Care transitions that involve moving from one health care provider to another can often be stressful and daunting for patients; looking for high quality follow-up care while trying to manage costs can be complex. This process is equally cumbersome for nurses and care coordinators who want to ensure that they send their patients to the…
Many healthcare systems have made creating high-quality and value-based care a top priority. Southwestern Health Resources (SWHR) used clinical data and predictive analytics to put a total cost of care plan in place to provide affordable and quality care to thousands of patients in North Texas and cost-effective care for their employers. Oftentimes in the healthcare market, purchasers…
According to the CDC, six in 10 Americans live with at least one chronic disease like heart disease and stroke, COPD, or diabetes. These and other chronic diseases are the leading causes of death and disability in America; they are also a leading driver of healthcare costs. These chronic conditions put stress on patients, nurses,…
Throughout the Coronavirus pandemic, several innovative data tracking tools have been identified to support population-based public health and individual patient level care management. Some of these are less traditional ways to look at health data, and can usefully inform health planning and system of care design strategies. A curious question is, can we use these…
The Medicare Shared Savings Program (MSSP) is the largest value based care program from the Center for Medicare & Medicaid Services (CMS) to date. Since its inception in 2012, Accountable Care Organization (ACO) participation has doubled; providing care to over 10 million beneficiaries, generating $1.94 billion in total savings, and earning over $1.47 billion in…
As healthcare technology continues to permeate the medical industry, experts are continuing to evaluate how connected health tools can impact patient engagement and the overall patient experience. As noted in a 2013 study in the International Journal of Medicine, connected health includes a broad set of definitions. “Connected Health encompasses terms such as wireless, digital,…
In 2011, the U.S. Department of Health and Human Services (HHS) released new rules under the Affordable Care Act (ACA), aimed at helping doctors, hospitals and other providers better coordinate care by way of accountable care organizations, or ACOs. ACOs provide a framework for rewarding providers financially — in both the public and private sectors…
Controlled studies have shown that some care management interventions, which typically support patients with outreach and regular contact by trained individuals such as nurse case managers or health coaches, can have a positive impact on health quality measures like HbA1c for diabetes. However, the impact of care management on associated costs of care is mixed…
In previous blogs, we have discussed programs whose goals are to improve patient outcomes through quality care while increasing provider efficiency. An additional program provided by CMS to help in these efforts is the Chronic Care Management (CCM) program. CMS has made CCM available to Medicaid ACOs as they seek to create savings for both…
Of the hundreds of conversations I’ve had this year about population health management, there is perhaps no question I get more than how to calculate the ROI of the incredible work many of you are doing to better manage patients and bend the cost curve. Since the impact of care management efforts is often articulated…