- What Does It Take to Be A World’s Most Ethical Company?
- Repeal and Replace: Managing the Uncertainty
- A Look Ahead: Healthcare Under a New Administration
- Data in the Clouds: Enterprise Resource Planning
- Optimizing Physician Practice Acquisitions
- Social Determinants in a New Era of Healthcare
- Behind the Curtain: Premier at HIMSS17
- A Dozen Population Health Developments to Watch in 2017
- A Matter of Life and Death: Advance Care Planning
- Value Analysis Process: Why Each Step Counts
What makes an ethical company? Is it a rigorous code of conduct? Extensive employee education? Implementing security and data stewardship programs? Having a strong mission and values that all employees not only believe in, but live? The Ethisphere institute recently held their annual World’s Most Ethical Company® Gala, where they honored companies that demonstrate leadership in ethical business practices. This year, Premier was recognized for the 10th consecutive year, making it one of only eight companies to have reached this milestone. To Premier, an ethical company is more than just the rigorous code of conduct we follow, it’s something that affects our members, suppliers, the communities we serve and each other. Our employees are dedicated to improving the health of communities. We are passionate about we do. Premier employees live the following core values to align integrity and respect with innovation. * FOCUS ON PEOPLE: Demonstrating respect for all, and a mutual commitment to the success of the alliance, our employees, our business partners and the communities we serve. * INNOVATION: Seeking breakthrough opportunities, taking risks and initiating meaningful change. * INTEGRITY: Integrity of the individual, the enterprise and the alliance. * PASSION FOR PERFORMANCE: A passion for performance and a bias for action, creating real value for all stakeholders and leading the pace. These values have helped shape a culture of ethics that empowers Premier employees with a shared vision and strong workforce relationships, which support their efforts in finding ways to improve healthcare and create lasting value. As a founding member of the Healthcare Group Purchasing Industry Initiative with one of the strongest group purchasing codes of conduct in the industry, Premier continues to raise industry standards. Together, all of these factors help create an ethical company that continues to support its members and employees. So, join me in congratulating Premier on this amazing milestone, a decade in ethical business practices! To learn more about Premier’s ethical business practices, click here. AUTHOR INFORMATION
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I’m an Ethics & Compliance executive working in a public company environment who leads and influences corporate culture and compliance matters at Premier, Inc. When I am not working you can find me spending time with my family and keeping up with my backyard.
The replacement of the Affordable Care Act (ACA) began last week with Republican lawmakers releasing their first proposal for a reconciliation package – the American Health Care Act. And, we’re learning there are some thorny issues to work through. It’s a very uncertain time but we can all agree that changes are needed to the ACA. Despite all of the developments we’ve seen over the past eight years, we still have a system that allows payer decisions to override a physician’s judgment, is micromanaged with outdated regulations that undermine innovation, and has perverse incentives that encourage volume over value and sickness over health. But we shouldn’t return to the days of millions of uninsured, coverage locks outs for people with preexisting conditions, emergency rooms being used for primary care and unsustainable cost increases. So, how do we progress? We must prioritize achieving measurable improvement, patient-centered care, and provider-led innovations. Healthcare providers are working with Premier to do this by being effective advocates to Congress and the administration, as well as working together to test and scale new value-based models of care delivery. A few things we are certain about is that providers are moving forward on these efforts by: • BETTER MANAGING COSTS AND FINDING NEW SOURCES OF REVENUE. This includes improving productivity, reducing supply chain inefficiencies and pharmaceutical costs, and removing unjustified variation, as well as expanding their systems to create a high value network. • SEEKING MEANINGFUL INSIGHTS FROM ALL THEIR DATA. Health systems are moving beyond recording data in electronic health records toward integrating and combining data to streamline analytics on supply chain, financial and clinical care for evidence-based decision-making. • ENGAGING IN RISK-BASED CONTRACTS AND DEVELOPING EFFECTIVE POPULATION HEALTH MODELS. Providers are being incented to be accountable for cost and quality of care in ways they have never faced. They want this change, but it requires new skills, care delivery infrastructure, data and analytics, and capabilities. If we partner together and bring scale to help solve local problems, we can be certain we’re taking the right steps to continue to improve the cost and quality of healthcare, as well as the health of our communities. To learn more about how Premier can help you navigate the change at your organization, CLICK HERE. AUTHOR INFORMATION
