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Which Do You Prefer…Tax Preparation or a Visit to the Doctor?

Posted by Matthew Smith on Apr 17, 2017 11:12:52 AM

By Robert Zisman, Vice President, and Mark Krivopal, MD, MBA, Vice President GE Healthcare Camden Group

Spring is here, and Tax Day is almost upon us. Hopefully you’ve filed your taxes. You’re not one of those procrastinators, right?

It’s hard to miss the noise related to potential changes in healthcare and tax policy. Given all the talk on these two topics, comparisons of these two “facts of life” cannot be avoided.

Our united view: As divided as our country may be at times on these two issues, it’s easy to miss where we are united. Most people don’t enjoy doing their taxes, nor do they enjoy going to the doctor. Understand the necessity? Absolutely. Enjoy it? Likely not.

So, let’s explore our common lack of enjoyment for these two industries and dream a bit as to how these experiences could catch up to those we truly enjoy (or at least look forward to).

Access: For most people, booking an appointment with a tax pro or completing your taxes online isn’t that bad. However, finding time on your doctor’s calendar or researching the right provider for a specific ailment tends to be a bit more challenging. Once you’re in—especially if you’re the first appointment of the day—congratulations, you’re golden! If you receive any other appointment slot, be prepared to wait. Sometimes after waiting weeks and months for the appointment in the first place, you realize that you need a different specialist to help you with a problem.  

Ability to figure it out on your own: Fortunately, the ability to do your taxes online has been simplified by companies like TurboTax and their proclamation, “You answer simple questions about your life. We do all the math.” The good news here is that taxes are fairly formulaic, so this approach can work. They also have online experts available for questions. On the healthcare side, when someone has a health issue, where do they turn? You guessed it – Google. Not the best idea when there are websites out there such as WebMD where you can utilize a symptom checker and online doctors to answer questions you may have. While the possibility exists in both industries to figure it out on your own, many still prefer meeting with your tax pro or doctor, eye-to-eye.

Ability to meet eye-to-eye… from your couch! When it comes to doing your taxes online, the market hasn’t dictated the need for video chat. While taxes are complicated - and no two returns are the same - they don’t have feeling or emotions (although many can admit to having wept silently and experienced a sense of loss after pushing the “file your return” button). On the other hand, the human connection in healthcare is still extremely important and virtual doctor visits are beginning to take off. Health insurance coverage is finally catching up to market demand, and several experts predict the number of virtual visits to double over the next several years. However, few physician practices have adopted virtual visits into their care delivery system and workflows. Yet some pioneers have figured this out and offer a glimmer of hope for the future of virtual medicine. For example, Kaiser Permanente performs more virtual visits than in-person office visits. Other progressive healthcare systems are dipping their toes in the world of telemedicine with a focus on improving convenience and reducing costs.

Value for the dollar and payment: Whenever paying for a service, it’s expected that you receive value in return for the money you spend. With taxes, we start with a formulaic approach set by the government. Then, each person has their own, unique opportunity to impact that approach. Fees are usually stated up front, but somehow they always seem to change (rarely decreasing) by the end of the tax meeting. However, if you receive a refund, those fees usually aren’t too hard to swallow (i.e. H&R Block – Get your billion back!). When visiting the doctor, it feels eerily similar—except you often don’t know how much your visit, tests, and procedure will cost until you receive several bills post-visit. Unfortunately, paying your medical bills is far more complicated and seems never-ending. And you don’t get money back…unless you mistakenly pay the same bill twice. Greater transparency from the healthcare system’s side—as well as simplified processes and enhanced consumer engagement—must be developed to improve the overall experience.

You receive the best possible outcomes based on data and science: The tax code itself is extremely complex (74,000 pages) and no two returns are the same. H&R Block recently took a step in the right direction by partnering with IBM’s Watson. They’ve taken H&R Block’s 60 years of experience and 600 million data points to figure out how to deliver each customer the best outcome--in most cases, a refund. In healthcare, it seems we still have an opportunity to catch up. When seeing a doctor in person, the digital data capture of that appointment has not kept up with advancements in other industries. You often check off your symptoms, review your medical history (sometimes electronically, more likely in a manila folder) and arrive at a solution that we “believe” will address the symptoms outline. The ability to use data, artificial intelligence, and predictive analytics is becoming more prevalent in healthcare and will soon transform how you interact with your doctor, how hospitals are managed, and more. There are some great highlights recently mentioned on this topic by The Economist.

