Difference between revisions of "Programs"

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(Risk Adjustment Factor (RAF) Coding)
 
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Ambulatory Care Sensitive Conditions <br>
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==Ambulatory Care Sensitive Conditions==
* Same Day Appointments
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Ambulatory Care Sensitive Admissions - Reviews <br>
* Ambulatory Care Sensitive Admissions and ER Visit Reviews
+
Ambulatory Care Sensitive Conditions - Best Practices <br>
* ACSC Best Practices
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Ambulatory Care Sensitive ER Visit - Reviews <br>
 
Care Gaps <br>
 
Care Gaps <br>
Clinical Team Coordination <br>
+
Same Day Appointments <br>
* In-Network Coordination  
+
 
* Out-of-Network Specialist Coordination  
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==Clinical Team Coordination==
 +
In-Network Coordination <br>
 +
Out-of-Network Specialist Coordination <br>
 
* [http://content.healthaffairs.org/content/36/3/492.abstract Los Angeles Safety-Net Program eConsult System Was Rapidly Adopted And Decreased Wait Times To See Specialists (3/2017)]
 
* [http://content.healthaffairs.org/content/36/3/492.abstract Los Angeles Safety-Net Program eConsult System Was Rapidly Adopted And Decreased Wait Times To See Specialists (3/2017)]
Determinants & Intervention Documentation <br>
+
==Determinants & Intervention Documentation==
High Value Office Visits<br>
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==High Value Office Visits==
* Reduce Low-Value Visits
+
Reduce Low-Value Visits <br>
* Lab Tests or ER Visit reports in advance
+
Lab Tests or ER Visit reports in advance <br>
Quality Measures <br>
+
==Patient Loyalty==
Referral Management <br>
+
* [http://www.beckershospitalreview.com/hospital-physician-relationships/the-4-biggest-factors-determining-a-patient-s-choice-of-physician.html The 4 biggest factors determining a patient's choice of physician (4/25/17)]
Risk Adjustment Factor (RAF) Coding <br>
+
* [http://go.americanwell.com/rs/335-QLG-882/images/American_Well_Telehealth_Index_2017_Consumer_Survey.pdf 20% of individuals polled stated they would consider changing their primary care physician (PCP) if another PCP offered telehealth services and their current one did not (1/2017)]
Second Opinions <br>
+
 
 +
==Quality Measures==
 +
==Referral Management==
 +
==Risk Adjustment Factor (RAF) Coding==
 +
* [https://venturebeat.com/2017/07/06/apixio-uses-ai-to-extract-patient-conditions-from-medical-records/amp/ Apixio uses AI to extract patient conditions from medical records (7/6/17)]
 +
 
 +
==Second Opinions==
 
* [https://www.bloomberg.com/news/articles/2015-08-20/the-startups-that-give-you-a-second-opinion-on-costly-surgery Second Opinion on Costly Surgery can control medical costs (8/20/15)]
 
* [https://www.bloomberg.com/news/articles/2015-08-20/the-startups-that-give-you-a-second-opinion-on-costly-surgery Second Opinion on Costly Surgery can control medical costs (8/20/15)]
Utilization Management <br>
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==Utilization Management==
* Variations
+
Emergency Room <br>
* Low-Value Care  
+
* [http://www.wbur.org/commonhealth/2017/05/25/emergency-department-health-costs Tip No. 1 For Taking Charge Of Mass. Health Care Costs: Avoid The ER. Doctors Push Back. (5/25/17)]
* Location of Services
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Location of Services <br>
 +
* [http://www.beckershospitalreview.com/finance/medpac-issues-march-report-to-congress-8-takeaways.html MedPAC recommends site-neutral payments for evaluation and management office visits so that the rates are the same whether the service is provided in a physician office or an outpatient department. (3/16/17)]
 +
Low-Value Care <br>
 +
* [https://www.healthnewsreview.org/2017/04/five-years-wisely-a-look-at-the-choosing-wisely-campaign-to-reduce-unnecessary-medical-tests-and-treatments/ Five years wisely: A look at Choosing Wisely’s effort to reduce unnecessary medical care (4/25/17)]
 +
Variations <br>
 +
 
 +
For more, see [http://www.patientdeterminants.org/index.php?title=Insight#Healthcare_Interventions_Insight Healthcare Interventions] and [http://www.patientdeterminants.org/index.php?title=Insight#Medical_Decisions_Insight Medical Decison Insight]
  
 
See [[Managing Health]]
 
See [[Managing Health]]

Latest revision as of 10:45, 18 July 2017

Ambulatory Care Sensitive Conditions

Ambulatory Care Sensitive Admissions - Reviews
Ambulatory Care Sensitive Conditions - Best Practices
Ambulatory Care Sensitive ER Visit - Reviews
Care Gaps
Same Day Appointments

Clinical Team Coordination

In-Network Coordination
Out-of-Network Specialist Coordination

Determinants & Intervention Documentation

High Value Office Visits

Reduce Low-Value Visits
Lab Tests or ER Visit reports in advance

Patient Loyalty

Quality Measures

Referral Management

Risk Adjustment Factor (RAF) Coding

Second Opinions

Utilization Management

Emergency Room

Location of Services

Low-Value Care

Variations

For more, see Healthcare Interventions and Medical Decison Insight

See Managing Health