The Role of Technology in Value Based Care & Patient Engagement
March 21, 2018
Agenda
Welcome and Overview • Claudia Ellison, Director Programs and Services, eHealth Initiative
Overview of Interview Results• Nekose Wills, Program & Communications Specialist
Discussion & Comments• Jeff Chester, Senior Vice President & Chief Revenue Officer, Availity• Taya Mohesier, Director of Health Policy & Product Development, HC3• Charlotte Hale, System Director Admission Services and Central Access, Cox
Health
Q&A
Speakers
Jeff Chester
Senior Vice President & Chief Revenue Officer,
Availity
Charlotte Hale
System Director Admission Services & Central Access,
Cox Health
Taya Mohesier
Director of Health Policy & Product
Development, H3C
Housekeeping Issues
• All participants are muted– To ask a question or make a comment, please submit via the Q&A feature and we will
address as many as possible after the presentations.
• Technical difficulties:– Use the chat box and we will respond as soon as possible
• Questions:– Use Q&A feature
• Today’s slides will be available for download on eHI’s Resource page www.ehidc.org/resources
Our Mission
eHealth Initiative's mission is to serve as the industry leader convening executives from multi-stakeholder groups to identify best practices to transform healthcare through use of technology and innovation. eHI conducts, research, education and advocacy activities to support the transformation of healthcare.
Multi-stakeholder Leaders in Every Sector of Healthcare
Convening Healthcare ExecutivesBest Practice Committees Identify & Disseminate SuccessStories
Value &
Reimbursement
Workflow for Providers
and Patients
Research & Identify Best Practices
Data Analytics
eHealth Resource Center AvailableWith Best Practices & Findings
Best Practice Committees contribute to the eHealth Resource
Center www.ehidc.org/resources which provides assistance,
education and information to organizations transforming
healthcare through the use of information, technology and
innovation. The Resource Center is a compilation of reports,
presentations, survey results, best practices and case studies
from the last16 years.
This webinar was made possible through the generosity and support of
The Role of Technology inValue-Based Care & Patient Engagement
Research Project – Executive Interviews
The impact of healthcare reimbursement polices on technology & revenue cycle
• How do policies, consumerism, and patient engagement strategies influence provider decisions around the acquisition and usage of technology, while also affecting revenue?
• October & November 2017
INTERVIEWEES
William Borden, MD Chief Quality & Population Health Officer, Associate Professor of Medicine & Health Policy
Chuck Christian Vice President of Technology
Gordon Edwards Chief Financial Officer
Jean Groves Chief Financial Officer
Keith Hepp Chief Financial Officer
Tom Lee, PhD Chief Executive Officer & Founder
Charles Macias, MD Chief Clinical Systems Integration Officer (Texas Children’s), Executive Director (EMSC), Associate Professor (Baylor)
Shawntea (Taya) Moheiser Director of Health Policy & Product Development
Mark Norby Vice President of Revenue Cycle
Albert Oriol Chief Information Officer
Dhruv Sikka LeHigh Valley Health Network
Michael Sims Chief Financial Officer
Interview Topics - Technology
VALUE-BASED CARE TRENDS AND THE IMPACT OF TECHNOLOGY
• Value-based care affects how data is conceptualized, collected, and analyzed in their practices
• Data & analytics are a priority when deciding how to build onto, and beyond, their existing fee-for-service platforms
• EHRs with built in population health analytic tools (close care gaps, identify populations)
• Tools that help with data for MIPS, APMs, CMMI, MACRA, and CPC+ programs
• There is no roadmap when moving from volume- to value-based care
ADOPTION OF TECHNOLOGY
• Tools to track and manage patient flow and admissions
• Tools specific to acute care
• Tools that document outcomes and free up provider time
• Tools that improve existing EHRs are important to providers
Interview Topics - Technology
TECHNOLOGY: IN-HOUSE, OUTSOURCED, CONSOLIDATED
• EHRs, the biggest factor in this decision and boiled down to preference
• Integration & Collaboration – when EPIC dominated in one region providers worked together
• Nothing must remain in house (1/3 of interviewees)
• Any solutions providing the greatest patient experience, with the lowest cost, and most amount of accuracy should be explored
CURRENT TECHNOLOGY USE
• Patient portals, doctor portals, EHRs, mobile health software, clinical data exchange portals, HL7 messages, population health tools, predictive analytics, PDMP, patient reminders
TOP TECHNOLOGIES IN THE NEXT 12-18 MONTHS
• Predictive analytics
• Document & Patient management
• Genomics
Interview Topics
IMPACT OF CONSOLIDATION
• Provider (more than half ) & Vendor consolidation
CONSUMERISM & EXAMPLES OF PATIENT ENGAGEMENT
• The move towards value-based care has prompted providers to leverage a variety of customer-centered technology- patients want engagement on their own terms
• Examples• Hospital Home / E-visits• Online scheduling, Book Now” through social media, evening & weekend appointments• Surveys and questionnaires
Consumers are shopping for health services and are interested in convenience and cost
Interview Topics
PRE-SERVICE INNOVATIONS—WHAT IS MISSING?