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Healthcare is no stranger to change. Neither is Washington. With a new administration in office, big adjustments are on the horizon. From the repeal and replacement of the Affordable Care Act to the rise of prescription drug costs, healthcare is a trending topic that’s certain to continue in D.C. President Trump and Congress have difficult decisions to make when it comes to healthcare. But, things can move pretty slowly on the Hill. So what changes can we actually expect to see in 2017? In the video above, Premier’s President and CEO, Susan DeVore, outlines five healthcare trends for 2017: * THE REPEAL AND REPLACEMENT OF THE ACA * The repeal of the ACA is a lot easier than developing a replacement plan, but the reimbursement pressures on providers will continue to build. * THE VALUE-BASED CARE MOVEMENT * The movement toward value-based payment will continue, with new options that give greater choice but more risk. * STATE-DESIGNED HEALTHCARE * Decision-making on healthcare insurance and Medicaid is shifting away from the federal government and toward the states. * INCREASED COMPETITION IN PHARMACEUTICALS * Drug pricing remains a top issue, but Republicans will focus less on price controls and more on promoting competition. * CONSUMER-DRIVEN HEALTHCARE * We’ll see a greater use of health savings accounts, incenting consumers to look for more convenient and less expensive options for their care. Want to learn more? Read Susan’s full article on the five trends to watch in 2017 and click here to find out how Premier is helping our members navigate change. AUTHOR INFORMATION
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I’m a public relations leader from Charlotte, NC, with nearly 10 years of experience in the healthcare industry. When I’m not working, you’ll find me testing out new restaurants in my new home city (Greater New York City area), working out and reading on quiet weekends at home.
Cost pressures, evolving payment models, integration in the face of mergers and acquisitions – these are just a few of the pressing issues health systems face each day. One strategy providers are looking to when trying to align decision-making and integration on sourcing and purchasing in this new era of healthcare is the use of enterprise resource planning (ERP) solutions. ERP solutions can help health systems both improve efficiencies and reduce costs. But for many, that is easier said than done. While health system leaders are working tirelessly to integrate ERP software across their acquired hospitals, many have found themselves stuck with a fragmented mess of products and data that don’t effectively communicate with each other. Managing multiple products is inefficient and expensive, and can impede health systems from maximizing opportunities to cut costs and improve patient outcomes. Having the ability to access the right data and analytics on one fully integrated and secure platform can reduce unnecessary burdens on staff and streamline decision-making in the midst of the value-based care transformation. Cyber security is another key area for concern. With the rise of electronic health records (EHRs), there has been an ongoing industry conversation around the security of confidential medical information. When working to automate functions of an ERP such as purchasing, payroll and human resources, technological security should be an important consideration. Cloud-based ERP platforms are an excellent solution for cyber security, offering a secure and affordable option for health systems looking to integrate their software. Recently, Premier’s own cloud-based ERP solution was ranked “Best in KLAS” for the first time in the category, selected based off user feedback – a true testament to the financial and supply chain capabilities of the ERP solution. Interested in learning more about Premier’s award-winning cost management solutions? View our ERP Buying Guide or get in touch to hear more. AUTHOR INFORMATION
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Andy is currently the subject matter expert on Premier’s ERP and Supply Chain technologies. He has over 18 years of healthcare IT experience, with multiple roles supporting and implementing healthcare financial software systems across a wide range of customers and care settings. Prior to joining Premier, Andy also worked as a hospital consultant on financial workflow optimization and ERP design and utilization.
