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  • messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a high ROI in speed to payment patient satisfaction and portal adoption for meaningful use HFMA Business Profiles Somnia Bending the Healthcare Cost Curve Toward Improved Anesthesia Value Somnia President and CEO Marc Koch MD MBA explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes HFMA RESOURCE LIBRARY Large Health System Drives 10 UP Patient Payments and 10 DOWN Billing related Costs Faced with a rising tide of bad debt a large Southeastern healthcare system was seeing a sharp decline in net patient revenues The need to improve collections was dire By integrating critical tools and processes the health system was able to increase online payments and improve its financial position Taking a holistic approach increased overall collection yield by 10 while costs came down because the number of statements sent to patients fell by 10 which equated to a 1 3M annualized improvement in patient cash over a six month period This case study explains how HFMA Business Profiles PMMC Navigating Revenue Cycle Management Challenges as Value Based Purchasing Emerges PMMC President Roger L Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC s products help clients adapt to a changing financial environment HFMA RESOURCE LIBRARY ICD 10 Managing Performance With the ICD10 deadline quickly approaching and daily responsibilities not slowing

    Original URL path: http://www.hfma.org/Leadership/Infographics.aspx (2016-02-10)
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  • Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a high ROI in speed to payment patient satisfaction and portal adoption for meaningful use HFMA Business Profiles Somnia Bending the Healthcare Cost Curve Toward Improved Anesthesia Value Somnia President and CEO Marc Koch MD MBA explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes HFMA RESOURCE LIBRARY Large Health System Drives 10 UP Patient Payments and 10 DOWN Billing related Costs Faced with a rising tide of bad debt a large Southeastern healthcare system was seeing a sharp decline in net patient revenues The need to improve collections was dire By integrating critical tools and processes the health system was able to increase online payments and improve its financial position Taking a holistic approach increased overall collection yield by 10 while costs came down because the number of statements sent to patients fell by 10 which equated to a 1 3M annualized improvement in patient cash over a six month period This case study explains how HFMA Business Profiles PMMC Navigating Revenue Cycle Management Challenges as Value Based Purchasing Emerges PMMC President Roger L Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC s

    Original URL path: http://www.hfma.org/Leadership/Tools.aspx (2016-02-10)
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  • only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a high ROI in speed to payment patient satisfaction and portal adoption for meaningful use HFMA Business Profiles Somnia Bending the Healthcare Cost Curve Toward Improved Anesthesia Value Somnia President and CEO Marc Koch MD MBA explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes HFMA RESOURCE LIBRARY Large Health System Drives 10 UP Patient Payments and 10 DOWN Billing related Costs Faced with a rising tide of bad debt a large Southeastern healthcare system was seeing a sharp decline in net patient revenues The need to improve collections was dire By integrating critical tools and processes the health system was able to increase online payments and improve its financial position Taking a holistic approach increased overall collection yield by 10 while costs came down because the number of statements sent to patients fell by 10 which equated to a 1 3M annualized improvement in patient cash over a six month period This case study explains how HFMA Business Profiles PMMC Navigating Revenue Cycle Management Challenges as Value Based Purchasing Emerges PMMC President Roger L Shaul discusses the effects of healthcare reform on revenue cycle management and how PMMC s products help clients adapt to a changing financial environment HFMA RESOURCE LIBRARY ICD 10 Managing Performance With the ICD10 deadline quickly approaching and daily responsibilities not slowing down final preparations for October 1 require strategic prioritization and laser focus HFMA Business Profiles Burgess Simplify the Business of

    Original URL path: http://www.hfma.org/Leadership/Multimedia.aspx (2016-02-10)
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  • HFMA's Leadership E-Newsletter Sign-Up Form
