceThe rapid consolidation within the healthcare industry means that many organizations are getting so large and multifaceted that they may need to reconsider their outsourcing versus insourcing strategy. Here are stories from five healthcare organizations.
ICD-10: The Pros and Cons for ValueThe increased specificity and thoroughness of ICD-10 coding will deepen the understanding of diseases and help to identify the most effective approaches to treatment and disease management. But this transition is a costly one—both in terms of dollars and staff time.
8 Stages to Service Line Growth
This infographic from HFMA’s Leadership publication illustrates eight common stages that hospitals and health systems often progress through when pursuing service line growth.
The Outpatient Migration: Nursing’s RoleAn interview with Linda Burnes Bolton“The footprint of the healthcare delivery system is widening, and nurses need to expand their reach to the places where people live, work, play, and go to school,” says Linda Burnes Bolton, DrPH, RN, FAAN, vice president, nursing and CNO, Cedars-Sinai Medical Center, Los Angeles.
Audio: A Cedars-Sinai Population Management Tactic
Fixing Disjointed IncentivesAn interview with Atul Gawande, MD“Without a system, things fall through the cracks,” says Atul Gawande, MD, MPH, surgeon, Brigham and Women’s Hospital. “And you can provide tremendous leverage and benefit by organizing people with relatively simple systems like a checklist.
Employers in the Driver’s SeatAn interview with David LanskyWhen asked about reference pricing, the Pacific Business Group on Health’s David Lansky says: “I hope that this approach will not be an enduring solution, but that it will be a signal to the market that everybody needs to perform at this level—and continuously improve from this level—going forward.”
Audio: Providers Contracting with Employers
GlobalHealth HMO Uncovers Hidden Opportunities to Prevent Unnecessary AdmissionsBy Karen WagnerThe Oklahoma health plan has used predictive modeling to identify a hidden group of members with a high risk for an acute event. By making sure that these members get needed care, the HMO has already reduced ED encounters by 20 percent.
Acquisitions and Affiliations: Why Transparency MattersBy Joseph J. Fifer, president & CEO, HFMA“Each organization is in the best position to make the case that an acquisition or affiliation has not led to higher prices in a particular market area. No research study can address community-specific issues and concerns as well as the organizations that serve that community,” writes Fifer.
Hard Versus Soft Savings from IT InvestmentsBy Russell Branzell, president and CEO, CHIME“The experience of Baylor Scott & White Health shows that soft savings contribute to long-term value," writes Branzell.
Developing Leadership SkillsFour healthcare leaders share what skills they struggled with when they first became managers—and how they gained expertise in those areas.
ClearBalance: Boosting Patient Payment through Consumer-Friendly Loan Programs
Deloitte Consulting LLP: Employing Innovative Solutions to Optimize Revenue Cycle Performance
Grant Thornton LLP: Maintaining and Improving Collections During an EMR Implementation
KeyBank: Offering Expertise in Tax-Exempt Financing to Give Health Systems Flexible Options for Growth
Xtend Healthcare: Enabling Efficient Business Office Workflow
SSI: Bringing Patient Access to the Next Level
Deloitte: Helping Organizations Elevate the Healthcare Consumer Experience
TriMedx: Elevating and Streamlining Clinical Engineering