Looking to a better future: It seems both industries and experiences are making advancements to move up the likeability chain. Yes, potential policy reform still lingers above both industries, but ultimately improving the experience will rely more on innovation led by the public and private sectors. We welcome your thoughts in the comments section below on which experience you like the most and what these industries can do to move up your likeability list.

P.S. Just one more day left to file. Don’t miss the deadline!


Robert_Zisman.pngMr. Zisman leads the GE Healthcare Camden Group’s US operations team, responsible for recruiting, staffing, marketing, business development, operations and knowledge management. He also leads efforts related to 3rdparty strategic partnerships and collaboration with GE Healthcare Partners consulting businesses around the world in areas such as Canada, Latin America, Europe and the Middle East. His previous roles included leading large and complex engagements focusing on improving key performance metrics such as growth, margin, quality, patient satisfaction, and sustainable results. He may be reached at robert.zisman@ge.com.

krivopal_M-963748-edited.jpgDr. Krivopal is a vice president with GEHC Camden Group and an accomplished senior physician-executive with 19 years of healthcare experience across the continuum of care. Dr. Krivopal is responsible for developing and leading innovative, value-based programs addressing client needs in healthcare organizations, hospitals, and physician practices focusing on transformational system integration strategies, service line optimization, throughput and clinical leadership development. His experience spans not-for-profit and privately held organizations of various sizes as well as start-up environment in the healthcare information technology space. He may be reached at mark.krivopal@ge.com

Topics: Patient Access, Patient Activation, Robert Zisman, Mark Krivopal, Integrated Care Delivery

Five Focus Areas for Medical Groups in 2017

Posted by Matthew Smith on Jan 26, 2017 12:59:09 PM

For medical groups, the last few years have been tumultuous with the shift to value-based care. In 2017, medical groups will continue to experience change on all fronts, including payment, care delivery, and interaction and communication with patients. Medical groups must contend with new payment models, fierce competition in their markets, increased regulatory requirements, clinical advances, digital and information technology changes, and population health management implementation.

In response to these shifts, medical groups should focus on five key areas to position themselves for the future. As Socrates said, “The secret of change is to focus all of your energy not on fighting the old but on building the new.” And that is what medical groups need to do in 2017: build the new by transforming the old ways of practice management.

To read this article in its entirely, please click the button below to be taken directly to the HFMA website.

Medical Groups, 2017 Trends

Topics: Population Health, Medical Groups, Patient Access, Trends, Medical Group Transformation

Redefine Your Practice's Care Team to Promote Patient-Centered Care

Posted by Matthew Smith on May 20, 2016 11:13:16 AM

Article and video courtesy of MGMA.com

“If we’re not making the patient the boss right now, someone else is going to get our business. It’s as simple as that,” said William Faber, MD, MA, MS, senior vice president, GE Healthcare Camden Group, who spoke about the changing patient relationship during the MGMA/AMA Collaborate in Practice conference, March 20-22, Colorado Springs, Colo.

Faber and Marc Mertz, MHA, FACMPE, MGMA member, vice president, GE Healthcare Camden Group, elaborated on the topic during an exclusive video interview with MGMA [video below].

“We’re reaching a crossroads,” Mertz says. “Historically, practices have been very physician-centric in the way they operate [from scheduling appointments to physical exams]. Yet patients are increasingly demanding greater access and more information to be engaged in their care.”

Responding to that new dynamic requires a fundamental shift in practice operations. “In the past, practices competed against other practices,” Mertz adds. “Now there are retail clinics, urgent care clinics and concierge medicine. Patients will go where they can get the type of care they want.”

