2017 Payer Solutions Summit: Bringing Together the MedeAnalytics Payer Community
From October 25-27, the MedeAnalytics payer community came together at La Cantera Resort and Spa in San Antonio, Texas for the 2017 Payer Solutions Summit. The event gave attendees the opportunity to collaborate to better understand how to keep up with the growth and evolution of the industry, with the support of MedeAnalytics’ solutions and thought leaders.
Our very own CEO, Paul Kaiser, kicked off the event, introducing himself and discussing his aspirations for the company. Kaiser highlighted how impressed he was with our committed associates, fantastic clients and great technology offerings. He realized how special of a company MedeAnalytics was within the first five months of his new role. Kaiser concluded his presentation by outlining his hopes for MedeAnalytics, which include continuing to evolve, innovate and scale in terms of client value management and transparency.
In addition to our CEO, Scott Hampel, SVP of product and strategy, and Tyler Downs, CTO, took the stage to discuss product innovation alignment and the payer portfolio. They also explored the company’s technology strategy and plans for growth, including platform innovations, machine learning, guided analysis, third-party integration and more.
In addition to key thought leaders within the company, several payer clients also delivered presentations that demonstrated their unique use of the MedeAnalytics platform and the results they achieved. Some of the representatives included Mississippi Division of Medicaid, St. Joseph Hospital, part of Covenant Health, Presbyterian Healthcare Services, MVP Health Care, and Kaiser Permanente.
EPM Series: Learn How to Create Organizational Alignment with Performance Management
With the shift to value-based care, new payment models now reward organizations that focus on improving quality and lowering costs and penalize those that do not. Under these models, organizations are now required to report on additional metrics and are faced with major time constraints as they try to ensure proper documentation. Because of this, health systems are looking for innovative ways to relieve doctors of their administrative jams and make all parties across the organization more productive. These efforts require a top to bottom initiative, with the organization taking steps to successfully transition to value-based care.
In this week’s blog, we share how one health system, Jersey City Medical Center (JCMC), part of Barnabas Health, a regional referral and teaching hospital, is driving transparency, communication, results and excellence across their organization by leveraging a Performance Management (PM) solution to ensure they are properly tracking and marching toward their organizational goals.
National Health IT Week In Review
Last week marked the 13th annual National Health IT Week. This event is dedicated to celebrating the essential role of Health IT in transforming health and healthcare in the U.S. As a healthcare analytics provider, MedeAnalytics is dedicated to continued innovation of our platform and suite of analytics solutions to meet the ever-changing needs of healthcare providers and payers.
This year, National Health IT Week focused on four integral themes that highlight the value of health IT, including:
- Supporting Healthcare Transformation
- Expanding Access to High Quality Care
- Increasing Economic Opportunity
- Making Communities Healthier
Here’s our recap of each:
- Supporting Healthcare Transformation – Digital health is playing a critical role in driving transformation in care delivery, including improving quality and safety, interoperability, data sharing and patient-consumer engagement. Analytics tools play a major role in helping organizations achieve their goals in healthcare transformation, but what else can they do? Our blog shares steps for organizations to ensure they are making the most out of their analytics investment and successfully supporting their organization’s transformation journey.
- Expanding Access to High Quality Care - As the industry shifts to value-based care, organizations are putting a greater emphasis on quality care. Innovative technologies like telehealth and remote patient modeling are helping to increase patients’ access to the care and the support they need, which in turn supports the industry on its journey to value. As part of this initiative, HIMSS shared its health IT “wish list” with Congress. which included a request to improve and expand telehealth offerings.
- Increasing Economic Opportunity – The healthcare industry makes up 17.8% of the U.S. economy and employs over 12,000 people. This growing workforce is full of diverse, competent individuals who are passionate about supporting economic growth. Part of this growth is dependent on ensuring that all clinicians have the IT fluency needed for success. As reporting requirements evolve, value-based hesitancy grows and the industry looks to reduce physician burnout, this will only grow in importance.
