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Former CMS Chief of Staff Previews 4 Areas of Value-based Care in 2022

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Value-based care continues to take root in healthcare. It’s clear the future of reimbursement will at minimum include a heaping portion of providers being paid for value as opposed to volume.

This is why, as the new year approaches, Healthcare IT News sat down with an expert in value-based care to get his views on what 2022 will hold for the payment system.

Caravan Health President and CEO Tim Gronniger previously was chief of staff and director of delivery system reform at the Centers for Medicare and Medicaid Services. Caravan Health is a privately held company formed to create sustainable methodologies for health systems to excel in value-based care. In 2019 and 2020, its partners earned $300 million in Medicare savings, more than $120 million in shared savings and quality scores exceeding 97%, the company reported.

Gronniger eyes four areas of importance for value-based care in 2022: telemedicine, staff retention and provider burnout, health equity, and growth in value-based payment.

Q. Health providers quickly pivoted to make the most of temporary telehealth flexibilities when the COVID-19 public health emergency (PHE) started in 2020. While Congress and CMS have considered permanently expanding access to telehealth and virtual care, there is a big price tag attached. What do you think will happen with telemedicine in 2022?

A. Telehealth has made a huge difference in delivering appropriate care to patients since the beginning of the pandemic. The COVID-19 public health emergency – and its expanded telehealth flexibilities – is continuing at least through the beginning of 2022. We hope to see some movement on a permanent telehealth arrangement before the PHE ends.

Before the pandemic, telehealth services in fee-for-service Medicare were restricted mostly to rural areas in which patients would travel to a healthcare facility, called an originating site, to receive care from a provider who also was in a healthcare facility, called a distant site.

Even in rural areas, making use of these pre-PHE authorities was not easy. Patients usually had to travel to their doctors’ offices, and offices had to own and maintain video and audio technology.

An abrupt end to telehealth would create access issues for patients who have grown used to accessing high-quality care more conveniently. Providers have invested in equipment and services to provide this important source of care, and those investments should not be abandoned.

CMS has taken regulatory action to increase the availability of telehealth. As Congress considers which elements of the current regime to extend, it should prioritize telehealth within accountable care and other value-based care arrangements, where physicians can select the most appropriate, high-value modality for care delivery.

Sometimes, that will be in-person, sometimes remote, but in either case, providers in accountable care arrangements internalize those costs. There are cost controls built into these programs, so telehealth can’t increase overall costs.

By linking telehealth reimbursement to value-based care, patients have access to telehealth services because it is the most appropriate care for the situation, not because it is more profitable than in-person care.

Q. The growing demands on clinical staff have led to staff burnout that threatens health access. You say that population health and team-based care can be effective approaches to retaining staff and improving clinician satisfaction. These retention concerns are heightened with the introduction of vaccine mandates. What can healthcare provider organizations do in 2022 to fight burnout and retain staff?

A. Healthcare organizations have to pay close attention to clinical and non-clinical staff satisfaction.

Team-based care means that patients are at the center of care delivery. For years, we have talked about the importance of the triple aim of advancing quality of care, reducing costs and improving the patient experience. In 2022 and beyond, we need to make sure that clinical satisfaction and retention is not overlooked.

This is an important issue in light of widespread concern about physician burnout. We have to have an honest discussion with our teams about the trauma that they have experienced as we come to the end of the second full year of the pandemic.

We have to provide providers with resources including counseling and even just giving them time to recover. That’s not easy while staffing is still stretched, but it’s important.

The federal vaccine mandates are not too old, but many providers have been working hard on complying with state, local or individual health system mandates for months. Even with new requirements, the approach to retaining staff should stay the same: create a system of care delivery that works for everyone.

Engaging the entire team in a proactive primary care system is the key to spreading out the work and placing resources where they can do the most good.

Q. The racial, ethnic and income-based health disparities in the U.S. are persistent and not easily fixed. You contend that traditional fee-for-service medicine pays providers for the volume of service delivered and does not appropriately compensate providers for promoting health and preventing acute illness or development of chronic conditions. How can value-based care help out in 2022 and beyond?

A. Traditional fee-for-service pays for services delivered to patients. The more services provided, the more the provider is reimbursed. The incentives are to treat sickness, rather than paying providers to keep people well and out of the hospital. We have to turn this model around to get the best outcomes.

In a value-based care model, providers have the incentives to create population health-focused care delivery and save money while keeping beneficiaries well. The incentives of a value-based care model can be useful in addressing our country’s stubborn health disparities. Metrics related to social determinants of health and reducing health disparities can be incorporated and refined within these models.

Our clients today are focusing their energies on serving their sickest patients. I fully expect and embrace that CMS and other payers will soon hold us accountable for improving clinical outcomes for minority populations, and we are ready for that.

For providers in value-based payment, assessing health needs of different populations and addressing the social factors that impact health are not driving up costs, they are aligned with the incentives of whole person care that ultimately saves money.