Accommodating Patient Demands

Meeting patient needs might require expanded hours, technology that allows patients to schedule appointments, get test results and ask questions online and a care team approach to increase access.

“The main issue is teamwork,” Faber says. “The doctor cannot just look at him- or herself as the full answer to the patient’s needs.” The more realistic answer, which will boost sagging morale, is to create a network. “Work with social workers, retail clinics, urgent care centers and care managers to address these needs,” he suggests. “Taking care of patients now is more of a team sport.”

Encouraging Change

“We are still incentivized to fill the schedule with as many patients as we can,” Mertz says. “Until some of the financial reimbursement models change, I think it will be hard for people to change.”

However, making small adjustments can ease the growing burden on doctors, Faber explains.  For example, he suggests that groups “Participate in new compensation programs that reward doctors for that which only doctors can do,” which means assigning low-acuity patients to other team members.

Collaboration between physicians and administrative leaders (dyads) is key for success. “I think of it as a marriage,” Mertz says. “They’re both jointly responsible and accountable for all aspects of the practice,” which means that neither party should shirk responsibility for clinical aspects or practical pieces of the business. “It’s a true partnership.

“Physicians are ultimately responsible for the clinical care but practice administrators need to be there to push and to challenge, to bring new, innovative technology, new processes and procedures to the table,” Mertz adds.

One new process they recommend: Create a network of facilities that provide convenient access for your patients and consider that network as your care team. “The biggest impediment is the human tendency to stay with what always worked before, just keep doing the same old thing,” Faber explains. “We’re practicing medicine as though it stayed stagnant in the 1970s or ’80s, and everything [has] changed around us.”

Watch more of the interview:

Webinar, Patient Experience, Patient Satisfaction

Topics: William K. Faber MD, Patient Access, Marc Mertz, Care Model, Care Delivery, Patient-Centered Care

Patient Access Infographic: How Consumers View the New Front Door to Healthcare

Posted by Matthew Smith on Apr 25, 2016 10:39:14 AM
This new infographic highlights results of a recent survey examining consumers’ experiences with alternative sites of care, such as retail health clinics, urgent care centers, and telehealth.
 
According to the new Oliver Wyman infographic and survey, consumers’ familiarity and use of alternative sites of care are on the rise. Furthermore, consumers who have used these “new front door” alternatives seem to like them and say they are willing to use them again. In fact, people who had new front door experience said they would be less willing to visit a traditional doctor’s office again.

NYC-MKT49701-002_infographic.jpg

Patient Access, Healthcare Networks

Topics: Infographic, Patient Access, Telehealth, Retail Clinic

PDF Download: The New Paradigm of Patient Access

Posted by Matthew Smith on Mar 9, 2016 2:18:02 PM

In 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—often 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 PDF 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

Patient Access, Healthcare Networks

Topics: Patient Care, CIN, Patient Access, Continuum of Care

Uber-izing Healthcare: Applying Nowait's Philosophy to the Patient Experience

Posted by Matthew Smith on Feb 17, 2016 2:14:01 PM

By Robert Zisman, Vice President, GE Healthcare Camden Group

Most people hate waiting. If you’ve ever lived in a city like Pittsburgh (or almost any major city outside of New York and Chicago) getting a taxi used to be a challenge. First, you had to call and hope someone would pick up the phone. Maybe they would actually show up. Once they arrived (if they arrived), it likely wasn’t the most pleasant of experiences. When you finally get to your destination, like that hot new restaurant that doesn’t take reservations that you’ve been dying to try, you’re hit with the cold reality of a two-hour wait!

But along came the magical innovation known as Uber, as well as an app called Nowait. If you haven’t seen Nowait, it’s exactly that—an app for getting in line at a restaurant. It allows you to see how long the wait is and secure a spot in line all from the comfort of your couch—before your Uber arrives.

The pace of change really hit me the other day when I got off a plane and requested my personal Uber (feels very concierge). As I walked out of the airport, I saw two lines--one for Uber rides and one for taxi service. Only, there was no one in line for the taxis. I wish that I had taken a picture to crystalize that moment of a new market entrant rising to success while the other had been left in the dust, relegated to a time gone by.

