HealthSounds

Rather than threatening to drop Medicare volumes or open a concierge practice, small and solo physician practices daunted by MACRA technology requirements should sit tight and avail themselves of current and promised education and training from CMS to support the transition, advises Eric Levin, director of strategic services, McKesson. In this audio interview, Levin describes what’s at risk for practices that don’t engage in at least one physician reporting program and four benefits of tapping into MACRA technical assistance from CMS.

Increasingly in motivational interviewing (MI) research, change talk—anything a patient or client says that counts as an argument for change—is a reliable sign they’re ready to make a change, notes Mia Croyle with the University of Wisconsin School of Medicine and Public Health. Here, Ms. Croyle shares some of the latest thinking regarding change talk: how motivational interviewing practitioners might interpret change talk in interactions with clients, particularly those with behavioral health diagnoses, as well as how to elicit more change talk during an MI session.

Whether an ACO is assessing readiness for CMS’s Next Generation ACO model or is already a Medicare Shared Savings Program (MSSP) participant, face-to-face education of non-executive providers living the day-to-day ACO reality is critical to that accountable care organization’s viability, advises Travis Ansel, senior manager of strategic services for Healthcare Strategy Group. Even within experienced MSSP ACOs, providers often don’t understand MSSP quality goals, the relationship of their actions to cost management or MSSP data requirements, noted Ansel. In this broadcast, Ansel describes the two biggest barriers to success across all ACO models, and offers two tips to organizations wishing to prosper in the value-based care reimbursement world.

While it does not immediately eliminate fee for service, a retrospective upside-only payment model is helping to transform the spirit of the payor-provider relationship, notes Lili Brillstein, director of the Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ) Episodes of Care (EOC) initiative where this methodology has been implemented. Listen as Ms. Brillstein describes how Horizon’s application of retrospective methodology across all episodes expands the program’s reach and opportunities while fostering a no-risk environment conducive to collaboration.

Community Care of North Carolina’s Transitional Care program was awarded the Hearst Health Prize this month not only for demonstrating how effective transitional care is for its 1.5 million Medicaid beneficiaries, but also for continually evaluating and modifying the intervention based on its findings. In this broadcast, Carlos Jackson, CCNC’s director of program evaluation, shares one of CCNC’s more interesting findings, identifying the priority population for the intervention, and explains why the care transition management mindset must expand beyond reducing hospital readmissions.

An accurate medication list is square one for clinical pharmacists working to reconcile prescriptions and reduce readmissions among Novant Health’s highest-risk patients, explains Rebecca Bean, director of population health pharmacy for Novant Health. But maintaining a valid list can be problematic when the inventory is accessed by multiple healthcare providers. Ms. Bean describes the challenges of maintaining an accurate medication list and suggests strategies for ensuring medication list integrity in this audio interview.

Beyond facilitating business decisions and improving quality of care and patient experience, data analytics help Collaborative Health Systems (CHS) to close gaps in preventive care within its 24 accountable care organizations (ACOs), explains Elena Tkachev, CHS director of ACO analytics. One key preventive metric for the largest U.S. sponsor of Medicare Shared Savings Programs (MSSPs) is the Medicare Annual Wellness Visit (AWV), which CHS has set as a core goal. In this audio interview, Ms. Tkachev describes the rationale behind this goal, how data analytics drives AWVs, and the dramatic correlation between AWVs and patient attribution.

When Bon Secours adapted Geisinger's case management model six years ago and embedded nurse navigators within physician practices, there was reluctance and even resistance from some solo cowboy physician practitioners, recalls Robert Fortini, PNP, chief clinical officer for Bon Secours Medical Group. Today, providers are fiercely protective of the cadre of 70 nurse navigators, who do the heavy lifting of chronic care management. In this audio interview, Fortini offers some lessons learned for organizations considering the embedded case management approach, including budgetary planning, calculations, and icing-on-the-cake outcomes for patients and hospitals.