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[edifecs]

5 Advantages of the New Quality Scaffolding On average, health plans calculate and report over 320 unique quality metrics to comply with government programs and commercial contracts. Larger ACOs and INDs have a slightly smaller load: 100+ measures – but with MACRA, this will increase! https://www.edifecs.com/e/5-advantages-new-quality-scaffolding/

5 Advantages of the New Quality Scaffolding

On average, health plans calculate and report over 320 unique quality metrics to comply with government programs and commercial contracts. Larger ACOs and INDs have a slightly smaller load: 100+ measures – but with MACRA, this will increase!

#AdministrativeSimplification, #Clinical, #TransactionManagement, #ValueBasedCare

[edifecs]

#NHIT: Interoperability is not just for IT This hope is based on a dream, a dream planting the seeds of health and wellness earlier in life. I imagine every system that contributes to the growth and development of a child is synergized –at home, in daycare, doctor visits, the music class, soccer camp and onto school, individual therapies and the specialist visits. The system should include all caregivers the parents and relatives, nanny, kindergarten teacher, school, primary physician and the health specialist and soccer coach. https://www.edifecs.com/e/nhit-interoperability-not-just/

#NHIT: Interoperability is not just for IT

This hope is based on a dream, a dream planting the seeds of health and wellness earlier in life. I imagine every system that contributes to the growth and development of a child is synergized –at home, in daycare, doctor visits, the music class, soccer camp and onto school, individual therapies and the specialist visits. The system should include all caregivers the parents and relatives, nanny, kindergarten teacher, school, primary physician and the health specialist and soccer coach.

#AdministrativeSimplification, #Interoperability, #NHITWeek2016

[edifecs]

National HIT Week: Personal Story for HIT During a visit to the primary ER, we were also shocked to learn that they did not have access my mother’s records since we had accessed them online. I ended up handing the attending doctor my iPad to see my mother’s charts. This saved us not only time in the ER, costly and repetitive tests, but helped the ER doctor explain to my mother her situation in the most professional and direct way possible. https://www.edifecs.com/e/national-hit-week-personal-story-hit/

National HIT Week: Personal Story for HIT

During a visit to the primary ER, we were also shocked to learn that they did not have access my mother’s records since we had accessed them online. I ended up handing the attending doctor my iPad to see my mother’s charts. This saved us not only time in the ER, costly and repetitive tests, but helped the ER doctor explain to my mother her situation in the most professional and direct way possible.

#Collaboration, #EHR, #NHITWeek2016

[edifecs]

#NHIT: Expanding the Opportunity – it’s personal Our mission: we want tomorrow’s leaders, our daughters and nieces and friends, to understand that what they can achieve is limitless… to pursue careers as business and IT leaders. We invited female leaders to raise their voices and share their stories so young women and girls raise their expectations for themselves by seeing all you do. https://www.edifecs.com/e/nhit-expanding-opportunity-personal/

#NHIT: Expanding the Opportunity – it’s personal

Our mission: we want tomorrow’s leaders, our daughters and nieces and friends, to understand that what they can achieve is limitless… to pursue careers as business and IT leaders. We invited female leaders to raise their voices and share their stories so young women and girls raise their expectations for themselves by seeing all you do.

#NHITWeek2016

[edifecs]

#NHITWeek here at Edifecs We believe HIT is tremendously important, but you can never lose sight of the patients and families that it impacts. That is why we are sharing our personal stories this week. https://www.edifecs.com/e/nhitweek-here-at-edifecs/

#NHITWeek here at Edifecs

We believe HIT is tremendously important, but you can never lose sight of the patients and families that it impacts. That is why we are sharing our personal stories this week.

#NHITWeek2016

[edifecs]

Why do hospital billing systems fall short of supporting payment programs like CJR? To succeed under CJR, hospitals need to start by understanding their historical cost and quality performance for all of their Medicare hip and knee replacements. Hospitals use the Episodes of Care Module to import historical payment data from CMS and perform a detailed analysis of cost drivers both within and outside of the hospital, with post-acute providers. In the following video Fred Guthrie – Architect of Population Payment Management Episodes of Care Module product explains the solution to solving this IT challenge providers face to manage new orthopedic bundled payments requirements. https://www.edifecs.com/e/hospital-billing-systems-fall-short-supporting-payment-programs-like-cjr/

Why do hospital billing systems fall short of supporting payment programs like CJR?

To succeed under CJR, hospitals need to start by understanding their historical cost and quality performance for all of their Medicare hip and knee replacements. Hospitals use the Episodes of Care Module to import historical payment data from CMS and perform a detailed analysis of cost drivers both within and outside of the hospital, with post-acute providers. In the following video Fred Guthrie – Architect of Population Payment Management Episodes of Care Module product explains the solution to solving this IT challenge providers face to manage new orthopedic bundled payments requirements.

