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Volume-to-Value

Measuring Value: Through the Lens of Patients

By | Affordable Healthcare Act, Healthcare Providers, Healthcare Quality, Healthcare Value, Volume-to-Value | No Comments

 

Hospital Value-Based Purchasing (VBP) is Medicare’s payment system to reward providers for the quality of care they provide. This program rewards acute care hospitals with incentive payments for the quality of care they give to patients, not just the quantity of services they provide. The payments are made by asking, “How well did you do? rather than How much did you do?.”

MEASURING VALUE

Management guru Peter Drucker is often quoted as saying that “you can’t manage what you can’t measure.”

The goal of value-based reimbursements is to replace the fragmented, fee-for service care with comprehensive, coordinated care using payment models that holds organizations accountable for cost control and high quality outcomes. The shift from volume to value starts with measurement. Measuring volume is simple, but how do you measure value in health care?

The health care value equation is defined as quality over cost.

TOTAL PERFORMANCE SCORE (TPS)

A hospital’s performance is assessed on the measures that comprise various domains. The domains are weighted and rolled up to the Total Performance Score. The FY 2017 Total Performance Score (TPS) is derived from 4 domains as below:

  1. Clinical Care (30 percent)
    • Outcomes (25 percent)
    • Process (5 percent)
  2. Patient and Caregiver Centered Experience of Care/Care Coordination (25 percent)
  3. Safety (20 percent)
  4. Efficiency and Cost Reduction (25 percent)

INCENTIVE PAYMENT

The Total Performance Score is then translated into an incentive payment that makes a portion of the base Medicare severity diagnosis-related group (MS-DRG) payment contingent on performance. It’s possible for a hospital to earn back a value-based incentive payment percentage that is less than, equal to, or more than the applicable withholding for that Fiscal Year (FY). Following is the withholding schedule:

FY 2013 1.00% FY 2016 1.75%
FY 2014 1.25% FY 2017 2.00%
FY 2015 1.50% Succeeding Years 2.00%

UNIT OF VALUE MEASUREMENT

The data collection and the performance improvement at the hospital level has been challenging, especially with the exponentially increasing metrics used to measure performance. The complexity increases when the unit value of measurement is at the individual provider level.

The next phase in the value transformation will focus on measuring individual provider performance in the delivery of high value care to address the question(s) – “How well did the individual provider do?” and more importantly, “How well did the patient do?”.

FURTHER DISCUSSION

CHI will further explore the evolving definitions of healthcare value at our Healthcare Executive Roundtable Discussion on 10/12/17 in Manhattan, NY. The Roundtable is an expert, cross-sectoral discussion designed to help healthcare stakeholders optimize engagement, communication, and collaboration. The exclusive roundtable provides the top thought-leaders, visionaries, and executives from the patient advocate, provider, biopharma, and payer spaces with the latest insights and ideas on how patient engagement drives healthcare value for all stakeholders. Please visit chisite.org/education/healthcare-executive-roundtable for more information.

Dr. Jason Arora, CHI Research Group Member & Director at ICHOM Named to Forbes 30 Under 30 List

By | Healthcare Value, Volume-to-Value | No Comments

LONDON (January 19, 2017) – Jason Arora of the International Consortium for Health Outcomes Measurement (ICHOM) and Member of the CHI Research Group, was named in Forbes’ second annual “30 Under 30 Europe” list, a list that features 300 young innovators, entrepreneurs and leaders across Europe who are under 30 years of age and who are transforming business, technology, science, finance, media, culture and more, as judged by some of the most accomplished and acclaimed individuals in each category.  For the full list, please visit:  www.forbes.com/30under30europe.

 

Jason Arora is a medical doctor, public health scientist and rising global expert in value-based healthcare, which focuses on delivering the best possible outcomes for patients at the lowest possible cost. Dr. Arora has helped grow ICHOM from a startup to innovative healthcare catalyst, successfully inspiring governments, hospitals and life-science companies to adopt the concept.

 

The Forbes 30 Under 30 Europe list covers 10 categories – Arts, Entertainment, Finance, Industry, Media, Policy, Retail & Ecommerce, Science & Healthcare, Social Entrepreneurs and Technology – with each of the honorees vetted by a panel of expert judges in their respective fields.

 

Randall Lane, Editor of Forbes, said “Researching, vetting and launching Forbes’ second annual 30 Under 30 Europe list was an incredible task.  We scoured the continent to find the most talented millennials and, with the help of our expert judges, are proud to honor 300 of the most important young entrepreneurs, creative leaders and brightest stars in Europe right now.”