- Making Communities Healthier – At the end of the day, efforts by the health IT community are focused on one outcome: keeping families and communities healthy. Population health has been a central theme across the industry as of late and recent technologies continue to support the health of the greater population. Learn how our client St. Joseph Hospital of Covenant Health leveraged data and analytics to create a population health program in their own organization to successfully improve the health of their employees and their dependents.
Mississippi Division of Medicaid Remains the First to Establish Clinical Data Exchange
Each year, state Medicaid leaders from all over the country gather at the Medicaid Enterprise Systems Conference (MESC) to talk about the role of technology in meeting Medicaid and industry initiatives, like value-based care. Our client, Mississippi Division of Medicaid (DOM), spoke on their use of the consolidated clinical document architecture (C-CDA) standard to coordinate care and improve outcomes for their Medicaid beneficiaries. DOM is the first Medicaid agency in the nation to establish clinical data exchange with healthcare providers to directly benefit patients and physicians at the point of care. DOM has successfully exchanged data with University of Mississippi Medical Center (UMMC) which resulted in more than two million clinical summaries. They also recently partnered with Hattiesburg Clinic and shared more than 100,000 clinical summaries.
To achieve this level of connectivity, DOM faced many challenges such as differences in vendor implementation of industry standards and providers’ use of unexpected medical codes. We connected with Ian Morris, Project Manager for the State of Mississippi DOM, to get his take on the overall lessons learned from this project and what fellow government organizations need to keep in mind for similar undertakings. Here are three key takeaways:
- Rely on Vendors’ Expertise – DOM would not be able to achieve this level of success without qualified vendors who have the expertise to develop and support the technology infrastructure and needs of real-time data exchange for hundreds of thousands of beneficiaries.
- Be Realistic – These projects are time and labor intensive and can take years to achieve. Be patient and work around your trading partner’s various schedules and technologies.
- Collaborate – Every stakeholder has different end-goals but these projects are a joint effort. This means that the conversation needs to move away from “my data” and towards “our data” to better coordinate care.
Looking ahead, DOM plans to continue integration with Medicaid-focused health systems, Health Information Exchanges and state and federal agencies. In fact, just last month they went live with their third clinical data exchange connection – Singing River Health System.
To learn more on UMMC and DOM’s success, read our announcement here.
CHIME Series: Are you making the most out of payer data?
This week, we continue to explore the results of our College of Healthcare Information Management Executives (CHIME) survey and the need for various data sources. Our survey asked the question: Do you have a strong grasp on how to deal with payer data today? The results show that the majority (57 percent) of provider organizations do not.
As healthcare costs continue to rise and the industry focuses on value-based care, payers and providers need to look for ways to collaborate. This relationship is critical to payers as they leverage EHR data to better understand the cost of services rendered by the providers, measured against the outcome of care. For providers, combining both claims and clinical data can reveal some extremely valuable insights that can positively influence clinical decisions and drive down costs. However, many organizations still face challenges, including a lack of appropriate tools and an influx of data that is difficult to manage. This then creates a lag in insights being delivered to the right people at the right time. Bruce Carver, associate vice president of payer services, believes optimized organizational coordination can help address some of these issues.
Here are two of his best practices for making the most out of payer-provider collaboration:
- Trust Each Other– The first step in any relationship is trust. Are your goals aligned? Do you have redundant reporting or processes to get to these shared goals? Where can things be streamlined? This relationship will take time as both parties must work together to improve collaboration and ultimately gain more insights.
- Establish Communication Processes – Communication is also key and establishing efficient processes can help ensure that organizations are on the same page when issues arise. Some of these issues include, gaps in payer data or instances when payer data is not directly aligned with provider data.
Once organizations are aligned, payer data can be leveraged to better meet industry-wide demands of becoming more patient-centric and value-driven. This collaboration can also help providers manage medication adherence and establish cohesive strategies that address this issue.
As providers continue to struggle with a lack of organizational resources and payers begin to shrink in numbers, payer and provider collaboration will be more important than ever. Additionally, creating this collaboration can help both parties ensure that they are on the right track towards value. To see more results from our CHIME survey, access recent blogs here and here. If we can help get your organization on the right track, make sure to contact us.