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Get advice on care management, chronic disease management, and care coordination.
Patients who are elderly, who have chronic or complex conditions, or who need specialty treatment for a one-time medical event will typically see multiple physicians. These patients may need laboratory tests, x-rays, and perhaps even stays in a healthcare facility. Coordinating this care for the highest quality outcomes for the patient requires collaboration among the healthcare providers.
Waiting for phone calls or faxes can be time-consuming and possibly even dangerous for the patient’s condition. When care is not collaborated, errors of omission or duplication can also be dangerous for the patient. Collaborating in real-time can not only save time and money but can also significantly improve the outcome for the patient.
For those patients with chronic diseases, in particular, treatment “involves changing lifestyles and navigating a complex web of treatments. Different health care professionals with different skills in different locations will need to collaborate to provide a cohesive care team.”
Electronic health records (EHRs) can play a pivotal role in facilitating that collaboration among the multiple healthcare providers treating a patient. Physicians who have access to a patient’s EHR can immediately review the patient’s medical history, lab results, and other relevant information.
Elation’s Collaborative Health Record (CHR) closes the care gaps for multiple healthcare providers treating the same patient. The CHR decreases duplicative testing and enables providers to avoid medication errors with uninterrupted communication. The timely sharing of patient information helps ensure that care is as efficient as effective as possible.
Providers can automatically share updates directly from the Clinical EHR. Other providers are immediately notified so they can take action based on the most up-to-date clinical information. In addition, each physician has visibility into the patient’s complete care record for more accurate reporting on clinical quality measures and compliance for value-based reimbursement.
With the CHR’s intuitive search bar, it is easy to make sure the problem list, medications, lab results, and notes are always kept current. Ensuring that medical information is up to date and accurate, using an EHR to collaborate, can dramatically improve the outcomes for the patient.
Prabhat Dhar May 22, 2018Read
Communication and engagement can help independent physicians overcome many of the challenges associated with bundled payment programs. The Centers for Medicare & Medicaid Services (CMS) has implemented two bundled payments, Bundled Payments for Care Improvement (BPCI – a voluntary bundled payment program) and Comprehensive Care for Joint Replacement (CJR – a mandatory bundled payment program). These programs are part of the CMS move toward value-based care and require physicians to more proactively plan and follow up on their patients’ care.
Rather than reward and reimburse independent physicians for the quantity of patient visits, which can also create fragmented plans that are not coordinated between providers, CMS is moving toward a focus on the quality of a patient’s total care. Towards this end, “bundled payments can align incentives for providers – hospitals, post-acute care providers, physicians, and other practitioners – allowing them to work closely together across all specialties and settings.”
Many independent physicians have expressed their concerns about how to make the bundled payment programs work for their practices. The key is engaging patients, which has the added benefit of improved outcomes for the patient, and maintaining communication with the patient and other providers during the entire care episode.
Proactively and creatively engaging with the patient throughout the care process can help the independent physician plan for the patient’s needs more effectively and more efficiently. Using technology such as electronic health records (EHRs) can also assist the physician in understanding the patient’s complete medical history, coordinating with other physicians and healthcare facilities treating that patient, and communicating with the patient before and after visits.
As a recent MedCity News article points out, “there are countless interaction points where providers can engage patients in their own care to lower costs, improve outcomes, and enhance experiences.” Patient engagement is the key for independent physicians’ success with the bundled payment programs.
Prabhat Dhar May 14, 2018Read
The core premise of Accountable Care Organizations (ACOs) is to “assign responsibility for a population of patients to health care providers, with payments depending on the cost and quality outcomes for that population,” as described by Managed Care. Participating in an ACO is voluntary for providers; however, the Centers for Medicare & Medicaid Services (CMS) has identified savings programs in which ACOs can share.
An ACO is formed by a group of independent providers. The ACO may find, though, that it needs to find new partners to fill a gap in medical service capabilities. When building partnerships with independent physicians, an ACO should consider a number of factors. While ACOs offer incentives for quality healthcare, they must “recognize the needs of their assigned populations and work to provide comprehensive care management across the spectrum of provider types.”
Recent research published in Managed Care suggests that “ACOs need a framework for evaluating potential partners that will help risk-bearing providers establish the partnerships that will enable them to achieve their goals.” That framework includes seven “high-value” elements to look for in potential partners:
The research involved interviews with ACO representatives as well as entities representing several different types of healthcare providers. Additionally, an expert panel was convened to “evaluate the framework and help prioritize provider types to evaluate.”
Managing care appropriately and in line with the move toward value-based care requires coordination across providers of different types and specialties. An ACO that can build effective partnerships with independent physicians based on the framework identified in the research “may allow providers to expand their influence throughout the delivery system as they begin to work across locations and episodes of care to manage population health.”
Prabhat Dhar April 11, 2018Read
The Centers for Medicare & Medicaid Services (CMS) defines Accountable Care Organizations (ACOs) as “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.” The goal of an ACO is to coordinate care, “avoiding unnecessary duplication of services and preventing medical errors.”
There are currently 171 physicians-only groups that make up 30% of the total ACOs. That number has increased from 134 in 2016. Physicians have also joined with hospitals and other facilities to form 324 ACOs, or 58% of the total.
The American Medical Association (AMA) reports that “Of the 432 MSSP ACOs operating in 2016, 31 percent generated shared savings with 45 percent of physician-only ACOs generating shared-savings, compared to only 23 percent of the 226 hospital-based ACOs.” In addition, CMS has launched a new Advanced Alternative Payment Model (APM) for physicians, which “limits downside risk for participating practices while also allowing them to collect a lump-sum bonus previously available only to those who assumed more risk.”
AMA also notes that “Physician-only accountable care organizations (ACO) … have significant flexibility to contract with allied providers to build the ACO’s network as a new enterprise.” The association points out some key takeaways regarding physician-only ACOs, including:
Physician-only ACO numbers are on the rise, as independent physicians participating in ACOs are realizing greater benefits in terms of shared savings, improved quality of care, and lower costs.
Prabhat Dhar March 29, 2018Read
Since the expansion of our blogs almost a year ago, we’ve been constantly looking for ways to continue to keep independent physicians and the healthcare community at-large informed and in the know about some of the most impactful areas of healthcare.
With care management being a growing area of interest among physicians and healthcare administrators, we’re excited to launch a blog solely focused on bringing information to you that can help reduce care gaps and improve care coordination.
From chronic disease management to independent physician associations (IPAs), and even accountable care organizations (ACOs), we’re dedicated to posting timely and relevant information to empower care managers at all levels to administer high-quality, coordinated care.
Nick Dealtry March 14, 2018Read