Hayes' Healthcare Blog

5 Benefits of Increased Patient Engagement You May Not Know

Posted by Susan Cruz on October 26, 2016 at 9:00 AM

In today’s disruptive healthcare environment, we’re hearing of all sorts of new initiatives that aim to provide the best and most
affordable healthcare to patients.  Everything from MACRA, to Meaningful Use, to interoperability.  A common theme among these is the active foundation of improving health and realizing increased patient engagement.  With the shift from fee-for-service to fee-for-value, patients and consumers are becoming less passive and more proactive and engaged.  With this idea on the tip of everyone’s tongue, one might ask questions like, how do I create the best environment for my providers and their patients? What is the best way to educate patients on what exactly is going into their healthcare? How do I increase my patient engagement?

Not unlike using the age-old sentiment that history repeats itself, you can begin to answer these questions by going back to examples of how people have been engaged in their education in the past.  When you talk about education, you intuitively think of school. Active learning is a methodology utilized in the classroom to move the students from the role of passive receivers of information to that of active participants responsible for their own learning.  Techniques used in active learning include discussion, self-assessment, projects, group learning, self-defined goals, and more.  These techniques have proven to be far more effective than the traditional learning environment in which students sit passively and listen to lectures from a seemingly autocratic authority.

Similarly, the provider-patient role in many healthcare institutions has evolved throughout history into an authority and passive recipient relationship.  But as we noted earlier, this is clearly starting to shift within the healthcare industry today.  With the implementations of value-based care, we are seeing the provider-patient relationship shifting to organically place more ownership of the patients’ own health onto their plates to become more like the traditional consumer of any good or service, and less like a passive student within a lecture-style environment. 

While the healthcare industry is abuzz with all sorts of opinions about these initiatives and the shift value-based care, one perspective you can take is to see the win-win benefits of such an evolution of healthcare, especially for providers.

Here are five benefits that you may not have realized since the industry has started to steer patients into becoming active learning healthcare consumers.

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Topics: Fee-for-service, value-based care, provider education, patient engagement

Payment Posting: A Crucial Link to Efficient Revenue Cycle Management

Posted by Sou Chon Young on October 19, 2016 at 9:00 AM

“For the want of a nail the shoe was lost,
For the want of a shoe the horse was lost,
For the want of a horse the rider was lost,
For the want of a rider the battle was lost,
For the want of a battle the kingdom was lost,
And all for the want of a horseshoe-nail.”

- Benjamin Franklin

What’s a horseshoe-nail story got to do with healthcare revenue cycle management? It illustrates that the smallest detail can ultimately make the difference between success and failure. In revenue cycle management, that detail is payment posting. Posting errors can lead to all the major revenue cycle issues: understated accounts receivable, mounting denials, false credits and inaccurate patient statements.

Payment posting has never been a glamourous position – considered a simple “heads-down” data entry job with little impact on the revenue cycle. If that was ever true, it certainly isn’t today.

The massive changes in the healthcare landscape have dramatically affected the professionals responsible for posting payments. Sophisticated new technologies, multiple new payment models and organizations transitioning from one billing system to another means today’s payment posters must handle a much wider range of scenarios.

The bottom line: take your payment posting operation for granted at your own peril. Here are some of the major new competencies you should be looking for in your payment-posting professionals.

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Topics: revenue cycle management, Payment Posters

DSRIP: A Major Step Toward Reinventing Medicaid

Posted by Kelly Barland, CIO on October 12, 2016 at 9:04 AM

By Kelly Barland, Chief Information Officer, St. John’s Episcopal Hospital, New York City

The pros and cons of the Affordable Care Act (ACA) continue to be debated, but one point appears to be beyond dispute: the ACA has significantly contributed to the explosive growth of the Medicaid program. In FY 2015 – the first full year of ACA coverage expansion – enrollment and spending in Medicaid across the 50 states and DC increased by an average of nearly 14%.[1] Combined federal and state spending for Medicaid was more than $500 billion in 2015 and is projected to reach $750 billion by 2020.[2]

Many initiatives are being implemented to help stem the rising costs and improve patient outcomes including increasing the value and quality in managed care contracts, instituting home health for individuals with chronic conditions, and testing innovative delivery and payment models.

One of the more promising efforts has been the Delivery System Reform Incentive Payment program (DSRIP). Rolled out in 2010-11 in California, Texas, and Massachusetts followed by New Jersey and Kansas, in 2012, DSRIP originally focused on funding for safety net hospitals and resulted from negotiations between HHS and the states on how to pay for hospital care. The program has evolved into a way to initiate payment and delivery system reforms and provide the states with funding to support hospitals and other providers in changing methods of providing care to Medicaid beneficiaries.

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Topics: Medicaid, Hayes Thought Leadership Blog Series, DSRIP, ACA

Amidst the Angst, Value-Based Care Is Working

Posted by Don Michaels, Ph.D. on October 5, 2016 at 9:00 AM

“It’s not the strongest of the healthcare organizations that survive, nor the most intelligent, but the ones most responsive to change.”

–With apologies to Charles Darwin

People – and organizations – tend to fear and therefore avoid change. That often applies to healthcare organizations facing the new reality of value-based care reimbursement models. As a result, many are holding back trying to maintain the status quo against the rising tide of inevitable change.

On the other hand, some organizations have embraced and committed fully to the change. They have implemented various versions of value-based care programs, been patient and as a result, are starting to reap rewards. They are proving the truth of Darwin’s “repurposed” statement above, and have the best chance to survive – and thrive – because they have been the most responsive to change.

The changes these organizations are going through are not only succeeding in strictly financial terms. They are also increasingly meeting the other major goal of value-based care – better patient outcomes.

Here are three examples of the kinds of positive change possible in the new value-based care environment.

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Topics: value-based care

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