Roji Intel Blog

Dave Halpert 1
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ACOsAPM Performance PathwayClinical Data RegistryValue-Based Health Care
November 30, 2022

Catapult Your Performance Using the APP and Achieve Data Sufficiency

In a previous post, we demystified the Alternate Payment Model Performance Pathway (APP) and explained how, by partnering with a Clinical Data Registry experienced in data aggregation and result submissions to CMS, you can avoid the bugaboos falsely attributed to APP reporting—perceived high costs and impossible timelines. Here we’ll show you how to leverage your new skills to elevate your ACO’s performance across the board, from quality scoring to effective patient management—and achieve data sufficiency, in the process. Achieve Better Scores and Insights from Quality Reporting Once your ACO’s data from all practices is aggregated, you will be ready to…
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Theresa Hush 0
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Alternative Payment Models (APM)APM Performance PathwayEpisodes of CareValue-Based Health Care
October 31, 2022

Launch Time! Five Intervention Strategies to Fuel Your APM Liftoff

If you've followed the Smart Guide articles so far, your APM is ready for take-off. You’ve developed a data-sufficient technology infrastructure with both provider and claims data, carefully constructed your clinical network and engaged your clinicians, and implemented strategies for payers and consumers. Your APM may be operating already, with data ready to use. Now you are at the crossroads, and your choice will determine whether your APM will really transform outcomes for your patients and achieve maximum Value, or whether your APM will be average. That choice pivots on interventions. Only through specific interventions with clinicians and patients can…
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Theresa Hush 0
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Alternative Payment Models (APM)APM Performance PathwayConsumers & PatientsFuture of Health CareValue-Based Health Care
October 26, 2022

Need to Fire Up Your APM’s Consumer Strategies? Start Here

You've read it and you've experienced it: consumer frustration with an impersonal health care bureaucracy offering few conveniences, difficult navigation, high cost, and lack of transparency. Even as some organizations try to move forward with consumer-focused strategies, these are often still fledgling efforts with little overarching structure that fail to attract consumer attention. Beyond implementing an EMR patient portal, traditional providers have been slow to develop the consumer focus necessary to generate trust and loyalty. Meanwhile, consumers are welcoming an abundance of health apps and other resources that enable them to manage their health and, if sickness strikes, get quick…
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Theresa Hush 0
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Alternative Payment Models (APM)APM Performance PathwayEpisodes of CareMedical Decision-MakingValue-Based Health Care
October 19, 2022

3 Ways to Engage Physicians to Lead Transformation in Your APM

Doctors leaving medicine spells trouble for health care. And there’s real reason for concern. A few weeks ago, the Mayo Clinic released its most recent study on physician burnout, revealing the highest rate in the survey’s 10-year history. Sixty-three percent of responding physicians reported one or more characteristics of burnout, with many noting depersonalization, an inability to maintain a work-life balance, and career dissatisfaction. The Mayo story was significant enough to be picked up by The New York Times. This worrisome trend creates a real quandary for Value-Based Care and adoption of Alternative Payment Models (APMs), since their success or…
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Theresa Hush 0
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ACOsAlternative Payment Models (APM)Future of Health CareValue-Based Health Care
October 5, 2022

Eight Key Strategies for APM Contracting Right Now

Are you considering entering into APM contracts with private payers? Bravo! Teaming with commercial health plans and employers is a strong opportunity for growing patients through APM arrangements. Expanding your APM agreements into all payment types will be essential to back the incentives you build into your workforce for performance-based pay. But those contracts must align with your APM strategies and support your goals. Our focus here is on APM contracts with health plans. Health plans may be eager to adopt these arrangements with you, if their analytics of your organization demonstrate good outcomes and reasonable costs. Population-based payments, which…
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Theresa Hush 0
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Smart Guide for APM Success, Terry Hush, Roji Health Intelligence
Alternative Payment Models (APM)Future of Health CareRiskValue-Based Health Care
August 11, 2022

Your Smart Guide for APM Success

In the next several years, one of two things will happen: Either traditional health care providers will make the largest, make-or-break transformation of health care system economics and delivery of care in U.S. history, or the legacy health care system as we know it will not survive, but will be absorbed into the new corporate business of health care. Successful APM adoption will make the difference. What is driving this transformation? Three forces are responsible: First, the urgent cost crisis in health care demands that providers become more accountable for costs and better patient care, and adopt value-based payment models…
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Dave Halpert 0
1
ACOsAlternative Payment Models (APM)MIPS Value PathwaysValue-Based Health Care
July 12, 2022

CMS 2023 Proposed Rule Accelerates ACOs, MVPs

CMS just set off summer fireworks, amping up incentives to adopt Value-Based Care in its just-released, 2,066-page 2023 Proposed Physician Fee Schedule Rule. By encouraging formation of new ACOs, the Proposed Rule establishes a pathway to expand beneficiaries' access to accountable care. Last year, CMS committed that every Medicare beneficiary will be in an accountable care relationship by 2030, to ensure quality and total cost control. Its October 2021 Innovation Center’s Strategic Refresh identified issues with provider adoption of accountable care networks and alternative payment models (APMs). It also identified two objectives: to drive providers into Accountable Care Networks, and…
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Theresa Hush 0
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5-imperatives-for-value-based-care-technology
Alternative Payment Models (APM)Episodes of CareFuture of Health CareNew Script for APMsPerson-centered Health CareValue-Based Health Care
June 23, 2022

5 Imperatives for Your Value-Based Technology to Support APMs

After years spent transforming your health care technology, you may feel like you're almost done. But Value-Based Care Technology requires a different mindset. With reimbursement scaling to a tipping point for APM adoption, think "reboot" instead. Your health system or group has a long way to go if your aggregated and integrated data cannot support person-centric care and data-directed population health, quality, and health equity strategies. The Value-Based Care Technology game is no longer focused on implementing an EHR, or even population health. Those are basic ingredients that make it possible to do more. Now it's about bringing all the…
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Theresa Hush 0
0
Alternative Payment Models (APM)Consumers & PatientsFuture of Health CareNew Script for APMsValue-Based Health Care
June 8, 2022

Six Ways Competition Must Shape Your APM Strategy

Now that you've made the decision to start your path to Alternative Payment Models (APMs), what's the first thing you need to consider? Hint: APM revenue calculation does not top the list. Obviously, APM revenue generation vis-à-vis traditional Fee-for-Service is critical. But those calculations assume constancy of two essential “assets”—clinicians and patients. Your competition is working hard to grow these same resources for their own operations. The easiest place to get them from is your organization. If you are following the growth of practice acquisitions from investor-backed health care companies and MSOs, payer practice acquisitions and retail giant investments in…
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Theresa Hush 0
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Alternative Payment Models (APM)Future of Health CareValue-Based Health Care
May 18, 2022

Wanted: Better Script for Health System and Medical Group Transition to APMs

Health care has been suffering for a while—just ask any participant, including patients. You will hear about burnout, pressures to perform, changes in the market, pressures of new technology, fiefdoms, consumerism, and to top it off, the buildup of competition between traditional health care enterprises and new corporate health care businesses. Then there’s the pandemic, which may be sidelined publicly but continues to ravage health and the business of health care. Value-Based Care and its sidekick, Alternative Payment Models (APMs), continue to pressure health care finances. Providers, who have played cat-and-mouse with APMs for a while now, are beginning to…
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