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Patient-Centered Medical Home (PCMH)

Reinventing Utilization Management to Bring Value to the Point of Care

February 21, 2018  |  Nilo Mehrabian Vice President, Product Management, Decision Support, Change Healthcare
article
How an automated exception-based approach can make UM more efficient and effective.

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

Managing the Consumer Data Deluge

October 2, 2018  |  Joe Marion, Industry Voice
commentary
In-home monitoring and diagnostic devices are likely to create substantial new diagnostic data to manage

Patient-Centered Primary Care Collaborative to Honor Dr. Karen DeSalvo

October 2, 2018  |  David Raths, Contributing Editor
news
Karen DeSalvo, M.D., M.P.H., former national coordinator for HIT, will receive the 2018 Barbara Starfield Primary Care Leadership Award from the Patient-Centered Primary Care Collaborative.

With $6.3M PCORI Contract, UPMC Health Plan to Study Tech-Based Approach to Chronic Disease

September 25, 2018  |  Heather Landi, Associate Editor
news
The UPMC Center for High-Value Health Care was recently awarded a $6.3 million contract from the Patient-Centered Outcomes Research Institute (PCORI) to study different care delivery models to improve outcomes for patients with chronic disease and a co-existing...

Connecting Medical Care and Social Service Needs: Chicago Health Leaders Take Charge

August 21, 2018  |  Rajiv Leventhal, Managing Editor
article
In Chicago, a group of healthcare leaders have been working on creating a seamless and purposeful link for sharing data between social services agencies and patient-centered medical homes.

At One Florida Practice, MD Leaders are Leveraging Telehealth to Bridge Gaps in Care for Pediatric ADHD Patients

April 20, 2018  |  Heather Landi
article
A leading private pediatric practice in Jacksonville, Florida is seeing success with the use of a telehealth platform targeting a particular population of pediatric patients, children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD).

Housing is Healthcare: How a PCMH is Caring for NYC’s Homeless Population

March 14, 2018  |  Rajiv Leventhal
article
A PCMH approach at Care for the Homeless has enabled the organization to improve access to care, increase care coordination, and enhance the quality of care for the city’s homeless population.

Patient Access and Analytics: Perfect Together

February 7, 2018  |  Jason Williams, Vice President, Business Strategy & Analytics, Change Healthcare
article
Applying analytics to patient access can radically improve a health system’s ability to understand what’s influencing financial performance, and improve the metrics that matter.

Study: Payers, Providers, Patients Differ on Consumer Engagement Investments, Effectiveness

January 29, 2018  |  Change Healthcare
article
Value-based care is driving investments in consumer engagement strategies and technologies, but consumers are not seeing the difference.

Rasu Shrestha, M.D. on Value-Based Imaging: “Radiologists Need to Become Part of the Care Team”

December 20, 2017  |  Heather Landi
article
Rasu Shrestha, M.D., chief innovation officer at Pittsburgh-based UPMC, shares his perspectives on what's at stake for the imaging industry in the ongoing evolution of healthcare and the path forward toward value-based imaging.

A Framework for the Future: 3 Steps to Building an Enterprise Architecture

December 18, 2017  |  Bob Hoover, VP of Consulting Services at Change Healthcare
article
Successfully delivering value from healthcare IT investments is difficult. That’s a refrain I’ve heard again and again from healthcare leaders, whether in the boardroom, the executive suite, or the data center.

Ten Steps to Reduce Denials, Win More Appeals, and Improve Hospital Performance

December 8, 2017  |  Carol Everhart, RN, MS, IQCI, Senior Clinical Consultant, Decision Support Change Healthcare
article
Hospitals everywhere are striving to answer this question: How can we better manage denials? Denials related to medical necessity account for about 5% of denials nationally. But by closing common gaps that lead to medical necessity denials, your...

Research Finds States Remain Committed to Value-Based Payment Models

November 16, 2017  |  Carolyn Wukitch, Senior Vice President & General Manager, Network & Financial Management, Change Healthcare
article
Alternative payment programs are now firmly rooted in state-level healthcare policy, as discussions regarding health reform continue in Washington. That’s according to a new national study commissioned by Change Healthcare which finds over 40 states pursuing...

MACRA Rule Reaction: CMS Gets Serious in 2018

November 7, 2017  |  Rajiv Leventhal
article
Despite the fact that many Medicare clinicians will be exempt from MIPS in 2018, for those that are participating, the stakes have been raised

Unnecessary Care: It’s Not Necessary

November 2, 2017  |  Suresh Yarlagadda, Medical Director, Clinical Strategy, Change Healthcare
article
Unnecessary care is unnecessarily in the news these days. We say “unnecessarily” because such care—as well as the associated costs it incurs and risks it poses for patients—can be mitigated. Kaiser Health News just published a report, “So Much Care It Hurts...

