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Quality & Continuous Performance Improvement

At UPMC, Turbo-Charging Quality Improvement Efforts through Data Analytics

December 11, 2018  |  Mark Hagland, Editor-in-Chief
article
At UPMC in Pittsburgh, Dr. Oscar Marroquin is leading a team of data analysts whose work is facilitating efforts to improve outcomes around readmissions and other important areas

NCQA Moves Into the Population Health Sphere With Two New Programs

December 10, 2018  |  Mark Hagland, Editor-in-Chief
news
The NCQA, known primarily for decades as a nationwide evaluator of managed health plan quality, announced on Monday that it was expanding its reach to encompass the measurement of population health management programs

How One Community Hospital is Leveraging AI to Bolster Its Care Pathways Process

December 6, 2018  |  Heather Landi, Associate Editor
article
Flagler Hospital physician IT leaders are leveraging an AI platform to develop care pathways for acute and non-acute conditions and are seeing measurable improvements in patient outcomes, while lowering costs.

What Does Your Magnum Opus Look Like? A Few Operatic Thoughts

November 20, 2018  |  Mark Hagland, Editor-in-Chief
commentary
Composer Richard Wagner spent a quarter of a century developing a unique, four-work opera cycle that redefined opera forever. What have you been working on lately?

Using Performance Management to Scale

November 20, 2018  |  Tim Tolan, Industry Voice
commentary
The "Rockefeller Habits," once adopted and measured regularly, can change any organization that wants to grow and scale, and keep everyone accountable along the way.

At the Beverly Hills HIT Summit, APG’s Crane Offers a Vision of the Future of Medical Care

November 11, 2018  |  Mark Hagland, Editor-in-Chief
article
Don Crane, CEO of APG, a nationwide association of physician groups involved in risk-based contracting, offered HIT Summit attendees a vision of a coordinated care-based future

BREAKING: CMS Publishes CY 2019 Physician Fee Schedule/QPP Final Rule

November 1, 2018  |  Heather Landi, Associate Editor
article
Late in the afternoon on Thursday, Nov. 1, CMS published the Physician Fee Schedule and Quality Payment Program final rule for 2019, which encapsulates the MIPS and Advanced Payment Models.

In Northern Virginia, Rethinking ACO Strategies—For PCPs and Specialists

October 30, 2018  |  Mark Hagland, Editor-in-Chief
article
Tricia Nguyen, M.D., a senior executive at the Falls Church, Va.-based Inova Health System shares her perspectives on what she and her colleagues are learning about some of the underlying challenges in ACO work

Nemours Children’s Health’s New CEO: “The Most Exciting Time in Healthcare”

October 12, 2018  |  Mark Hagland
article
R. Lawrence Moss, M.D., who joined Nemours Children’s Health as CEO on Oct. 1, discusses the challenges and opportunities facing children’s hospitals and healthcare in the current environment

KLAS Report: Behavioral Health EHR Vendors Demonstrate Poor Performance

October 10, 2018  |  Heather Landi, Associate Editor
news
The behavioral health electronic health record (EHR) vendor market has shown poor performance, to date, according to customers, who cite slow development, implementation challenges and lackluster customer support, according to a KLAS Research report.

At the HIT Summit in Raleigh, a Health Plan Executive Points to the Future of Value-Based Care

October 8, 2018  |  Mark Hagland, Editor-in-Chief
article
Speaking at the HIT Summit in Raleigh last month, Humana’s Ben Lunsford offered attendees insights into the future of value-based healthcare, and his health plan’s future intentions

At the HIT Summit in Raleigh, a Probing Discussion of the Value of Data Analytics

September 27, 2018  |  Mark Hagland, Editor-in-Chief
article
At the Health IT Summit in Raleigh on Thursday, a panel of industry leaders considered carefully some of the value-add issues around data analytics—and the implications for healthcare IT leaders nationwide

Premier Inc. Executives: Time to Unpack Some of the Challenges and Opportunities Inherent in the Path Into Risk

September 24, 2018  |  Mark Hagland
article
Shawn Griffin, M.D. and Steve Valentine of Premier Inc. discuss the challenges involved in the path into risk-based contracting, and the potential upending of the landscape by new disruptors

Is the Discourse Over the MSSP Program Teetering Towards Potential Conflict?

September 21, 2018  |  Mark Hagland, Editor-in-Chief
commentary
The joint statement by nine associations challenging CMS Administrator Seema Verma around her plans to insert more rigor into the MSSP program, feels like a teeter-totter moment for CMS

Survey: Physicians Sour on Value-Based Care Metrics, EHRs

September 19, 2018  |  Rajiv Leventhal, Managing Editor
news
More than 50 percent of U.S. physicians who receive value-based care compensation said they do not believe that the metrics the reimbursement is tied to improve the quality of care or reduce costs, according to a new survey.

