My optimistic view… As a provider of health care services, there is always concern with how and who will be paying for the services that are provided to patients in government programs. As a consumer, you are concerned with how you will be able to afford your premiums when they once again increase disproportionally with your income.
At the current growth rate, high deductible insurance plans offered through employers will predominate within four years. This has broad implications, which are only beginning to be felt.
It’s important to realize that there isn't a single silver bullet that will solve all your patient experience problems.
One of the biggest challenges healthcare organizations face today is patient engagement. At Citra, we define successful engagement as:
With HEDIS®, CAHPS®, STARS and HRSA Clinical Core measures tied directly to reimbursements, care gaps can have a serious negative impact on a health care organization’s bottom line. Every year billions of dollars in reimbursements and other payer incentives are tied to quality performance. Quality scores can also have a big impact on a plan’s Exchange rating. As a result, many organizations are implementing formal quality improvement programs.
CMS announced that a new mandatory payment model will go into effect beginning TODAY. Comprehensive Care for Joint Replacement (CJR) will hold hospitals and their partners accountable for quality measurement for an episode of care associated with knee and hip replacements – from initial hospitalization through recovery. This is the latest example of CMS migrating toward a value-based reimbursement model.
This year's convention covered more square footage than 21 football fields and showcased over 1200 vendors, with almost 300 of them exhibiting at HIMSS for the first time. The booths were divided over several exhibition floors along with educational sessions and professional certification exams being conducted in separate meeting rooms for those interested in continuing education. All in all, more than 45,000 people attended. With all of these attendees and spectators, there were a number of recurring themes:
JACKSONVILLE, FLA. – March 01, 2016– Citra Health Solutions, a leading healthcare services and technology firm and portfolio company of Great Point Partners, LLC., announced today the acquisition of SironaHealth, a company delivering a full spectrum of clinical care management services. Citra purchased SironaHealth as the next step in an on-going plan to extend its integrated population health solutions in the value-based market. SironaHealth, a URAC and NCQA accredited health services company, has a long history of clinical care coordination and patient care and case management. With a multi-modality approach, the clinical teams are driving quality care into programs that support patients’ access and outcomes. SironaHealth will do business as a Citra Health Solutions company and will continue to maintain an operational center in Portland, Maine. “By managing the health of populations, including disease management, care management and wellness, Sirona will fit into Citra’s holistic approach to drive increased member engagement, reduce health care costs and improve the quality of care,” said Howard Buff, CEO and Founder of Citra Health Solutions. “The integrated healthcare model will provide a service and technology enabled platform that supports a multitude of payment models and risk arrangements for Providers and Health Systems. Citra helps healthcare organizations maximize performance and empower consumers. Best-in-class solutions include 24/7 care coordination, point of need engagement, re-admission reduction, ER diversion, star rating improvement, bundled payment administration and chronic care management. Serving over 22 million members across a nationwide service and technology foundation, Citra continues its quest to improve every organizations’ core competencies while diminishing spending and improving clinical and financial outcomes. With CMS designing and releasing new, specialized programs to address chronic illnesses, Citra-led programs are already assisting more 2500 providers and over 250,000 patients to engage in advanced care paradigms that are proving beneficial across the United States with patients successfully co-managing a multitude of conditions. As oncology and joint replacement programs come on-line this year, Citra is already leading global healthcare mind share with proprietary technology and processes that assist in delivering successful clinical outcomes. Citra’s acquisition of SironaHealth further increases its clinical capabilities to meet the needs of the market and strengthens the portfolio of solutions to meet the needs of all healthcare’s personas: Patient, Provider and Payer. “We view ourselves as innovators in the healthcare marketplace, so we know our company will be the perfect complement to Citra,” said Jeff Forbes, CEO of SironaHealth. “Our mission has been to guarantee satisfaction through compassionate and competent care with a relentless focus on quality improvement and that will not change. What will change is the fact that with these augmented resources, we will have the ability to offer our customers more than ever before.”