Roji Intel Blog

Theresa Hush 0
0
ACO ReportingClinical Data RegistryFuture of Health CarePerformance ImprovementRegistry ScienceResearchValue-Based Health Care
January 26, 2016

Why Traditional VBHC Trouble Shooting Will Get You in Trouble with Performance Improvement

You’ve heard the phrase. You know it’s a key goal in Value-Based Health Care. But many providers don’t understand the full meaning of performance improvement. All too often, health care systems rely on piecemeal, troubleshooting approaches that emphasize short-term gains over meaningful, improved outcomes. Here’s a common example: Almost every hospital has adjusted its discharge process to avoid readmissions. But unless they can explain why patients were readmitted—few actually can—gains will diminish. New patients presenting with the same high-risk conditions will challenge reduction of readmissions because efforts addressed the symptom but not the root cause. Improving performance means more than…
Read More
Robert McNutt, M.D. 0
0
Clinical Data RegistryFuture of Health CarePerformance ImprovementRegistry ScienceResearch
January 19, 2016

The CDR Advantage: Why Registry Research Minimizes Study Bias for Performance Improvement

The Clinical Data Registry is a powerful research tool for improving patient health. But what makes Registry-based study design better than pre-post study design? The answer has far-reaching implications for how we will use data to determine treatment effectiveness in the future, as well as how we will meet the challenge of improving health outcomes. Research can be built on the case-control study, observational study designs, N-of-1 study designs, randomized trials or the N-of-1 population study. Most of these approaches—except those facilitated by a Registry—will be limited by small patient samples due to the patient selection process. But that’s a…
Read More
Robert McNutt, M.D. 0
0
Future of Health CarePerformance ImprovementRegistry ScienceResearch
October 27, 2015

How to Harness Clinical Data Registry Power to Improve Outcomes

At the center of Medicare’s Value-Based Health Care, the Clinical Data Registry (CDR) is introducing new possibilities for outcomes improvement. Under this month’s final rules, Medicare expanded the role of Specialized Registry and Clinical Data Registry reporting in its future Meaningful Use program. Specifically, CMS initiated provider reporting to a “Specialized Registry” in 2015 as an option to meet Stage 2 requirements, while establishing the CDR as the future avenue for capturing outcome data over time. The question now is: How can we use a CDR to improve patient health? Some providers may “check the box” on Meaningful Use objectives…
Read More
Theresa Hush 0
0
ACO ReportingFuture of Health CarePopulation HealthQualified Clinical Data Registry ReportingRegistry ScienceResearchValue-Based Payment Modifier
August 4, 2015

ACOs and the Referral Revolution Part 2: How to Align Objectives and Referral Practices

There’s no getting around it. Disruption in referrals under new Value-Based Health Care programs will upset both primary care and specialty practices under any change scenario. Physicians with historical relationships will undoubtedly resent an edict to redirect referrals, if they don’t understand or believe comparative data on cost and quality. On the other side of the equation, physicians who accept that aligning referrals with outcome data is part of being in an ACO will object if they see that referrals are driven, instead, by physician employment status. Every participant in an ACO must eventually accept that achieving shared savings will…
Read More
Robert McNutt, M.D. 0
0
Registry ScienceResearch
July 21, 2015

Are You Measuring Effectiveness of Your ACO’s Population Health Interventions?

It’s time to reboot your method of deploying population health initiatives, if you really want a return from your ACO efforts. Despite the intense focus on data and analytics in health care, most start-up ACOs adopt identical population health initiatives, such as intensive case management for high cost patients. The choice is not made because of proven outcomes and lowered costs from these initiatives, but because everyone else is doing the same thing. It’s ironic that we adopt evidence-based performance measures, but rely on anecdotal results in population health. With a research-capable Registry and reliable data, we can be smarter…
Read More
Theresa Hush 0
0
Population HealthRegistry ScienceResearch
May 19, 2015

Population Health: Fact or Fiction?

For the past couple of years, “population health” has become a popular catchphrase.  Everyone is talking about it, adopting it or selling it. But if you ask anyone what it means, you’ll get very different answers. That’s because there seems to be only one point of consensus—we need to focus health care efforts on specific populations. Should you care? I think so, and here’s why: Providers and ACOs are beginning to spend a lot of money on population health, yet no one is measuring the effects of those efforts and whether they actually achieve positive outcomes. Fuzzy Definitions Can Lead…
Read More
Dave Halpert 0
0
Population HealthPQRS ReportingQualified Clinical Data Registry ReportingRegistry ScienceResearchValue-Based Payment Modifier
April 28, 2015

Better Hypertension and Diabetes Outcomes: From Basic Measurement to a Plan for Improvement

Are you caught in a squeeze between avoiding penalties in both PQRS and the Value-Based Payment Modifier (VBPM)? Medicare’s move to Pay for Performance has created a Catch-22 for many groups:  you may have enough data to report enough PQRS measures, but if you choose to report measures where your performance is below the CMS mean of your peers, you risk penalties under the VBPM. As a CMS reporting registry that integrates VBPM Consultation Services, we commonly find at least one or two measures per client with scores that could negatively affect the VBPM if used in PQRS reporting—especially for…
Read More
Theresa Hush 0
0
Future of Health CareMedical EducationPopulation HealthPQRS ReportingQualified Clinical Data Registry ReportingRegistry ScienceResearchValue-Based Payment Modifier
April 7, 2015

Academic Medical Centers at Risk: How to Survive Medicare and Medicaid Value-Based Health Care

Academic Medical Centers (AMCs) provide care to the most complicated patients and have surmounted some of the worst clinical challenges of all time. Yet the biggest issue to threaten survival of AMCs might well be Medicare and Medicaid Value-Based Purchasing. While AMCs incorporate the training of new physicians in both community and highly specialized care, the clinical complexity of their patient population is higher than other institutions. At the same time, AMCs are the most likely medical centers to offer trauma and burn care, new medical technology and clinical research. But with typically high volumes of Medicare and Medicaid patients,…
Read More
Thomas Dent, M.D. 0
0
Population HealthRegistry ScienceResearch
March 17, 2015

Placebo v Nocebo: How to Test Methods of Physician Engagement in Population Health

The Holy Grail for value-based health care is to improve patient quality and cost outcomes, while stabilizing or reducing annual aggregate payouts for insurance and government benefits. By holding physicians and health systems accountable, the theory goes, providers will engage with patients in a process leading to better status and lower costs. The key word here is “engage,” because none of this happens in a vacuum. Provider engagement is essential for making change happen. But if engagement is the key, how do physicians’ mindsets, attitudes and language play into outcomes?  Providers are not a homogenous group, any more than patients…
Read More
Robert McNutt, M.D. 0
0
Population HealthRegistry ScienceResearch
February 24, 2015

Population Health: What Should It Really Mean?

A long time ago, on my first day of an Oncology fellowship, my soon-to-be-mentors asked me if I had a research interest. “Yes,” I said, “I want to cure breast cancer.” Their kind smiles belied their recognition of my naïveté. In retrospect, thinking too broadly leaves one adrift. To navigate to your goal, you need to chart a specific, systematic course. Talking without specificity about “population health” can lead to thinking as murky as my claim to cure breast cancer. Population health is sometimes defined so broadly that it becomes meaningless.  Unfortunately, population health has also become synonymous, for some people, with…
Read More