    Name Title Organization E mail Back to HFMA s Leadership site ADVERTISEMENTS HFMA Business Profiles Aidin Better Manage Your Post Acute Provider Network and Improve Patient Outcomes Russ Graney founder and CEO for Aidin and John Laursen head of business development for Aidin share insights on how to improve care transitions between acute and post acute care settings and incentivize high quality patient outcomes GE Healthcare Delivering Sustainable Cost Reduction Scott Elston strategic accounts manager GE Healthcare Services describes how substantial cost reduction in health care requires rethinking business strategy and asset use Deloitte Solutions for Healthcare Transformation Robert Williams MD director Deloitte Consulting LLP and Arielle Freiberger product strategist ConvergeHEALTH by Deloitte explain how sophisticated retrospective real time and predictive data analytics can inform decision making to reduce costs and improve care Citi s Money 2 for Health Your All in One Healthcare Payment Solution Stuart Hanson director of business development healthcare solutions at Citi Retail Services discusses how improving the payment experience can benefit consumers and healthcare providers Readying Your Revenue Cycle Performance for Tomorrow Scott Schmidt vice president Cerner RevWorks LLC shares insights on best practices for maximizing a revenue cycle management partnership Most Read Most Shared

    Original URL path: https://www.hfma.org/Site/publications/subscribeleadership.cfm (2016-02-10)
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  • Patient Harm: Attaining & Sustaining Dramatic Improvements
    elimination of fall alarms or detectors attached to mattresses chair pads or clothing that emit a signal to alert nursing home staff when a patient is trying to get up and move around One study found no difference in fall rates at an urban hospital between nursing units that actively used alarms and those that did not calling into question the effectiveness of this common and pricey technology Shorr R I et al Effects of an Intervention to Increase Bed Alarm Use to Prevent Falls in Hospitalized Patients A Cluster Randomized Trial Annals of Internal Medicine 2012 vol 157 no 10 pp 692 699 The alarms can also agitate and distract patients Jorlett says Plus anecdotal reports suggest that nursing home residents may be inclined to move less contributing to muscle loss and frailty because they are afraid to set off the alarms and disturb roommates or staff Nursing Homes Find Bed Chair Alarms Do More Harm than Good The Boston Globe March 15 2015 Jorlett s staff replaced the alarms with hourly peace of mind rounds When looking in on all residents staff members assess four P s as defined by Nurses Improving Care for Healthsystem Elders Personal needs For example do residents need to go the bathroom Position Do they need to be turned get up in the chair return to bed Placement of personal items Do they have their tissues water glasses phone and call bell close at hand Pain Is their pain under control By administering to those needs frequently Minnesota Masonic staff proactively eliminate the necessity for a nursing home resident to get up and move unattended These rounds also help staff see the importance of building relationships with residents The better you know your residents Jorlett says the better able you are to anticipate their needs and the less likely they are to do dangerous things like self transferring and the more likely you are to prevent a fall Measuring performance Minnesota Masonic leaders also believe that falls have declined because the nursing home gives staff data on how well they are preventing falls Jorlett devised a formula to determine the fall rate for each nurse or nurses aide using the number of hours worked the shifts worked the number of residents he or she is responsible for and other factors The rate is reported annually to each staff member showing how he or she compares to peers We congratulate the nurses and aides who are on the top end praise those who are in the middle and encourage the ones who are on the other end to get better she says Once they got the fact that we were measuring they owned the responsibility more Spreading the responsibility However leaders at Minnesota Masonic have been careful to ensure that fall prevention is embraced as a priority for all staff and not only seen as a nursing responsibility That is why Jorlett the quality assurance coordinator reports directly to the nursing home administrator rather than the director of nursing In addition fall prevention by specific resident is discussed daily in interdepartmental team meetings and in weekly fall committee meetings on each unit Meanwhile housekeeping and maintenance staff are trained to alert nursing staff if they notice a patient who is trying to move or if they identify a possible fall hazard that needs to be remediated The nursing home s fall prevention work was initially supported by a three year grant from the state of Minnesota that tied the organization s progress in reducing falls to its Medicaid payments That created a laser like focus on falls prevention Our administrator wanted a report on how we were doing at every staff meeting she had daily weekly and monthly and she would say to everyone present Money is tied to this You will be doing this This is not