The criteria for honorees making the list included leadership and disruption in their field; entrepreneurial mindset and results; and the likelihood of changing their field over the next half-century.

 

The judges have created a unique list of the 300 prodigious stars who are making a difference in our world.  The judges were:

 

  • Arts: Jeremy Till of University of the Arts London, Chef Heinz Beck, and Italian photographer Oliviero Toscani;
  • Entertainment: Forbes editor Mike Ozanian, Afrojack, and British director SJ Clarkson;
  • Finance: Klaus Hommels of Lakestar, Henning Potstada of DWS, and Sonali De Rycker of Accel Ventures;
  • Industry: Phillip Greenish of Royal Academy, Stephane Israel of Arianespace, and former 30 Under 30 Honoree Cornel Amariei of Continental Automotive Systems;
  • Media: Kai Diekmann of Bild, Antonia Rados of RTL Group, and Max Guen of Magna Carta TV;
  • Policy: Josef Janning of European Council on Foreign Relations, Richard Youngs of Carnegie, Endowment Europe, and Brigid Laffan of European University Institute;
  • Retail: Amber Atherton of My Flash Trash and Dharmash Mistry of blow LTD;
  • Science: Barbara Prainsack of King’s College London, Jason Levine of IT and Clinical Informatics at National Cancer Institute, and Iain Woodhouse of University of Edinburgh;
  • Social Entrepreneurs: Forbes Editor Randall Lane, Cheryl Green from Echoing Green, and Jean Case from Case Foundation;
  • Tech: Brent Hoberman of Lastminute.com, former 30 Under 30 Honoree Ophelia Brown at Local Globe, and Tom Hulme of Google Ventures.

 

The complete list, along with video interviews with some of the honorees, is online at www.forbes.com/30under30europe.

 

Forbes’ Under 30 franchise is a global multichannel platform, that comprises 30 Under 30 lists featuring young global game changers published in print and online all over the world; live summits in the U.S., Asia and Israel; an Under 30 channel on Forbes.com; and a Forbes Under 30 app. To access Forbes magazine’s 2017 30 Under 30 U.S. list, please visit www.forbes.com/30under30.

 

 

For these stories and more, visit www.forbes.com

Follow Forbes on Twitter (www.twitter.com/Forbes)

 

 

How Does Patient Engagement Drive Value?

By | Collaboration, Global Healthcare Trends, Healthcare Innovation, Healthcare Value, Patient Engagement, Patient-Driven Healthcare, Patients, Volume-to-Value | No Comments

The 21st-century healthcare landscape is characterized by a consumer-driven, patient-centric model of care delivery, with patients, their caregivers, and advocacy groups playing a vital role in today’s healthcare ecosystem. Patients and their families are taking an active role in their healthcare and proactively interacting with providers and other healthcare stakeholders to improve health and wellness. Today’s patients are better informed and more financially invested than ever before, and they play a key role in decision-making processes that can positively impact health outcomes.

 

This paradigm shift has dramatic implications not only for patients – but also for providers, biopharma, and payers. As healthcare costs pressures continue to increase, incentives are shifting from a fee-for-service environment to a value-based healthcare system. More than ever, it is critical to understand how patient engagement drives value for patients, providers, biopharma, and payers, and ensure your organization is aligned to operate in the new healthcare economy.

 

The How Does Patient Engagement Drive Value? Healthcare Executive Roundtable on Thursday, 10/13/16 in Manhattan, NY, is an expert, cross-sectoral collaborative discussion designed to help healthcare stakeholders optimize engagement, communication, and collaboration. The exclusive, limited-attendance roundtable is designed to provide the top thought-leaders, visionaries, and executives from the patient advocate, provider, biopharma, and payer spaces with the latest insights and ideas on how patient engagement drives healthcare value for all stakeholders. The roundtable focuses on pragmatic and actionable ideas designed to empower you and your organization to understand the intersection of patient engagement and healthcare value. Additionally, the Healthcare Executive Roundtable helps healthcare stakeholders build open and collaborative relationships to positively impact healthcare delivery and outcomes.

 

We have a very limited number of registrations remaining. Please visit chisite.org/education/healthcare-executive-roundtable for more information. We invite you to join us for a day of thought-provoking discussion regarding patient engagement and healthcare value.


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