Monday, 08 August 2016 21:43

Don’t Blink – Healthcare is Evolving that Fast

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Lately I feel as though time is passing by faster than ever – after all, my father always said the older you get, the faster it goes. I believe this is how most of us feel about the healthcare industry right now as well. We are facing changes that are forcing us to look outside the box and get out of our comfort zones. While I believe that we all have the patient’s best interests at heart, we have been functioning in silos – and this is no way to coordinate and impact patient care.

“Care coordination” is a phrase we have been seeing a lot of lately, but what does it really mean? The past several weeks have been crazy in healthcare, with the Centers for Medicare & Medicaid Services (CMS) releasing several policy and payment updates, including:

As I began to read and decipher these updates, it became clear to me that the underlying message is that we must do more with less. Not that I didn’t know this already, as we have been struggling with it for years. But now we must actually begin to report the improvement in care that our patients have been seeing, and we must also show that patients are satisfied, all while reducing costs.

I am grateful for the opportunities I have had recently to attend some very dynamic conferences: the LTPACHIT (Long-Term Post-Acute Care Health IT Summit), the National Association for Healthcare Quality (NAHQ) National Quality Summit, the Agency for Healthcare Research and Quality (AHRQ) Research Conference, the Association of Clinical Documentation Improvement Specialists (ACDIS) Annual Conference, the Healthcare Compliance Association (HCCA) annual conference, the New York Information Management Association (NYHIMA) annual conference, the Radiology Business Management Association (RBMA) Spring Summit, and the American Health Information Management Association (AHIMA) Leadership Conference. Speakers at all of these conferences were passionate in their messages regarding the move to payment for quality and working together (care coordination) to illustrate improving patient outcomes and to ensure financial survival. There is a reality check involved with admitting that we need to be financially successful; otherwise there will not be anyone to provide care to patients who need it.

So my point today is that in my opinion, care coordination is the key to making us all successful. We have to break down walls and begin talking to each other. We have to begin to trust each other. We need to think out of the box.

Much of our focus has been on the inpatient side of care and physician services, but much of the key to successfully managing patients is the care that happens on the post-acute side of care – rehabilitation, skilled nursing, long-term care, assisted living, home health, and hospice. These areas have traditionally taken a back seat to some degree, but it is extremely important that we reach out to them and include them in our discussions and decisions on how we are going to manage all of this. Without them, we will not be successful.

Below are a few items that I think should be on everyone’s population health management to-do list to analyze and establish a plan:

  • Communication – internal and external, with partners and with patients
  • Technology – to help us work smarter and more efficiently
  • Patient care – ensuring we provide care in the right setting and at the right time, being as proactive as we can
  • Data analytics – using our data to improve by identifying high-risk patients with multiple chronic conditions and high costs, as well to identify quality areas we need to focus improvement on
  • Quality data collection and reporting processes – these activities can be scattered within organizations, so we need to ensure continuity in both
  • Payor contract negotiations – as we move into more shared saving s models and APMs (alternative payment models), we need to ensure that we are negotiating smart contracts
  • Pricing and purchasing – to control and reduce costs where we can and reflect accurate costs per beneficiary
  • Leveraging community-based services – to manage patients in the right setting for both quality of care and cost control
  • Physician engagement – we are approaching a physician shortage, so it is important that we engage and support them
  • Patient engagement – we must engage patients to assist them in wanting to participate in their care to be compliant with treatment and care

VBPmonitor will be focusing on bringing you real-life experiences, case studies and best practices from hospitals and health systems, eligible clinicians, accountable care organizations (ACOs), health plans, payors, associations, and more to assist you in your transformation to true population health management.

About the Author

Kim Charland is the editor of VBPmonitor and the senior vice president of clinical innovation with Panacea Healthcare Solutions. Kim has 30 years of experience in health information and reimbursement management for hospitals and physician offices. Kim’s primary role with Panacea is publisher of VBPmonitor.com, which is the company’s newest online monitor and is focused on value-based purchasing and quality. She is also co-host of ICD10monitor.com’s Internet news broadcast Talk-Ten-Tuesdays. In addition, she assists with product development for Panacea’s consulting and software divisions, as well as the MedLearn publishing division. Kim is also recognized as a national speaker who has spoken for numerous organizations.

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Last modified on Tuesday, 09 August 2016 05:28