In order to better shape the path toward population health two objectives are being proposed: (1) Providing a direct connection between the patients who would most benefit from health care and supportive services to the appropriate clinical and community resources; and (2) by developing strategies to address diseases with high quality-of-life (morbidity) burdens, not just those with high mortality burdens. If implemented, these strategies would address determinations such as education, poverty, and exposure to trauma.
According to research issued by Excellus BlueCross BlueShield, ten common conditions represent more than 2 million annual visits to hospital emergency rooms statewide resulting in an estimated $1.3 billion cost. And the astonishing fact is 9 out of the 10 of them could have been avoided or treated elsewhere.
The Birmingham Medical News reports, “Providers paid on MPFS will have to choose one of two paths – either Alternative Payment Models (APM’s) or the Merit-based Incentive Payment System (MIPS). APM’s offer a 5% incentive program. This approach is more likely to be used with accountable care organizations (APOs), bundled payments and other models that have the advanced technology resources and strong data and analytics to manage risk.”
PPH Solutions, LLC can help your practice with exactly this at no cost to you. Please call or email us today to find out how your practice can benefit from our expertise. (205) 703-8285 or http://www.pphsolutions.org
To read the full article go to: http://birminghammedicalnews.com/news.php?viewStory=2255
PPH Solutions, LLC is proud to announce we are now members of Medical Group Management Association!
Is your wellness program really yielding the clinical and financial benefits you imagined? Your chronically ill employees, dependents and retirees simply don’t use wellness programs. PPH Solutions, LLC can solve this problem.
Please visit our website at http://www.pphsolutions.org or call us at (205) 703-8285
The transition from Fee-for-Service reimbursement to Value-Based reimbursement is happening! Primary care practices have to prepare to survive. PPH Solutions has a zero cost comprehensive solution for primary care practices.
Please visit our website at http://www.pphsolutions.org for more information or feel free to call us at (205) 703-8285.
Health Affairs Blog (March 14) – A New Understanding of Health System Performance For Older Adults
The strength of the American health care system is its highly skilled and specialized clinicians who are able to rally the best technology to cure disease. Yet at older age, the problem is not curing a single disease, but the need to manage multiple diseases and allow people to live well with their changing health state and declining life expectancy. Fortunately, what older adults need and want from the health care system is very well aligned with the goals of many health care reform efforts.
Watching from England, one of the most remarkable and well-documented developments in US health care of recent years has been the rapid adoption of a value-based approach to health care and the creation of hundreds of accountable care organizations (ACOs). By contrast, developments with value-based and ACO-like care in the English National Health Service (NHS) are less prevalent and much less well documented. Nevertheless, significant lessons are beginning to emerge from the NHS, some of which may have relevance internationally.
Wellness programs remain a popular feature of the employer landscape, but the legal environment surrounding them has long been uncertain. In April 2015, the Equal Employment Opportunity Commission took a significant step toward resolving this uncertainty by formally proposing a rule clarifying the applicability Americans with Disabilities Act of 1990 (ADA) to wellness programs.
The Veterans Health Administration (VHA) is transforming into a major health care payer in addition to its role as a provider. In 2014, in response to scandals in the Department of Veterans Affairs (VA) related to access to care, Congress opened the door to a marked expansion of VA-paid care in the community with its “Choice” program and a $10 billion appropriation. A 2015 law then mandated consolidation of the VHA’s many established community care programs into one – the Veterans Choice Program. The VA, with forward-thinking leadership, responded with an ambitious plan to alter its approach to care.
Thanks to tools provided by the Affordable Care Act, an estimated 30 percent of Medicare payments are now tied to alternative payment models that reward the quality of care over quantity of services provided to beneficiaries, HHS announced today. Today’s announcement means that over 10 million Medicare patients are getting improved quality of care by having more time with their doctors and better coordinated care – nearly a year ahead of schedule.
With reimbursement for services increasingly riding on readings from clinical outcomes, patient experience and cost of care, the desire to slice and dice patient and population data in the name of value-based healthcare has never been stronger. The healthcare publisher’s January 2016 survey identified a number of factors behind widespread data analytics adoption, including population health management (25 percent), predictive analytics (15 percent) and cost savings (15 percent).
University of California San Francisco (Feb 16) – Team-Based Health Care Model Reduces Need, Improves Quality of Life for Complex Patients, Study Shows
A complex care model that is interdisciplinary and team-based and utilizes home visits reduces health care need and improves quality of life for medically complex patients, according to researchers at UC San Francisco and the affiliated San Francisco VA Health Care System.
PR Newswire (Feb 25) – Washington Health Alliance Survey Finds Provider’s Knowledge of the Patient and Effective Communication Are Most Critical Elements of the Patient’s Experience
Patient experience is an important element of overall care. Research shows that, in addition to improved clinical outcomes, excellent patient experience is an outcome unto itself, and one that is highly valued by patients. Patients want to be respected, feel heard, get the care that they feel they need when they need it, and understand their health conditions.
The Health Care Blog (March 1) – Getting to the Patient Cloud and Guardian Angels
How much longer must we wait to finally have a ‘patient cloud’ – a sharable and relatively complete cloud based health record for each patient? This is seemingly an obvious prerequisite condition so that providers can deliver better care for patients. The patient controlled medical record is an old idea that goes back to the Guardian Angel manifesto published in 1994 at the dawn of the Internet era and yet 22 years later we have haven’t achieved the first steps of the fundamental core of a universal life long patient record.
Health Affairs Blog (March 4) – Leveraging Today’s Health Care Environment To Achieve The Triple Aim
The great hope for the current consolidation activity is that cross-segment entities can help steer the transformation of care from a fragmented, fee-for-service based system to a delivery system focused on value-based care. Through coordination, integration, and quality services, the grand aspiration is the achievement of what has been labeled in health care the “Triple Aim” — improved population health, improved individual outcomes and experience, and greater efficiency.
Health Affairs Blog (March 4) – Reimagining The Health Care Industry
This is a fascinating time in health care. It is a time of experimentation and innovation. We are reimagining a $3 trillion industry to improve quality, construct a better payment model, and develop a more integrated system of care delivery that will enhance access and convenience. As we embark on this journey, a simple but important question faces all providers: Do we understand the difference between medical delivery and health? Those who do—and see themselves in the ‘health business’—will succeed as the industry transforms. Those who do not—and remain only in the ‘hospital business’—will feel it in their wallets and struggle to survive.