Download e-book Improving Value in Health Care: Measuring Quality (ECONOMIE)

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With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus. Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process. Revenue Cycle Payment Clarity. To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid—by whom—and the ability to better navigate obstacles to payment.

They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals. Streamlining the Patient Billing Process. Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.

Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy. Key Capital Considerations for Mergers and Acquisitions. Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities.

These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.

This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks. Providers adapt as value-based care moves from hype to reality. Announcements from several commercial payers and the Centers for Medicare and Medicaid Services CMS early in around increased efforts to form value-based contracts with providers seemed to point to an impending rise in risk-based contracting.

Rather than wait for disruption from the outside in, health care providers are now making inroads on collaborating with payers on various risk-based contracting models to increase the value of health care from within. Yuma Regional Medical Center case study. Before becoming a ZirMed client, Yuma was attempting to manually monitor hundreds of thousands of charges which led to significant charge capture leakage.

Every facility and challenge is unique, and requires a full objective analysis. As the critical link between patient care and reimbursement, health information enables more complete and accurate revenue capture.

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Speedier cash flow starts with better CDI and coding. This 5-Minute White Paper Briefing explains how providers can improve vital measures of technical and business performance to accelerate cash flow. Qualified coders are getting harder to come by, and even the most seasoned professional can struggle with the complexity of ICD This 5-Minute White Paper Briefing explains how partnerships can help improve coding and other key RCM operations potentially at a cost savings.

The reasons claims are denied are so varied that managing denials can feel like chasing a thousand different tails. Read about how predictive modeling can detect meaningful correlations across claims denials data. Emergency Mobile Health Care EMHC was founded to be and remains an exclusively locally owned and operated emergency medical service organization; today EMHC serves a population of more than a million people in and around Memphis, answering 75, calls each year. Maximizing Medicare Reimbursements White Paper.

Included in this whitepaper are implications of increasing patient responsibility, collections best practices, and collections and internal control solutions. Getting Your Claims Paid. Yet even for the best billers, achieving that success can be elusive when denials stand in the way of success, presenting challenges at every turn. Join practice management expert Elizabeth W. Discover methods to translate denial data into business intelligence to improve your bottom line, determine staff productivity benchmarks for billers, and recognize common mistakes in denial management.

Physician practices must improve organizational efficiency to compete in this era of reduced reimbursement and escalating administrative costs. Many healthcare organizations are pursuing next-generation health information systems solutions. Building a Clinically-Integrated Network. As value-based payment models evolve, providers are challenged to maintain superior clinical outcomes while controlling costs. Winning in the Post-Acute Marketplace. Read more about factors contributing to the changes in the post-acute marketplace and what it means for manufacturers, physicians, clinicians, patients, and post-acute facilities as they anticipate the transition to the second curve.

HSG helped the physicians and executives of St.

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Milestones in Quality Improvement Measurement | HFMA

Claire Regional in Morehead, Kentucky, define their shared vision for how the group would evolve over the next decade. In most of these communities, the system was the sole source of care. Though the clinics were of substantial size they employed 98 physicians and comprised of multiple specialists, the physicians functioned as individuals and the practices lacked any real group culture. Clinical Integration Without Spending a Fortune. Does it have to cost millions to initiate a clinical integration strategy?

Moving Beyond Concepts to Measures

Contrary to popular belief, we have clients who have generated substantial shared savings and a significant ROI over time, without massive investments. But the size of that investment can be miniscule relative to the value it produces: Adding Value to Physician Compensation.

The transition to value is slow, but finally becoming a reality. Proactive hospitals want to ensure that provider incentives are properly aligned with ever-increasing value-based demands. This report focuses on the three big questions HSG receives about adding value to physician compensation; Why are organizations redesigning their provider compensation plans? What elements and parameters must be part of successful compensation plans?

How are organizations implementing compensation changes? Revenue Cycle Management has become an even more complex issue with declining reimbursements, implementation of Electronic Health Records, evolving local carrier determinations LCD , and payer credentialing [The emphasis on healthcare fraud, abuse and compliance has increased the importance of accuracy of data reporting and claims filing. In many cases, patient billings are the primary revenue source that pays staff salaries, provider compensation and overhead operating cost. Inefficiencies or inaccurate billing will contribute to operating losses.

Succeeding in Value-Based Care. This publication identifies and outlines the necessary characteristics of a fully-functioning clinically integrated network CIN. Benefits at All Levels of Care. Nearly half of all Medicare beneficiaries treated in the hospital will need post-acute care services after discharge. For these patients, a stay in an inpatient rehabilitation facility, skilled nursing facility or other post-acute care setting comes between hospital and home.

