Future Cognitive Healthcare

Future Cognitive Company

Thomas Davenport in his article “AI for the Real World” describes how the “Future Cognitive Company” would use Artificial Intelligence and Machine Learning to help find answers to the key strategic questions for the firm. He writes: “Most cognitive tasks [performed by AI algorithms] do work that wasn’t done by humans in the first place, such as big-data analytics.”

Healthcare providers are Cognitive Companies — today and in the future. And as Value-Based Care continues to grow, the various reimbursement and incentive models make care delivery increasingly complex, adding to the need to be [...]

Population Health Needs a Tight Definition to Succeed

populations of colorfully illustrated people, arranged as upward arrows on white background, representing population health definition The Jefferson College of Population Health (JCPH) celebrated its 10th anniversary last week – Congratulations!! That means that the concept of Population Health is now well established, not the novelty and the experiment that it was a decade ago. But, in my travels and meetings with healthcare providers and health IT firms in the Pop Health space, I notice that there’s a lot of variation in what people mean by the term Population Health – and this variation [...]

Social Risk Adjustment for Provider Quality measures

Physicians have two classic responses to quality or performance reports:

  1. My patients are sicker, or
  2. Your data is wrong.
We use risk-adjustment and data quality checks to address these concerns and to ensure that quality reports are accurate and fair.
But there is a third concern, very significant and real:
My patients…
  • …are poorer, less educated
  • …live in challenging neighborhoods
  • …don’t have access to healthy food, or for other reasons don’t eat healthy food
  • …don’t exercise, breathe unhealthy air or drink unhealthy water
  • …in short, are more “difficult”
We need to apply social risk adjustment to quality and performance metrics. This is not a [...]

How fast are we moving to Value-Based Payments?

Two of our Jefferson College of Population Health students presented on the progress of Value-Based Payments. Their chart is the blue line, and it’s based on CMS data. According to CMS targets, 30% of payments will be tied to quality or value in 2016, with a target of 50% in 2018. For these targets and updates, see CMS’ Healthcare Payment Learning and Action Network.

 » Read more about: How fast are we moving to Value-Based Payments?  »

Alternative Payment Models for Health Care

The Alternative Payment Model (APM) Framework white paper from the Health Care Payment Learning & Action Network (see report here) is a useful guide as we’re trying to understand the direction of Population Health initiatives. It lays out the transition from a Fee for Service payment model to a much more diverse environment with many concurrent plans – a variety of Alternative Payment Models (APMs), through both Medicare and private health plans. The appendix lists many good examples. Some of these APMs are “beginner” models – with a modest amount of upside only risk to the provider. And [...]

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