optional If you re thinking that you can t prevent falls get on board because we are going to be preventing falls Jorlett says University of Vermont Medical Center A Culture of Safety When University of Vermont Medical Center UVMC standardized its central line insertion kits every clinician who conducts the procedure was required to be retrained in the simulation lab Anna Noonan RN vice president of UVMC s Jeffords Institute for Quality was thrilled to see highly experienced physicians acknowledge their shortcomings UVMC s Anna Noonan RN cites a culture of safety as key to the medical center s success in preventing approximately 150 infections over five years avoiding more than 5 million in related treatment costs Photo University of Vermont Medical Center It is very powerful when a senior physician turns to a junior physician and says Just so you know I was doing it incorrectly and here s how I ve learned to do it correctly she says That really helps spread the whole culture of safety Going for zero That culture of safety is behind UVMC s success at dramatically reducing infection rates and sustaining them for years Among its accomplishments No surgical site infections in knee replacements in the past four years A three year run of zero CLABSIs in the neonatal intensive care unit NICU and near zero rates in other ICUs Only 0 8 bloodstream infections associated with dialysis access per 100 patient months in its six outpatient dialysis clinics down from 4 8 infections per 100 patient months in 2008 Starting at the top UVMC s success has stemmed from the medical center s decision in 2008 to make the elimination of healthcare acquired infections an organizational priority One of the top success factors in Noonan s view is executive leadership support We got full commitment from our CEO that getting to zero infections was the right thing to do which meant building that into our strategic priorities she says We re an academic medical center so getting support from the departmental chairs and in turn the board of trustees was absolutely critical Combining infection prevention and quality The next most important factor moving infection prevention specialists into the Jeffords Institute for Quality which supports UVMC s goal of providing high value care Typically infection prevention is under the purview of epidemiology with a focus on surveillance rather than quality improvement Bringing infection prevention and performance improvement expertise into the same group prompted a major shift in our effectiveness Noonan says Infection prevention specialists shared their knowledge with quality improvement experts who in turn trained the infection prevention specialists in quality improvement methodologies The work started by identifying priorities to focus on After comparing the medical center s infection rates with benchmark data from the Centers for Disease Control and Prevention CDC and a consortium of academic medical centers UVMC identified five areas where it was lagging and needed to improve Total joint replacement surgical site infections Orthopedic spinal fusion surgical site infections Medical intensive care CLABSIs Neonatal intensive care CLABSIs Outpatient dialysis centers central line access related bloodstream infections Creating new workflows Multidisciplinary teams were formed for each priority area For example the total joint replacement team included orthopedic surgeons an epidemiologist a pharmacist an orthopedic inpatient nurse manager outpatient clinic staff perioperative services staff an orthopedic OR clinical specialist and an infection prevention specialist For each type of infection targeted the teams used Plan Do Study Act and other improvement methods tools to identify test and standardize new protocols To combat spinal fusion surgical site infections surgeons initiated a triple play pause for complex cases antibiotic redose glove change and wound irrigation every three hours Air quality is now monitored monthly and OR disinfection was improved among other things What s really critical is to make sure that the changes that you are trying to implement are built into the workflow so it makes it easy for people to do the right thing Noonan says For example one team determined that a lack of standardization was contributing to the bloodstream infection rate Clinicians were using more than 200 types of central line insertion kits Today only six types of kits are stocked and each is specific to a particular segment of the patient population In our organization it is impossible to order something else she says Creating a culture of safety UVMC was well positioned to push for getting to zero because staff have become accustomed to talking openly about patient safety problems For more than two decades the medical center has been focused on promoting a culture of quality and safety One example is the Good Catch award given to staff members who report something that could have caused patient harm Award recipients are heralded in internal publications and