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In This Issue
Fueling the Need for Price Transparency
Sending Health Care Leaders Back to School
Out of Pocket Cost Transparency Can Influence Patient Behavior
Medicare Pays Providers for Important Care Transitions Work
Bundled Payment Seminar May 1st
Nurse Navigators Decrease Costs and Improve Care in SW Colorado
New Articles and Resources
Fueling the Need for Price Transparency
By Phil Kalin, CIVHC President & CEO
Phil KalinOnly a self-admitted data wonk has a favorite health care economist. Mine is Dr. Uwe Reinhardt of Princeton. Over the years he's amazed me with his witty and succinct analyses of the health care marketplace and why it is so profoundly broken. He just came out with his latest blog, "U.S. Health Care Prices Are the Elephant in the Room". I highly recommend this article for the nuggets of insight it provides as well as a range of other resources and articles that he points to.

Uwe's article comes on the heels of two other publications that have received a great deal of notice over the past weeks. 

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Sending Health Care Leaders Back to School
By Edie Sonn, CIVHC VP of Strategic Planning
Edie SonnMeasuring outcomes in meaningful and consistent ways; giving providers incentives to improve; holding them accountable for their results.  Comparing providers against their peers as well as against their own historical trend. Rewarding low-performers who improve, without penalizing high-performers that don't have as far to go. Making sense of a bewildering tangle of expectations and requirements.

 

That's the landscape of health care accountability, right? Yes - and it's also the landscape of school accountability.  

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Out of Pocket Cost Transparency Can Influence Patients Behavior
By Bob Kershner, CIVHC Director of Health System Payment Strategies

I read with great interest the Health Affairs Article," Focus Groups Highlight That Many Patients Object to Clinicians' Focusing on Costs."  This study found that patients will opt for a more expensive treatment or diagnostic option even if the more expensive choice offers only a slightly improved chance for a better outcome.  I am paraphrasing and simplifying the scope of the study but the general sense is that when it comes to a patient's decision on what medical intervention they want, cost is not important.  My professional experience as a physical therapist and orthopedic practice administrator has shown me that costs can play a major role in a patient's decision to seek elective care.  I would like to contrast the Health Affairs study using focus groups with the real world experience of actual patient dollars being part of the patient's decision.

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Medicare Pays Providers for Important Care Transitions Work

By Kristin Paulson, CIVHC Policy Coordinator
This January, the Centers for Medicare and Medicaid Services (CMS) introduced two new billing codes for Medicare - CPT TCM 99495 and 99496. These Transitional Care Management codes pay doctors to manage the transitions of high-needs patients from hospital to home or another care facility, including non-face to face care and management, something Medicare has never done before. The codes are part of CMS's commitment to managing care transitions and reducing hospital readmissions and have the potential to bring provider involvement in care transitions to a new level.

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Bundled Payment Seminar May 1st Features Walmart Expert

Bundled Payment Photo - purchased

When: May 1st, 9:30-11:30am

Where: Children's Hospital Auditorium 

 

Description: Our next CIVHC Connect meeting features leaders from around the country, including Ruth Coleman, who was instrumental in developing the Walmart bundled payment program that has received national attention. Attendees will leave with a better understanding of why to engage in bundles, how bundles can be developed, and best practices in designing and operationalizing bundled payments from the business, health plan and provider perspectives.    

More Information and Registration   

Spotlight on Innovation: Nurse Navigators Decrease Costs and Improve Care in SW Colorado
By Jane Looney
 
San Juan PhotoJuan Romero is a 4th generation Southwest Coloradoan who proudly traces his family history back to the 1500s. Last year, an alarmed disability health screener told Romero to immediately go to the hospital because of concerns over his high blood pressure and cholesterol. When he arrived at the front desk, he was told to go to the Emergency Room. After adamantly refusing to incur unnecessary debt, Romero was referred to Helen Joline, a Nurse Navigator with San Juan Basin Health's Care Coordination Team of the Southwest (CCTSW). Looking back, he reflects, "I didn't know what kind of help I needed or which way to turn." Romero's now the healthiest he's been in a decade, and he credits his Nurse Navigator.

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CIVHC Welcomes Three New Staff Members

Please join us in welcoming three new employees to our team! Visit our staff webpage to learn more about their positions and background. 
  • Margaret Nardini, Health Care Business Systems Analyst  
  • Erin Perry, Program Assistant
  • Matt Thompson, Account Manager

Spreading the Triple Aim Message

Below are just a few examples of external stakeholder meetings where CIVHC is promoting improving health, enhancing quality and containing costs.

Contact us if you would like us to present at your upcoming event! 

Stay on Top of Important Reform Updates!
Looking for more ways to keep apprised of Colorado and national health care reform activities focused on the Triple Aim? Click on one of the links below to follow or like CIVHC today!
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The Center for Improving Value in Health Care is a non-profit, collaborative organization supporting the Triple Aim for health care: improving health, increasing quality and containing costs. We would like to thank The Colorado Trust, the Colorado Health Foundation, Rose Community Foundation and Caring for Colorado for providing funding to support our organization and focus areas.