Having the pain of waiting being lifted from our shoulders, it’s hard not to scratch your head when you look at other industries operating  in yesterday’s times, wondering if they will catch up or be left behind. Cable is certainly one, but one that really hits home is healthcare.

Access is a tremendous challenge in today’s environment. Getting specialist appointments can take weeks to months, even with provider organizations that advertise “same day appointments." Securing primary care appointments can often take days, weeks, or longer if you prefer a certain doctor. Even with an appointment, you may find yourself stuck in the waiting room for hours, wondering why it’s even called an appointment. Then, when you’re finally seen, your visit might only last 5-15 minutes. And the icing on the cake…you get several bills in the mail, and a huge chunk of your healthcare savings is gone.

Imagine if…Nowait entered the healthcare environment. Yes, some healthcare providers do have online scheduling, and they may even alert you when it’s time to schedule your next appointment. But what if a new technology made it possible to see the current wait times for all primary care physicians, ERs, and specialists, and you could get in line at the one of your choosing in a timeframe that suits you?

Imagine if…there was an app as easy as Trip Advisor or Zomato where you select your healthcare symptom or need just as easily as selecting your desired trip experience or cuisine. You could then see hundreds of reviews that people shared about their healthcare experiences, rating their physician and offering comments to help you make informed decisions. Yes, there are traditional websites like this out there, but news flash—the usage rate is way below that of most apps used on a daily basis.

Imagine if Uber brought surge pricing to healthcare. That’s right, I said it—and it could be a game changer for patients as well as providers. Do you want to go to the emergency room when it’s currently full if you know that you have to pay three times the normal rates? Or is your emergency not as much of an emergency, or are you willing to drive to another emergency room that is currently empty (or maybe even an urgent care center—after all, maybe it’s not an emergency)? Would this balance out supply and demand so physicians on call could see that the ER is on a three-hour backlog, and if they come in they get paid at a three times rate, thereby instantly decreasing the patient wait time?

And, what about the other aspect of Uber, such as how easy payment is. The technology understands the insurance payment, calculates the patient cost share, and collects it from a credit card on file. This would be an amazing win for healthcare providers as it would eliminate the costly administrative process and for patients who are tired of having to spend hours trying to figure out how to pay their medical bills.

It’s fun to imagine waiting less and being able to navigate the complex healthcare environment in a way that’s easier to understand while making it easy to pay a fair price for your experience.

The good news is the technology is here, and there are several start-ups out there beginning to get into this space such as Doctors on Demand, ZocDoc, and Pager. But in order to truly transform healthcare’s patient experience and access challenges, healthcare providers must adapt to these new innovations. Healthcare organizations must take a leap of faith and give up some control, create more transparency, and rethink their business models. Fortunately, the push to population health and value-based payments are driving many to reexamine their infrastructure across a broader setting to increase access, manage cost, and improve quality.

Here’s to imagining a no-wait future for everything and to wondering what we will do with all of our extra time. It may be closer than we think.


Robert_Zisman.png

Mr. Zisman leads the GE Healthcare Camden Group’s US operations team, responsible for recruiting, staffing, marketing, business development, operations and knowledge management. He also leads efforts related to 3rd party strategic partnerships and collaboration with GE Healthcare Partners consulting businesses around the world in areas such as Canada, Latin America, Europe and the Middle East. His previous roles included leading large and complex engagements focusing on improving key performance metrics such as growth, margin, quality, patient satisfaction, and sustainable results. He may be reached at robert.zisman@ge.com.

 

Topics: Patient Access, Patient Experience, Robert Zisman

Content Download: The New Paradigm of Patient Access

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

In 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

Patient Access Innovations: Integrating Patients Within the System of Care

Posted by Matthew Smith on Dec 1, 2015 3:21:44 PM

Provider coordination is of paramount importance for healthcare organizations preparing for the industry’s shift in focus from volume to value. The most ambitious coordination model that has been developed to date is the clinically integrated network ("CIN")—a contractual collaboration among hospitals, physicians, and other providers to manage patients across the entire continuum of care. A CIN uses population health management tools, including care management techniques, to build value through improving patient outcomes and controlling costs. This innovative model offers providers access to value-based payment contracts and an opportunity to improve quality and reduce costs.

