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GE Healthcare Camden Group Insights Blog

Two New Downloads: Analytics-Based Value Model | Health System Integration

Posted by Matthew Smith on Oct 8, 2016 10:16:45 AM


Download_White-resized-600.jpgTwo new downloads from GE Healthcare Camden Group are now available for download. Simply click the button below each description, and you will be taken to the respective download page.

Leveraging an Analytics-Based Value Model to Optimize Healthcare Strategies

Healthcare organizations are faced with the challenge of measuring optimal performance in a complex environment. An analytics-based value model can provide decision-making capabilities to measure performance, risk, and evaluate return on investments.

This new download from GE Healthcare Camden Group details the importance of creating an effective analytics-based value model and focuses on:

  • Key components of an analytics-based value model
  • Key drivers behind value modeling
  • Sample value drivers and KPIs
  • Benefits of leveraging advanced data mining
  • Relationships between trends and outcomes
  • Components of risk stratification
  • Barriers to success

Value Model, Health Analytics


Health System Integration: You Need a Plan!

Health systems fail to achieve full integration due to a lack of effective planning, poor management collaboration, or subpar implementation. Regardless of the reason, a sound integration plan focused on the goals of the system and dedicated true integration will increase the odds of success.  

This new download from GE Healthcare Camden Group details the importance of creating an effective integration plan and focuses on:

  • The increase in the number of hospitals in mergers and acquisitions
  • Health system efficiency imperatives
  • Definition and applications of a business plan of operational efficiencies ("BPOE")
  • Individual hospital vs. system-based savings
  • System integration efficiency strategies

Health System Integration

Topics: Download, Data Analytics, Hospital Integration, Value Model

New Download: Considering the Next Generation ACO Model

Posted by Matthew Smith on Apr 8, 2016 8:52:37 AM

Download, PDF, NGACOCMS recently launched the first step of the application process for its Next Generation ACO (“NGACO”) Model. The NGACO, CMS’ newest two-sided risk model, accepted 21 organizations for 2016.

Our 7-page PDF document, Considering the Next Generation ACO Model, includes information explaining and highlighting:

  • Model Highlights
  • Risk Arrangements
  • Payment Mechanisms
  • Timelines
  • Our Experience
  • Our ACO Services

To download this document, please click on the button below.

Next Generation ACO

Topics: Download, Next Generation ACO Model, NGACO

Content Download: The New Paradigm of Patient Access

Posted by Matthew Smith on Dec 15, 2015 1:23:09 PM

Health-Clinic.jpgIn order for new clinically integrated networks (CINs) to achieve success, they must increase ways for patients to access care. To accomplish this, CINs and hospital leaders must embrace non-traditional access points that patients use to enter their systems.

Patients may choose to access the system through retail clinics because it is easy and convenient, and they are able to get what they need quickly. Those components, successfully integrated into a CIN, can serve as significant access points into a network.

In instances when CINs identify outside providers where their patients are going to get care, CINs should establish a contractual relationship with the provider. Such new access points come with their own challenges, including difficulty with sharing patient information and with communication. 

But hospitals need to think about the issue of access beyond patient visits to the emergency department, primary care, or even retail clinics. More CINs are focusing on access points to help keep patients in their networks. When analytics indicate the patient outmigration rate (patients going outside the network—sometimes referred to as "leakage") is more than 5 to 10 percent, the providers must find ways to keep more patients in the network.

Increasing access can also turn into a selling point for the CIN to increase volume by touting its ability to provide convenient care. Selling the CIN to patients is particularly important in the era of high-deductible health plans, where patients actively select providers based on price and quality. 

This popular download from GE Healthcare Camden Group provides insight surrounding:

  • How people rate access
  • What consumers want (old vs. new models)
  • Expectations surrounding access redesign
  • Consumer trust statistics
  • The new paradigm of patient access
  • Objectives of "best in class" patient access
  • Creating loyal patients for life
  • The continuum of organized care

Please click the button below to access the download page:

Patient Access, The Camden Group, Clinical Integration

 

Topics: Clinically Integrated Networks, Patient Access, Download, CINs

New Download: Clinically Integrated Networks

Posted by Matthew Smith on Jun 4, 2015 4:14:00 PM

download_1Mobile.jpgIndustry pressures are driving physicians and hospitals toward tighter alignment models.Because of these pressures, clinically integrated networks ("CINs") are emerging across the country with the potential to influence payer and direct-to-employer contracts and drive members into organizations. 