entered into a drawing for a cash reward That sends a message that we want you to catch defects and identify when something has not gone optimally Noonan says Additionally the medical center continually emphasizes the importance of improving patient safety performance At its annual Quality Forum in 2014 more than 100 projects were presented in storyboard format at an off site conference center When you walk around the room and look at all of these performance improvement projects it s clear that our organization has embraced a culture of quality and patient safety she says UVMC also holds its annual Quality Symposium featuring national and local experts who discuss topics such as high reliability organizations and innovation Calculating results UVMC leaders estimate their organization has prevented approximately 150 infections in the five focus areas over five years and avoided more than 5 million in related treatment costs The number of infections prevented was determined using the UVMC baseline rate along with the expected number of infections as calculated by the CDC s National Healthcare Safety Network The cost savings was calculated using the attributable cost figures identified in a recent study Zimlichman E et al Health Care Associated Infections A Meta analysis of Costs and Financial Impact on the U S Health Care System Journal of the American Medical Association Internal Medicine 2013 vol 173 no 22 pp 2039 46 Those results and others prompted the U S Department of Health and Human Services and two epidemiology societies to honor UVMC with the 2014 Partnership in Prevention Award for sustainable improvements in eliminating healthcare associated infections El Camino Hospital Reducing Pressure Ulcers Both CMS and the state of California require hospitals to report serious i e Stages 3 and 4 hospital acquired pressure ulcers as adverse events One study found that 4 5 percent of newly admitted Medicare patients developed a pressure ulcer while hospitalized These patients generally had longer lengths of stay 11 2 days compared to 4 8 days and a greater risk of readmission and death Lyder C H et al Hospital Acquired Pressure Ulcers Results from the National Medicare Patient Safety Monitoring System Study Journal of the American Geriatrics Society September 2012 vol 60 no 9 pp 1603 8 When 25 patients at El Camino Hospital suffered reportable pressure ulcers in 2011 it was time for emergency action Since then many interventions have contributed to the dramatic decrease in serious pressure ulcers at El Camino which has campuses in Mountain View and Los Gatos But the obvious key to its success is an unrelenting focus on fixing a fixable problem Huddling every day Every day all charge nurses meet to report on all pressure ulcers both hospital acquired and those present on admission And all hospital acquired pressure ulcers are reported at the daily enterprise huddle which includes the hospital s clinical managers and executives Skin is one of the things that nurses are completely responsible for It s not physician care it s nursing care says Chris Tarver RN nursing director of medical surgical services By talking about it every day we demonstrate our commitment that this is important Tarver headed the pressure ulcer rapid improvement team that kicked into action after the disturbing performance in 2011 The team identified the three most common types of serious pressure ulcers among El Camino patients coccyx or tailbone heel and mechanical device related Then it developed a three year plan to get to zero hospital acquired pressure ulcers The plan worked The number of reportable hospital acquired pressure ulcers decreased every year So far in the fiscal year that began July 1 2014 the hospital has had zero Getting to Zero Reportable Pressure Ulcers Implementing a range of interventions Tarver attributes the progress not to any single intervention but to the cumulative effect of many ranging from expensive and innovative technology to basic education For a few years we had Wound Care Wednesday during which I asked the nurses What s wrong with this picture to provide education about preventing pressure ulcers she says The first big victory came from an experiment to see if silicone dressings would reduce El Camino s single biggest pressure ulcer problem coccyx ulcers suffered by critical care patients We halted the study early because our results were so good she says Now we do proactive placement of silicone dressings on any patient who is at risk for coccyx breakdown In addition protocols were developed for proactive placement of silicone dressings for patients having back surgery and other medical situations that put them at high risk for pressure ulcers El Camino also found success with a wound therapy that delivers low frequency ultrasound energy through a saline mist The treatment which is applied three times per week for up to 20 minutes per treatment speeds healing and can help Stage 2 pressure ulcers from further deterioration In addition the hospital