Success in Risk-Based Contracts: Building the Right Level of Incentives

Post on November 7, 2019 in Insights, and Value-Based Strategy

As Chief Medical Officer of NextGen HealthCare, Betty Rabinowitz, MD, FACP's role is to promote and improve NextGen's solutions in support of provider performance, clinical outcomes, patient satisfaction, and financial efficiency. In this episode of Value Based Care Insights, host Daniel J. Marino, Principal Partner at Lumina Health Partners, and Betty discuss to how create the right incentives under risk-based contracts and how organizations can achieve the right amount of success in a value-based care environment.

The 4 Pillars of Clinical Service Line Success:
Part 4 – Analytics and Innovation

Post on November 7, 2019 in Clinical Transformation, and Insights

Hospitals and health systems across the country are reexamining their clinical service line strategies and operations in response to the shift from volume to value. In addition to population-based and episode-based payment reforms initiated by public and private payers, providers are challenged by mergers and acquisitions, clinical integration, consumerism and price transparency. Strengthening clinical service ...Read More

The 4 Pillars of Clinical Service Line Success:
Part 3 – Clinical Transformation

Post on November 7, 2019 in Clinical Transformation, and Insights

Hospitals and health systems across the country are reexamining their clinical service line strategies and operations in response to the shift from volume to value. In addition to population-based and episode-based payment reforms initiated by public and private payers, providers are challenged by mergers and acquisitions, clinical integration, consumerism and price transparency. Strengthening clinical service ...Read More

The 4 Pillars of Clinical Service Line Success:
Part 2 – Clinical Integration

Post on November 7, 2019 in Clinical Transformation, and Insights

Hospitals and health systems across the country are reexamining their clinical service line strategies and operations in response to the shift from volume to value. In addition to population-based and episode-based payment reforms initiated by public and private payers, providers are challenged by mergers and acquisitions, clinical integration, consumerism and price transparency. Strengthening clinical service ...Read More

The 4 Pillars of Clinical Service Line Success:
Part 1 – Governance and Leadership

Post on November 7, 2019 in Clinical Transformation, and Insights

Hospitals and health systems across the country are reexamining their clinical service line strategies and operations in response to the shift from volume to value. In addition to population-based and episode-based payment reforms initiated by public and private payers, providers are challenged by mergers and acquisitions, clinical integration, consumerism and price transparency. Strengthening clinical service ...Read More

The Human Factor in Organizational Change

Post on August 2, 2019 in Insights, and Lumina Leadership Institute

Healthcare organizations are continuously under pressure to evolve to meet patient needs while maintaining standards of care and keeping costs contained. Getting people on board with organizational change or innovation is hard, especially in health care. Staff are less likely to adopt new behaviors and practices if they perceive change or innovation clashing with longstanding ...Read More

Addressing Hospitals’ Concerns about the Proposed Release of Negotiated Charges

Post on August 1, 2019 in Insights

National hospital advocates, executives, and industry advisers have identified early concerns with the proposed mandatory release of hospital-negotiated charges. The Medicare Outpatient Prospective Payment System CY20 proposed rule would require all nonfederal hospitals to post online their gross charges and payer-specific negotiated charges. Addressing Contractual Requirements Lynda Mischel, a managing principal for Lumina Health Partners,  described the ...Read More

Digitization of Care Plans Boosts Clinical Decision Making

Post on July 30, 2019 in Clinical Transformation, Digital Innovation & Analytics, and Insights

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

Turning Conflict into Collaboration: How to Manage Workplace Disagreements

Post on June 28, 2019 in Insights, and Lumina Leadership Institute

Healthcare organizations are experiencing change at a rapid pace as technological innovations and alternative payment models greatly impact operations—and people. As a leader, you can expect these changes to create workplace conflict. But you also should be assured that you can manage this conflict, and make it a productive rather than disruptive force, by using ...Read More

What’s the Blueprint for Taking on Risk?

Post on June 25, 2019 in Insights, and Value-Based Strategy

Although the healthcare trend is shifting risk to providers, health plans have important roles to ensure both parties succeed. Although provider risk needs include a blueprint to prepare and engage in risk-based contracts, health plans can help determine success by sharing knowledge and insight with them, said Meredith Duncan, executive director and COO of Aetna’s ...Read More

Reducing Clinical Variation to Drive Success in Value-Based Care, Part 2

Post on June 19, 2019 in Clinical Transformation, and Insights

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

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