This new download shares concepts tied to CINs, including:

  • The changing healthcare paradigm
  • Driving America's healthcare transformation
  • Trends in inpatient utilization 
  • The continuum of organized care
  • Economic drivers of clinically integrated networks
  • The evolution of clinically integrated care
  • Alignment strategies
  • Analytics strategies

To download the PDF presentation, please click the button below.

Clinical Integration Networks, CIN, Daniel J. Marino


Topics: Clinically Integrated Networks, Regional Clinical Integration Networks, Daniel J. Marino, Download

Straight From MGMA 2014: Are You Ready for Revenue Cycle 2.0?

Posted by Matthew Smith on Nov 4, 2014 11:01:00 AM

Revenue Cycle, Clinical Integration, DownloadDownload the latest Health Directions presentation: Are You Ready for Revenue Cycle 2.0? by Health Directions President/CEO Daniel J. Marino. Presented at the 2014 MGMA Annual Conference in Las Vegas, this presentation will share how to manage at-risk fee arrangements by coordinating discounted up-front reimbursement with future reconciliation payments.

Highlights include:

  • Manage bundled payment contracts by re-tooling revenue cycle processes to focus on disease state or clinical programs.
  • Harmonize billing among several care providers to ensure proper claim adjudication with payers and patients.
  • Modernize the verification process and use a practice management information system to ensure proper reconciliation of patient accounts to performance-based contracts.

Learning Objectives

  • Identify traditional revenue cycle processes that represent weak spots
  • Manage documentation, billing, collections and payment allocation under shared savings contracts and at-risk arrangements
  • Re-engineer revenue cycle processes for value-based contracts by coordinating billing and receivables across providers

To download the PDF of this presentation, please click on the buttown below.

Webinar, Webcast, Revenue Cycle, Health Directions, Ambulatory Payment

Topics: Bundled Payments, Clinical Integration, MGMA, Revenue Cycle, Daniel J. Marino, Download

New Download: Denial Management Through Process Improvement

Posted by Matthew Smith on Oct 14, 2014 11:44:00 AM

Denial Management, According to University Health Consortium (UHC), rejected claims are the number one challenge facing the business offices of physician practices today. Every 1% of claim denials can cost an organization $7,000 to $20,000 per physician in annual net revenue.

The use of denial metrics support proactive management and can significantly improve your practice’s profitability making effective denial management the key to revenue enhancement and efficient processes.

This new PDF presentation from Health Directions examines current trends in Denial Management and provides reporting tools to allow physicians and practice managers to manage the process and prepare for the future: ICD-10, value-based contracting, reimbursement analysis, etc.

Key topics include:

  • The shift in revenue cycle activity
  • Top denial reasons
  • Where do you begin to manage denials?
  • Denial key performance indicators
  • Collected vs. Collectable metrics
  • Case study of a 90+ provider, multi-specialty group practice

Also included are tools for you to use to begin improving your denial rate, including:

  • Sample Denial Survey
  • Sample Denial Report
  • Sample Action Plan

To access this presentation, please click the button below:

Denial Management, Revenue Cycle,

Topics: Revenue Cycle, Download, Rejected Claims, Denial Management

Download: Improving the Physician Revenue Cycle Through KPIs

Posted by Matthew Smith on Sep 19, 2014 10:36:00 AM

Download, Revenue Cycle, Health DirectionsThe healthcare revenue cycle is complex and interconnected. A few flawed processes can weaken the entire reimbursement chain and lead to poor financial results. Fortunately, this also represents an opportunity.

Optimizing business office processes, payer relationships, patient flow and information system configuration can bring about exceptional gains in both cash flow and net revenue.  This is especially important as organizational structures, reporting requirements, and reimbursement methods are changing to accommodate the new realities of the healthcare system. 

Asking the following questions can help healthcare leaders evaluate the revenue cycle strengths and weaknesses of employed physician practices.

Scheduling

  • Does the practice verify insurance info (using batch eligibility) prior to appointments?
  • Are the patients informed of payment expectations prior to arrival for their appointment?

Registration/Check-in

  • Is the staff trained to collect co-pays, deductibles and past-due balances at check-in?
  • Does the practice have a written financial policy that is provided to all patients?

