Assessing the needs of a community — through preparation, coordination and implementation — does more than check a box. It provides hospitals with insight into where time, money and resources should be dedicated to improve population health. This is the purpose of the Community Health Needs Assessment. Per the American Hospital Association’s guide , the CHNA includes multiple moving parts and contributors who: interview community leaders; hold stakeholder meetings; conduct patient surveys and query results; establish and participate in community focus groups; and analyze population health metadata. These steps can be time-consuming and unclear, leaving many to question whether they’re accurately evaluating their community’s needs — or just trying to meet compliance requirements. But, what if there’s a better way? In this blog, we’ll break down three steps you can use to simplify your CHNA, so you can drive the best outcomes for patients and providers. Three ways to simplify the CHNA 1....

Achieving Patient-Centered Medical Home recognition sets your practice apart from others as you focus on the quadruple aim: continual improvement of outcomes, decreased expenditures and increased patient and staff satisfaction. PCMH adopts repeatable processes, policies, communication, documentation and reporting, which is ─ the backbone of value-based incentive programs and payer initiatives nationwide. Using a team approach to best understand patient populations and meet patients where they are leads to more equitable healthcare across all patient populations. To keep the benefits of PCMH recognition, practices must keep their medical homes current and sustain the program from year to year. Sites must demonstrate in Q-PASS (the National Committee for Quality Assurance’s web-based evaluation tool) that their medical home workflows are in place by their stated reporting date. NCQA updated the PCMH standards, guidelines and annual reporting requirements for 2023. Standards and Guideline...

The challenges and benefits of bundled payments and risk-based arrangements is one of the biggest issues facing the healthcare field. Kelly Price, DataGen’s Vice President and Chief of Healthcare Data Analytics, and Stephanie Kovalick, Chief Strategy Officer at Sage Growth Partners sat down to help shed some light on ways to succeed with bundled payments and risk-based payment models. Read more about this conversation in our new installment, “The Future of Payment Reform: How can providers, patients, and payers benefit—and who bears the burden? ” 

As we look ahead to 2017—a year that’s sure to bring changes to the way healthcare is delivered under the new Trump Administration—Kelly Price, DataGen’s Vice President and Chief of Healthcare Data Analytics, sat down with Stephanie Kovalick, Chief Strategy Officer at Sage Growth Partners, to provide expert perspective on the current and future states of payment reform. Download 

The healthcare industry is in a state of quiet anticipation as we await the second data feed from the Centers for Medicare and Medicaid Services’ (CMS) Comprehensive Care for Joint Replacement (CJR) bundled payment model. Participants still have a lot of questions?  Will the program help hospitals deliver better accountability for care? Will care be coordinated more effectively? Is it going to help reduce costs—and if it does, for whom?  Learn more

Launched on April 1, 2016, CJR is the first mandatory bundled payment program from CMS.  Affecting more than 750 hospitals in 67 markets, CJR creates a host of new challenges and opportunities for participants. Read the article to learn more about the program and prepare for the initial data release .

Announced by the CMS in January 2015, OCM is one of the most recent programs in a litany of new experiments.   Simplifying and organizing the complex data and policy component of this program requires specialized expertise in healthcare analytics. Read about DataGen's recent work related to the OCM in Achieving Data-Driven Success Under the OCM , which identifies four critical areas data analytics will need to address for any bundled payment model. Download the article .

It is critical that healthcare executives understand and stay abreast of the implications on their organizations of the rapidly evolving innovation in healthcare payment and delivery driven by Medicare and other payers. This white paper examines areas of opportunity and ways for hospitals to achieve CJR success. Download Now

CMS has released its final rule for the Comprehensive Care for Joint Replacement (CJR) model.  In addition to dropping one “C” from the acronym, there are several substantive changes from the proposed rule; most important of which is that the program will now begin on April 1, 2016.   DataGen is revising its analytics to reflect all of the changes.  We will be ready to share insights on opportunities under CJR prior to the program’s official start.  We have updated our "Ten Things" paper to reflect the final rule.   Download White Paper

Hospitals may be the only risk-bearing entities under the Centers for Medicare and Medicaid Services' (CMS) Comprehensive Care for Joint Replacement (CJR) payment model, but there are major implications for post-acute care (PAC) providers.  Based on our review of the CJR program, this white paper outlines the top seven things PAC providers need to know about and act on to be successful partners in this and other emerging payment models. Download White Paper

In July 2015, the Centers for Medicare and Medicaid Services (CMS) proposed its Comprehensive Care for Joint Replacement (CCJR) payment model, a pilot bundled payment program for the most common inpatient surgeries for Medicare beneficiaries—hip and knee replacements, known as lower extremity joint replacements (LEJRs). While CMS’ increasing interest in bundled payments has been apparent, the announcement of this mandatory initiative was a surprise to many, given that the Bundled Payments for Care Improvement (BPCI) demonstration program, initiated in 2013, is still in its early stages.  CCJR would be mandatory for hospitals in 75 Metropolitan Statistical Areas (MSAs). This white paper examines the top ten things every hospital executive should know about the proposed CCJR program, its relationship to the BPCI demonstration, and the implications of this model for other innovative payment models.  Download White Paper

What is the most cost-effective post-acute care setting for rehabilitation after a medical or surgical hospital stay—an inpatient rehabilitation facility (IRF) or a skilled nursing facility (SNF)?  It is widely assumed that rehabilitative care in an IRF may be more effective because of its higher-intensity programs, lower lengths of stay, and fewer readmissions.  But, is this the full story?  Download this article

For 30 years, Medicare's hospital Inpatient Prospective Payment System has used DRGs to account--or risk adjust--for the differences in the cost of care for clinically complex patients.  By creating a direct link between reimbursement and outcomes, pay-for-performance adds a new layer to the issue of risk adjustment. Download this article

A new approach to data-driven decision making  Healthcare reform initiatives, driven by government, healthcare providers, and payers, are  shifting the focus of care delivery and payment from individual points of service to the whole patient and entire populations. This transition from “volume” to “value” (or population health) requires a mindset change for hospitals, health systems, and other providers. It necessitates an expanded perspective that encompasses the full spectrum of care for patient populations—from primary to post-acute services—to improve health and outcomes while reducing costs. Download Now