Online patient portals are easy to access but may be failing is as a substitute for discharge orders By Katie Wike, contributing writer
A study released by Truven Health Analytics estimates 6 million people will be added to Medicaid and 21 million to affordable insurance exchanges starting in January, 2014 as the next stage of the Affordable Care Act is rolled out. What else can we expect? By Lisa Kerner, contributing writer
Interoperability and Population Health Management were once again the hottest topics at the health IT industry’s largest conference. The event helped to clarify efforts in one of these areas while muddling the messages delivered in the other.
As new value-based payment models emerge in the healthcare industry, hospitals that demonstrate high-quality, efficient patient care will have a distinct advantage over those organizations that remain mired in unwarranted variation in care processes, unnecessary and duplicative tests, and an inability to coordinate care.
This success story from Greenway focuses on Dr. G. Edward Newman and his vision of a comprehensive, 21st century medical practice.
Many industry leaders championed a free market approach to healthcare during the 12th Annual World Health Care Congress last week. Here are a few key reasons why I don’t think this model is “the fix” our industry so desperately needs.
An Accountable Care Organization (ACO) utilizes a payment and care delivery system that bases payments to providers on quality metrics and seeks to reduce the total cost of care for a certain population of patients. ACOs use a range of payment models and consist of groups of coordinated healthcare providers that provide care to groups of patients. ACOs are accountable to a third-party payer and the group of patients for the appropriateness, quality, and efficiency of the health services they provide.
In 2011, the Department of Health and Human Services (DHHS) set forth initial guidelines for ACOs to be created under the Medicare Shared Savings Program. These guidelines contained all necessary steps required for a physician, health care provider, or hospital to voluntarily participate in ACOs.
The quality measures used to evaluate an ACO's performance as defined by the Center for Medicare and Medicaid Services (CMS) fall into five domains. These domains are patient/caregiver experience, care coordination, patient safety, preventative health, and at-risk population/frail elderly health.
The three stakeholders in an ACO are the providers, payers, and patients. Providers are a network of hospitals, physicians, and other healthcare professionals. The primary payer is the federal government, Medicare, but also includes other payers such as private insurances or employee-purchased insurance. The patient population of an ACO will primarily consist of Medicare beneficiaries, but in larger ACOs can also include those who are homeless and uninsured.
According to a new report, a lack of out-of-network interoperability is the biggest obstacle facing ACOs today. By Katie Wike, contributing writer