With the new administration and Congress moving forward at a rapid pace, many in the healthcare industry are looking for consistency amid the tide change. What certainties exist when a new administration is considering a different approach to healthcare reform? Unquestionably, the pace at which hospitals acquire physician practices is set to continue and potentially increase as the Medicare Access and CHIP Reauthorization Act’s (MACRA’s) Quality Payment Program drives physician practices to operate under a new value-based reimbursement system. When faced with the need to acquire a physician practice, how can healthcare systems evaluate both the clinical and economic value of the acquisition target, in light of the changing healthcare climate? PRE-ACQUISITION EVALUATION PHASE Acquiring physician practices often involves purchasing hard assets, such as real estate, furniture and equipment, assumption of existing leases, supplier contracts and payer agreements and more. These considerations should be addressed in the pre-acquisition phase during the determination of the fair market value (FMV) of the targeted practice. In addition to determining FMV, there is more to consider during the pre-acquisition phase. Typically, upon acquisition and employment of physicians by hospital organizations, the following may be observed: * Reduced productivity and poor compensation alignment; * Increased practice expenses (e.g. increased support staffing levels); * Reduced practice revenue streams (e.g. ancillary & technical services); and * Other impacts to profit or loss. In addition, penalties and bonuses under the Merit-based Incentive Payment System (MIPS) follow the physicians. Health systems will need to develop internal mechanisms for evaluating performance and estimating financial impact, as well as potentially creating employment contracts that take these issues into account, or be prepared to absorb the impact post-acquisition. POST-ACQUISITION OPTIMIZATION PHASE After your organization has closed on a newly acquired physician practice, how do you assess whether or not the acquisition is creating the synergies needed for the expected return on investment? Several key metrics can help you assess your performance, including: * Physician Productivity * Practice Expenses * Provider Access / Patient Flow * E&M Coding * Ancillary & Technical Services * MIPS Penalties and Bonuses ROUTINE AND ONGOING STEPS TO PRACTICE OPTIMIZATION Maximizing practice performance is a science as well as an art. Click here to learn more about the ten key steps that any physician network executive should be considering as they work to optimize the operational and financial performance of employed physician practices. AUTHOR INFORMATION
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Gregory M. Schulz, FACHE, is Director of Physician Practice Management Advisory Services at Premier Inc. and has over 30 years of business and healthcare management experience. Greg welcomes the opportunity to discuss any issues or questions you may have about your employed physician network. Connect with him on LinkedIn.
| LinkedIn |
As the saying goes, we are products of our environment. SOCIAL DETERMINANTS OF HEALTH, or conditions in which people live, learn, work and play, can all influence how healthy we are. Everything from the quality of schooling to the cleanliness of water can impact a community’s overall health. _Healthy People 2020__, _a program for improving the nation’s health, developed a framework to reflect five key areas (determinants) to categorize the social determinants of health: * Economic Stability * Education * Social and Community Context * Health and Healthcare * Neighborhood and Built Environment Social structures and environmental conditions in these key areas can result in unequal care delivery, which partly explains why some Americans are healthier than others. And as the movement toward managing targeted patient populations continues to gain momentum, social determinants of health are increasingly seen as critical components of care management in a value-based care environment. Just how important are social determinants of health? One analysis found that clinical care was responsible for as little as 10 percent of the impact on health outcomes in some states. _HOW DO I IMPROVE CARE FOR PEOPLE THAT ARE AFFECTED BY THE SOCIAL DETERMINANTS OF HEALTH?