HealthEC reported last month that we helped our Accountable Care Organization (ACO) clients achieve $21.4 million in Medicare Shared Savings Program (MSSP) savings and receive reimbursements totaling more than $9.5 million for the 2017 performance year.
Just like the innovative venture announced earlier this year between Amazon.com, Berkshire Hathaway and JPMorgan Chase, the developing relationship between Medicaid, Artificial Intelligence and Data Analytics has the potential to spur dynamic change in the healthcare industry.
Medicaid is neck deep in the opioid epidemic – covering 4 in 10 non-elderly adults with opioid addiction – and well aware of the critical need to explore technology solutions to address the crisis. Solutions that incorporate 21st century innovations like Big Data analytics and Artificial Intelligence are showing incredible promise, and with the crisis accelerating, now is the time to start implementing them across the board.
Ahead of the 2018 Medicaid Enterprise Systems Conference next month in Portland, Oregon, we’re circling back to Washington D.C. Specifically, the District’s state Medicaid agency, the Department of Health Care Finance, and the District of Columbia Primary Care Association, a non-profit organization serving 200,000 residents through nine Federally Qualified Health Centers and community health centers at more than 50 care delivery sites.
From improving patient communication and self-management skills to boosting preventive services, CMS’s Chronic Care Management Program has proven to be a tremendously successful platform for providers. In many instances, however, the clinical and financial benefits have not been fully realized.
To counter the opioid crisis, holistic solutions that rely on technology, intervention and education, and account for social determinants of health, must be prioritized. Population health management platforms and artificial intelligence can analyze enormous amounts of data and play a vital role in addressing this epidemic.
More than nine in 10 physicians say that pre-authorization programs have a negative impact on patient outcomes, according to a recent survey by the American Medical Association. Imagine the efficiencies that could be achieved if these manual workflows were replaced with automatic approvals that relied on artificial intelligence solutions.
Think about how a child acts when he really wants ice cream.If he asks his mother and she says no, it's entirely possible that the child will do what millions of other kids have done for generations – seek out the father and make the same request. Only this time banking on a less-informed dad approving it, and not conferring with mom.Patients seeking opioids are likely to follow a similar path of the child. That is, make an additional "ask" until the need is met.
About 30 years ago the World Wide Web was developed. About 15 years ago researchers cracked the human genome. About 10 years ago the first iPhone was rolled out. Yet, in the year 2018 at the height of the digital age, why is it so difficult to visualize a scenario where every single patient’s primary care physician (PCP) is notified once they are admitted to the emergency room?
Predictive analytics are all around us. And as the digital age progresses, using data to forecast outcomes will be used even more across the industrial landscape, including healthcare.
But, how do you look at healthcare data to predict future clinical outcomes?
When asked about provider acceptance of population health management initiatives, the leaders charged with implementing these programs are apt to say that most physicians see them as little more than an unnecessarily complex administrative endeavor instead of a tectonic shift in how health care will be delivered over the next several decades.
Implementing a value-based care model and increasing physician awareness of high-risk, high-cost patients is just like beginning a new diet and exercise program – that is, starting is the hardest part.
By acting as an intermediary between patients and providers, care coordinators play a vital role in the delivery of healthcare. And just like diplomats translating the comments of global leaders, care coordinators translating the languages of "doctor speak" and "insurance speak" can have a significant impact – maybe not on global affairs, but certainly on patient health and the cost of care.
Recognizing value-based models as the future direction of health care, Alliance Cancer Specialists began a population health management (PHM) journey in 2016.
In the spirit of the winter Olympic Games, where hard work and dedication can lead to a gold medal, let’s take a closer look at MIPS quality calculations, as these same traits can optimize a provider’s bonus for Performance Year 2018.
As health care providers adjust to value-based care models, it would be wise to incorporate the lesson from The Hare and the Tortoise – slow and steady wins the race.
Artificial intelligence within the healthcare IT space is gaining momentum. And while its applications may not align directly with popular consumer solutions like Amazon's Alexa that can play music or order pizza on command, health care-based AI will be capable of doing other really cool things in the not-too-distant future - like saving your life.
With the March 31, 2018 MIPS reporting deadline for Performance Year 2017 fast-approaching, some providers might be feeling a similar type of stomach-turning anxiety that affected them years ago – exam stress.
Running a consumer-facing business in today’s world can be difficult. In addition to overseeing day-to-day operations, keeping up with technology, and staying compliant with applicable regulations, business owners must have a handle on reputation management.
In the May 5, 2017 Healthcare Financial Management blog post, I discussed strategies to tackle the two-pronged challenge in acclimating to the new value-based payment models -- achieving better outcomes while reining in costs.