In this special edition of our Healthcare Leaders blog series, we have asked some of the country’s leading experts to give us their predictions for 2017. From analytics to consumer engagement to interoperability, we get a glimpse of best guesses on what is sure to be an interesting year.
Hayes' Healthcare Blog
By Susanna Partrick, Senior Privacy and Compliance Administrator, Weill Cornell Medicine
Nearly eight out of ten healthcare internal auditors in a recent survey by PwC believe risks are increasing. As a result, almost nine out of ten say they have gone through or will soon be involved in significant business transformation. The conclusion is that these increased risks and transformative changes in the healthcare industry will require internal auditing to change as well.
Unfortunately, few healthcare organizations are able to add resources during a time of shrinking revenue and tightening margins. To meet this increased demand, therefore, those of us responsible for the internal compliance program functions must find ways to be more efficient with the resources we do have. Doing more with less has become an inevitable mantra for compliance auditing groups in healthcare organizations striving to minimize overall risk.
The concepts of productivity and efficiency are often viewed negatively – as simply buzzwords to wring more output from overworked staff. That doesn’t have to be the case. A huge part of our responsibility as leaders is to work cooperatively with our teams to improve the amount of work being performed by optimizing their skills, our processes, and the technology under our control.
Here are five key steps you can take to improve the productivity and efficiency of your compliance audit team.
Over the past few months, I’ve been in England, China, Denmark, New Zealand, and Canada.
Each of them is rethinking their healthcare IT strategy and is not entirely satisfied with past progress.
I’m often asked by senior government officials to help harmonize IT strategy at the country level. That I can do. I’m also asked to discuss the US Presidential campaign, but that defies rational explanation.
I frequently say that healthcare IT issues are the same all over the world. Here’s a few common observations:
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%. Combined federal and state spending for Medicaid was more than $500 billion in 2015 and is projected to reach $750 billion by 2020.
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.
In a recent survey, eight out of 10 consumers believe taking a greater, more active role in their healthcare is a positive. Nearly nine of 10 reported feeling a need to be more proactive in managing their own healthcare. The sea change that has since washed over the healthcare industry over the past few years has only served to strengthen those opinions.
By Steven M. Wagner, PH.D., M.P.A, Executive Director Medical Practice Income Plan; Clinical Instructor in Health Policy, Finance and Administration, Department of Medical Education, Texas Tech Health Sciences Center El Paso at the Paul L. Foster School of Medicine, faculty instructor for Independence University, and Research Fellow at the Centers for Healthcare Research in the School of Advance Studies for the University of Phoenix.
Healthcare leaders need to look at the bigger picture of healthcare reform rather than narrowly focusing on its separate components. Fragmented legislation and grants led us to where the healthcare industry stands today, and only integrating networks of components in healthcare can lead us to successful reform. Success means that healthcare becomes accessible and affordable with or without insurance to all payors, quality outcomes take into account the functional and holistic health of the patient, and patients are satisfied and feeling well.
The hard reality is that in the end, everyone in the industry will be dealing with less revenue because the over-arching goal for the US government is cost containment. Only when leaders take all the changes into account will we, as an industry, be able to facilitate truly beneficial change. To make that happen, revenue cycle leaders need to be able to integrate cost, quality, and access into our routine processes of patient care, frequently analyze outcomes including the patients’ self-perceived health statuses, and develop actionable solutions.
By Don Livsey, former Vice President and CIO, UCSF Benioff Children’s Oakland, Founder DZL Solutions
Big data, informatics, business intelligence, and data mining have all been floated as “silver bullets” to solve the riddle of healthcare reform. One that will likely have the biggest impact, however, is population health. HealthcareIT News recently reported that population health and data analytics are the top two topics of interest for 2016. Everyone wants it, but few can clearly define what it is, and we don’t know what it will cost.
David Kindig of the Department of Population Health Sciences at the University of Wisconsin and Greg Stoddart from the Department of Clinical Epidemiology and Biostatistics at McMaster University in Ontario, are credited with this first attempt at a definition of population health in 2003:
“The health outcomes of a group of individuals, including the distribution of such outcomes within the group. These groups are often geographic populations such as nations or communities, but can also be other groups such as employees, ethnic groups, disabled persons, prisoners, or any other defined group.”
A 2015 survey of 100 healthcare leaders conducted by Milken Institute School of Public Health noted that the definition was accurate but focused strictly on measurement and didn’t explain or acknowledge the “role that healthcare providers must take to impact those outcomes.”
What isn’t in dispute is the fact that population health will be a significant focus of the healthcare industry going forward. A recent industry 2015 report identified three key trends involving population health:
“We are deadly serious about interoperability.”
-Andy Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) at the J. P. Morgan Healthcare Conference in San Francisco in January 2016.
For those of us in the healthcare vendor community, that defining statement sets the tone for the future interaction between organizations. Slavitt was also clear that achieving interoperability means “leveling the technology playing field” and requiring vendors to interchange data. He discussed open Application Programming Interfaces (APIs) as a specific model for integrating and moving data seamlessly between technologies. These are now guiding principles as we collectively try to benefit more from interactions outside our specific verticals.
By Mark Schneider, Vice President, MedStar Health
According to a survey by Hospital and Health Networks magazine, only 39% of respondents integrate clinical data so it is accessible, searchable, and reportable across the care community. That’s up from 33% in 2014 but far short of the type of connectivity needed to ensure quality patient outcomes.
With 10 hospitals, 6,000 affiliated physicians, and 30,000 employees, MedStar, like most healthcare organizations, has its share of IT priorities like Meaningful Use, electronic health record (EHR) optimization, and establishing a consistent set of platforms across all of our inpatient departments. But some of the most exciting and important work we are doing is focused on initiatives outside our hospital walls – connecting to our patients, connecting our clinicians (visiting nurses and geriatric providers making home visits), connecting our myriad of outpatients sites (clinics, physician offices, rehab facilities, urgent care centers) and connecting with other major health organizations, once viewed as competitors, in the Maryland and Washington, D.C. area.
According to the CMS National Healthcare Expenditure Projections report, the U. S. healthcare system is the most expensive in the world, making up 17% of the country’s gross domestic product. Projections have that number reaching to nearly 20% by 2020. Aging populations combined with chronic health problems have put an enormous strain on medical and social services.
The reality is our healthcare system is broken. The way it’s constructed makes it difficult to navigate – for patients, providers, and employers. The good news is that visionary leaders and organizations are embracing change in an attempt to make a meaningful difference. That’s important because we should not be handing over the healthcare delivery system we’ve created to future generations. But instead of pointing fingers or assessing blame, we should be working together to make needed changes.