_ Providers have identified and continue to test a number of programs and initiatives to manage the social determinants of health. These include, but are not limited to: CARE MANAGEMENT A number of health systems have created care teams of nurses, social workers and community health workers to provide high-touch care to high-cost patients. PARTNERING WITH COMMUNITY ORGANIZATIONS Joining forces with local organizations, including faith-based communities, schools, and organizations created to help those in poverty, to create a safety net for patients is another approach to managing social determinants of health. These initiatives expand the network of groups with a stake in patients’ health. HEALTH EDUCATION Providing appropriate healthcare education to patients and staff is one of the easiest ways to influence health decisions made outside of the hospital. Staff should have an in-depth understanding of health literacy issues and cultural sensitivities. ASSET MAPPING Bringing together community groups that provide similar services and recording detailed information on those services can forge relationships and create important networks for providers and patients. _IS THERE A FINANCIAL BENEFIT?_ Many hospitals and health systems are stretched thin financially on a number of levels. Initiatives that are not affordable are often simply off the table. How can managing, or not managing, social determinants of health impact the bottom line? READMISSION RATES: Implemented effectively, programs that manage social determinants of health will reduce readmission rates for high-utilizers, thus decreasing associated penalties. CAPITATED PAYMENTS: Health systems implementing programs with capitated payments for beneficiaries will create savings by reducing unnecessary hospitalizations. UNCOMPENSATED CARE: Targeted care management for specific populations can provide patients with the resources they need to use the hospital appropriately; reducing uncompensated care while increasing preventative care. STATE AND FEDERAL GRANTS AND INITIATIVES: A number of funding sources are available on the state and federal level for the implementation of programs that address social determinants of health. A lack of aligned incentives can pose many challenges for stakeholders interested in addressing the social determinants of health. A return on investment may be realized if these services target the appropriate patients. Putting policies in place that positively influence social and economic conditions can improve health for a vast number of people over time. Providers can begin thinking about areas of opportunity when building out their population health strategy in this new era of care delivery. Need help working on your own population health management plan? Our team of expert consultants, recently recognized as Best in KLAS in value-based care consulting, can help accelerate your transition to effective population health management. AUTHOR INFORMATION
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Beth Anctil leads the Clinical Transformation Team in Population Health Advisory Services for Premier Inc. With over 35 years of healthcare management experience spanning settings across the continuum of care, she has proven leadership skills and success in fully deploying initiatives to transform models of care. Connect with her on LinkedIn.
If you’re just planning on attending HIMSS17, you can more than likely pack your bags in less than an hour. But if you’re a presenter or exhibiting vendor, you’ve probably spent months preparing to dazzle the masses. In the days leading up to the event, the HIMSS exhibit hall is filled with hundreds of multi-layered meeting spaces being built from the ground up; dozens of cranes hanging lights, monitors and signage; parades of golf carts buzzing from one end of the floor to the other; and vendors….lots and lots of vendors preparing for the thousands of visitor eyes on their final display. Premier is no exception when it comes to preparing for HIMSS17. We aim to create an exhibit that not only showcases our newest and most cutting edge solutions and technologies, but that is also engaging and enjoyable for exhibit hall attendees. CAN’T WAIT UNTIL HIMSS17? Here’s our current lineup, all powered by information on 40 percent of U.S. hospital discharges and more than $50 billion in annual supply chain spend. ENTERPRISE ANALYTICS - We’re helping healthcare organizations acquire, integrate and leverage their vast array of data to improve outcomes and their bottom lines. *HIMSS17 TIP: Ask for Vlad. He'll demonstrate one of our recently launched solutions that marries clinical and cost data to help providers eliminate high cost supplies without adversely impacting outcomes. CLINICIAN PERFORMANCE MANAGEMENT – We’re projecting “MACRA” will be most used word at the conference. It’s certainly top of mind for us and is one of the driving forces behind our