In New Mexico, a Medical Home Model Created Outside the Hospital

October 12, 2017  |  Rajiv Leventhal
article
Barbara McAneny, M.D., an oncologist/hematologist, was the leader behind the Community Oncology Medical Home, a model built around keeping patients out of the hospital.

The Dawn of Consumerism: Key trends and strategies for healthcare consumerism

October 6, 2017  |  David V. Gallegos, SVP, Consulting Services, Change Healthcare Consulting
article
Reducing costs and improving quality are the two prevailing objectives behind most healthcare initiatives. However, one leg of the proverbial stool that doesn’t get much attention are the efforts to improve the patient experience. Healthcare in the United...

Research: Interoperability Focus Needs to Shift from Moving Data to Information Usability

October 3, 2017  |  Heather Landi
news
Hospitals’ progress toward interoperability is slow and that progress has mainly been focused on moving information between hospitals, such as sending and receiving data, and not on ensuring the usability of information in clinical decisions, according to...

Chronic Care Management: A Strategic Step to Improve Quality of Care in the Value-based Reimbursement Era

September 15, 2017  |  Bill Sillar, National Director of Clinical Call Services, Change Healthcare
article
Quality of care through optimized performance is today’s mantra in healthcare. It underpins our industry’s pursuit of the Triple Aim: to improve the experience of care, improve the health of populations and reduce per capita costs of healthcare.1 Achieving...

The Road Ahead: The Future of Value-based Care in Today's Climate

August 29, 2017  |  Norberto Correo, Senior Director of Consulting Services, Change Healthcare
article
The U.S. healthcare industry is in a unique situation — organizations are faced with tough decisions as they move forward in today’s turbulent regulatory environment. In fact, many industry experts struggle to provide concrete guidance around value-based care.

Reinventing Claims Management for the Value-Based Era

August 8, 2017  |  Carmen Deguzman Sessoms, FHFMA, AVP, Product Management, Change Healthcare
article
Provider claims management can no longer exist as a silo. With the rapid transformation from fee-for-service to value-based models, denial rates remain high despite advances in technology and automation. For providers to be effective, the revenue cycle...

Getting Ready for MACRA: At World Health Care Congress, an Insightful Look into What Physicians Need to do Next

May 2, 2017  |  Rajiv Leventhal
article
On the first day of the World Health Care Congress, two physician leaders reflected on their organizations' push into APMs while expert panelists gave advice to those who are not yet ready for MACRA.

HIMSS Preview: How R.I. HIE Expanded Real-Time Notifications

February 17, 2017  |  David Raths
article
The Rhode Island Quality Institute (RIQI) is expanding the statewide HIE's capacity to deliver real-time notifications for care transitions from and to emergency departments and hospitals for providers' attributed patients.

ACOs Looking to Expand Population Health Management Capabilities, Report Finds

October 27, 2016  |  Rajiv Leventhal
article
As ACOs continue to progress, they are seeking to expand population health management capabilities, including their relationships with community organizations and patients, according to new research from Charlotte, N.C.-based Premier, Inc.

At New York HIT Summit, an MD Leader Outlines How HIT Can Enhance Patient Centered Medical Homes

September 27, 2016  |  Heather Landi
article
At the Health IT Summit on Tuesday, Salvatore Volpe, M.D, chief medical officer at Staten Island Performing Provider Systems, urged physician leaders to adopt health IT to increase efficiency and improve patient care within Patient-Centered Medical Homes.

HHS Awards $350,000 to American Academy of Pediatrics to Improve Care for Children Impacted by Zika

September 8, 2016  |  Heather Landi
news
HHS has awarded $350,000 to the American Academy of Pediatrics (AAP) to provide education, including tele-consultations, to clinicians providing care to children who are or may be impacted by the Zika virus.

HHS Awards $100 Million to Improve Health Center Quality

August 19, 2016  |  Heather Landi
news
The U.S. Department of Health and Human Services (HHS) has awarded more than $100 million in grants to 1,304 health centers to invest in healthcare quality improvement efforts that engages patients and improves care coordination.

HHS Announces $100M in Funding to Help Small Practices with MACRA

June 21, 2016  |  Rajiv Leventhal
news
The Department of Health and Human Services (HHS) has announced $20 million each year over the next five years to fund on-the-ground Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) training and education for Medicare clinicians in individual or small...

Study: HIT Use and Participation in ACO, PCMH Initiatives Facilitates Advanced Care Delivery

April 19, 2016  |  Heather Landi
news
Physicians who adopted electronic health records (EHRs) in 2012 and participated in new models of payment and care delivery were more likely to perform care processes associated with improved care delivery, according to a recently published study.

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