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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.
Somnia: Bending the Healthcare Cost Curve Toward Improved Anesthesia Value
PMMC: Navigating Revenue Cycle Management Challenges as Value Based Purchasing Emerges
Burgess: Simplify the Business of Healthcare
J.P. Morgan: Managing Cybersecurity and Protecting Patient Data
Brian DiPietro, Managing Director, Commercial Bank Technology, JPMorgan Chase & Co., discusses the importance of evaluating your cybersecurity protocols to help prevent malicious data breaches.
TransUnion Healthcare: Smarter Revenue Cycle Solutions
Gerry McCarthy, President of TransUnion Healthcare, discusses industry trends contributing to higher bad debt and what to do about them. Gerry is responsible for the strategic direction of the healthcare business and expanding its footprint in the healthcare market overall. He has more than 20 years of experience in healthcare information technologies.
Deloitte: Creating Value with Effective Care Management
Scott Kolesar, principal and senior leader in Deloitte Consulting LLP's Value Based Care practice, and David Wennberg, MD, MPH, adjunct associate professor of The Dartmouth Institute and former chief executive officer, Northern New England Accountable Care Collaborative, discuss the challenges and competencies involved in creating a care management organization.
American Express: Streamlining Supplier Payments and Boosting Revenue
Andrew Jamison, vice president in the Global Corporate Payments division of American Express, discusses trends and opportunities in supplier payments.
Deloitte: Realizing the Potential of Your CDI Program
Suzanne Whitworth, director at Deloitte & Touche LLP, and LaVerne Romberger, MSN, CCM, CCDS, clinical operations manager-Seton Healthcare, share leading practices for maximizing the potential of clinical documentation programs under value-based care.
RevSpring: Customizing a Technology Platform to Drive Patient Payment
Martin Callahan, Senior Vice President, Healthcare Solutions, RevSpring, describes key industry trends affecting how patients engage with the revenue cycle and ways payment processes are changing as a result.