Care Transformation Center Blog

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

Reflecting on ACO success: Kindred Healthcare and the Silver State ACO

by Jared Landis and Keerthi Bandi May 18, 2017

Kindred Healthcare is a strategic owner and partner in the Silver State ACO, a Las Vegas-based MSSP Track 1 participant that generated shared savings in 2015.

We recently sat down with Kindred's Drew Sheinen, Vice President of Strategy and Network Operations, and Linn Billingsley, Division Vice President of the Las Vegas Integrated Market, to discuss the lessons they've learned through ACO participation. 

Read more »

CCM codes: Are you leaving money on the table?

by Rebecca Tyrrell and Hunter Sinclair May 12, 2017

About 99% of all Medicare dollars are spent on patients with chronic conditions. Until CMS introduced Chronic Care Management (CCM) codes in 2015, much of the work providers put into helping patients manage these conditions went uncompensated.

Now, providers have the opportunity to bill for non-face-to-face chronic disease management services for Medicare and dual-eligible patients with two or more chronic conditions. These non-face-to-face services might include coordinating referrals, taking inbound calls, scheduling appointments, reviewing medical records and test results, or exchanging information with other providers.

Read more »

Weighing the ABCs of ACOs: Which program is right for you?

by Hunter Sinclair May 4, 2017

We're already a quarter into the first performance year of MACRA and we've noticed a significant uptick in the number of organizations trying to evaluate which Medicare Alternative Payment Model (APM) may be the right one for them—particularly, which Accountable Care Organization (ACO) model.

While organizations do not have to join an APM, we strongly recommend at least joining an APM without downside risk (such as MSSP Track 1). Doing so enables organizations to not only take advantage of the MIPS-APM scoring standard, but also helps them prepare for future payment reforms.

Here are four questions we'd recommend asking to inform which ACO model is right for your organization:

Read more »

3 steps to advancing your approach to ambulatory care management

by Tomi Ogundimu and Petra Esseling May 3, 2017

No organization has the resources to actively manage an entire population of attributed lives by touching every patient. However, the most successful organizations are tailoring ambulatory care management services to smaller patient segments based on risk stratification.

The path to success often starts with developing a high-risk care management program and then expanding the care management model to include rising- and low-risk patient populations. Here are three key steps on that path to success.

Read more »

The future of health care is here. But the 'clinician of the future' needs your help.

by Rob Barras and John Kontor, MD April 21, 2017

Over just the past four years, hospitals and health systems have started to take on challenges that they could have only dreamed of addressing a decade before.

Consider that at the start of 2013, only 9% of hospitals had implemented full clinical decision support via variance and compliance alerts, according to HIMSS Analytics. By the end of 2016, more than 35% had reached this significant milestone.

Four years ago, just over a third of hospitals had implemented computerized physician order entry. Today, more than 80% have.

Hospitals and health systems have become wired and, after decades of limited clinical benefits from EHRs, have the foundation for data-driven strategies to better serve their missions. They're achieving efficiencies in clinical quality, patient experience, and the revenue cycle that previously seemed out of reach.

We've helped lead that transformation alongside our members, and we're honored that others have taken note—Washingtonian magazine recently named The Advisory Board Company and our Chairman and CEO Robert Musslewhite as Tech Titans for the third biennial cycle in a row.

But while technology has helped transform our industry, there are still so many cases in which it can be used more effectively and efficiently. Here are two best practices we've learned from working with our members:

Read more »

How technology supports accurate risk adjusting for Medicare ACOs

by John Kontor, MD, Executive Vice President, Advisory Board April 20, 2017

Over the past several years, I've helped dozens of health systems optimize their EHRs to be able to better manage clinical and financial risk in their ACOs. In the process, I've observed that many system executives don't fully understand the risk-adjustment concepts that determine value-based payment under MSSP (or other Medicare programs). Often, their ACO strategies suffer—or completely stall—as a result.

If your organization is struggling with some of the mechanics, here is a primer to help get you up to speed.

Read more »

When too many meds are the problem: The benefits of deprescribing

by Rebecca Tyrrell and Molly Stein April 13, 2017

We don't often think of pharmacists taking medication away from patients, but that's exactly what deprescribing protocols are designed to do.

Deprescribing is defined as the planned process of reducing or stopping medications that may no longer be of benefit or may be causing harm. These practices are especially relevant for aging patients with chronic diseases who are often prescribed duplicative or unnecessary medications that can end up doing more harm than good. In fact, 44% of frail, elderly patients were given at least one unnecessary drug at discharge, according to a study of Veteran's Affairs hospitals.

Instituting pharmacist-led deprescribing protocols as part of medication reconciliation can lead to major benefits for both patients and health systems.

Read more »

Prove it to your C-suite: 3 tips for measuring progress on community health

Rebecca Tyrrell April 5, 2017

Health systems play a pivotal role in supporting their communities. However, these community health efforts are often seen as separate from larger strategic aims. As the industry shifts toward value-based care and holistically addressing consumers' needs, leaders should integrate community partnerships to achieve quality, cost, and experience imperatives.

Read more »