Q. CMS recently announced a goal of serving all Medicare beneficiaries through accountable care or other total cost of care arrangements by 2030. You believe this goal is a step in the right direction for our healthcare system that has too often paid based on volume rather than value. However, CMS can’t do it alone. What are some ways accountable care organization (ACO) management and other organizations are helping guide providers through value-based payment?

A. The most encouraging part of the Center for Medicare and Medicaid Innovation’s (CMMI’s) goal of expanding total cost of care arrangements is the explicit link to achieving equitable outcomes for patients.

CMMI leadership is keeping its focus on the outcome of broad health system transformation. ACO management organizations are in touch with these providers every day and know the specific concerns or barriers to entry. Companies that specialize in building and managing ACOs have proven they can get all kinds of providers into accountable care with strong quality and financial results.

This goal of increasing participation in accountable care is shared by other important value-based care stakeholders.

MedPAC recently considered innovative ideas to change benchmarking for ACOs to be more attractive and realistic for participants. Benchmarks are the key to earning shared savings – an important marker of success for any ACO participant. CMS also is raising fundamental questions about making benchmarks more fair and more predictable.

It is possible we will see policy changes that appear to be technical changes to benchmarking but are critical to getting more participants in sustainable value-based care relationships. These might include fixing the “rural glitch” or addressing the HCC risk score cap. Both of these were discussed but not ultimately finalized in the 2022 Medicare Physician Fee Schedule.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

What the uptick in interest and usage of digital health will mean for the future of healthcare and what to expect in 2022 for the industry.

Original Article: healthcareitnews.com

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Health Care

Singapore’s Public Health System Rolling Out the Clinician’s ZEDOC Platform

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Singapore’s health tech agency Integrated Health Information Systems has partnered with Auckland-headquartered digital health firm The Clinician to deploy a patient-reported outcome and experience measures platform across the island state’s public healthcare system.

WHAT IT’S FOR

The Clinician’s ZEDOC platform, the company describes, assists healthcare providers in managing patient-generated health data outside the hospital through digitisation. Integrated with HIS, the system supports timely exchange of health data and information between providers and patients, including subjective PROMs and PREMs, objective wearable device data, and other communication or educational materials. By streamlining the digital collection of critical health data, ZEDOC is able to render real-time, actionable information crucial for improving health outcomes and experiences.

The partners are working on multiple ZEDOC integrations with existing health information systems (HIS). A privacy-preserving hybrid infrastructure has been implemented which ensures that all personally identifiable information stays within the IHiS’s private health cloud while all anonymised health data are collected through a secure commercial cloud platform.

WHY IT MATTERS

Singapore intends to measure and improve health outcomes and patient experience with the rollout of The Clinician’s ZEDOC platform. Their partnership will “bolster patient engagement and enable clinicians to more effectively assess patients’ health status before, during and after receiving a health service – closing the loop when they are outside the hospital,” said The Clinician CEO Dr Ron Tenenbaum. It will also allow providers to deliver “more holistic and personalised care for patients by taking into account their perspectives for the first time,” he added.

To demonstrate the benefit of routine collection and analysis of PROMs, The Clinician shared that this has resulted in over 50% reduction in 90-day complications for hip and knee surgery patients in one study and a five-month improvement in the survival of cancer patients in another.

Among benefits for care providers, the ZEDOC integration will replace existing paper-based forms with an integrated digital platform that automates data capture, as well as benchmark outcomes across providers to reduce variability and waste. For patients, they can become more involved in the treatment decision-making and be informed early of health risks and warning signs.

THE LARGER TREND

Last month, Cabrini Health and The Alfred, two of the largest healthcare providers in the Australian state of Victoria, deployed the ZEDOC platform to automate the collection and analysis of health data from colorectal cancer patients. The installation is said to adhere to the colorectal cancer standards outlined by the International Consortium of Health Outcomes Measurement.

Original Post: healthcareitnews.com

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Health Care

EU Analysis Highlights Digital Health Lessons From COVID-19

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An EU analysis has outlined the effect of COVID-19 on healthcare systems in Europe and the role of digital innovation in building their resilience.

Experts from the Organisation for Economic Co-operation and Development (OECD) and the European Observatory have published a set of 29 country health profiles, covering all EU member states, as well as Iceland and Norway. A companion report also highlights a selection of cross-country trends.

Speaking at a virtual launch event on Monday (13 December), Josep Figueras, director, European Observatory, highlighted two main lessons learnt from the use of technology in the pandemic.

Using telemedicine as an example of digital health innovation, he said the number of teleconsultations had increased in all EU countries during 2020. However in some countries, such as France, teleconsultations had decreased when lockdowns ended.

“The key issue here is how we harness and sustain innovation – how we make sure that these improvements in the use of telemedicine (as an illustration of the use of other digital technologies) can be maintained and sustained to increase the effectiveness of the health system,” Figueras said.

He also highlighted that the technology for telemedicine and other innovations was already available in many European countries before the pandemic but was not being used.

