Healthmonix Advisor

With the new year comes a renewed focus on data analytics and interoperability.

“The early bird gets the worm.” 

I'm not sure when I heard this for the first time, but it became the guiding principle to my work ethic. Always show up first to any event whether personal or professional - that's the code.  This time it paid off!

Value-based care seems like such a good idea. Who doesn’t want better health, and better care, at a lower cost? It is one of the premises of the MACRA legislation: “Change the way that Medicare rewards clinicians for value over volume.” We all think, in theory, preventive care is better than fixing problems after they occur. That’s why we take our cars in for regular maintenance, we have our furnace checked each year before winter, we get our teeth cleaned and checked every six months.

Yet, the current evolution to value-based care is adding burden and distracting from care in many ways, rather than focusing on the intended goals. I attended the Patient-Centered Oncology Care (PCOC) 2018, the annual meeting presented by The American Journal of Managed Care, last week and listened to some of our most highly-trained and most needed oncologists talk about how the current payment models have affected their practices. Oncology practices have been asked to take on risk for the cost of care and manage that cost. These practices are now responsible for costs that are not within their control, and that they don’t even know about until long after decisions have been made.

Conferences are a reality of business life.  Whether this is your first conference or your 10th, it's easy to be overwhelmed by the exciting blend of travel, free meals, sessions, contacts, conversations, and business cards.  Truth be told, conferences are a great way to learn from experts in your field and an essential networking opportunity (yes, even for introverts!). As we prepare for the upcoming MGMA Conference, we want to share some tips and tricks for new and experienced conference attendees. From the pre- conference planning to the post- conference follow up, we're here to provide you with 10 tips and tricks to get the most out of your next conference.

The tracks of the Medicare ACO model vary greatly, but have been steadily gaining in prevalence since their launch in 2011. Despite the steady increase in ACO participation, most groups are staying at the Track 1 level. In fact, in 2018, 460 of the 649 ACOs existed at the Track 1 level.

When I was in graduate school, I quickly gravitated to projects and classes that focused on the relatively new field of database design and database technology. I loved the deep analysis of data and exploring the question of how to leverage technology to support storage and access to data in order to find answers. It was challenging, it was new, and it was a field that I knew would have a huge impact. My thesis was about data organization and optimization, and I was lucky to be able to experiment with all sorts of database challenges and software as I ultimately built my own contribution to the science.

At the Optum Forum conference this year, once again I was brought back to the data. As a recent partner with Optum, Healthmonix provides MACRA (MIPS and ACO) reporting for Optum clients in addition to our existing client base. At the conference, I heard the cries of how fundamental the data really is as we move forward in the value-based care market. As much as we need to work with providers and payers to change patterns of practice, a critical component is the data that supports the change and that measures the impact.

This is because data is what drives precision medicine and AI initiatives. It drives understanding, affirms what we already know, points out new patterns that we haven’t realized, and shows us where our perceptions are correct and where they are not.

If you keep up to date about healthcare payment model trends, you may have noticed a newly re-ignited concern about the future of value-based care. A recent Quest Diagnostics survey highlighted perceptions that physicians lack the tools to succeed under the payment model, and that payers and providers are not well aligned in this endeavor. The survey further showed that over two-thirds of health plan executives and physicians believed the U.S. has a fee-for-service healthcare system versus a value-based care system. Overall, the study concluded that physicians and health plan executives perceive that progress toward value-based care has stalled.

I was intrigued by a recent Becker’s article which outlines the results of Mount Sinai’s use of the “Hospital at Home” model for acute care. According to the article, patient experience showed improvement and readmission rates were noticeably lower. I had to know more, so I decided to do some research into exactly what this model of care looks like.

My parents love to reminisce about the good old days. They paint a picture of a “simpler” world where milk, ice, and the occasional Schwan’s were delivered right to your doorstep, and where doctors still made house calls. They were direct beneficiaries of the technological advancements that came about after the second industrial revolution and were part of one of the greatest economic expansions in history following WWII. They experienced the evolution of cars, colored television, mass production of penicillin, and automation.

Last week’s 2018 HIMSS Conference presented, as every year, a profusion of insights into the current landscape of healthcare technology. With over 300 education sessions, 1,300 vendors, and hundreds of special programs and events, a HIMSS conference can be hard to boil down into just a few key points. Still, I wanted to share one particularly salient impression that stuck with me after I attended, one that I think anyone with an interest in healthcare should stick a pin in.