began using special fluid immersion beds originally developed for out of water transport of dolphins and seals that simulate the effects of a body floating in fluid Immobilized patients such as those awaiting surgery to repair broken hips are placed in the beds which reduce the likelihood of skin breakdown Plus the hospital introduced a new technology that helps ensure patients get turned on the appropriate schedule which helps prevent pressure ulcers from forming A wireless sensor attached to the patient s sternum tracks his or her position and movements The sensor communicates with a monitor at the nurse s station which is counting down the two hours between scheduled turns The monitor informs nurses when it is time to turn a patient and if the patient has turned without assistance In a test of the technology on a single unit El Camino found that turn compliance increased to 98 percent up from 64 percent before the sensor system was used If a patient has moved enough to make a difference in his or her position the two hour clock automatically starts over Tarver says It helps with patient satisfaction because we aren t waking patients up with It s time to turn when they have already turned themselves Chris Tarver RN nursing director of medical surgical services led El Camino s rapid improvement team that developed a three year plan for getting to zero reportable hospital acquired pressure ulcers Photo El Camino Hospital Preventing mild ulcers While the hospital appears to have found sustainable ways of reducing pressure ulcers Tarver is not ready to declare the problem is solved Now that serious pressure ulcers are under control she is turning her attention to prevention of mild to moderate Stages 1 and 2 pressure ulcers And that means discussing them at each daily huddle I fear that if we turn away something will slip she says This is too important until we get to zero at all stages Challenges to Overcome Some patient safety practices are so common and so ingrained in institutional operations that it is difficult to let them go even when evidence emerges that they are not effective For example when Minnesota Masonic joined a group of 16 nursing homes collaborating around fall prevention the members were presented with information against using fall alarms But Jorlett and others were slow to embrace the idea because it was so counter intuitive Not only were we resistant to that idea our staffs were very resistant she says After months of no progress the group set a deadline for eliminating alarms at all participating facilities That would be the only way this was really going to happen Don t talk about it anymore Just roll out a plan and do it she says Having the deadline prompted Minnesota Masonic staff to start hourly rounds which decreased the likelihood that patients would try to get up on their own Since 2010 the facility has been alarm free and falls have continued to decline Another patient safety challenge evaluating new products and equipment The field of wound care and dressings and ointments is so fast changing Tarver says Every time our nurses go to a conference they come back with 57 new things to try That statement is true for almost every aspect of patient safety And it can pose a dilemma for the health system s supply purchasers who need to stock as few items as possible and are always on the lookout for cost effectiveness Thus Tarver says patient safety advocates must engage materials management staff by including them on improvement teams and working with them to evaluate products and equipment Is Zero the Goal Many health systems say their goal is to eliminate patient harm but that may be setting an unrealistic bar That is the case with hospital acquired infections Clance says The idea that we can have zero healthcare acquired infections is misplaced because our patients are not sterile and we perforate them with devices she says Many infections can be reduced but the idea of zero is just not biologically plausible Noonan and Tarver would agree When UVMC started its getting to zero campaign leaders recognized that even if a certain type of infection were eliminated for a period of time sustaining that forever was unrealistic That said no patient or family member wants a healthcare team that considers a certain number of

    Original URL path: http://www.hfma.org/Leadership/Archives/2015/Spring/Patient_Harm__Attaining___Sustaining_Dramatic_Improvements/ (2016-02-10)
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  • Balancing Population Health with Individual Patient Needs
    to readmit says Hansen Karen Wagner is a freelance healthcare writer and member of HFMA s First Illinois chapter Quoted in this article Cynthia Barnard MBA MSJS CPHQ is vice president quality Northwestern Memorial HealthCare Chicago Luke Hansen MD MHS FACP is staff hospitalist and unit medical director hospital medicine Northwestern Memorial HealthCare Chicago Pradeep Sama is director analytics Northwestern Memorial HealthCare Chicago Comments Please login to add your comments Add Comment Text Only 2000 character limit ADVERTISEMENTS HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points

