Improving quality is incredibly important, but it is only half of the story that should be told when it comes to successful initiatives meant to reduce harm. What about cost? Cost is often left out of the success narrative because there has been no good, reliable and valid way to calculate the associated costs to harm events – until now.
Shaping Your Reimbursement Environment with StrataJazz
Many health systems are feeling pinched by reductions in overall reimbursement rates, high deductible health plans, more aggressive payer tactics to reduce payments, and potential growth in uninsured populations. Moreover, ACOs are adding downside risks and payers are getting much more savvy with using data to target care they deem unnecessary. In short, the environment is difficult and payment from traditional payers and plans is trending down.
For years, organizations have been talking about how to better use their data to influence payers, increase reimbursement, and grow volume. They want to get rewarded for their high quality, their care coordination, and their investment to go into the community. This has proven challenging for a variety of reasons as organizations do not have trusted cost data to share with payers, find it difficult to put cost and quality together in a meaningful way, and are challenged with analyzing the cost of care and quality of care across the continuum of care.
This session will explore more advanced tools which available to combine clinical and cost data, to run algorithms to group episodes of care, ID variation, and ID quality incidents.
1. Learn how to identify gaps in your current state that are hinderances from either being profitable on alternative reimbursement models or from taking on more risk.
2. Explore new tools that providers can utilize to identify specific case types or care pathways that are known to be effective.
3. Discuss creating specific initiatives to improve cost, quality, or care coordination.