The CEO of a Nationwide Association of MD Groups Sees the Future—and It’s Not in Fee-For-Service

September 18, 2018  |  Mark Hagland
article
Don Crane, CEO of APG, a nationwide association of medical groups working in risk-based contracting, shares his perspectives on the future of medical groups in a shifting landscape

On Staten Island, a Highly Innovative Program That's Redefining What’s Possible Under Medicaid

September 17, 2018  |  Mark Hagland, Editor-in-Chief
article
Healthcare leaders on New York City's Staten Island have been achieving exciting success in population health management in their community’s Medicaid and uninsured populations

Physicians Cite Lack of Interoperability, Documentation Burden as Top EHR Pain Points

September 12, 2018  |  Heather Landi, Associate Editor
news
A recent survey of primary and specialty care physicians by Deloitte reveals that physician feedback on how to improve EHRs is often overlooked as physicians continue to be frustrated with EHRs, particularly due to lack of interoperability and the burden of...

In Eastern North Carolina, an MD-Run ACO Shows its Success

September 10, 2018  |  Mark Hagland
article
Stephen Nuckolls, CEO of the New Bern, North Carolina-based Coastal Carolina Quality Care, shares his perspectives on why some physician-led ACOs are making huge breakthroughs on quality and cost

Seema Verma’s Big Picture: Tough Love, ACO Acceleration, Interoperability, and Consumer Empowerment?

August 29, 2018  |  Mark Hagland
commentary
Will CMS Administrator Seema Verma’s strategy of pushing hard on providers around ACO development and interoperability help to accelerate the shift to value-based healthcare—or will it backfire?

Announcing Next Gen ACO Results, CMS Administrator Verma Makes the Case for Moving ACOs to Two-Sided Risk

August 27, 2018  |  Heather Landi, Associate Editor
article
During a webinar, CMS Administrator Seema Verma touted the results of the Next Gen ACO model as evidence that ACOs succeed under two-sided risk as CMS proposes major changes to MSSP ACO program.

A Pioneering M.D. Leader Shares Insights on Successfully Navigating the Massachusetts Healthcare Market

August 9, 2018  |  Rajiv Leventhal
article
At the Boston Health IT Summit, the veteran healthcare expert dropped in to give attendees an inside look at how her organization has achieved value-based care success

At the Health IT Summit in Boston, One ACO’s Data-Facilitated Journey Into Value

August 7, 2018  |  Mark Hagland
article
What does it mean for an organization to pursue a data-facilitated journey into value-based care? Bill Gillis, CIO of the Beth Israel Deaconess Care Organization, shared his learnings and perspectives on that subject, at the Health IT Summit in Boston

Pondering the Psychology of Incentives in Bundled-Payment Contracts

July 27, 2018  |  Mark Hagland
commentary
Healthcare policy researchers, in an op-ed piece in the Health Affairs Blog, ponder the differences between prospectively and retrospectively based bundled payment incentives to providers—at a moment of early experimentation

Could Last Week’s Proposed-Rule Release Represent an Inflection Point for CMS and for Value-Based Federal Payment?

July 18, 2018  |  Mark Hagland
commentary
CMS’s release of a proposed rule that will impact a range of issues, from physician payment to quality measures, has unleashed a range of reactions from industry leaders—could this prove to be an inflection point?

Healthcare Leaders React to CMS’ 2019 QPP Proposed Rule and E&M Coding Changes

July 18, 2018  |  Heather Landi
article
Some health IT industry groups have voiced concerns that the CMS proposals, specifically in its proposed rule for the third year of the Quality Payment Program, will undermine efforts to move Medicare provider payment to value.

Value-Based Care Shift Has Halted, Study Finds

July 17, 2018  |  Rajiv Leventhal
news
A new study of 451 physicians and health plan executives suggests that progress toward value-based care has stalled. In fact, it may have even taken a step backward over the past year, the research revealed.

Aligning Incentives in the Forward Evolution Around Value-Based Payment: Major Obstacles Cited

July 16, 2018  |  Mark Hagland
commentary
The implications of a recent HFMA-sponsored analysis of value-based healthcare are many—and challenging, for the pioneers of VBP in new payment models in U.S. healthcare

BREAKING: CMS Proposes Dramatic Changes with Aim to “Modernize Medicare and Restore Doctor-Patient Relationships”

July 12, 2018  |  Rajiv Leventhal
article
CMS today proposed changes that the agency believes will “fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to use their EHRs to document clinically meaningful information.”

The Rocky Path to Value for Medicaid Programs—and HIT’s Key Role in Making It All Work

July 11, 2018  |  Mark Hagland
commentary
Medical researchers share some insights on the broad range of challenges facing the pioneers attempting to move Medicaid towards value-based payment incentives, including around the key role that HIT and data analytics will play in success

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