recently-launched Clinician Performance Management solution that helps healthcare organizations monitor and manage clinician performance across the continuum. *HIMSS17 TIP: Ask for Sarah. She’ll show you how this solution is helping providers prepare to thrive in the Quality Payment Programs set forth by MACRA. ENTERPRISE RESOURCE PLANNING (ERP) - Multiple health system surveys indicate legacy ERP systems are not prepared for the coming challenges facing health systems. That’s why we’ve built a secure, cloud-based ERP solution exclusively for healthcare organizations to manage all of their financial and supply chain functions. *HIMSS17 TIP: Ask for Bill. He’ll explain how we’re blending operational efficiency and better decision making across the continuum. WE’RE ALSO CELEBRATING! Industry-leading research firm KLAS recently awarded Premier with FIVE prestigious Best in KLAS awards across five categories, including our first ERP award. SEE YOU AT HIMSS17! If you’re at HIMSS early in the week, we’re sponsoring the Pre-Conference Symposium on Population Care Management. Visit Premier at booth #5571 MONDAY – WEDNESDAY and enjoy a custom mixed soft drink from our specialty soda bar. While you’re with us, find out how the "right mix" of data, technology and services can get you on the road to success. AUTHOR INFORMATION
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_Chief operating officer, ITS at Premier, INC_
Leigh is a healthcare IT and supply chain leader who develops and executes procurement technologies and strategies within healthcare. When Lee isn’t working, you’ll find him reading Percy Jackson with his children and playing scrabble with his wife. Connect with Leigh on LinkedIn
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In 2017, we know many changes in healthcare are coming. While there’s much uncertainty, there are a number of population health developments that we expect to see. * The speed of the transformation to VALUE-BASED CARE and payment models will continue to accelerate, while payment pressures on fee-for-service models grow. * MACRA to prevail and become both an economic opportunity, and threat to physicians and health systems. * An increase in the number of CONSUMER-DRIVEN HEALTH PLANS, and greater price and quality transparency, which will encourage consumers to be more price sensitive and involved in their personal health and healthcare decisions. * The Trump administration to stimulate growth of MEDICARE ADVANTAGE plans and expand similar “MEDICAID ADVANTAGE” models, and to potentially provide vouchers to Medicaid beneficiaries to purchase commercial Medicaid managed care policies. * More EMPLOYERS TO CONTRACT DIRECTLY with integrated delivery systems and clinically integrated networks to align incentives through shared savings arrangements and lower administrative costs. * CMS to release additional PHYSICIAN-LED MEDICARE PAYMENT MODELS (similar to CPC+) providing physicians and physician groups the opportunity to lead payment models and accept additional risks/rewards. * Continued growth in PHYSICIAN-OWNED and VENTURE CAPITAL-PHYSICIAN-OWNED healthcare services to create more price competition for outpatient services. * Demand for greater price and quality TRANSPARENCY to continue as consumers become more responsible for the first dollar and a greater percentage of their healthcare costs. * CONSOLIDATION of hospitals, physician groups, health systems, and population health entities to continue in order to expand market reach, and to build scale and efficiencies. * The AFFORDABLE CARE ACT to be “politically” repealed, however many key aspects will be retained, and either rebranded or privatized. * INFORMATION TECHNOLOGY opportunities to continue to improve in several areas, including for analyzing claims data and managing populations, patient communication, and remote and wearable monitoring services, all of which will enhance transparency. * Investments and research in PRECISION MEDICINE PROGRAMS to grow significantly to integrate genetic, clinical and claims information, and the social determinants of health into both predictive and personalized treatment models. To learn more about how Premier can help you, click here. Be sure to also check out Susan DeVore’s top five healthcare trends to expect in 2017. AUTHOR INFORMATION
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_Vice president, population health management at Premier, Inc._
I’m a population health expert who helps organizations manage the transformation to population health. When I’m not working, you’ll find me reading, playing golf, exercising and traveling. Connect with me on Twitter and LinkedIn.
