The Catalyst … accelerating business growth in healthcare

The Supreme Court Ruling, and What it Means for Purchasing Patterns Moving Forward

Posted by Jessica Hartman DeVore on Fri, Jun 29, 2012 @12:29 PM

The Supreme Court Ruling, and What it Means for Purchasing Patterns Moving Forward

The Supreme Court on Thursday largely upheld the constitutionality of the Patient Protection and Affordable Care Act, including the individual health-insurance mandate, ruling it is permissible under Congress's taxing authority. The court did find one part of the law unconstitutional, according to the Wall Street Journal, saying its expansion of the federal-state Medicaid program threatened states' existing funding. The court ruled that the federal government can't put sanctions on states' existing Medicaid funding if the states decline to go along with the Medicaid expansion, the Journal reported.  

What this means for the industry:

• Hospitals will continue to chase cost savings. For buyers, the stakes are higher than ever for understanding the supply chain and where those dollars go. The Association for Healthcare Resource & Materials Management (AHRMM) (Chicago, IL) reports that, on a per-case basis, as much as 31 cents of every dollar spent by providers is for supplies associated with care. In other words, these costs are second only to the cost of labor for hospitals. With such a huge proportion of provider expenditures going toward supplies and services, the opportunities for cost-savings are enormous (Excerpt fromMuddy Waters - Making Sense of the Healthcare Supply Chain in the Era of Reform)

• Quality will be an ever important measurement that affects reimbursement rates. IDNs, hospitals and physicians will have to demonstrate how they are providing quality care for reimbursement in general and also the potential of shared savings. Benchmarks and performance will be compared, and the difference between the two will be the amount of money that is the potential for shared savings. 

• Patient experience will become critical in the value equation. Fee for service is being replaced by a holistic approach to care. Quality care will boil down to outcomes-based medicine.

From MDSI

Tags: healthcare, hospitals, Accountable Care Organizations, healthcare suppliers, HHS Regulations, Center for Medicare and Medicaid Services, ACA, Afforable Care Act

Final Rules for Accoutable Care Organizations

Posted by Stan Schroeder on Tue, Oct 25, 2011 @01:35 PM

The Department of Health and Human Services (HHS) released its final rules for Accountable Care Organizations. Initial impression? Less restrictions and more flexibility for physicians and providers wishing to participate. Look for complete coverage, insight, analysis and commentary regarding the final rules in upcoming issues of ACO Insights (www.acoinsights.com). Here are some initial thoughts:  

  • The risk-reward of the final rules is much more favorable toward providers.

  • Providers will be able to participate in an ACO and the Medicare Shared Savings program without the risk of losing money with one of the tracks provided.

  • ACOs will be able to start sharing in the savings earlier.

  • The number of quality measures was reduced from 65 to 33, and five domains to four.

  • There is no EHR requirement in the final rules.

  • Participants can only be part of one ACO.

  • Beneficiaries will be assigned to an ACO based on how they utilize primary care services, but if they aren't seeing a primary care physician, then they may be assigned based off of services provided by other physician specialties. Providers will be informed which Medicare beneficiaries will likely be a part of the ACO.

Tell your colleagues to subscribe to ACO Insights for detailed features, news and opinions on accountable care (http://www.acoinsights.com/Subscribe.aspx

 

 

John Pritchard
ACO Insights
MDSI
1735 North Brown Road
Suite 140
Lawrenceville, Georgia 30043
United States
(770) 263-5261

Tags: medical, ACO, Accountable Care Organizations, healthcare suppliers, Regulations on ACOs, ACO Regulations, ACOs and suppliers, HHS Regulations, gpos, Healthcare Service Provider, GPO, Center for Medicare and Medicaid Services, Affordable Care Act

The Virtues of the Outsourcing Model, Part 4: Examining Culture

Posted by Stan Schroeder on Wed, May 11, 2011 @10:11 AM

In our final installment on the virtues of the outsourcing model, we examine the third factor you should consider when evaluating whether outsourcing could improve the productivity and financial climate of your company. Robert Ryan’s position paper on the topic of outsourcing posited that restructuring how companies utilize their human capital, or, in other words, their workforce in-house and elsewhere, will affect how profitable they will be in the future. Ryan suggests that by increasing a company’s agility, or the speed at which they are able to adapt, it will be more likely to weather the many changes to come in the business world.

