Tuesday, 08 March 2016 20:38

Cutting-Edge Quality Strategies Take Center Stage at HIMSS Conference

Written by Mark Spivey VBPmonitor.com Correspondent

The style at the HIMSS 16 Conference & Exhibition in Las Vegas last week was provided by none other than keynote speaker and recent Super Bowl champ Peyton Manning of the Denver Broncos.

The substance was provided by those speaking on the pressing issues of population health, revenue cycle, and quality.

Matters associated with the healthcare industry’s massive swing toward value-based care grabbed the spotlight at the Conference – with the exception of Manning’s time spent on stage – as an estimated crowd of more than 40,000 gathered to share stories, sentiments, and best practices.

RACmonitor.com, one of VBPmonitor’s sister monitors, via its weekly live internet broadcast Monitor Mondays offered wall-to-wall coverage of the festivities, starting with comments by HIMSS Director of Payer and Life Services Shelley Price, who spoke about shifting from a fee-for-service (FFS) mentality to fee-for-value (FFV).

“Our current FFS system focuses on care delivery that is volume-based. It addresses the individual, it is reactive, and typically in the acute-care setting. Payment for FFS care is based on numbers of procedures, actions taken, and orders made. The more activities, the more the reimbursement,” Price said. “A FFV focus looks at the group. It is proactive, preventive in nature, and addresses wellness and chronic care management. Payment for FFV care is based on health and wellness, is outcomes-oriented, and rewards quality of outcomes as compared to a baseline of health for a group.”

Price estimated that 15 percent of care nationwide is currently being delivered under an FFV model. She noted that the U.S. Department of Health and Human Services (the county’s largest payor) has set a goal of getting that number up to 30 percent as it pertains to reimbursed care by the end of 2016, and 50 percent by the end of 2018.

“Many provider organizations are turning to population health management programs to produce the clinical results that will enable them to financially succeed under value-based reimbursement. These initiatives aim to enhance outcomes for an entire group of individuals, instead of merely looking to improve health on a one-to-one basis,” Price said. “However, population health and population health management does not look and feel the same for every organization or collaborator involved.”  

With that, Price pointed to the HIMSS Population Health Knowledge Center: a special three-day, 30-session feature of the Conference intended to help providers learn how to employ interventions and solutions that leverage technologies, processes, and connected health strategies to improve health and quality outcomes while aligning organizational strategy to deliver sustainable practice efficiency, productivity, and positive economic value through population health management (for more information, go online to (www.himssconference.org/exhibition/specialty-exhibit-areas/population-health-knowledge-center).

“I think this is a very exciting time of change and transformation in our healthcare system. But it is not easy for anyone, for any stakeholder, including the patient and consumer,” Price said. “There will be bumps in the road and continuing challenges. We are all in this together, and as such, culture, attitudes, roles and responsibilities, and trust will need to adjust to this new course.”

Another prominent voice within HIMSS, Revenue Cycle Improvement Task Force Chairman Stuart Hanson, offered perspective on the activities of a group organized for the purpose of creating a vision for the next generation of revenue cycle management tools and processes that recognize the impact changing payment models, increased direct patient financial responsibility, and consumerism.

“We are committed to developing and promoting an approach that keeps administrative cost containment, interoperability, and consumer engagement front and center,” Hanson said. “The work of the Task Force is underpinned by a specific set of guiding principles that include ensuring the approach we recommend is patient-centered and involves solutions that are standards-based, leverage existing and emerging technologies, and are designed with the full revenue cycle business process flow in mind.”

In 2015, Hanson explained, the Task Force applied these principles to the development of an overarching vision for the patient financial experience of the future; this vision was shared in a white paper, Rethinking Revenue Cycle Management, and articulated in an infographic that illustrated the Task Force’s vision for a simple, pre-planned office visit.

In 2016, the group has applied its vision to a more complex scenario involving an unplanned episode of care with multiple providers in a variety of healthcare delivery settings. The scenario is played out in a microsite that demonstrates how all of these activities will be coordinated in the patient financial experience of the future and incorporate consideration of patient financial responsibility along the way. 

Lastly, Peyton wasn’t the only award recipient highlighted during the Conference – HIMSS lauded the four winners of its Nicholas E. Davies Award, created to recognize hospitals, ambulatory practices, clinics, community health organizations, and public health entities that use electronic health records and information technology to generate sustainable value and improve clinical and financial outcomes.

Award Enterprise Committee Chair Janis Curtis announced the winners from among a pool of applicants that were asked to provide a minimum of 12 months of trended data clearly illustrating improved outcomes; to demonstrate that the improvements were a product of data addressing specific workflow protocols; and to reflect a replicable and actionable blueprint for using health information technology to improve care quality and/or business outcomes.

One winner, Centura Health, demonstrated that it had reduced heart failure patient readmissions by 17.48 percent, COPD patient readmissions by 16.02 percent, and diabetes patient readmissions by 10.22 percent. Another Award recipient, MetroHealth, significantly improved care outcomes for its diabetic population as determined through composite measures consisting of smoking, body mass index, optimal glycemic control, and blood pressure.

HealthNet of Indianapolis, the third recipient, increased first trimester entry into prenatal care to 71 percent and decreased low birth weight deliveries to 6.8 percent. And lastly, Ontario Shores increased adherence to polypharmacy, metabolic monitoring, and referral to cognitive behavioral therapy for psychosis (CBT-P) by 5.8 percent, 51.0 percent, and 74.8 percent, respectively, reducing incidence of cardiovascular disease and type 2 diabetes.

All of the winners have the following characteristics, Curtis noted:

  • Collaborative teamwork that involved active engagement of clinicians and non-clinicians;
  • Baseline and continuous data collection and analysis to ensure progress towards the intended goal; and
  • Strong support organizational executive leadership.

Submission for the next round of Davies submissions are being accepted now, Curtis added; the submission period runs from Jan. 1 through July 1, 2016. To review case study templates or to acquire more information, email This email address is being protected from spambots. You need JavaScript enabled to view it..

To listen to our streaming podcasts of LIVE from HIMSS 2016 produced by Monitor Mondays please click here. And stay tuned for announcements and registration for VBPmonitor’s weekly broadcast “Thought Leader Thursday” scheduled to begin this summer.

Mark Spivey is a national correspondent for www.VBPmonitor.com. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..

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