Revenue Cycle Under Pressure: Five strategies for surviving and creating new opportunities
June 4, 2020
COVID-19 has put the financial stability of hospitals and healthcare systems in a tailspin. This has led to dramatic changes that are impacting revenue cycle operations today and for the foreseeable future.
In the latest HealthLeaders Industry Focus Section, we had the opportunity to interview Thomas Jackiewicz, senior vice president and CEO for Keck Medicine of the University of Southern California and Donna Graham, executive director of revenue cycle at MetroHealth, about the situations their facilities are facing and what they are doing to ensure long-term success.
Changing payment models and the push for quality metrics and all-payer reviews are among the bigger shifts impacting clinical documentation integrity (CDI) programs in 2020. With such disruption, CDI leaders face an important question: What are the best key performance indicators (KPI) to track progress and measure success? What are the ways that CDI departments can demonstrate meaningful improvements and impact as healthcare reimbursement shifts from fee-for-service to pay-for-performance?
This industry focus report offers some suggestions from three leaders of high performing CDI programs. They discuss the base metrics they monitor including chart review rates, query review rates, provider response rates, and more, as well as the baseline percentages that indicate success in their respective programs. Also discussed are areas of expanded focus including CDI impact on quality initiatives, service-line specific metrics, collaboration with case management on length of stay metrics, and expansion into outpatient services, and some of the KPIs used.
Nursing Innovations: Mobile technologies and artificial intelligence rank high with clinical leaders
April 13, 2020
Healthcare organizations are investing in numerous technologies aimed at giving nurses more autonomy and creativity as well as empowering them to deliver high quality care and a more personalized patient experience. These technologies include AI, predictive analytics, and wireless technologies.
At El Camino Health in Los Gatos, CA, Cheryl Reinking, RN, MS, CNO, is on a mission to find that one “do-everything device” that will allow the organization’s 1,270 nurses to become fully mobile. In the Midwest, Northwestern Medicine is using simulation and virtual reality to train both new and experienced nurses. These advanced technologies allow healthcare professionals an opportunity to learn and practice new skills in real-life scenarios without the risk to patients.
In this latest HealthLeaders Industry Focus Section report, nursing and other healthcare leaders examine technologies that are transforming nursing.
CMS may have introduced value-based care a decade ago, but the fee-for-service payment model is playing out much longer than anticipated. Despite the slow trajectory, industry experts say value-based care is taking hold in markets where there is significant competition. At the same time, the majority of Medicare beneficiaries are in value-based arrangements and an increasing number of new payment models include downside risk for physicians.
In this latest HealthLeaders Industry Focus Section report, healthcare executives, including Jonathan Jaffery, MD, senior vice president and chief population health officer at UW Health in Madison, Wisconsin, share what’s ahead for value-based care in 2020 and beyond.
Coming Soon to the ED: How service industry models, wireless communications, and tiny data points are changing the emergency room
October 3, 2019
The pace of hospital emergency rooms can only be described as moving from fast to faster as organizations experience growing volumes and patients with increasingly complex healthcare needs. In grappling with these challenges, hospitals find themselves renovating and expanding their EDs. But they are also learning this is not a complete solution in the changing world of the ED.
HealthLeaders recently spoke with leaders from Hardin Memorial Hospital and CHA Hollywood Presbyterian Medical Center about what changes they are making to their ED’s to ensure they are ahead of the curve and maintaining the highest quality of care for their patients.
Population Health: How Healthcare Leaders Are Re-envisioning Data Integration and Care Management
August 19, 2019
As provider organizations take on risk and quality-based contracts through ACOs and other payer models, they must carefully consider the next stage of their population health management journey. Fort Myers, Florida–based Millennium Physician Group (MPG) and Western Connecticut Health Network (WCHN) in Danbury have carefully crafted population health strategies over the last several years that include harnessing the power of data and analytics to manage patients differently.