Care Transformation Center Blog

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

3 innovative service lines advancing population health goals

by Shay Pratt and Clare Wirth October 16, 2018

Health systems have long used services lines as an organizational model for specialty care. Service lines integrate services such as orthopedics and neurosciences into a single administrative structure. In the legacy fee-for-service market, the service line model helped many systems organize strategy, grow services, and plan investments.

Read more »

These 3 tools will help you make data-driven population health decisions

by Clare Wirth, Tomi Ogundimu, and Petra Esseling October 9, 2018

Despite the rise in popularity of population health management since the Affordable Care Act, nearly all providers trying to advance care transformation strategies confront some unchanging challenges:

  • An undefined end state that makes it difficult to prioritize across competing goals and population health needs;
  • Limited benchmarks, little evidence, and unclear ROI that complicate decision-making; and
  • Too many stakeholders, which often results in fragmented program development and can hinder broader system buy-in.

Read more »

Population health's financial imperative for HCC improvement and 3 opportunities to get there

Petra Esseling , Tomi Ogundimu October 2, 2018

Coding and documentation (e.g., ICD-10 codes) are important under value-based reimbursement models. They inform Hierarchical Condition Categories (HCCs), a measure of disease burden, and Risk Adjustment Factors (RAFs). Physicians do most coding and can help ensure provider organizations are accurately reimbursed and held to fair standards in risk-based contracts.

Read more »

3 lessons learned from health systems that turned to philanthropy to fund population health

by Abby Burns and Nick Cericola September 27, 2018

In a recent Advisory Board survey of health system foundations and development teams, 59% of respondents reported fundraising for programs aimed at improving population and community health.

Read more »

Are patient-management apps a 'magic bullet' for chronic disease management? Not quite yet.

by Darby Sullivan and Tomi Ogundimu September 25, 2018

Population health leaders have been investing in chronic disease management efforts for decades, but the management challenge is not getting easier. Today, some providers are integrating IT-based innovations into their care models, including self-management applications and platforms that have measured promising results.

Read more »

Affected by Florence? Here are 4 ways to support chronically ill populations post-disaster.

by Praveena Fernes and Tomi Ogundimu September 20, 2018

In the wake of high-profile hurricanes that have hit the southern United States, population health leaders are increasingly interested in disaster-recovery. Looking back to 2005, when Hurricane Katrina hit New Orleans, 41% to 74% of victims had one or more chronic conditions, and continuity of care for these patients was identified as a major health care provision issue in the storm's aftermath.

Read more »

How to make the most of Medicare's CCM codes: Your top questions, answered

by Tomi Ogundimu and Abby Burns September 18, 2018

Patients with two or more chronic diseases account for 93% of Medicare spending, yet few providers have taken advantage of Medicare's fee-for-service mechanism for managing them: chronic care management (CCM) codes. In the program's first year and a half, only 4.5% of eligible primary care providers billed for CCM services. That means that many organizations continue to perform care management activities without being reimbursed.

Read more »

How States of Jersey uses postal workers to bend their cost curve

by Petra Esseling and Paul Trigonoplos September 11, 2018

This is the fourth blog in a series about care transformation around the globe, where we look at successful population health managers outside the United States. In this post, we highlight the successful partnership between the health system and postal service in States of Jersey, an island off of Great Britain.

Read more »