We have already examined how capacity and capability can affect a company’s decision to outsource. Culture ranks as the third factor that should be considered before making the leap to outsourcing. As Ryan asks, “Do the current organizational norms and values support the development and implementation of the strategy?”

While culture can also refer to the acceptability of this practice in a certain office, it also relates to the acceptability of outsourcing in a particular industry. Ryan points to technology as an industry particularly well-suited to outsourcing. “Competition for specialized technological expertise is found on the world market,” he writes. “With the rise of efficient collaboration capabilities, services can be found in many emerging countries of the world…. Because of technology improvements, work groups can all be brought into our living rooms.”

The health care industry also offers a culture that allows for ad hoc collaboration to fill any gaps in capacity and capability that may exist in one company. Here at EHM we not only serve as the link to connecting health care suppliers with the group purchasing organizations (GPOs), accountable care organizations (ACOs) and integrated delivery networks (IDNs), but we can also handle all of your marketing, advertising and selling needs for you. If you need help determining if these options are right for you, contact us, and we can talk you through the entire process and answer any questions that you have.

Tags: Essential Healthcare Management, Schroeder, Ripullo, marketing, EHM, healthcare, hospitals, ACO, Accountable Care Organizations, healthcare suppliers, HHS, Regulations on ACOs, ACO Regulations, ACOs and suppliers, HHS Regulations, gpos, outsourcing model, IDNs, integrated delivery networks, patient satisfaction

The Virtues of the Outsourcing Model, Part 3: Examining Capability

Posted by Stan Schroeder on Thu, May 05, 2011 @09:59 AM

Over the past two weeks, we have begun to examine the outsourcing model and how to determine if it is right for your company. Over the past decade, outsourcing has become more of a reality than ever before thanks to technological advances that allow people to work together no matter where their office is.

Last week, diminished staff capacity in light of the economic downturn was discussed. Capability serves as the counterpart to capacity. Without the optimal staff capacity a company has become accustomed to, its capability surely will be diminished as well. And from there, performance may begin to decline as a result. This is what all companies hope to avoid in the face of layoffs. As fewer employees take on more work, quality begins to suffer, and previously handled tasks begin to fall down the cracks.

The leading causes of a decline in capability will be the loss of institutional experience, knowledge, special skills and historical competencies. In addition to layoffs because of economic constraints, the generational shift in the workforce likely will also contribute to diminished capability. Because younger workers are likely to work at five to six times as many companies as their older counterparts, their own general business acumen is likely to suffer as well. Instead, these workers will only have the time to learn the one aspect of the company they are involved in as opposed to receiving the institutional, years-long education of how an organization runs that their parents did. As Robert Ryan states in his position paper on outsourcing, “The generational trend is toward specialization, further diluting the general business cognition.”

With layoffs and the generational shift of the workforce, companies will begin to see gaps in their capabilities. That is where outsourcing comes in. How have you used outsourcing to fill capability gaps?

 


Tags: Essential Healthcare Management, Schroeder, Ripullo, EHM, healthcare, ACO, Accountable Care Organizations, healthcare suppliers, HHS, ACO Regulations, ACOs and suppliers, HHS Regulations, gpos, outsourcing model, integrated delivery networks

The Virtues of the Outsourcing Model, Part 2: Examining Capacity

Posted by Stan Schroeder on Wed, Apr 27, 2011 @10:13 AM

As discussed in last week’s post, economic difficulties and technological advances have combined to make outsourcing more of a compelling and intriguing option for companies than ever before. By allowing companies to maximize limited financial resources, the outsourcing model may be exactly what your company needs.

