Yes, this blog post is about population health, accountable care and the changing economics of healthcare payment. But first, a little bit about ice hockey from Walter Gretzky, father of Wayne “The Great One” Gretzky.
When Wayne was a young boy, Walter encouraged his son’s interest in hockey. In the family’s back yard he built an ice rink, the Wally Coliseum, where he taught Wayne and the neighbor kids to skate. Wayne was obsessed with hockey. Walter recalls seven-year-old Wayne’s fascination during a televised hockey match. On a pad of paper, the boy traced the path of the puck as it careened across the ice. To Walter, the lines on the notepad were scribbles. But to Wayne the pattern showed the places on the ice where the puck was most likely to be at any given time. The intersections, as he called them.
That was part of the Great One’s strategy, to know where the puck was most of the time.
In a way, the same strategy applies to accountable care and population health management. Continue reading
As the Medicaid rolls and costs of those covered expand, many policymakers, particularly those leading state health agencies, are ramping up efficiency to squeeze more value out of healthcare dollars. Texas and New York, two states normally considered at opposite ends of the political spectrum, are focusing on outcomes as the ultimate goal of healthcare delivery and the means to rein in wayward budgets. This is not an ideological shift; it is recognition that cutting waste to improve quality is a goal that everyone can embrace.
This blog will focus on the concept of outcomes and how to incentivize better outcomes as an essential component of stabilizing healthcare costs.[i] Simply put, we need to learn how to walk and chew gum at the same time. We do this by acting upon two types of outcomes in unison: those that have immediate bottom-line savings and those that have an impact on a patient’s long-term survival and quality of life. When national organizations instead focus on hundreds of largely process measures, most of which have little relevance for cost savings, it simply confuses policymakers charged with decision making. Continue reading
by Kristine Daynes and guest blogger Lisa Lyons, RN, Product Marketing Manager with 3M Health Information Systems
The media is flooded with discussions about the demands of accountable care on information technology. There isn’t as much public discussion, though, about the implications for health information management.
Without a doubt, accountable care will change health information management, as will other models that combine payment reforms with changes in delivery of care, such as bundled payment and patient-centered medical homes. Accountable care requires health information beyond single encounters, sometimes from multiple providers and facilities, often concurrent with a patient visit. It also requires a combination of information—business, claims, and clinical data—aggregated in one place for reporting and analysis. Continue reading
I recently attended a conference put on by the Institute for Healthcare Improvement on “Improvement Skills for Tomorrow’s Healthcare.” The conference itself was focused on developing quality improvement skills for participants to take back to their individual hospitals, organizations, and teams in order to immediately begin to take on quality improvement projects.
I’m sure most folks who work in healthcare have a general idea about what improved healthcare could or should look like. I talk about it often with my colleagues, but one thing really struck me during this conference (pardon the creative license I’m taking with the “It takes a village…” proverb): It takes a hospital to change a hospital. This also applies to the broader level that “it takes a healthcare system to change a healthcare system.” Continue reading
My first epiphany at the 3M Client Experience Summit this week came ten minutes into the first client presentation I attended. Here it is: There is a simple approach to the complex issue of reducing hospital-acquired complications (HACs).
By simple I don’t mean easy, because there is plenty of hard work involved. Nor is it simplistic, because it requires smart problem-solving. Yet I can count the guiding principles on the fingers of one hand: Continue reading
In December, states had to let the Department of Health and Human Services know whether they would set up their own state-operated health insurance exchanges. The deadline was not a surprise, although several states protested they didn’t have enough time to consider the issue. The mandate originates with the 2010 Accountable Care Act. What is surprising is the number of states who declined the opportunity to create their own insurance exchanges.
Federal health law requires states to establish health insurance marketplaces to serve individuals and small businesses that need access to affordable health benefits. HHS outlined a federal model, which was intended as a default option, fully expecting most states to choose local control and operation of their exchanges. Continue reading
Since 2009, the State of Maryland has operated a pay-for-performance program, the Maryland Hospital-Acquired Conditions Program. According to an article in the December issue of Health Affairs, the Maryland program is going gang busters. And there are two big reasons why.
Unlike CMS’s hospital acquired condition program, the Maryland program uses a different approach to measuring inpatient complications—a rate-based, risk-adjusted methodology, not a case-based approach. Also unlike CMS’s HAC methodology, which is limited to ten types of conditions, the scope of the Maryland program covers 49 types of potentially preventable complications (PPCs). Continue reading
Within an ACO, profitability no longer depends on increasing the volume of care, but refining the efficiency of care throughout the system. That requires new measures and analytics to evaluate clinical and financial performance for entire episodes of care, not just discrete inpatient and outpatient services.
Last week, 3M’s chief medical officer, Sandeep Wadhwa, presented a framework for analytics in accountable care at an industry conference in Chicago. Titled “Measure Twice, Cut Once,” the webcast is free to viewers who register at this link: http://bit.ly/boNXru. Continue reading
Partnering with health systems, industry associations and think-tanks on projects that can benefit the healthcare industry as a whole is extremely exciting and rewarding. 3M’s newest partnership is with The Academy Huron Institute. I am pleased to announce that we will partner with The Academy in the newly-launched Population Health Management Infrastructure Collaborative.
A long-time member of The Academy, 3M, joins The Academy Huron Institute in undertaking a 9 month intensive collaborative for 10 health systems to more fully understand critical success factors and infrastructure for Population Health Management. In particular, the project will focus on the data, analytics, roles and positions required and characteristics of the environment that affect timing and progress. Continue reading
Skeptics of the Affordable Care Act and accountable care should be paying attention to Colorado. They might be pleasantly surprised.
This week The Denver Post published preliminary results for the Accountable Care Collaborative (ACC), a Medicaid reform initiative in Colorado. The news boosts confidence that programs to cut healthcare costs and improve quality can be self-funding.
More than 128,000 of the state’s Medicaid clients are enrolled in the Colorado ACC. Within the first six months the program showed promising results:
- a 14 percent drop in billings for hospitals stays among children
- a 9 percent drop in hospital stays for adults with disabilities
- a 5 percent drop in emergency room visits by adults
The ACC will deliver an official report to the state legislature in November. Continue reading