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

How Physician-Finance Partnerships Pave the Way to Higher-Value Care

Post on June 6, 2019 in Insights, Lumina Leadership Institute, and Value-Based Strategy

In the past few years, a growing number of physicians have taken leadership roles in hospitals and health systems. Given that value-based care is a team sport, this is a positive trend. Yet conflict between physicians and finance executives can arise because of their respective knowledge gaps and differing perspectives and work styles. To work ...Read More

7 Winning Strategies for CMS’s MSSP Pathways to Success, Part 1

Post on April 29, 2019 in Insights, and Value-Based Strategy

The decision about whether to participate in the Centers for Medicare and Medicaid Services’ (CMS’s) new Medicare Shared Savings Program (MSSP), Pathways to Success, is complicated. It requires a detailed understanding of the rules of the program, your patient population, as well as your level of maturity with several key population-management capabilities (e.g., care management, ...Read More

Patient Risk Scoring Is the Key to Value-Based Payment

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

The U.S. healthcare system is steadily transitioning from fee-for-service (FFS) reimbursement to fee-for-value (FFV) payment. This change has already started to affect medical practice revenue, and it will have an even bigger impact in the years ahead. Unfortunately, most physicians and practice managers understand only part of the FFV equation. While they know the quality ...Read More

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