Is your provider organization maximizing its performance in value-based care programs?

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Over the past few years, there has been a significant increase in value-based care programs offered by health plans and government payers including accountable care organizations, bundled payment programs, pay-for-performance and quality improvement programs.  These programs often include a multitude of measures related to costs, quality, patient experience, and outcomes, along with sometimes complex methodologies to determine success.

Given the increasing financial impact associated with these programs, it is important for providers to understand the program’s intricacies as well as the analytical, operational, and clinical requirements to ensure its success.  This paper discusses how success with these programs is possible.

A Billion Data Points for Innovations in Care and Care Coordination

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Northwell Health, based on Long Island, New York, is one of the largest private health systems in the United States. Northwell uses InterSystems HealthShare to take a “bimodal” approach to innovation. This approach ensures that Northwell’s mission-critical EMR systems remain up, stable, and secure, while HealthShare’s unified health record captures their data in real-time for use in other, value-added applications.

Northwell initially used HealthShare to improve care coordination for women in high-risk pregnancies. The organization then used it as the foundation for a rule-based care management application that identifies high-risk patients, assesses needs, shares care plans across providers and locations, supports efficient workflows, and provides quality metrics for continuous improvement.

Now, through its Center for Health Information Technology and Innovation, Northwell uses HealthShare to develop new systems that:
• Target gaps in clinical workflows not typically covered by EMRs
• Simplify management of risk in at-risk contracts
• Automate establishment of patient cohorts for population health management and cohort analytics

Download this free case study now to uncover how Northwell achieved their goals of care quality, patient satisfaction, and business performance without having to disrupt the familiar workflows of existing EMRs and other clinical systems.

8 Strategies to Cut Denials, Speed Payment

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Revenue cycle leaders cannot go it alone when it comes to navigating roadblocks to reimbursement. Front- and back-end staff play an integral role in calculating payment estimates, collecting dollars in advance of procedures and tests, and communicating the often-puzzling connection between hospital charges for physician practice and provider-based department patients.

Margin of Excellence: Total Joint Replacements

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An in-depth report examining the drivers of variation in cost metrics for total joint replacements. It includes key findings from an analysis of more than 800 hospitals, project improvement success stories and best practices.

Designing a New Path to Patient Financial Engagement

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Healthcare organizations face growing financial burdens and increasing competition for patients as a result of the move to value-based care, EHR investments, and patient consumerism. As they address these challenges, it is crucial to improve patient financial engagement practices. This report explores key steps healthcare organizations should take to create a better patient financial experience, including offering detailed price estimates and creating an advanced, patient friendly financial platform that steers patients to a broad array of payment options.


Designing Impactful Provider Risk Management Strategies

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SCIO Health Analytics

According to the 2018 HealthLeaders Media Buzz Survey, Managing Population Risk, 54% of respondents from provider organizations either plan to or have already taken on additional risk beyond their current at-risk populations.

The degree of risk they are taking varies greatly. This report describes the ways in which a strong data and analytics strategy will help healthcare organizations improve documentation and coding, as well as strengthen care coordination practices to improve quality outcomes across at-risk populations.