    Original URL path: http://www.hfma.org/Leadership/E-Bulletins/2015/July/Balancing_Population_Health_with_Individual_Patient_Needs/ (2016-02-10)
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  • Martin Health Pilots New Model to Coordinate Surgical Care
    with IT to build prompts into the EHR to trigger these activities so care is consistent across the surgical population Engage social workers and care managers early on In a PSH model the team starts planning postoperative care before the patient has surgery At Martin Health social workers financial counselors and care managers are prompted by the EHR to identify community resources that patients need upon discharge weeks before the actual surgery Build on early results In addition to eliminating same day surgery cancellations Martin Health has improved its on time starts since implementing the PSH model In addition they have achieved almost 100 percent chart completion 24 hours prior to surgery The PSH team also reduced blood utilization in surgical patients by 20 percent and improved pain scores Patient experience scores also have improved The perioperative surgical home model has been a big win for me and my patients says Matthew Peebles MD chief of surgery at Martin Health System The pre op process has grown into a robust screening optimization and patient engagement program and the perioperative enhanced recovery aspects have improved outcomes and patient satisfaction significantly Learning What Works ASA s nationwide PSH pilot runs through the end of this year The collaborative plans to analyze financial and clinical data from preoperative intraoperative and postoperative care in all 44 organizations Early anecdotal evidence suggests the PSH model is improving performance at other organizations as well One Arkansas hospital has increased the number of discharged surgical patients entering home health as opposed to nursing homes by 20 percent Another provider decreased the LOS for pediatric spine surgery patients by 1 5 days in the first 30 days of implementing a PSH model By re engineering the perioperative process providers can help reduce variability across the continuum and be better positioned as the industry moves toward value based care All health systems are going to be paid less in the future so improved efficiency is critical says Robert L Lord Jr COO Martin Health Also critical are better coordination of care and the involvement of the entire care team to achieve improved outcomes This program does all of those things That is the reason we view it as critical to our mission Related tool Perioperative Surgical Home Executive Dashboard for Lower Extremity Joint Replacement Related Articles Successful Physician Hospital Alignment Admission Plan Eases Patient Transition and Care Coordination Sonya Pease MD is CMO TeamHealth Anesthesia Palm Beach Gardens Fla Mike Schweitzer MD MBA is vice president of healthcare delivery system transformation VHA Southeast Tampa Fla This article is based in part on a presentation at the Congress of the American College of Healthcare Executives in Chicago in March 2015 Quoted in this article Sharon Andre RN MS FACHE is assistant vice president and administrator for the perioperative service line Martin Health System Stuart Fla Matthew Peebles MD is chief of surgery Martin Health System Stuart Fla Robert L Lord Jr is COO Martin Health System Stuart Fla Comments Please login to add your comments Add Comment Text Only 2000 character limit ADVERTISEMENTS HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by

    Original URL path: http://www.hfma.org/Leadership/E-Bulletins/2015/September/Martin_Health_Pilots_New_Model_to_Coordinate_Surgical_Care/ (2016-02-10)
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  • Making Good on the Promise of Big Data in Health Care
    modern sensor technology deep computing and analytics and smartphone platforms to get an early warning of worsening heart failure so clinicians can adjust therapies remotely and keep patients out of the hospital says William T Abraham MD FACP FACC FAHA FESC director of cardiovascular medicine at OSU s Wexner Medical Center Abraham is studying a unique biosensor designed by OSU bioengineer Emre Ertin PhD The biosensor is placed on the chest for a few minutes and uses electrical waves to detect fluid in the lungs and chest This measurement can help clinicians determine whether a heart failure patient is stable or getting worse William T Abraham left MD FACP FACC FAHA FESC director of cardiovascular medicine at The Ohio State University Wexner Medical Center is testing a predictive analytics tool to prevent heart failure hospitalizations Photo courtesy of The Ohio State University Wexner Medical Center Part of the challenge of managing heart failure patients is determining which data are truly actionable Abraham says We need to create data driven