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Home > Healthcare Trends
7 Patient-Centered Strategies to Generate Value-Based Reimbursement
7 Patient-Centered Strategies to Generate Value-Based Reimbursement
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Healthcare companies seeking a roadmap to richer reimbursement should begin with the seven value-based healthcare priorities for 2014 identified by the healthcare C-suite: population health management, care coordination, integrated care delivery, e-health and telehealth, access to care, health and wellness, and dual eligibles.

7 Patient-Centered Strategies to Generate Value-Based Reimbursement explores the seven healthcare areas ripest for development in 2014, prioritized by 136 respondents to HIN’s ninth annual Trends & Forecasts survey.

These seven value-based healthcare action items for 2014 are the following:

  • Population Health Management
  • Care Coordination
  • Integrated Care Delivery
  • E-Health & Telehealth
  • Access to Care
  • Health & Wellness
  • Dual Eligibles

This 100-page special report, a desktop guide to the most innovative approaches on healthcare's radar, shares tactics, lessons learned and results from some of the most recognizable names in healthcare — Kaiser Permanente, Mayo Clinic Health System, Monarch HealthCare, HealthFitness, WellCare, Summa Health System and others, as well as 2013 benchmarks in telehealth and telemedicine applications from 129 healthcare companies.

Illustrated with more than 75 charts and graphs, 7 Patient-Centered Strategies to Generate Value-Based Reimbursement provides details on these approaches:

  • CMS five-star quality population health management strategies from 'star czar' Kaiser Permanente;
  • Dozens of ideas to improve physician practice efficiency and increase revenue from Mayo Clinic Health System;
  • Integrated care delivery success strategies from Monarch HealthCare, a top-performing CMS Pioneer ACO;
  • An integrated health coaching approach by HealthFitness that aligns individuals with the right coaching service at the right time, putting them on the road to health and wellness;
  • Summa Health System's accountable care strategies to improve hospital-SNF care transitions;
  • The WellCare HealthConnections model of care that is closing dual eligibles' care gaps and linking community and public health;
  • Dozens of 2013 benchmarks in telehealth and telemedicine, including results achieved with remote monitoring, most successful telehealth applications, the health plan perspective on telehealth, and much more.

Table of Contents:

  • Population Health Management: Kaiser Permanente's Five-Star PHM Approach
    • Quest for Total Panel Ownership
    • KP’s ‘Whiskey Barrel’ Model of Population Health Management
    • Integrated Regional Outreach System
    • Proactive Care Approach Maximizes Office Encounters
    • Panel Management Integration
    • Integrated Registry Tool
    • Performance and Results
    • Future Plans
  • Care Coordination: Summa Network Reduces SNF-Hospital Readmissions
    • Developing a Care Coordination Network
    • Decision to Developing a Care Coordination Network
    • Staffing and Implementing a Care Coordination Network
    • What Does the Care Coordination Network Accomplish?
    • Barriers to Patient Care
    • Formulating Solutions to Barriers
    • Transfer Form for Post-Acute to the ED
    • Measuring Outcomes Between Facilities
    • Calculating Readmission Rate
    • Formation and Development of an ACO
  • Integrated Care Delivery: Tactics from Monarch HealthCare Pioneer ACO
    • Motivations for Monarch Pioneer ACO Participation
    • Developing Population Disease Profile
    • 3 Opportunities to Improve Patient Engagement
    • Engaging Monarch Physicians in Pioneer ACO
    • 4 Drivers of Performance Year 1 Results
    • Physician Tools
    • 5 Lessons Learned
    • Future Evolution of ACO Strategy
  • E-health and Telehealth: 2013 Benchmarks and Metrics
    • 2013 Survey Highlights
    • Program Components
    • Results and ROI
    • Future Programs
    • Results Achieved with Remote Monitoring
    • Taking Advantage of Telehealth Provisions in the ACA
    • Most Successful Telehealth Applications
    • The “Other” Perspective
    • The Health Plan Perspective
    • Conclusion
    • Survey Methodology
    • Respondent Demographics
  • Access to Care: Redesigning the Physician Practice for Improved Efficiency
    • New Model of Nursing and Team Care
    • Efficiencies of the Two-Nurse Model
    • Responsibilities for Preventive Services
    • Planning Care Visits
    • Post-Visit Planning
    • New Medication Protocols
    • Additional Nursing Duties in the Practice
    • Sticking to the Patient Schedule
    • Identifying Productivity Gains
    • Still Room to be More Patient-Centered
  • Health & Wellness: Integrated Health Coaching to Foster Behavior Change
    • Key Coaching Philosophies
    • Three Levels of Health Coaches
    • Example 1: Advanced Practice Coach and Client
    • Example 2: Nurse Coach and Client
    • Example 3: Health Coach and Client
    • Coaching Tools and Appreciative Inquiry
    • Technology to Monitor Risk and Health Status
    • Riding the Client's Emotional Wave
    • Case Study: Integrated Health Coaching at Work
  • Dual Eligibles: Closing Duals’ Care Gaps and Encouraging Self-Management
    • HealthConnections Model of Care
    • Four Socially Based Care Gaps
    • Impact of Federal Funding
    • Connecting Community-based Programs and Social Supports
    • Community Advocates and Health Needs Assessments
    • HealthConnections Pilot Results
    • WellCare's Community Service Database
    • Program Evaluation
  • Glossary
  • About the Contributors
Publication Date: January 2014
Number of Pages: 100
ISBN 10: 1-939167-86-8 (Print version); 1-939167-87-6 (PDF version)
ISBN 13: 978-1-939167-86-6 (Print version); 978-1-939167-87-3 (PDF version)
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