See 10 insights from our experts on the transition to population health. More

 

The Growth Channel

The latest innovations in market strategy and share competition

What you need to know about MitraClip’s CMS coverage decision

July 22, 2014

In October 2013, the FDA approved the use of MitraClip for patients with symptomatic degenerative mitral regurgitation who are ineligible for surgery. In May, the Centers for Medicare & Medicaid Services (CMS) issued a coverage decision detailing conditions that institutions must meet to receive coverage for transcatheter mitral valve repair (TMVR). 

While these requirements will provide guidance for hospitals evaluating the MitraClip device, they won’t likely change much about the adoption landscape. Below, we examine the key points of CMS’s coverage decision, how it will impact MitraClip adoption, and highlight our best resources to on how to successfully develop TMVR programs.

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Game-changer: Why dual-energy CT could be a key to post-reform success

July 15, 2014

With increasing utilization scrutiny, dose reduction pressures, and cuts to reimbursement, the world is changing for radiology. It’s time to start thinking creatively about ways to leverage technology to meet new demands on imaging. 

We recently spoke with a few institutions that are doing just that by introducing dual-energy CT (DECT) scanning for regular clinical use. No longer reserved for research purposes, DECT produces high-quality images at reduced radiation levels, an increasingly valuable combination in a post-reform care.

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Virtual visits: The new data on demand

July 10, 2014

Verizon just announced that it's entering the telehealth space, joining the likes of vendors such as American Well, Teladoc, Stat Doctors, and MDLive.  But many providers I’ve spoken with remain wary of virtual visits and wonder if there will be enough demand from consumers to justify the investment.

We think so—at least among certain cohorts. 

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Members ask: Do we need to build a women’s health center?

July 8, 2014

The answer is: It depends. 

Each organization needs to choose a structure that best fits their infrastructure and market. While many hospitals select a one-stop shop women’s health center model, this strategy is not always ideal in sparely populated regions with limited capital budgets.

In the absence of a comprehensive women’s health center or hospital service line, a satellite outpatient women’s clinic can help patients better understand the spectrum of women’s services available to them throughout a health system. With limited capital budgets and facility space, organizations can use existing outpatient facilities or critical access hospitals to deliver additional programming for women in the community. 

To ensure downstream referrals are directed to the “hub” facility, many health systems dedicate a women’s health navigator to streamline referrals and provide a direct line of contact to all related women’s health services.

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Is your oncology program ready for immunotherapy?

June 30, 2014

Earlier this month at the American Society for Clinical Oncology (ASCO) annual meeting, researchers unveiled a groundbreaking new immunotherapy for cervical cancer: Adoptive T cell therapy. With just one infusion, this breakthrough treatment demonstrated complete remission for two women with metastatic cervical cancer.

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Who will take the lead? New EP devices may introduce new specialists.

June 25, 2014

With a rapidly growing population in demand for EP services, more technologies are coming to market to meet this patient need. Simultaneously, as traditional CV businesses decline, hospital executives are shifting their strategy towards EP to catalyze service line growth. 

As a result, a wide range of physician specialties providers intend to enter this service. But as technology advancement continues, the question remains—who will actually perform these procedures in the future?

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MD loyalty: It’s worse than we thought.

Michael Koppenheffer June 24, 2014

We knew physicians weren't referring in-network—our Crimson Market Advantage data has been telling us that for years now. But physicians participating in an ACO would take care to refer in-network, right?

Apparently not. A new JAMA study of Medicare ACOs found that for patients attributed to a Medicare ACO, two-thirds of specialist referrals went to physicians outside the patient’s ACO network.

Two-thirds. And leakage rates were even worse for high-cost beneficiaries.

This may be the best illustration yet of the scope and intractability of the issue. Even in accountable care organizations, where there are clear incentives for participants to work together to improve cost and quality, the primary care doctors at the front lines of accountable care are not directing patients to providers within their ACO networks.

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New tool: Rationalize your hybrid OR investments across hospitals

June 13, 2014

Over the past three years, the customized Hybrid OR Business Plan has been the most commonly requested project for Service Line Strategy Advisor members. Today, health system planners continue to receive requests for hybrid OR investment from hospitals across the system, including both academic medical centers and community hospitals.

But in a time of limited resources, the high cost of the room—between $3.5 to $6 million on average—makes investing in a hybrid OR at every requesting hospital impossible for most systems. For this reason, health systems must think acutely about how to identify the optimal hospital, or hospitals, for hybrid OR investment.

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