Care Transformation Center Blog

The insights, tools, and resources you need to take on population health management

Three referral management must-haves to shut down 'medical infidelity'

Dennis Weaver, MD, MBA October 20, 2016

'Medical infidelity' is a term I stole from the physician executive of a large health system owned medical group. He used it to describe physicians referring outside the network. I've written on this topic before to encourage administrative leaders to understand why their physicians refer out of network, and explain why I believe keeping patients in the network results in better overall care.

But that was just the tip of the iceberg. Across the last year, I continued to meet clinical leaders struggling with out-of-network referrals. The comment I hear most often is, "I know we have a referral problem, but I can't force my physicians to refer in-network."

Fortunately, I have some good news: My team has seen numerous ways that the Clinically Integrated Networks we're building are getting referral management under control—and in ways that help participating physicians and benefit patients. Here are what I believe to be three must-have elements for a best practice referral management/network integrity strategy.

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The case for home-based care for geriatric patients

by Clare Wirth October 17, 2016

As seniors continue to make up a growing proportion of patients, providers are innovating on their approach to home-based care. In a recent webconference, Senior Consultant Christina Wild highlighted three key points in the case for home-based care:

1. Home-based acute care programs improve outcomes and satisfaction

By enabling elderly patients to remain in a familiar environment and avoid the hectic hospital setting, home-based care acute models have lower costs, fewer incidences of delirium, and reduced utilization.

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2 retail pharmacy trends to keep your eye on

by Samm Freedman October 14, 2016

Retail pharmacy seems to be on the mind of every pharmacy leader I speak to these days. They're feeling pressured to leverage retail pharmacy to improve patient experience, health outcomes, and brand loyalty—not to mention to turn a profit.

To better understand the state of retail pharmacy operations and services across the country, the Pharmacy Executive Forum recently surveyed pharmacy leaders at hospitals and health systems across the nation to understand their retail pharmacy operations and services. Here's a sneak peek at some of our most interesting findings.

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What providers can do to address food insecurity

Rebecca Tyrrell October 11, 2016

One in six households experience food insecurity: limited or uncertain access to nutritionally adequate and safe food. Individuals who are food insecure are two times as likely to suffer from diabetes and are three times as likely to have poor overall health status.

When you consider these realities and the fact that many non-profit hospitals serve food deserts—areas devoid of healthy or nutritious food options—there is a largely untapped opportunity to better serve the community while achieving population health objectives.

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How to build a broad network of community partners

Rebecca Tyrrell October 6, 2016

While efforts to improve PCP-specialist collaboration or build tighter post-acute care networks are critical to achieving clinical success, community-based partnerships provide the foundation for addressing socioeconomics, healthy behaviors, and the physical environment.

Identifying and creating positive working relationships with these groups can help to extend the reach of clinical staff, prevent duplication of effort, build a positive community presence, address underlying issues that impact a patient's ability to adhere to a care plan or become healthier, and improve overall health and well-being.

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3 keys to advancing pharmacy systemness

by Molly Stein September 30, 2016

I’ve recently had the opportunity to speak with pharmacy executives from across the country and delve deeper into the murky waters of "systemness"— how centralizing or standardizing pharmacy services can help health systems advance strategic goals such as cost savings and improved patient care.

Systemness is especially top of mind given the current wave of health system mergers and acquisitions (112 in 2015 alone) and the growing push toward population health management, which highlights the impact of drug management across multiple care settings.

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Need an alternative to SNF? Try the medical foster home.

Christina Wild September 29, 2016

As the health care industry shifts toward value-based care, many organizations are innovating on how to provide high quality care in the lowest cost setting. Pioneer organizations are finding ways to provide care in one of the lowest cost care settings—the home.

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What 100+ providers told us about the path to value-based care

Dennis Weaver, MD, MBA September 22, 2016

A few weeks ago we launched the Pop Health Pop Quiz to help our members understand where they fall on the path to value. We asked 12 questions on the current status of each organization's value-based care contracts, care transformation strategies, network alignment, IT, and financial management capabilities.

Over 100 people from 87 provider organizations took the survey, and they were able to immediately see whether their organization was a skeptic, intender, builder, advancer, or committed in relation to population health management.

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