topic: Strategic and Advisory Services
All-Payer Claims Databases (APCDs) offer considerable potential, yet what is their ultimate value? What can states with new APCDs, such as California, learn from one another as they build them? And how can health care organizations in these states best prepare to be part of an APCD?
Symphony’s success in gaining increasing marketplace interest shows the opportunities available when introducing a statewide health-related database. Yet there can also be significant stumbling blocks. As one of the nation’s leaders in offering statewide health-related databases, California offers ample examples of the possibilities - and challenges - common with such initiatives.
With enterprise portfolio management (EPM), large projects are centrally evaluated to determine overall progress and effectiveness, actual project spend versus budget, and continued alignment with the larger, strategic objectives of the organization.
As primary care practitioners consider participating in the Primary Care First (PCF) initiative, it will be prudent to determine their practice’s tolerance to assume the financial risk for population management, as well as broadly assess their readiness to deliver comprehensive primary care to achieve PCF's targets.
How can organizations more consistently enjoy the benefits of superior program management? Start by avoiding these five leading program management pitfalls and instead embracing best practices.
Many questions arise with a merger or affiliation: Will departments and staffs be combined, will there be a consolidation of the systems used, and will there be opportunities to create a shared services model? Ultimately, how do you ensure merger or affiliation success? Here are seven detail-oriented steps to consider.
Is Your Health Care Project Headed the Wrong Way? By Zaida S. Aronovsky & Chet Stagnaro
Just because a major project is treading new ground does not mean it is destined for failure. By knowing the warning signs of a troubled project, you can intervene more quickly and effectively. Based on our more than 45 combined years of experience rescuing faltering projects, here are five of the most common red flags – and what you can do about them.
Once an insurer or hospital has acquired a medical practice, what is next? Acquirers should proactively ensure a seamless integration of services within their new practices. The success of a major medical foundation in acquiring and integrating a pair of specialty physician practices offers six rich lessons other organizations should consider with their integration implementations.
Depending on which types of patients you serve, your health plan audit may be made by many regulatory entities. Your compliance department should be notified when an audit will be conducted. If you do not have a compliance department, your point of contact will typically be in your C-Suite, such as your CEO or CFO.
A new workflow automation tool was burdened with a difficult-to-learn user interface and workflows which didn’t fully match users’ jobs, resulting in employees who didn’t use the tool or did so incorrectly. Because managers didn’t believe the tool facilitated their employees’ work, they didn’t recommend it or use the tool’s reporting features to drive decision-making.
More providers and health care organizations are forming clinical integration networks (CIN) to collaborate on improving the quality and efficiency of care, while allowing themselves to continue to operate independently.