Four ways demand for healthcare data will grow in 2017

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/four-ways-demand-healthcare-data-will-grow-2017

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The New Year presents challenges on many fronts, including questions surrounding how President-elect Donald Trump will change healthcare policy. Yet, “repeal and replace” or “replace and improve” activities on The Hill, though not “business as usual,” won’t necessarily slow down data-driven focus areas in healthcare that will continue in 2017.

Here are four key ways demand for data will grow in the year ahead:

1. Increased demand for insight into discharge gaps, risks and exposures.

As delivery and payment models continue placing risk within the care setting, increased insight into the member’s (the patient’s) likelihood of adherence or compliance is critical in evaluating expected outcomes and coordination of care post-discharge. Socioeconomic data surrounding the patient and their caregiver can complete the picture of their expected behavior.

2. Maximizing identity management capabilities.

Identity insight and management solutions will be critical to ensure the right approach for the right member but, more importantly, to securely house and validate identity data. While a national patient identifier may become closer to reality at some point, for now, identity management techniques can be critical to ensuring all operational processes and players within the care payment and delivery setting can link the right information for each individual.

3. Integration of health-tracking wearables into care analytics.

The market for wearable fitness and health devices has grown exponentially. Integration of health tracking wearables into the care analytic systems creates opportunities for using wearable metrics as a basis for member rewards but also in risk scoring for compliance augmentation for new targets, for member engagement, and for prediction of medical complications or improvement.

4. Evaluation of provider performance.

While the release of MACRA benchmarks has gotten considerable attention the past month, it is really only a beginning. Commercial plans have attempted various P4P approaches over the years with one missing ingredient, now shared with MACRA: Insight into patient profiles and behaviors and their influence and impact on ultimate outcomes. Socioeconomic data augmenting existing measurement sources can serve a critical role in tiering performance measures with patient make-up to arrive at a more mutually accepted performance structure.

Healthcare organizations and payers should reach out to new data sources, augment their thinking with them, and redefine how their day is focused on insights into their most valuable player: the customer, the member and the patient.

Top 2017 challenges healthcare executives face

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/top-2017-challenges-healthcare-executives-face?cfcache=true&ampGUID=A13E56ED-9529-4BD1-98E9-318F5373C18F&rememberme=1&ts=15022017

Working as a managed care executive in today’s healthcare environment is a demanding role. According to Managed Healthcare Executive’s 2016 State of the Industry Survey, challenges abound. Government requirements and mandates, such as implementing value-based reimbursement, are difficult to meet. Meanwhile, employing new technologies, such as electronic health records and data analytics, is no easy task. Pharmaceutical costs continue to rise dramatically, burdening the entire system.

The survey findings, based on 160 responses, show the biggest challenges that executives at health systems, health plans, pharmacy benefit organizations, and more anticipate next year. Here’s a closer look at the survey results, and what industry experts say organizations can do to overcome them.

Consultant: Trump’s choice for HSS, CMS leadership spells trouble for hospitals

http://www.healthcarefinancenews.com/news/consultant-trumps-choice-hss-cms-leadership-spells-trouble-hospitals?mkt_tok=eyJpIjoiWm1Fd1pEWXdPV1V3TlRRNSIsInQiOiJqRitmbGZXbGdhVndGYytNYkdtSFkzMVlrM2tYanVNbXVJM1wvT3M3cHBmTnZHNDRkTG56MVwvZVQwQm5taExhRHlYaEtGYXFJWXd6WTBvbGdDRlJscFAwRThWMnFyejM2SUhFVmU5d0hxRGhJPSJ9

Most major healthcare organizations lavished praise on Price in statements released Tuesday, but Keckley paints a much less rosy picture.

“The big losers from November 8 on, with repeal a virtual certainty, are hospitals,” Keckley said. “They end up getting the raw end of the deal on doing away with the exchanges. They end up with uncertainly about ACO and bundles they’ve been developing.”

Keckley said healthcare systems are being cautious and are taking a second look at their value-based programs.

“The CFOs are saying to CEO, it’s time to be rethinking our capital commitments, interest rates are going to go up, the cost of borrowing is going up, margins are going down,” he said. “This is not a forward view where the knowns are clear. The only thing they can count on right now is, margins are going to shrink, cost of capital is going to go up.”

Hospitals oppose potential rebirth of ‘public option’ coverage

http://www.fiercehealthcare.com/finance/hospitals-chafe-against-potential-rebirth-public-option-coverage?mkt_tok=eyJpIjoiTXpVMk1HRm1NRE5pWW1JMSIsInQiOiIrM3BwTVBRRXorTzl3NjQxOWNPOUh1UUxUT0ZcL2xNTGdleWQzKzRFRzIwZzhHYTg2T0c3TWlZV1BjUEsxd0JBRmNJaGk0WU9NMTRvWmFyZndPVit2SzZmUDFxM1dWSm1OV2l4Rnd1YlBMWTQ9In0%3D&mrkid=959610&utm_medium=nl&utm_source=internal

Pillar of building etched with the word insurance

Under pressure from onetime rival Bernie Sanders and the liberal wing of her party, Hillary Clinton has pushed for a “public option” form of coverage in the state and federal health insurance exchanges.

The decision is considered to be a middle ground option away from Sanders’ primary campaign push for single-payer coverage. The proposal was recently endorsed by President Barack Obama.

However, the public option has drawn fire from the hospital sector, which fears it would depress the payments it receives to provide care. As a result, the American Hospital Association and the Federation of American Hospitals reached out last week to the Democratic Platform Drafting Committee.

Covered California will exclude hospitals with high rates of C-sections

http://www.healthcarefinancenews.com/news/covered-california-will-exclude-hospitals-high-rates-c-sections?mkt_tok=eyJpIjoiWkRjM1pHWXhaamRtTjJJdyIsInQiOiIrNU1UM0tidlREYndvZ05BQ1hESEZUaFZUV3Jkd0lDVnZTRVhkaWQ3cTZ2ZHJIMk9SZ0ZSSEZGdDhKK3BJS3V4RkkzdDcrR2Y1MDd1K0FabllGQ1p2ZjdGanAybDlCUFJBRWo4eFVRK1IwRT0ifQ%3D%3D

State want to bring down rate of Cesarean births to national target of 23.9 percent

Dozens of Georgia hospitals operating in the red: 5 things to know

http://www.beckershospitalreview.com/finance/dozens-of-georgia-hospitals-operating-in-the-red-5-things-to-know.html

OR Efficiencies

Growth, hospitals say, is crucial for the future of health care

http://www.bendbulletin.com/health/3491293-151/growth-hospitals-say-is-crucial-for-the-future#

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