Only about a third of the accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) qualified for bonuses in 2017. Our ACO, the Rio Grande Valley Health Alliance (RGVHA), was one of them. In fact, we’ve generated enough MSSP savings to net bonuses for five years in a row.
In 2015, RGVHA saved Medicare $14.2 million, of which our providers received half. In 2016, our ACO’s first year in Track 3 of the MSSP, we received 75% of the $8.5 million we saved. And in 2017,
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Health IT & Digital Health-Opinion | Op-Eds | Guest Columns | Analysis, Insights - HIT Consultant
The Blueprint to Scaling Social Determinants of Health (SDOH) Data Collection
In the value-based care world, cost-effective treatment, quality of care, and patient outcomes determine payment. Social determinants of health (SDOH) represent the economic, psychological, educational, environmental and social barriers that limit healthy behaviors, access to care and adherence to treatment resulting in poor health outcomes. Many stakeholders in health care are trying to address social determinants as part of their value-based care strategy. However, many organizations are
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Do Americans Have Too Many Healthcare Choices? Can Healthcare IT Help?
A creatively illustrative scene from the 2008 film The Hurt Locker follows the primary character, William James, on a trip to a local grocery store.
James is an ordnance disposal technician home from the war in Iraq whose wife asked him to pick up a few things from the store, including cold cereal. As James stands dazed and overwhelmed before the wall of cereal options, the camera pans back to reveal an entire aisle wall—floor to ceiling, end to end— of cereal boxes from
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3 Health Markets Ripe for Disruption to Watch
There are two constants in the healthcare industry. First: the field is dynamic to the point of perpetual change; innovations inevitably kick old practices to the curb. Second: patients will always need high-quality care from their medical providers, even as those practices and the medical landscape shifts under their feet. Investors in the field are perpetually on the lookout for ways to take advantage of the opportunities that arise in this dynamism, and to find ways to disrupt stale
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Why AI-Enabled EHRs & Telemedicine is Transforming Behavioral Health
Behavioral healthcare is on the precipice of an exciting new frontier. While the sector has been slow to adopt major tech innovations, emerging tools are ushering in unique advantages that allow providers to maximize profit, advance their sector and improve care for patients more than ever before.As a CEO working within the tech and revenue cycle management industries, I listen to the concerns of both insurance companies and healthcare providers to identify trends in behavioral healthcare every
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Why Walmart Centers of Excellence Model Could Redefine How Employers Deliver Quality Care
Mitigating the cost of healthcare expenses has long been an uphill battle for employers, though the problem has become particularly pressing in recent years. The price tags for routine treatments and specialty services alike are on the rise; patients and payers alike shoulder heavy cost burdens for everyday care needs. The benefits packages that may have provided sufficient coverage a decade ago are now stretching to cover costs -- and the companies paying out those benefits are desperately
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3 Principles to Value-based Care Contracting Arrangements for Behavioral Health
It’s long past time for the U.S. health system to improve care for our behavioral health patient population.With every headline about our country’s mental health crisis or opioid crisis, this painful reality becomes more apparent – and as time passes, more expensive. At $201 billion annually, mental disorders top the list of the most costly conditions in the U.S., according to Health Affairs. The economic toll of the opiate crisis alone has exceeded $1 trillion since 2001, according to research
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Optimizing Opioid Management Through Health IT
From cancer care and chronic pain management to emergency care, dental care and episodic pain management – the use of opioids have reached a national platform because of its potentially devastating effects.The CDC reports the significance of its rise in the U.S.:- From 1999 to 2017, almost 400,000 people died from an overdose involving an opioid, including prescription and illicit opioids.- Around 68% of the more than 70,200 drug overdose deaths in 2017 involved an opioid.- In 2017, the number
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Overcoming Piecemeal EHR Problems with Integration, Insight and Engagement
My father, Jeffry, and I manage our own dermatology practice in Colorado Springs. In addition to our genes, we share a lot in common: we were both in the military, and we had the same vision for the Colorado Dermatology Institute: a streamlined, full-service private practice that’s focused on providing attentive, personal care.Unfortunately, our initial technology solutions – electronic health record (EHR) and practice management software – were too piecemeal to facilitate our vision.
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Value Exchange: The Solution to Patient Fatigue?
Living with a rare disease can be exhausting. Symptoms, limitations, and medications are all obvious contributors, but there is another, less obvious challenge to living with a rare disease: the experience of simply being a patient.Patients, especially those with rare and complex diseases, are required to be their own health historians to manage and track all of their health needs and keep documents and paperwork up to date. They are also asked to fill out the same forms repeatedly – the same
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