Coding

  • Does the practice verify coverage for specific services?
  • Does the practice update procedure and diagnosis codes annually, as well as perform a coding audit?

Charge Capture/Claim Submission

  • Does the practice capture 100% of office and hospital charges?
  • What is the lag time from date of service to date of claim submission?
  • Are claims submitted daily?

Cash Application

  • Does the practice use electronic funds transfers (EFTs) and electronic remittance advices (ERAs)?
  • Does the practice load payer allowables and track payment variances?

Denial Processing

  • Does the practice track denials?
  • Does the practice monitor write-offs and have an appeals process?

Accounts Receivable Follow-up

  • Does the practice follow up on all outstanding balances: payer and patient?
  • Does the practice have a dashboard report that is reviewed monthly and compared to industry standards?

This Health Directions presentation discusses the use of key performance indicators to improve the revenue cycle in hospital owned physician practices. 

To access this presentation, please click the button below:

Revenue Cycle, Key Performance Indicators, KPIs,

Topics: Revenue Cycle, Physician Revenue Cycle, Charge Capture, Cash Application, Claim Submission, Download

New Download: Population Health Management--What Does It Mean To Your Practice?

Posted by Matthew Smith on Sep 8, 2014 11:00:00 AM

Clinical Integration, Clinically Integrated Care, Population Health

The time has come for primary care physicians to reboot their practice operations and begin the process of managing population health. Many physicians are delaying the planning and implementation process that will prepare them for a transformation of how they are paid from fee-for-service to reimbursement-for-results. 

This new PDF presentation from Health Directions examines current trends in Population Health Management as they pertain to physician practices and addresses such topics as:

  • Population Health Defined
  • The Building Blocks of Clinical Integration
  • ACO/Clinically Integrated Network Components
  • Case Study: Forming an ACO
  • Key Implementation Steps
  • Implications for Physicians and Office Managers
  • Participation Considerations

To access this presentation, please click the button below:

Population Health, Practice Management, Clinical Integration

Topics: Clinical Integration, Population Health, Clinically Integrated Care, Physician Practice, Clinically Integrated Network, Download

HD Download: Utilizing Clinical Integration to Align Physicians & Increase Market Share

Posted by Matthew Smith on Aug 5, 2014 8:37:00 AM

Clinical Integration, Health DirectionsDownload our presentation, "Utilizing Clinical Integration to Align Physicians and Increase Market Share."

This Health Directions presentation offers recommendations on how to align community physicians with the hospital in order to build a clinically integrated care model.

Key takeaways include:

  • Analyze 5 keys to creating quality clinical integration infrastructure
  • Identify complex questions that guide clinical integration
  • Define success criteria of clinical integration
  • Develop a plan for clinical integration based on the 4 Pillars approach
  • Identify how to track clinical outcomes starting with meaningful use data

Simply click the button, below, to access the download.

 

Clinical Integration, Health Directions

 

Topics: Clinical Integration, Physician Alignment, Download

Six Clinical Integration Articles Available as PDF Downloads

Posted by Matthew Smith on Jun 20, 2014 8:52:00 AM

Clinical Integration, Health DirectionsAs part of our ongoing commitment to our clients, social media followers, and the healthcare industry, Health Directions authors original content that is published regularly in national publications as well as on our HD Insights Blog. We create this content to educate and inform, as well as stimulate important conversation around these key topics. 

You may have read one, or all, of these articles, but we've re-packaged them for you into individual PDFs that may be downloaded and printed out at your convenience.

We hope that you receive some valuable insight from these articles and invite you to subscribe to the HD Insights Blog and comment on the articles in the Comments section, below. 

To download each article, simply click on the respective button which will automatically direct you to an online PDF. To download, right click on the page and save to your device.

Clinical Integration, Health Directions, Population Health Funding Clinical Integration, Population Health, Health Directions

Clinical Integration, Health Directions, Population Health, Regional Clinically Integrated Networks, CINs, Health Directions, Population Health, Clinical Integration

Clinical Integration, Hospital-Physician Collaboration Clinical Integration, Franchise Model, Health Directions

  HD Insights Blog, Health Directions, Blog Subscription  

Topics: Clinical Integration, William K. Faber MD, Physician Engagement, Daniel J. Marino, Download

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