Calculating KPIs for Value-Based Payment Models
If hospitals and health systems know the patients for whom they’re at risk and the benchmarks against which they are held accountable, they can lower costs and improve outcomes for an entire population—not just a single patient.
Challenges and Opportunities Seen in Social Determinants
Oct. 10—Providers and insurers are seeing a range of obstacles and new opportunities in efforts to better address the most powerful factors affecting patient health.
Transitioning to a New Medicare Benchmarking Paradigm
As commercial health plans adopt a case-rate approach to payment based on Medicare’s MS-DRGs, modifications are needed to account for how health plans’ populations differ from the Medicare population.
Cost Accounting: Bridging the Gap Between Where You Are and Where You Should Be
By creating a single source of truth, MultiCare aims to have coordinated oversight of all data, including security and design, and provide a consistent training curriculum for its finance team.
A Growing Health System Contains Costs Through Outsourcing
Methodist Health System wanted to manage and maintain its facilities more efficiently after more than a decade of expansion. Improved contracting practices saved $250,000 in the first several months.
Your Health System Is Ready for the Future—But Is Your Leadership Structure?
John Johnston and Vincent Joseph explain that even as revenue and volume continue to move into nonhospital entities, leaders must be held accountable for the performance of their own individual business units or regions, as well as for systemwide results.
Employer Plan Deductibles Increase by 11 Percent: Survey
Oct. 8—In 2018, the share of workers enrolled in high-deductible health plans (HDHPs) resumed increasing, and deductibles among all workers increased by an average of 11 percent from the year before, according to a national survey.
The Conscience of the Generic Drug Market
Created to address the high costs and shortages of generic medications, the not-for-profit generic drug manufacturer Civica Rx aims to be a societal asset by providing patients across the nation with affordable access to the medications they need.
Launching Revenue Integrity Programs in Hospital-Owned Practices
University of Maryland St. Joseph Medical Center’s revenue integrity program ensures a formal process to perform regular audits and educate physicians and their staff about compliance, and under-coding as well as over-coding.
An Ounce of Prevention: Intervention Engagement Strategies in Population Health Management
Pete Desai explains that as consumerism and value-based care collide, providers would be remiss to neglect the important role that preventive patient intervention programs can play in improving the health of patient populations.