Leveraging Technology to Improve Patient Satisfaction

Dwindling are the days of printing paper charts, filing massive folders, sorting through Excel sheets, and faxing patient records to compile a person’s health story. For the Medicare population especially, healthcare technology is becoming the primary way to manage patients when they are enrolled in an Accountable Care Organization (ACO), Medicare Advantage (MA) Plan, are members of a Clinically Integrated Network (CIN), or are part of a different provider system. The transition to shared savings programs has a twofold purpose: mitigate waste in healthcare spending while ensuring that patients receive a high level of care. The technology available today for …

Start the Year Off Right with Healthy Living Practices

Jessica Scruton, BSN, RN, CCM, joined me once again on the Population Health Podcast discussing a topic that has no designated month: healthy living. Undoubtedly, you have seen plenty of New Year’s resolution articles on how to make 2020 “your year.” That is not a bad sentiment, and there are always reasons to make impactful changes for your physical and mental health. Be sure to listen to the full episode on YouTube or SoundCloud. Before we begin, Jessica wants to stress an important first step: speaking with your doctor. That way, you can develop the best and approved methods to …

A Crash-Course in Comprehensive Risk Stratification

Risk stratification, or separating patient populations based on specific variables, is a central precept in managing value-based contracts like the Medicare Shared Savings Program (MSSP) or Medicare Advantage (MA) plans. The process of risk stratification helps identify patients based on conditions like congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), or diabetes. Stratifying patients can also be deployed based on predicted resource utilization (cost of healthcare) over a determined period. For those still familiarizing themselves with population health management and data analytics, comprehensive risk stratification requires different measurements to create a full, accurate picture of a patient’s health status …

Risk Adjustment and the ABCs of HCCs

Today on the blog, we are discussing two central questions that directly determine how providers receive their operating revenue: What is risk adjustment? What is hierarchical condition category (HCC) coding? Risk adjustment alters the cost of healthcare coverage based on a patient’s health status. The payments are adjusted according to the patient’s age, disability, financial status, and diagnoses. Hierarchical condition category (HCC) codes leverage ICD-10 codes to document those health statuses. Each chronic condition is assigned a payment value on the care of a patient with that condition. When providers document HCC codes, it allows payers to calculate their risk-adjustment …

Questions to Ask GPRO Reporting Partners

Accountable Care Organizations (ACOs) know that when the calendar turns to January, it is time to prepare for quality measure reporting in the new year. For those still transitioning to the shared savings program, the Group Practice Reporting Option (GPRO) is a Centers for Medicare & Medicaid Services (CMS) reporting process to measure quality scores for the previous performance year to obtain eligibility for shared savings and other incentives. But for the performance year (PY) 2019, the process goes by a new name for reporting: the CMS Web Interface. The PY 2019 quality data submission period for ACOs started on …

Our 2020 Predictions at Lightbeam Health Solutions

We predict that 2020 will be a positive year for healthcare, especially in value-based care initiatives. To close out 2019, members of the Lightbeam Health Solutions team are sharing their predictions for innovations in the coming year!  “2020 is the year of the primary care physician. Organizations are realizing the need to restructure antiquated care models built on fee-for-service care to better engage and support doctors, which will dramatically improve the quality of life and patient outcomes.” – Josh Patten, Vice President of Advisory Services “I am hoping that in 2020, we continue to expand telehealth resources and technology so …

The Vitality of HIEs

Health information exchanges (HIEs) allow clinicians and patients to have secure access to electronic patient data across counties, states, and regions. In 2019, there are still many obstacles. Many are now on their second HIE vendor, and vendors are consolidating in the market with payers or other data warehouse offerings. The shift from fee-for-service to value-based care means that HIEs must quickly establish themselves as self-sustaining organizations with genuine business value. HIE vendors must also prove able to deliver efficient exchanges in a timely, cost-effective, and standards-based way. The Ideal HIE Adoption must be supported by an HIE vendor who …

Tried and True Areas of Focus for 2020

Throughout my 22 years in the healthcare technology space, including the last seven in value-based care, I have found that there are a few core strategies that can be deployed to better engage and manage high-risk or high-cost patient cohorts. Focusing care initiatives around these patient groups create impactful outcomes that are clinical and financial in nature. All successful population health endeavors begin with identifying groups of patients where there appear to be opportunities to intervene with care in a way that would close care gaps, reduce unnecessary utilization, help patients better manage a condition or benefit from a preventative …

Seasonal Depression Awareness Month

Seasonal Depression Awareness Month has begun, and in light of the colder, grayer weather, it is an important topic to discuss. According to Johns Hopkins, seasonal depression, or “seasonal affective disorder,” affects approximately 10-20% of the entire population this time of year. Lightbeam’s Clinical Transformation Advisor, Jessica Scruton, will join me again on the Population Health Podcast for our second care transformation-focused episode next week, but we wanted to begin the discussion today on the blog to ensure that everyone has the information they need to maintain strong mental health this winter. The Science Behind Seasonal Depression The Mayo Clinic attributes three main causes to the development of seasonal …

3 C’s to Jumpstart Value-Based Care Programs

Success when it comes to value-based care initiatives does not occur by chance. It takes commitment to engage patients to take advantage of preventative services, capture the attention of providers, and reduce costs. Implementing this kind of care requires cultural alignment, shared risk and rewards, the right infrastructure, and the right resources to deliver.  So, where do we start? Besides having an excellent team, our clients’ value-based care success often involves three “C” qualities throughout the implementation and deployment of their initiatives: communication, coordination, and common goals.  Communication  We have discussed the importance of being on the same page and maintaining …