#BundledPayments, #CCJRSolution, #Clinical

[edifecs]

Analytics Are Key to Transition to Value-Based Care Payers and providers alike are developing new analytical capabilities and new workflows to improve their management, measurement, and delivery of value. During the last few years, much of the analytics development has been focused on care delivery transformation, in the form of population health management, new models of care and disease management, and the adoption of value considerations into electronic medical record (EMR) workflows. https://www.edifecs.com/e/analytics-key-successful-value-based-care-transition/

Analytics Are Key to Transition to Value-Based Care

Payers and providers alike are developing new analytical capabilities and new workflows to improve their management, measurement, and delivery of value. During the last few years, much of the analytics development has been focused on care delivery transformation, in the form of population health management, new models of care and disease management, and the adoption of value considerations into electronic medical record (EMR) workflows.

#RevenueManagement, #ValueBasedCare

[edifecs]

Creating Marketplace 2.0 Success Blueprint By now, the 2016 CMS Risk Adjustment and Reinsurance report has been published and we are all painfully aware of the “winner” and “losers” (those health plans who paid into the program and those who received payments). And with that, two of the 3Rs (risk corridors and reinsurance) have run their course, leaving risk adjustment as the only risk stabilizing mechanism operating in 2017 and beyond. https://www.edifecs.com/e/creating-marketplace-2-0-success-blueprint/

Creating Marketplace 2.0 Success Blueprint

By now, the 2016 CMS Risk Adjustment and Reinsurance report has been published and we are all painfully aware of the “winner” and “losers” (those health plans who paid into the program and those who received payments). And with that, two of the 3Rs (risk corridors and reinsurance) have run their course, leaving risk adjustment as the only risk stabilizing mechanism operating in 2017 and beyond.

#Consumer, #EnrollmentManagement, #Financial, #RevenueManagement, #RiskAdjustment

[edifecs]

Comment Letter: Proposed MACRA Rule MACRA will require eligible clinicians to submit data and performance measurement for MIPS. All of these areas should be developed by CMS with a view toward improving the data movement industrywide through clinical and performance transactions. Edifecs strongly supports the creation of a computer adaptive quality measure portfolio and believes measures should be an area of significant focus in the final rule, including portability. https://www.edifecs.com/e/comment-letter-proposed-macra-rule/

Comment Letter: Proposed MACRA Rule

MACRA will require eligible clinicians to submit data and performance measurement for MIPS. All of these areas should be developed by CMS with a view toward improving the data movement industrywide through clinical and performance transactions. Edifecs strongly supports the creation of a computer adaptive quality measure portfolio and believes measures should be an area of significant focus in the final rule, including portability.

#Financial, #Interoperability, #RevenueManagement

[edifecs]

Top HCI 100 for the 7th consecutive year Edifecs has been named to the HCI 100. Every year Healthcare Informatics ranks the 100 vendors with the highest revenues derived from healthcare IT products and services earned in the U.S. based on revenue information from the previous year. https://www.edifecs.com/e/lucky-number-seven/

Top HCI 100 for the 7th consecutive year

Edifecs has been named to the HCI 100. Every year Healthcare Informatics ranks the 100 vendors with the highest revenues derived from healthcare IT products and services earned in the U.S. based on revenue information from the previous year.

#Corporate, #EdifecsNews

[edifecs]

Would you use an abacus to do your taxes? The advent of the Marketplaces/Exchanges and sizable membership growth in both Medicare Advantage and managed Medicaid translates into greater market opportunities for health plans… along with increased levels of risk. And when you take into account the pace of change in the industry with regards to formats and rules (such as the RAPS to EDPS transition), the choice becomes clear- upgrade your encounter management system and processes or suffer the financial consequences. https://www.edifecs.com/e/use-abacus-taxes/

Would you use an abacus to do your taxes?

The advent of the Marketplaces/Exchanges and sizable membership growth in both Medicare Advantage and managed Medicaid translates into greater market opportunities for health plans… along with increased levels of risk. And when you take into account the pace of change in the industry with regards to formats and rules (such as the RAPS to EDPS transition), the choice becomes clear- upgrade your encounter management system and processes or suffer the financial consequences.

