Emerging and Evolving Trends in Ambulatory Care

Emerging and Evolving Trends in Ambulatory Care

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  Phil DeBruzzi, FACHE Emergingand Evolving Trends in Ambulatory Care March 27, 2015
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 2 The World is Changing • Aging population driving different services • Payment reform shaping incentives, care models • Primary care shortage hindering access • Increasing competition • Technology advances • Patient financial burden increasing 16,000 10,000/day
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 3 Value-Based Care Trend Accelerates Better, Smarter, Healthier: In historic announcement, HHS sets clear goals and timeline for shifting Medicare reimbursements from volume to value… Source: www.cms.gov “Better care, smarter spending, healthier people: Paying providers for value, not volume.” January 26, 2015 Value-based reimbursement increasing (away from fee for service) 20172014 20162015 20182013 COMMERCIAL PAYMENTS MEDICARE PAYMENTS 50% 11% 40% ??
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 4 Implication for Providers • Declining inpatient volumes, increasing outpatient volumes posing financial challenges and requiring performance improvement across all sites and resources • Increased care coordination across the continuum and among providers to deliver high value care • Being patient centered is a given, shifting to patient engaged is imperative • Managing the cost structure of the entire network is paramount – ‘expect to do less with less’
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 5 Keys for Success In order to affect the health of a population and be financially viable… Access Patient Experience Quality of Care Operational Efficiency
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 6 The Value of Digital Health
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 7 Emerging Technologies • TeleHealth • Scheduling • mHealth • Diagnostics • Patient Portal • eVisits • Wellness • Documentation
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 8 Evolving Operations Increased patient engagement, changing behaviors Financial counselors, educators, nurse triage Team based care, care managers, navigators Virtual visits and tele-health technology, resources Re-evaluate physician productivity expectations based on the above
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 9 Emerging Models Healthcare System/group of providers take clinical and financial responsibility for a patient population – Communication & Access : Provider to Provider and Provider to Patient – Physician Involvement & Empowerment – Data Integration Accountable Care Organizations/Population Health Management:
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 10 Emerging Models Penny George Institute at Allina Health Combining leading medical practice with ancient healing wisdom to optimize health and wellness in the whole person—mind, body and spirit – promote health through education, coaching, self-care and wellness practices – tap into the body's natural healing capabilities – involve individuals as empowered partners Integrative Health Centers:
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 11 Emerging Models Team works together with patient to enhance continuity and coordination, encouraging self- care, measure and managing patient populations – Team-Based Care: PCP, RN, MA, APRN/PA – Mental Health Integration: Delivered at PC Office by psychologist, LSW Personalized Primary Care/Patient-Centered Medical Home:
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  BLUE COTTAGE CONSULTINGEmergingand Evolving Trends in Ambulatory Care 12 Emerging Models Functional Medicine: Personalized, systems-oriented model that empowers patients and practitioners to address the underlying causes of disease