As technology continues to change how we practice medicine, hospitals and health systems should consider digitizing care plans to support providers in clinical decision making that is evidence-based and avoids unnecessary variation. Too often, providers rely on memory to create orders sets or develop pathways. This approach can lead to overutilization of tests or treatments ...Read More
Join us as Lumina’s Managing Principal Douglas Ardoin, MD, MBA, Managing Principal Lynda Mischel, and Principal John Malone explore how to achieve clinical transformation. Learn more and register here.
Previously, we examined the issue of clinical variation reduction in terms of the stakes for value-based care. We also discussed two vital strategies for reducing clinical variation: physician engagement and implementation of risk-based analytics. Below, we describe two more key aspects of initiatives to reduce clinical variation. Deployment of Physician Scorecards Physicians, like most people, ...Read More
Join us as Lumina’s Managing Principal Lynda Mischel, Principal John Malone, and John P. Marren, founding partner and shareholder for Hogan Marren Babbo & Rose, Ltd., explore the case for community care integration in securing tertiary and quaternary service lines. Learn more and register here.
Now is the time for healthcare organizations to take the next step in elevating quality while reducing the cost of care. This will involve creating service line structures designed to function in the developing environment of value-based payments. In contrast, the original purpose for most health systems was to more tightly tie specialists to each ...Read More
Nearly every aspect of the healthcare world is changing―constantly, unpredictably, and quickly. As stakeholders navigate their various paths, knowing what to expect can help with decision making about compliance, risk, cost, and more. We have identified 7 areas that healthcare leaders must navigate to stay ahead of change and remain agile, effective, and profitable. 1. ...Read More
It is well-known throughout the business world that variation and a lack of standardization lead to poor quality and higher costs. The same is true in health care, whether the issue is an episode of care around a surgical procedure or long-term management of chronic disease. Standardized care that reduces clinical variation—defined here as the ...Read More
The implementation and use of clinically integrated networks (CIN) continues to be an essential strategy in the journey to value-based care. The healthcare delivery system continues to become more and more complex, with new technologies, ongoing changes in the competitive landscape with mergers, acquisitions, and partnerships, and challenging payer contracts that are heading to real ...Read More
Clinical integration emerged as a healthcare-delivery strategy in the late 1990s, when the Federal Trade Commission and the Department of Justice put forth guidelines to ensure that healthcare systems, hospitals, and physicians that were affiliated in larger structures could do so in ways that would serve the public interest and not be anti-competitive. The primary ...Read More
Financial challenges again rank No. 1 on the list of hospital CEOs’ top concerns, according to the American College of Healthcare Executives’ annual survey of top issues confronting hospitals. In addition, Moody’s recently confirmed its negative outlook for nonprofit hospitals, citing weak volume, reimbursement constriction, and increased numbers of Medicare patients. Financial issues are especially ...Read More
With recent changes to the Medicare Shared Savings Program (MSSP), all accountable care organizations (ACOs) need to pay closer attention to their compliance obligations and be prepared to make changes quickly. Each time the Centers for Medicare and Medicaid Services (CMS) updates its MSSP rules, as it did in 2016, it frequently follows these changes ...Read More
Recently, several clients who are working to improve value-based contracts have asked, “How do we better engage specialists in the reduction of total cost of care and improve access and outcomes for our members?” Nationally, the total cost of care increased 4.3 percent in 2016, and, according to CMS, is expected to increase at a ...Read More