Despite the compelling benefits of clinical integration, this approach also poses risks. Value-based payment contracts hold CIN participants accountable for both clinical and financial outcomes, although the ability to influence these outcomes depends largely on patient choice and patient compliance. Whenever a patient leaves the CIN, even if the patient returns to the network for certain services, network providers lose the opportunity to fully manage the patient’s care and utilization, ultimately undercutting their ability to coordinate the patient’s care and accrue the benefits of improved clinical outcomes and reduced costs.

This risk makes it critically important for CINs to keep patients within their organized systems of care. CINs need to make sure patients can access the network easily and are motivated to stay connected, requiring a strategic focus on patient access and engagement.

Based on the experiences of leading CINs, strategies aimed at improving patient access tend to be most effective when they are focused on three primary objectives: expanding entry points to the network, making access more convenient and inexpensive, and keeping patients engaged in the care they receive from network providers. The following five strategies, in particular, have been proven effective for ensuring in-network access and strengthening patient engagement.

To read the rest of this article in its entirety, please click the button below to immediately access the article on the hfm magazine site:

 Patient Access, Clinically Integrated Networks

Topics: Clinical Integration, Clinically Integrated Networks, Patient Access, Patient Engagement, Daniel J. Marino, Value-Based Payments

New Download: The New Paradigm of Patient Access

Posted by Matthew Smith on Sep 29, 2015 1:04:53 PM

In 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 new download 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: Clinical Integration, Clinically Integrated Networks, Patient Access, Daniel J. Marino

Access is "Critical" for Hospitals, Clinically Integrated Networks

Posted by Matthew Smith on Jun 23, 2015 3:10:25 PM

Via HFMA News

Nurse, Primary Care, Retail Clinic, The Camden Group, Access, Patient Access PointsIncreasing ways for patients to access care through a hospital’s clinically integrated network ("CIN") is a key to the success of new CINs, one healthcare finance advisor said Monday during a morning pre-conference session at ANI: the HFMA 2015 National Institute.

Daniel Marino, senior vice president at The Camden Group, said CINs and hospital leaders need to stop fearing non-traditional access points that patients use to enter their systems, and instead find ways to embrace them.

“Patients are accessing the system through retail clinics because it is easy, it’s convenient, and they are able to get what they need quickly,” Marino said. “Just think how those components successfully integrated into your clinically integrated network can be significant access points into your network.”

In instances when CINs identify outside providers where their patients are going to get care, he urged the CIN to 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. Marino described how one hospital client approached a primary care provider to act as medical director of a retail clinic.

“That helped create some alignment,” Marino said.

But hospitals need to think about the issue of access beyond patient visits to the emergency department, primary care, or even retail clinics.

One organization used social media to set up Facebook clubs to help patients manage diabetes and different cancer services, describing the step as a social support structure.

“What they found is that by creating that, they were able to monitor the information that went out, and it created a connection to the clinically integrated network,” Marino said. “The hospital wasn’t doing this, it was the clinically integrated network.”

More CINs are focusing on access points to help keep patients in their networks. When analytics indicate the leakage rate—patients going outside the network—is more than 5 to 10 percent, the providers need to find ways to keep more patients in the network.

“At the end of the day, if they leave your network then your ability to manage costs goes down dramatically and you have very limited ability to influence,” Marino said.

Increasing access can 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. 

An additional reason to focus on patient access points and leakage is because a CIN’s focus on reducing costs and improving clinical care can reduce revenue.

“If you are going to make up the difference in the revenue, the short play from the hospital CFO perspective is that you have to drive members into your organization, you have to create that value,” Marino said. “However, if you have created that value, then you can then negotiate those contracts with your payers. So access becomes critical.”

Clinical Integration Networks, CIN, Daniel J. Marino

Topics: Clinical Integration, Clinically Integrated Networks, Patient Access, Daniel J. Marino, Access

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