algorithms for patient care and we cannot rely on our intuitions which are often wrong he says Daily weight monitoring is a prime example For some time we believed that having patients monitor their weight every day would be a great way of knowing when they were getting worse Abraham says But it turns out that the sensitivity of using daily weight to predict heart failure hospitalizations is only 10 percent to 20 percent We hope that a single measurement such as a lung fluid measurement or combination of measurements such as lung fluid heart rate and breathing rate will be most predictive of how a patient is doing and guide therapy so we can adjust medications and keep patients out of the hospital Empowering clinicians and patients OSU s biosensor technology is being tested among inpatients and the study will be expanded to include outpatients next year Ideally the final product will issue smartphone alerts to clinicians only when intervention is needed The idea is to let the computer platform analyze the data and then present what really counts to the clinicians on their smartphone Abraham says If the algorithm determines the patient is at risk the clinician might alert the patient to take an extra dose of a water pill Such a tool also could be used by heart failure patients for self monitoring similar to how patients with diabetes use glucometers he adds Using Data to Create a Safer ICU Many big data initiatives are focused on using analytics to determine how an individual patient s risk can change But researchers at Boston s Beth Israel Deaconess Medical Center BIDMC are harnessing analytics to predict how a complex environment such as an intensive care unit ICU can become riskier Specifically Kenneth Sands MD MPH chief quality officer and his colleagues are looking at how a combination of clinical parameters derived from ICU patients as well as environmental factors such as staffing and the churn of patients coming in and out of a unit affects a patient s risk of harm These harms include cardiac arrests falls medication errors acute bleeding episodes and similar events that can happen immediately Problems that tend to manifest over time such as catheter associated urinary tract infections are more difficult to attribute to the short term ICU environment and are not being measured as part of the study Sands says Helping staff make decisions to reduce risks Now in the proof of concept stage BIDMC s Risky States application could allow managers to make decisions that would lower the risk of immediate harms in their ICU How it might work A web based status dashboard in a nurses station would be updated every 15 minutes to show the current risk of harms across several ICUs using a red yellow and green color coded intensity index If the intensity index is yellow in the cardiac care unit CCU and green in the medical ICU a nurse manager might decide to float a nurse from the MICU to the CCU Or the nurse manager may choose not to take a patient transfer to the CCU until another patient is discharged from the unit the following morning Sands expects the tool to go live in the ICUs at BIDMC this fall Cleaning the data Sands says the most challenging part of the project has been cleaning the data from multiple sources for use in the project The team analyzed two years of retrospective patient data from seven BIDMC ICUs to determine which scenarios were associated with higher patient risks We underestimated the time it would take to get clean analyzable data Sands says Ensuring the data were legitimate for analysis required multiple steps of making sure the fields were valid and that the information was complete To help with the analysis Sands partnered with systems engineers at the Massachusetts Institute of Technology Getting data ready for research queries Ensuring data integrity essentially its accuracy and validity across the life cycle is a critical step in research projects that aim to harness big data Sands says Even before you generate the research question make sure that your information systems are set up so they can be queried in the aggregate so you can get that information into a data mart Sands says You also need a way to merge data sets and an emphasis on making sure the data has integrity at the times it is collected Lessons Learned Using analytics to transform care and reduce costs requires an enterprise wide approach to ensuring data quality and integrity Healthcare leaders who are making strides in their big data efforts offer the following advice Establish a data warehouse Make sure that people who want to use data to make care better can actually get at the data BWH s Bates says The architecture of the data warehouse should include several data marts so different data are available to different stakeholders He also advises adding robust self serve tools

    Original URL path: http://www.hfma.org/Leadership/Archives/2015/Fall/Making_Good_on_the_Promise_of_Big_Data_in_Health_Care/ (2016-02-10)
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