In Robert Ryan’s recent position paper on the topic, he repeatedly refers to a need to make companies agile, which better allows for course corrections in times of rapid change, like now. When it comes to agility, size will always be a factor, no matter if it is comparing the way a sports car whips around corners in comparison to the much larger minivan or in seeing how small companies can make changes much more simply than larger ones. In fact, the workforce itself is becoming more agile, with the average Baby Boomer expected to work for only two to three companies throughout his or her career, while members of generations X and millennium will likely average 15-18 tenures at different companies.

When capacity shrinks, a company may no longer have the size of the workforce necessary to handle all tasks and strategies. With a smaller capacity, organizations begin to struggle with completing the functions they completed prior to the downsizing, much less be able to actually keep up with technological advances and changes in the industry. Once a company reaches a point where it can no longer keep pace with its competitors, then it is no longer agile.

Also, as the number of employees of many businesses has dwindled down to a core staff as a result of the economic downswing, many people are now doing multiple jobs, and with more people changing jobs at different companies than ever before, it makes sense that workers are no longer perfectly suited and trained for every aspect of their positions. Rather than allow quality and service to deteriorate in the wake of this situation, it makes more and more sense for companies to carefully examine the capacity of their workforce in terms of not only numbers but also capabilities, which we will discuss in more depth next week.

As Ryan states, “Too expensive to hire and train, most organizations acquire expertise episodically for strategic initiatives. This includes increasing capability and capacity over a short, definable period of business or technical transition.” How have you seen capacity make a difference when a company is considering outsourcing? How do you determine which functions your team can handle in-house and which can be outsourced? How do you determine when a company should take on added capacity to achieve a goal?

Tags: Essential Healthcare Management, Schroeder, Ripullo, EHM, healthcare, medical, hospitals, ACO, Accountable Care Organizations, healthcare suppliers, HHS, Regulations on ACOs, ACO Regulations, ACOs and suppliers, HHS Regulations, gpos, outsourcing model, IDNs, integrated delivery networks

The Virtues of the Outsourcing Model

Posted by Stan Schroeder on Thu, Apr 21, 2011 @01:21 PM

With fuel costs rising almost daily, the purse strings on company travel budgets continue to be drawn tighter and tighter. In fact, some companies have eliminated travel entirely in favor of outsourcing the sales, advertising and marketing work that once required separate departments.

The outsourcing model offers a way for company’s to maximize limited resources in a time of economic constraint. As a cost-saving tool, outsourcing allows the same work to be done by a strategic partner for a fraction of the price that it would cost to be done in-house.

Robert Ryan, Co-founder and Vice President of TrustedCare, Inc. in Austin, TX, recently delved into the outsourcing model in a position paper. In it, he referred to ways to make your company more “agile” - and agility is actually what all companies should be striving for. Ryan states, “Because change is constant, the agile enterprise is able to adroitly adjust to and take advantage of rising opportunities…. It is apparent in studies that the agile organization shows significant profit growth…”

EHM has built a business based on connecting medical suppliers to the healthcare organizations with purchasing power, but the company also offers its clients much more in the form of outsourced sales, advertising and marketing support. As an EHM client, we can use our resources and connections to sell your products directly to the Integrated Delivery Networks (IDNs), Group Purchasing Organizations (GPOs) and Accountable Care Organizations (ACOs) who most need access to them.

Over the next few weeks, we’ll be examining some questions that will you help you determine if the outsourcing model, and a partnership with EHM, is right for you, so stay tuned to the EHM Catalyst Blog each week.

In the meantime, please tell us whether you have examined if outsourcing is right for your organization. There are pros and cons to both models, and we are interested to hear your end result.

Tags: Essential Healthcare Management, Schroeder, Ripullo, ACO, Accountable Care Organizations, healthcare suppliers, ACOs and suppliers, gpos, outsourcing model, IDNs, integrated delivery networks

ACO Regulations Defined by HHS

Posted by Stan Schroeder on Wed, Apr 13, 2011 @11:05 AM

The US Department of Health and Human Services (Washington, DC) released regulations on accountable care organizations (ACOs), providing rules to enable organizations in setting up exchanges of healthcare data to improve care and reduce costs, as mandated under the Accountable Care Act. A press release was distributed at the end of March detailing the announcement and includes links to the specific regulations.

