Physicians, COVID19, Value-Based Care Hannah Russell Physicians, COVID19, Value-Based Care Hannah Russell

Physician Workforce and Burnout

We hear a lot about burnout in healthcare these days. To start a conversation about physician and clinician burnout, I like to think back to what the term means from a mechanical perspective: the reduction of a fuel or substance to zero and/or the failure of an electrical device or component due to overheating. You’re either out of gas or you’ve worked so hard as to blow a circuit and shut down – or both.

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Value-Based Care, Patient Care, Operational Hannah Russell Value-Based Care, Patient Care, Operational Hannah Russell

Clinically Integrated Networks

A clinically integrated network (CIN – sometimes pronounced “sin,” which is why I prefer to spell out the letters, “C-I-N”) is a group of healthcare providers that work together to actively assess and modify services to deliver efficient and affordable coordinated care to specific groups of patients. They share pertinent information and data, creating a high degree of interdependence and cooperation among the clinically integrated providers to control costs and ensure quality, usually via an electronic platform.

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Value-Based Care, Big Ideas, Primary Care Hannah Russell Value-Based Care, Big Ideas, Primary Care Hannah Russell

TEAM-BASED CARE – The future (and present) of Primary Care

At the Reimagining Primary Care (RPC) Forum this spring, a prevailing theme about how primary care can and should be done in the future was one of team-based care. Our current paradigm of primary care comes with some mismatches, even conflicts to the notion of care delivered by a team, and this leads to challenges in transforming care.

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Primary Care, Patient Care, Value-Based Care Hannah Russell Primary Care, Patient Care, Value-Based Care Hannah Russell

Navigating Patient Financial Responsibility

Patient financial responsibility plays a significant role in revenue management. As out-of-pocket expenditure continues to rise, healthcare providers face challenges in collecting payments, leading to increased accounts receivable (A/R) and uncollectible revenue. Understanding the impact of patient responsibility and implementing effective strategies are essential for maintaining financial stability and delivering quality care.

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Value-Based Care, ACO, Notes On News Hannah Russell Value-Based Care, ACO, Notes On News Hannah Russell

CMS Introduces ACO Primary Care Flex Model

The US Centers for Medicare and Medicaid Services, through their Innovation Center (CMMI) announced a new ACO program to go live in 2025 – ACO Primary Care Flex. The hope is to build on the data, experience, and successes they have had with their other models that promote primary care, but with a focus on rural and underserved regions.

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Physicians, Primary Care, Value-Based Care Hannah Russell Physicians, Primary Care, Value-Based Care Hannah Russell

The Sacred Patient-Healer Relationship

I had the honor and pleasure once of sitting in on a broadcasted conversation with Faisel Syed, MD on the Sacred Patient-Physician Relationship. (Faisel and Friends) That discussion got me thinking more about the special rapport needed between the Person we call the Patient and the Healer for healthcare to be effective and to optimally create value.

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Physicians, Primary Care, Value-Based Care Hannah Russell Physicians, Primary Care, Value-Based Care Hannah Russell

Aligning Physician Compensation with VBC

One of the first and most important challenges an organization faces when moving from strictly fee-for-service (FFS) healthcare delivery to value-based care (VBC) is aligning physician and provider compensation to the new priorities of VBC. If this gets left to be done “later” or not at all, the disconnect between incentives will make VBC success very difficult. 

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Primary Care, Value-Based Care Hannah Russell Primary Care, Value-Based Care Hannah Russell

Facts and Stats – Things to consider when analyzing Data

We have an unfathomable amount of data available to us today in healthcare. Beyond our clinical data, we have multiple discrete fields of other bits and bytes that we can look at to discover better ways to care for our patients. Sometimes, though, in our zeal to find problems or solutions, we get things a bit wrong in putting the data together into useful, actionable insights.

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Value-Based Care, Primary Care, Physicians Hannah Russell Value-Based Care, Primary Care, Physicians Hannah Russell

Preferred Provider Network

Throughout this series of articles, we’ve discussed value-based care (VBC) drivers of gross income – attribution, risk coding and activities-based bonuses – and spent a good amount of time on drivers of net income, those that lower medical expense. Of these, we have looked at access, Annual Wellness Visits, and managing patient care. These six levers get pulled by most all organizations and practices to some degree regardless of their position on the VBC spectrum.

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Primary Care, Healthcare, Value-Based Care Hannah Russell Primary Care, Healthcare, Value-Based Care Hannah Russell

Annual Wellness Visits

This series has been focusing on levers to be pulled that can increase revenue in value-based care (VBC) practices. The second installment started looking at ways to decrease medical expenses, thereby increasing the potential revenue through shared savings or premium risk (Link to Part 2). Part 3 will now dig into the Swiss Army Knife of VBC, the Annual Wellness Visit (AWV).

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Value-Based Care, Primary Care, Healthcare Hannah Russell Value-Based Care, Primary Care, Healthcare Hannah Russell

Medical Expense Drivers: Access

As more practices and organizations pursue the principles of value-based care (VBC), they look for ways to improve their financial outcomes, the drivers of net revenue. Part 1 of this series focused on some of the main determinants of gross revenue in VBC and how to increase the size of the gross revenue bucket, or pie, depending on how hungry you are. These next installments will speak to the ways of decreasing medical costs, thereby increasing the risked savings to be shared or kept, decreasing the amount of pie eaten by medical expenses, thereby increasing the remainder in the bucket after expenses are paid.

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Value-Based Care, Primary Care, Healthcare Hannah Russell Value-Based Care, Primary Care, Healthcare Hannah Russell

VBC Drivers Part 1

We’ve become very familiar with the revenue drivers in fee-for-service (FFS) healthcare delivery over the past 100 years. Find the highest priced visits, treatments, and procedures a doc can perform and run as many patients as possible through those visits, treatments, and procedures. Since reimbursement rates for medical services have been going down, net revenue increases have more recently been driven by adding new types of visits or procedures to a practice’s repertoire and constantly honing efficiencies in moving people from the front door, through the exam/treatment room, and back into the parking lot as quickly as possible.

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Value-Based Care, Primary Care, Healthcare Hannah Russell Value-Based Care, Primary Care, Healthcare Hannah Russell

VBC Introduction – Commonly Used Terms

If you’re new to Value-based Healthcare, first of all, Wake Up! Where have you been? Just kidding. Even though I’d like to think that the concepts and practice of value-based care (VBC) are well-known to all and practiced diligently by most – VBC as a mode of operation in healthcare delivery that improves outcomes, improves patient and physician experience, improves revenue for physicians, and decreases overall cost of medical care – the realist in me recognizes that’s definitely not the case.

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Value-Based Care, Primary Care Hannah Russell Value-Based Care, Primary Care Hannah Russell

The Importance of a Hospitalist Relationship in Primary Care

PCP practices engaged in shared savings or at-risk contracts can have tremendous medical expenses related to hospitalizations and the downstream impact of the hospital stay – beyond the DRG payment for hospital care. There are multiple opportunities to address issues that impact medical spend during and after a hospital stay, but they are dependent on a hospitalist team dedicated to work with the PCP practice, functioning within service level agreements around communication, referral patterns, and timely follow up with the PCP.

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