With the proper process, tools, and feedback mechanisms in place, budgeting can be a valuable exercise for organizations while helping hold organizational leaders accountable. Having a proper monthly variance review process is one of the most critical factors in creating a more efficient and accurate budget.

Monthly variance reporting puts parameters around what is to be expected during the upcoming budget entry process. Managing the cost of patient care is the top strategic priority of most hospital CFOs today. As healthcare shifts to more data-driven decision making, having clear visibility into key volume, cost and profitability measures across clinical service lines is becoming increasingly important for both long-range and tactical planning activities.

High Value Healthcare Collaborative: Member Healthcare System Transparency Delivers Results

In turn, the cost accounting function in healthcare provider organizations is becoming an increasingly important and strategic function. This whitepaper includes five strategies for efficient and accurate cost accounting and service line analytics and keys to overcoming the associated challenges. Milestones in Quality Improvement Measurement. Betty Hintch Mar 24, Quality teams need to go beyond the common measures used in the past and identify initiatives that address the current emphasis on effective and efficient care.

Moving Beyond Concepts to Measures Teams typically start with a desire to improve an aspect of care or service that is encapsulated by a concept such as reduced harm, improved customer service, or more effective use of resources. Building Operational Definitions Once the measures have been identified, it is time to build clear and consistent operational definitions.

Gives communicable meaning to a concept Is clear and unambiguous Specifies measurement methods and equipment Identifies detailed criteria for inclusion and exclusion Provides guidance on sampling For example, a team that wants to reduce medication errors may have decided to use the percentage of inpatient medication errors as an outcome measure.

Gathering Data Taking the time to develop an appropriate data collection plan is critical. The team should also track the process measures related to fall reduction, including: The percentage of patients screened upon admission for the potential of falling The percentage of patients determined to be at risk for a fall The percentage of at-risk patients re-screened within 24 hours The percentage of staff in compliance with proper use of the falls protocol. Using Stratification Stratification involves putting data into distinct buckets.

Applying Sampling Techniques Not every quality improvement project will require sampling. Using Technology Wisely A potential roadblock in the quality measurement journey is an excessive dependence on technology to deliver meaningful results. Add Comment Text Only character limit. Helping Organizations Embrace Robotic Process Automation Two senior leaders at Grant Thornton talk about the advantages of robotic process automation to improve office efficiency, reduce costs, and mitigate risk. Meeting the Mandate to Post Standard Hospital Pricing A senior leader of VitalWare talks about the need to create a comprehensive pricing strategy for consumers and how to get started.

Approaching New Problems with New Approaches This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Payment Portals Can Improve Self-Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs.

Managing Performance With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus. Clarity Drives Collections Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.

Revenue Cycle Payment Clarity To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid—by whom—and the ability to better navigate obstacles to payment. Streamlining the Patient Billing Process Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Wallace Thomson Hospital Automates to Maximize Limited Resources Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher.

The validity of research into measuring wellbeing, by asking people about their life satisfaction, is now widely accepted. Such measures capture a range of things that people care about and that policies can influence — from income and health to housing and social connections. Some governments do measure life satisfaction, including the UK it increased from 7.

However, it remains at the margins of policymaking. The NEF propose a national indicator of lifestyle-related carbon emissions, relative to an allocation calculated from global targets for avoiding dangerous levels of climate change. As climate is a global problem, this indicator is effectively a measure of responsible global citizenship. Research increasingly shows that high income inequality has negative social consequences, while casting doubt on the idea that it incentivises hard work. But they are, in principle, just as meaningful for other countries. The shortcomings of GDP, as a measure of what we want from an economy, are not a new discovery.

The NEF and others have been making the case for years. But while various proposals for alternatives have engaged the interest of policymakers and technocrats, they have not yet taken hold among politicians. More broadly, there remains a reluctance to move away from viewing economics as a hard, mathematical science, and accept the need to incorporate more of a social science mindset.

Five measures of growth that are better than GDP

In effect, we need another value shift in economics, comparable to those that shaped the last century — Kenyesianism and neoliberalism. However, while the problems with the current economic system are increasingly widely appreciated, we still lack a compelling, coherent, simple alternative narrative. I hope these indicators can help that narrative to develop. This article is part of our Beyond GDP series. You can read more here. Our economic model is broken - so how can we fix it?

The science of happiness can trump GDP Is it time to rethink the way we measure growth? Stewart Wallis , Independent thinker, speaker and advocate for a new economic system. The views expressed in this article are those of the author alone and not the World Economic Forum.

Stewart Wallis Independent thinker, speaker and advocate for a new economic system.