ACOs are pivotal to the federal government's plan to reduce healthcare costs and improve quality. Some providers, such as Intermountain Health (Salt Lake City, UT), have been using an approach that's something similar to ACOs for years. Collaborations between doctors and other providers make care more uniform, based on the best outcomes. Often, this care is also the most cost-effective. Some have called ACOs the HMOs of today.

EHM has the experience and knowledge to help guide suppliers through this new market structure.  We can provide product marketing and positioning support, make appropriate introductions and get you in front of the right decision-makers to help make you more successful.

Tags: Essential Healthcare Management, Schroeder, Ripullo, EHM, healthcare, ACO, Accountable Care Organizations, healthcare suppliers, HHS, Regulations on ACOs, ACO Regulations, ACOs and suppliers, HHS Regulations

Patient Satisfaction

Posted by Stan Schroeder on Wed, Apr 06, 2011 @02:43 PM

TruthPoint Helps Hospitals Improve Patient Satisfaction Scores

EHM prides itself on connecting valuable medical industry suppliers with those who have purchasing power. Our latest client that we are positioning for success is TruthPoint, which offers an innovative method of helping hospitals dramatically improve their patient experience scores. With this technology in place, TruthPoint can greatly assist Accountable Care Organizations (ACOs) with meeting their own goals when it comes to patient satisfaction.

ACOs will likely become the predominant option for integrating healthcare services for Medicare recipients beginning in January 2012, and EHM aims to ease the way for medical industry suppliers to align their missions to this new system. As the number of registered ACOs continues to skyrocket, EHM is focusing on helping its clients become as marketable as possible to these new organizations and their potential purchasing power. One of the primary ways this can be achieved is by helping clients create services that will appeal across a broad range of healthcare spectrums.

Having accurate and easy-to-procure patient experience scores can eliminate a large burden from hospitals. By relying on TruthPoint, healthcare providers will be able to spend less time obtaining their own figures and more time using the figures from TruthPoint to strategize on how best to serve their patients and strengthen their financial results. TruthPoint’s system is so easy for patients to use that hospitals can implement it at every point of care throughout their system to get a wide-ranging array of results.

For more information on TruthPoint or EHM, please contact EHM.

Tags: Essential Healthcare Management, Schroeder, Ripullo, EHM, healthcare, medical, ACO, Accountable Care Organizations, healthcare suppliers, patient satisfaction, truthpoint

The New Market Player: ACOs

Posted by Stan Schroeder on Wed, Mar 23, 2011 @03:02 PM

Accountable Care Organizations (ACOs) may soon reshape the way healthcare is delivered in the United States by integrating under one umbrella a patient’s network of medical caregivers. While it is hoped that ACOs will help cut unnecessary healthcare costs while improving patient care, this change means that medical industry suppliers must not only quickly learn but also master how to navigate this new system in order to best position their companies for success.

Essential Healthcare Management’s (EHM) industry experts have been closely following these changes and are already helping healthcare suppliers align their businesses with the new system, which will launch in January as a Medicare option. Suppliers that can tailor their products and services to cater to as many healthcare segments (acute care, geriatrics, home healthcare, long-term care, etc.) as possible can benefit from the changes by growing the demand for their products.

The potential market is huge. The number of organizations announcing plans to register as ACOs has exploded to more than 100 in just a short period of time, and more are announcing plans every day. EHM’s team can give suppliers a head start by offering introductions and helping them adapt their products to ACOs. The company is creating a section on its website that is dedicated to providing information and tips on working with ACOs.  It will be unveiled soon.

In the meantime, contact EHM for more information on how its industry experts can help your company compete in serving ACOs. 

Tags: Essential Healthcare Management, EHM, healthcare, ACO, Accountable Care Organizations, healthcare suppliers