Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Care Coordination

Team-Based Care for Kidney Disease Saves Park Nicollet $1.2M

January 25, 2018 - End-stage renal disease comes with a hefty price tag for both patients and providers. But Park Nicollet Health Services, an integrated care system in Minnesota, found that a team-based care approach to late-stage kidney disease helped to drastically drop the costs of care by $1.2 million. Costs of care quickly add up with end-stage renal disease patients, explained Gena Graves, Senior...These patients with late-stage kidney disease are also typically already sick to begin with, suffering from conditions such as long-standing hypertension, uncontrolled diabetes, or other medical diseases that result in kidney function deterioration and additional costs, added Rajeev Kaul, MD, Department Chair of Nephrology at Park Nicollet. High blood pressure and diabetes are the...“Our team works with these companies and tries to get patients situated, especially patients who are already on dialysis and came to the emergency department for some ailment, but don't necessarily need to be admitted to the hospital,” he said. “We are getting the process in place so that these dialysis patients can be sent back to their outpatient dialysis...


More Articles

How Mercy Improved Care Transitions for Risk-Based Care Success

by Jacqueline LaPointe

For the thousands of patients released from their 23 acute care hospitals a year, Mercy Health ensures that each patient receives the highest value care. But there is only so much providers can do within the walls of their health system to ...

Care Coordination, Community Health Workers Reduce ED Costs, Use

by Jacqueline LaPointe

Average direct emergency department costs dropped 15 percent for frequent emergency department users after Brigham and Women’s hospital implemented a care coordination program using community health workers, according to a recent stud...

Limited Healthcare Payment Incentives Challenge Care Management

by Jacqueline LaPointe

Misaligned healthcare payment incentives topped the list of challenges providers and payers faced when implementing effective care management programs under Medicare Advantage plans with capitated payments, a recent Robert Graham Center for...Additionally, healthcare stakeholders should keep in mind that the four successful care management models studied indicated that payer flexibility and provider empowerment were critical to effective programs. The models suggested that allow...

Patient Engagement Critical to Bundled Payment Model Success

by Jacqueline LaPointe

Under bundled payment models, healthcare providers take on the clinical and financial risk payers traditionally managed. But providers at OrthoCarolina found that patients also play a major role in improving care quality and decreasing heal...“The patients may be going to a hospital that they wouldn’t have initially thought that they were going go to,” he said. “It’s not the one in their backyard. We need them to go to one that’s 20 miles away...Beyond setting bundled payment model expectations, care navigators at OrthoCarolina also function as the single point-of-contact for patients throughout the care episode. “They attend the patient’s post-operative appointments in...He pointed out that OrthoCarolina recently joined Humana’s new round of orthopedic bundled payment models. The commercial payer expanded its program into North Carolina and Virginia to improve care quality and reduce healthcare costs ...

Health IT, Care Navigators Most Effective at Lowering Costs

by Jacqueline LaPointe

While countless strategies are out there for making care delivery more efficient, a recent Health Affairs study revealed that interventions that use health IT and community health workers realized the greatest cost savings. Researchers exam...Health IT implementation was the most common transformation among the 43 care delivery innovation projects studied. Of the five innovation components, health IT was the only one used in more than half of the innovation projects. Researchers...The cost effect of the interventions ranged from almost $1,000 in savings per beneficiary per quarter to $750 in financial losses per beneficiary per quarter. But most interventions fell in the $0 to $250 in cost savings group and the $0 to...

ACO Incentives, Coordination Improve Complex Pediatric Care

by Jacqueline LaPointe

Children with medical complexities, or children who require the highest level of service and support, are one of the most expensive pediatric patient populations. But provider collaboration and financial incentives through an accountable ca...Using a CMS Innovation Center grant to expand their ACO, however, Noritz and his team at Nationwide Children’s Hospital in Ohio developed a care delivery model to improve outcomes and reduce costs for some children with medical comple...In the December 2016 study in Pediatrics, Noritz and other program leaders attributed the program’s success to the financial incentives provided through an ACO model because the incentives promoted care coordination. Noritz elaborated...As part of their smarter healthcare culture, Nationwide Children’s also hired care coordinators for the duration of the initiative. Using the grant, Noritz and his team demonstrated to the hospital that care coordination eff...

HHS Sec. Burwell Shares Vision for Value-Based Care Future

by Jacqueline LaPointe

In a recent Health Affairs blog post, HHS Secretary Sylvia Mathews Burwell called for value-based care progress after the Obama administration ends through more alternative payment models, care delivery transformation, and health data acces...

Payment Reform Suggestions to Improve Complex Pediatric Care

by Jacqueline LaPointe

Payment reform for medically complex children is needed to support a more family- and patient-centered care delivery model that requires extensive care coordination and non-face-to-face services, a new study in Pediatrics indicated. Researc...

AMA Backs Team-Based Care Delivery, Value-Based Drug Pricing

by Jacqueline LaPointe

The American Medical Association (AMA) recently released updated organization-wide ethical guidelines that detailed how organizations can lower healthcare costs using team-based care delivery as well as how the industry can implement value-...

Group Calls for Dual-Eligible Claims Reimbursement Changes

by Jacqueline LaPointe

In a recent report, the Bipartisan Policy Center’s Health Project has urged federal officials to improve care delivery for dually eligible Medicaid and Medicare beneficiaries by revising claims reimbursement models to better align wit...

AMGA: Tie Medicare Reimbursement to Care Coordination Metrics

by Jacqueline LaPointe

According to two comment letters to CMS, the American Medical Group Association (AMGA) has urged the federal agency to better align Medicare reimbursements and value-based incentive payments to promote enhanced care coordination. The indust...

Team-Based Primary Care Cuts FFS Healthcare Revenue by 2.5%

by Jacqueline LaPointe

As healthcare providers continue to transition to value-based care, many hospitals and physician practices have focused on how to improve care coordination and team-based approaches to improve patient outcomes and boost their healthcare rev...

Post-Acute Care Can Help Accountable Care Organizations Save

by Clay Ackerly, MD

As the Center for Medicare and Medicaid Innovation (CMMI) continues to deploy new programs, evidence of the impact of existing models continues to trickle in. One consistent theme: the importance of, and opportunity presented by, improvemen...

Anthem Accountable Care Organizations Save $14.8 Million

by Catherine Sampson

Four medical groups participating in Anthem Blue Cross accountable care organization (ACO) arrangements were able to save a total of $14.8 million from 2013 to 2014 due to improved coordinated care efforts, according to an Anthem press rele...

X

Join 30,000 of your peers and get free access to all webcasts and exclusive content

Sign up for our free newsletter:

Our privacy policy

no, thanks

Continue to site...