• Standardization
• Solutions that meet the needs of providers and payers
• Prior authorization & Referral Management
• Tools to help patients share clinical data
• Price transparency
• WHAT DO BOARDS, PATIENTS, & INTERVIEWEES WANT?
Board of
Directors and
CEOs want
organizational
progress with
fiscal security
and their
strategic plans.
“America has
the most
expensive
health system
in the world
because there
are so many
layers of
overhead that
require
constant
tweaking.”
--Interviewee
Jeff Chester
Senior Vice President & Chief Revenue Officer, Availity
HCSC becomes
third owner
Provider and Health
Plan Portfolios
Intelligent Gateway
Provider Engagement
Network
Anthem becomes
fourth owner
BCBS Minnesota
becomes fifth owner
Acquisition of
RevPoint
Acquisition of
Health-e-Web
Launch of Provider
Data Management
Launch of Revenue
Program Management
Availity becomes Optum’s
exclusive clearinghouse
partner, implements Advanced
Claims Editor
Anthem’s central
region portal
migrated
Deployment of
Availity clinical
services
Acquisition of
RealMed
Availity reaches
500M annual
transactions
Availity
founded
by Florida
Blue and
Humana
Availity
becomes
gateway for
Florida Blue
and Humana
Acquisition of
FORE Support
Services
Completion of
Anthem/Amerigroup
Migration
Availity HistoryFrancisco Partners joins
Availity as a minority investor
Anthem signs exclusive
gateway agreement with
Availity
Siz
e o
f Ne
two
rk
© 2018 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.17
Taya Mohesier
Director of Health Policy & Product Development, HC3
What we do: Supporting VB Care Delivery
Supporting VBC
Varying Service Support
Advisory Services
Industry Education
Adaptive Processes
Licensed Clinical Staff
Experienced SMEs
Service Delivery Options:Full Support & StaffA-la-Carte ServicesTemporary to In-House
Including: VB Program Compliance, In-house setup, Performance Projections, etc.
All of our staff (RNs, LPNs, CNAs, etc) are licensed in the state where the patient resides
Our experienced SMEs have worked with global and national organizations, including CMS, MGMA, HIMSS, VA, Microsoft, GMAC, Bank of America and provide guidance, strategy, and compliance throughout our organization
By EHR. By Clinic. By Provider.
Chronic Care Management
(CCM)
Annual Wellness Visit (AWV) Support
Transitional Care Management (TCM)
Care Gap Closure Support Services
General Patient Engagement
Management Advisory Services
How we do it: Integration of Data Services
Clinical
Other
Claims
EHR, HIE, Ancillary
CMS, Commercial, TPA
Demographics, Social, Biometric, etc.
ETL
EDW
Risk Stratification
Cohort Builder
Quality Measures
Workflow Automation
Patient Attribution
Care Management
Patient Engagement
Analytics
• Automated outreach• Text, E-mail, and/or IVR• On-demand outreach via CM• Psychographic profiling• Engagement analytics
Licensed, dedicated clinical staff (RNs, LPNs,
CNAs)
Additional Tools:The Johns Hopkins ACG ModelSchmitt-Thompson Triage ProtocolsMedline Plus Patient EducationHCC Coding & RAF Scoring
Charlotte Hale
System Director Admission Services and Central Access, Cox Health
1906 – from humble beginnings to an industry leading healthcare system
• MISSION
• “To improve the health of the communities we serve through quality healthcare, education and research.”
• VISION
• To be the best for those who need us.
• VALUES
• Safety, Compassion, Respect, Integrity
23
CoxHealth Facts• A community-based, not-for-profit health system, CoxHealth is headquartered
in Springfield, Mo. It has been recognized with 28 number one ratings from CareChex, a division of Comparion Medical Analytics, and is nationally accredited by DNV GL - Healthcare.
• Established in 1906, the organization serves more than 900,000 people in a 24-county service area in southwest Missouri and northwest Arkansas, offering a comprehensive array of primary and specialty care including five hospitals and more than 80 clinics in 25 communities.
• The health system includes Cox Medical Center South, Cox Medical Center Branson, Cox North Hospital, Meyer Orthopedic and Rehabilitation Hospital, Cox Monett Hospital, Oxford HealthCare, Home Parenteral Services (home infusion therapy), CoxHealth Foundation, Cox College, Cox HealthPlans, Barton County Hospital and more.
•
Cox Health Facts
Staff
• 10,789 employees with 600+ staff physicians
Volunteers
• 1,672 volunteers are members of Cox Auxiliaries with 235,359 volunteer hours
Beds
987 licensed beds
Services
• 958,736 clinic visits
• 200,558 days of care
• 237,755 emergency, urgent care and trauma visits
• 34,499 surgeries
• 4,373 babies born
• 36,248 ambulance services
Q&A
Jeff Chester
Senior Vice President & Chief Revenue Officer,
Availity
Charlotte Hale
System Director Admission Services & Central Access,
Cox Health
Taya Mohesier
Director of Health Policy & Product
Development, H3C
This webinar was made possible through the generosity and support of