#Consumer, #EncounterManagment, #Financial, #ImpactAnalytics, #RevenueManagement, #RiskAdjustment, #ValueBasedCare

[edifecs]

How to ensure RAPS and EDPS Submissions become a key to revenue success The first and foremost action…understanding the real challenges of the RAPS to EDPS transition. In conjunction, MAOs but be able to quantify the impact of the less obvious impacts such as the ICD-10 transition on HCC scores as well as the cost of not having prioritized exception management capabilities. https://www.edifecs.com/e/ensure-raps-edps-submissions-become-key-revenue-success/

How to ensure RAPS and EDPS Submissions become a key to revenue success

The first and foremost action…understanding the real challenges of the RAPS to EDPS transition. In conjunction, MAOs but be able to quantify the impact of the less obvious impacts such as the ICD-10 transition on HCC scores as well as the cost of not having prioritized exception management capabilities.

#Financial, #RevenueManagement, #ValueBasedCare

[edifecs]

The Power Lighting the Blue Button on FHIR One of the major success factor for FHIR has been, the diversity of the FHIR community where co-learning and exchange of experience happens helping to solve challenges more efficiently and effectively. This “idea cross-pollination” platform was a two day Code-a-Thon event held in Washington DC on April 1st and 2nd, 2016. https://www.edifecs.com/e/empowering-health-care-engagement/

The Power Lighting the Blue Button on FHIR

One of the major success factor for FHIR has been, the diversity of the FHIR community where co-learning and exchange of experience happens helping to solve challenges more efficiently and effectively. This “idea cross-pollination” platform was a two day Code-a-Thon event held in Washington DC on April 1st and 2nd, 2016.

#CollabLynk, #Collaboration, #EDI, #Interoperability, #Trading

[edifecs]

Preventing a fall through the gap: Technology and Population Health Management It depends on the organization’s goals for population health management, an understanding of stakeholders’ functions and how care delivery is changing, and an assessment of the existing systems in place. Most likely one solution will not meet the needs of the entire strategy. A multi-faceted approach is necessary for value based care delivery with data and technology supporting it. https://www.edifecs.com/e/preventing-fall-gap-technology-population-health-management/

Preventing a fall through the gap: Technology and Population Health Management

It depends on the organization’s goals for population health management, an understanding of stakeholders’ functions and how care delivery is changing, and an assessment of the existing systems in place. Most likely one solution will not meet the needs of the entire strategy. A multi-faceted approach is necessary for value based care delivery with data and technology supporting it.

#Financial, #PopulationHealth, #ValueBasedCare

[edifecs]

A Retrospective: HIMSS16 Round-Up Sad fact that we need an entire industry of hyper-vigilant cybersecurity and ransomware – Having my identify stolen 7 times in the past year (three times through healthcare company breaches), I appreciate the significant advances in combining an intricate mix of technology, skill sets and big data to tackle hackers, medical information pirates and identity thieves. https://www.edifecs.com/e/retrospective-himss16-round/

A Retrospective: HIMSS16 Round-Up

Sad fact that we need an entire industry of hyper-vigilant cybersecurity and ransomware – Having my identify stolen 7 times in the past year (three times through healthcare company breaches), I appreciate the significant advances in combining an intricate mix of technology, skill sets and big data to tackle hackers, medical information pirates and identity thieves.

#AdministrativeSimplification, #Interoperability, #PopulationHealth, #PopulationPayment

[edifecs]

7 Strategic Steps for Success under the Comprehensive Care Joint Replacement Program It is clear that a hospital’s biggest customer is changing the rules. Executives should note the other great power of CMMI – they have the authority to unilaterally change any part of the traditional Medicare payment system with a stroke of a pen and no action by Congress. While the following points will apply generally to any payment reform initiative, the following strategies are suggested here in the context of CJR. https://www.edifecs.com/e/7-strategic-steps-for-success-under-the-comprehensive-care-joint-replacement-program/

7 Strategic Steps for Success under the Comprehensive Care Joint Replacement Program

It is clear that a hospital’s biggest customer is changing the rules. Executives should note the other great power of CMMI – they have the authority to unilaterally change any part of the traditional Medicare payment system with a stroke of a pen and no action by Congress. While the following points will apply generally to any payment reform initiative, the following strategies are suggested here in the context of CJR.

#BundledPayments, #CCJRSolution, #Clinical, #Financial, #ValueBasedCare

[edifecs]

What is the recipe for Value-based Care Success? Three crucial ingredients include, understanding health care data integration and its role in enabling a holistic view of patients across population health programs. Clear uses cases highlighting the need for data exchange and monitoring patients in the context of value-based care and population health management. https://www.edifecs.com/e/recipe-value-based-care-success/

What is the recipe for Value-based Care Success?

Three crucial ingredients include, understanding health care data integration and its role in enabling a holistic view of patients across population health programs. Clear uses cases highlighting the need for data exchange and monitoring patients in the context of value-based care and population health management.

#Financial, #PopulationHealth, #PopulationPayment, #ValueBasedCare