What Makes an ACO Tick? Three Tips from Tucson
Arizona Connected Care brings together Tucson Medical Center, local physicians, and three federally qualified health centers into an accountable care organization (ACO). The organization is busy implementing payer strategies and encouraging participation by additional providers.
Another key strategy: patient engagement. Tucson Medical Center launched a program called Volunteer U that trains healthy older adults within the local Medicare beneficiary pool to serve as patient advocates to offer support and education to peers who are transitioning from a hospital stay. "We recruited local seniors who were retiring from successful careers but weren't ready to stop contributing to the community. They run support groups and identify discharged patients who may need additional help managing their illnesses," says Friend.
Admission Plan Eases Patient Transition and Care Coordination
Southeast Texas Medical Associates (SETMA) developed an admission plan of care template that helps patients transition into the hospital setting and improves coordination among caregivers. "This tool is intended to help address major problems that can stem from a lack of coordination, such as unnecessary days in the hospital, low patient satisfaction, re-hospitalizations, and inadequate staff communications," says James L. Holly, MD, SETMA's CEO.
A template for the hospital admission plan is built into SETMA's EHR system, which physicians can access in the four hospitals in which they practice. So creating the document adds little extra work for the admitting physician, Holly says.
SETMA began using the hospital plan of care this summer, and early feedback has been good. "The nurses particularly like this," Holly says. "We have fewer complaints from patients saying, 'No one has told me anything about why I am here or what I can expect!'"
Restructuring Academic Medical Centers for Value
Many academic medical centers (AMCs) face the challenge of distinct governance structures that don't allow the flexibility they may need to embrace emerging evidence-based care models and a call for greater transparency. AMCs often have different boards, leadership structures, and mission statements governing each of their teaching, research, and care delivery functions. These distinct governance structures make it challenging for AMCs to make decisions nimbly and strategically.
The CFO of one academic center noted, "We are using the possibility of a bundled payment project not because we think it will be a big winner for our system, but just to get an early dialogue going between the key elements of our system."
Partners HealthCare and UAB Hospital are making strides in centralizing leadership structures that can make critical decisions on behalf of the AMCs. Partners HealthCare developed a single board with responsibility for all key aspects of clinical care, while UAB Hospital is instituting a funds-flow model that combines all revenue from clinical practice and hospitals into one operation.
Launching an Innovation Journey
Memorial Hospital of South Bend's innovation journey is championed by its CEO, Phil Newbold. "A lot of innovation projects are experiments that won't make money in 10 months," says Diane Stover-Hopkins, chief marketing and experience officer, Beacon Health System, which is Memorial's parent organization. "The CEO has the authority to protect projects from budget cuts and encourage organizational patience."
Memorial's approach is decentralized with employees empowered to launch projects. "But this is not a suggestion-box model," says Stover-Hopkins. "We develop platforms, or big plays, that we want everyone to address." Current platforms include improving patient safety and home-going instructions. When employees have an innovation idea, they must consider seven criteria to determine if the idea is worth pursuing. The criteria range from the potential to improve value to the employee's passion about the project.
A recent Leadership breakthrough map highlights more about Memorial's innovation journey, as well as the experiences of Presbyterian Healthcare Services.
TriMedx: Elevating and Streamlining Clinical Engineering
TriMedx helps health systems control costs and uncover savings opportunities by optimizing the clinical engineering function.
6 Patient Revenue Cycle Metrics You Should Be Tracking (and How to Improve Your Results)
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
McKesson: Leveraging Predictive Analytics to Rein in Operating Costs
A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow.
10 Ways to Reduce Patient Statement Volume (and Reduce Costs)
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
Accretive Health: Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment
Emad Rizk, MD, president and CEO of Accretive Health, discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management.
Reduce Patient Balances Sent to Collection Agencies: Approaching New Problems with New Approaches
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
Conifer Health Solutions: Helping Providers and Employers Build a Foundation for Better Health
Jim Bohnsack, vice president, solution & corporate development for Conifer Health Solutions, explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements.
The Future of Online Patient Billing Portals
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Ontario Systems: Optimizing Accounts Receivable in a Rapidly Changing Environment
Steve Scibetta, senior director of channel sales for Ontario Systems' healthcare product line, shares insights into effectively managing receivables.
Payment Portals Can Improve Self-Pay Collections and Support Meaningful Use
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Optum: Enabling Transformative Change
Elena White, vice president of risk, quality, and network solutions for Optum, discusses how healthcare providers can leverage data and technology as they enable risk in their organization.
Large Health System Drives 10% UP (Patient Payments) and 10% DOWN (Billing-related Costs)
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
Somnia: Bending the Healthcare Cost Curve Toward Improved Anesthesia Value
Somnia President and CEO Marc Koch, MD, MBA, explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes.
ICD-10: Managing Performance
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
PMMC: Navigating Revenue Cycle Management Challenges as Value Based Purchasing Emerges
PMMC President Roger L. Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC's products help clients adapt to a changing financial environment.
Clarity Drives Collections
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Burgess: Simplify the Business of Healthcare
Greg Burgess, Founder and Chief Product Officer at Burgess Group shares insights and opportunities for payment integrity in the rapidly changing healthcare IT landscape.
Orlando Health Gains Insight into Denials, Reduces A/R Days with RelayAnalytics Acuity
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
Revenue Cycle Payment Clarity
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Streamlining the Patient Billing Process
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Wallace Thomson Hospital Automates to Maximize Limited Resources
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
7 Steps for Building and Funding Sustainability Projects
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Key Capital Considerations for Mergers and Acquisitions
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
Key Capital Considerations for Mergers and Acquisitions
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.