The Value of Integrating EMR and Claims/Cost Data in the Transition to Population Health Management
It might be a move in the right direction, or it could be a significant change in how the physician fee schedule encourages certain types of care—we won’t know until later—but right now it’s encouraging that CMS is considering paying primary care physicians for chronic care management services without an in-person visit, and also for telehealth services. “I think primary care physicians are going to see a tsunami of patients wanting care and newly insured in 2014, and this is one of the easier ways to expand capacity,” said Tom Doerr, MD. “You don’t have to take on the hiring of a new midlevel clinician. There is a lot less stress involved with just sending an email and getting reimbursed for it.”
Reports, dashboards, analytics, and workflow all serve as essential parts in achieving the Triple Aim +1™: better health outcomes, lower costs and improved patient plus physician satisfaction.
In my role at Lumeris I often get asked by our clients, “What does care management really mean?” For me, having spent decades practicing geriatric medicine and teaching the principles of post-acute care coordination at a private research university and medical center, care management can be defined, most completely, as better care at lower cost for people with multiple health and social needs.
Physician satisfaction is a crucial part of the model for accountable care organizations, according to Dr. Debbie Zimmerman, the chief medical officer for Lumeris. She also spoke to Best’s News Service about improving clinical outcomes and physician incentives.
“Big data” has become a big, intimidating buzz phrase in health care. Health systems and provider groups are all trying to collect large amounts of clinical data, make it meaningful, and according to the American Hospital Association, use it to “facilitate the coordination of patient care across conditions, providers, settings, and time.” While collecting clinical data is a natural first step on the road to value-based care, the integration of that data is often complex, costly and time consuming.
CMS released a long-awaited checkpoint status on its Pioneer ACO program. Of the 32 entities enrolled in the program, according to CMS…
Next week I’ll be traveling to D.C. to speak at the Fourth National Accountable Care Organization Summit sponsored by the Engelberg Center for Health Care Reform at Brookings and The (…)
I have used the last two blog posts to introduce the Accountable Primary CareSM Model*, or the NineSM C’s* for short. To illustrate the power of the model, I used (…)
Lumeris developed the Nine C’s℠ to ensure a powerful, proven framework for delivering the Triple Aim +1™: quality, cost, plus patient and physician satisfaction. The Nine C’s offer providers a roadmap for making a successful transition from a volume-based to a value-based model.