Figueras asked: “What did we do within the pandemic that literally within a couple of weeks, we got all this telemedicine in place?”

To sustain the use of telemedicine and other health technologies, he said it was important to look at the regulatory measures, financial incentives, training and changes in culture needed.

“Something the pandemic has taught us loudly and clearly is the importance of digital innovation – not only the new technologies, but the ability to implement them,” Figueras added.

WHY IT MATTERS

The State of Health in the EU cycle is a two-year process initiated by the European Commission in 2016, designed to improve country-specific and EU-wide knowledge in healthcare.

It aims to gather data and in-depth analyses on health systems and make the information accessible to policy makers and stakeholders.

THE LARGER CONTEXT

During the pandemic, digital tools have been used in the EU to boost public health measures such as the implementation of the EU Digital COVID Certificate, vaccination booking systems, and cross-border interoperability for contact-tracing apps.

There has also been investment in EU-wide COVID recovery initiatives such as the EU4Health programme.

ON THE RECORD

Maya Matthews, head of unit performance, European Commission said: “COVID-19 illuminated the fact that in many European countries we do not have a strong public health system. We cannot do testing and tracing. Even surveillance is done sometimes in a very fragmented fashion.

“I think if one thing comes out of COVID-19, it’s to say that public health matters – that public health is a very important part of health systems and has not really received the attention it deserves.”

Source Here: healthcareitnews.com

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Health Care

Clinical Messaging Platform Hospify to Close, Bupa Arabia Invests in Global Ventures, and More News Briefs

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Clinical messaging platform Hospify to close

British healthtech startup Hospify has announced it will close its secure clinical messaging platform on 31 January 2021.

Hospify said it suffered a decline in demand after the government suspended the UK 2018 Data Protection Act in relation to healthcare last year for the duration of the COVID-19 pandemic.

It also cited difficulties caused by “post-Brexit uncertainties surrounding the future of the UK’s data adequacy agreement with the EU”.

A statement from the Hospify team says: “It’s a sad end to a wonderful vision, a vision of universal health care communication that was both free of data exploitation and free at the point of use.”

Insurance giant Bupa Arabia invests in Global Ventures

UAE-based international venture capital firm Global Ventures has announced new investment from Bupa Arabia, the leading health insurance company in the region.

Bupa Arabia’s participation in Global Ventures Fund II as strategic partner aims to foster the healthcare ecosystem in the region and particularly in Saudi Arabia.

The investment is part of the Bupa Arabia’s strategy to participate and invest in disruptive healthcare and insurance technologies, amongst other targeted growth sectors.

Noor Sweid, Global Ventures founder and general partner, said: “Bupa Arabia shares our outlook and ambition on the digital health sector, and its potential for technology and innovation to deliver long-term economic benefits particularly in emerging markets.”

Liverpool Heart and Chest Hospital achieves EMRAM Stage 6

Specialist NHS trust Liverpool Heart and Chest Hospital (LHCH) has been awarded Stage 6 of the EMRAM, or Electronic Medical Record Adoption Model, by HIMSS.

The EMRAM measures the adoption and maturity of a health facility’s inpatient EMR capabilities from 0 to 7. Achieving Stage 6 means the trust has established clear goals for improving safety, minimising errors, and recognising the importance of healthcare IT.

Kate Warriner, chief digital and information officer said: “Digital excellence must be the cornerstone if we are to continually improve the care that we provide for our patients in the years ahead. Therefore, whilst we are rightly proud of this achievement, we have ambitions for further pioneering innovation and advancing our use of technology to become a Stage 7 hospital.”

More than $110m raised by Sheba’s ARC Innovation Center

Israel’s Sheba Medical Center has announced that six companies from its Accelerate Redesign Collaborate (ARC) Innovation Center raised more than $110 million (EUR97.2m) in 2021.

ARC brings new technologies into the hospital and community ecosystem focusing on digital health technologies including precision medicine, big data, artificial intelligence (AI), predictive analytics, telemedicine and mobile health.

Sheba MedTech startups receiving investments this year included: Aidoc, BELKIN Laser, Starget Pharma Append Medical, Innovalve Bio Medical and TechsoMed.

Professor Eyal Zimlichman, ARC director and founder, said: “The ARC Innovation Center has been focusing on ground-breaking, innovative technologies with a prime directive to redesign healthcare.”

Konica Minolta named as part of NHS Digital Documents Solutions framework

Konica Minolta Business Solutions (UK) Ltd has been named as one of 46 suppliers on the new ?5 billion Digital Documents Solutions framework.

The firm will provide solutions across five key areas: internal print, external print, digital mail room, scanning and electronic document management solutions.

Jason Barnes, head of public sector, Konica Minolta, said: “Having been chosen through a competitive tender process, we are especially pleased to be newly appointed to the LPP framework, which deepens and furthers our reach into the NHS health sector.”

Original Source: healthcareitnews.com

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