CONSIDER THIS: If you are in a serious accident or have an illness that leaves you unable to talk about your wishes, who will speak for you? When it comes to important personal decisions regarding medical care for serious illness and eventual end-of-life care preferences, one conversation can make all the difference. ADVANCE CARE PLANNING (ACP) is the process that enables individuals to make plans about their future healthcare. Typically, advance care planning includes: * ACCESSING INFORMATION on the life-sustaining treatments that are available; * DECIDING WHICH TREATMENTS you want should you be diagnosed with a life-limiting illness; * SHARING YOUR PERSONAL VALUES and preferences with your loved ones; * ENSURING YOUR WISHES are documented in your health record; and * WRITING LEGAL INSTRUCTIONS (advanced directive) on treatments you would/would not want to receive. Advance care planning has not yet become a common practice, yet most people feel it should be. In fact, while 90 percent of people say that talking with loved ones about end-of-life care is important, only 27 percent have actually done so. And while most people—up to 80 percent—feel that sharing treatment wishes (should they become incapacitated) with their doctor is vital, only 7 percent report having had the conversation. Patients who have ACPs in place when they are needed report greater satisfaction with their healthcare and have been shown to have lower costs of care. There are excellent resources on advance care planning available both to patients/families and clinical care. One focused on ambulatory practices and other sites of care is the Institute for Healthcare Improvement’s program, “The Conversation Project.” At the QUEST National Meeting in December 2016, best-selling author Dr. Angelo Volandes also led a very popular presentation of his work with the non-profit ACP Decisions, which helps patients visualize the actual care decisions to be addressed. Fortunately, there is strong support for physicians, patients and family members to engage in end-of-life planning conversations. As of January 2016, the Centers for Medicare & Medicaid Services (CMS) pays for voluntary advance care planning under the Medicare Physician Fee Schedule (MPFS) and the Hospital Outpatient Prospective Payment System (OPPS). This has created appropriate incentives to promote spending time on these experience-enhancing discussions. Additionally, under CMS’ new Merit-based Incentive Payment System (MIPS), doctors and other clinicians must report on a certain number of quality measures successfully, and ACP leading to a plan of care for complex medical conditions can be an effective component of MIPS success. Most importantly, ACP enables Medicare beneficiaries to make important decisions that give them control over the type of care they receive and when they receive it, ultimately increasing patient satisfaction scores and overall physician performance metrics. Making the investment in advance care planning is beneficial, and will certainly pay off for physicians when reimbursement season rolls around. Even more importantly, the quality of care for many patients is sure to improve as a result. Interested in learning more about MIPS performance improvement services or the QUEST 2020 collaborative? Visit our website for more information. AUTHOR INFORMATION
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Dr. Madeleine Biondolillo is vice president, Quality and Safety at Premier, where she is responsible for growth of strategic quality and population health initiatives to support members in value-based healthcare delivery improvement. When shes not working, her hobbies are running half-marathons and volunteering in organizations that support victims of domestic violence.
In today’s value-based healthcare landscape, transparency, managing and evaluating patient outcomes, financial performance and operational efficiency is becoming more and more important. But keeping track of all the moving parts in various healthcare settings with numerous different processes can be quite a daunting task. So how do you provide the best possible mix of quality and affordability that ensures you’re delivering the highest quality care for patients at a cost they are willing to pay? AN EFFECTIVE VALUE ANALYSIS PROGRAM can help you thrive. Value analysis is a systematic, objective process that uses evidence-based and data-driven decisions to ensure physicians and clinicians have access to quality products at the right time and at the right price. These programs can help to manage the process for obtaining quality supplies, services and equipment, and ensures their availability at the lowest total cost to support quality patient care. THE VALUE ANALYSIS PROCESS Successful value analysis programs are structured in a way that follow and adhere to the organization’s processes and supports the health system’s mission, vision and strategic goals. In addition, these programs must also have a strong framework built around quality and safety and focus on the appropriate utilization of supplies and services. Value analysis helps to properly vet products and services used in our facilities, especially new technology, and demands an evidence-based, structured and rational approach that includes all key stakeholders in the decision-making process. These processes provide the structure that healthcare organizations will need to face the challenges of an ever-changing healthcare landscape. To learn more about the value analysis process and best practices that can help enrich your program, download our Value Analysis Guidebook. AUTHOR INFORMATION
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_Senior director, comparative effectiveness at Premier, Inc._
As the senior director of comparative effectiveness, I help to bring healthcare organizations together to share information and improve performance.