人口健康服务
什么是人口健康? As defined by the Center for Disease Control (CDC), 《明升app》重点关注重大的健康问题,并探讨如何分配资源,以克服导致人口健康状况不佳的问题.“人口健康的使命是改善我们所服务社区的健康结果. 以价值为基础的合同的有关偿还是最常用于为该特派团提供资金的手段.
LBMC拥有一支强大的人口健康顾问团队,他们可以帮助您了解如何提高为社区员工和患者提供的护理质量, 以及如何优化基于价值的合同补偿和激励机制.
准备评估 & 策略
- Value-based Contracting and Reimbursement Assessment
- Clinically Integrated Network (CIN) and ACO 准备评估
- 策略 & 路线图设计
设计 & 实现
- Accountable Care Organization (ACO) / CIN Network 设计
- 路线图的实施
- 站立能力 & 网络功能
人口健康管理
- Facilitating Transitions of Care and Post-Acute Management
- 数据分析 Program Development
- Care Management Program Development
医师网络发展 & 协议
- Supporting Development of Health System & 供应商ACO/CIN网络
- ACO and CIN Governance Structure, Participation 协议, Committees, & 任务部队
奖状
常见问题
- 我是否必须牺牲我的服务报销费用来参与基于价值的报销?
- What channels (types) of value-based reimbursement programs do I pursue?
- 我是否需要投资额外的资源来优化我的基于价值的报销?
- Is there an eventual return on investment in value-based contracting? How long before the return on investment becomes positive?
- What is a Clinical Integration Organization (CIN)?
合作伙伴关系是医生和医院之间的伙伴关系,为特定人群提供医疗保健和保健服务. 治理通常是由两个合伙人的同等代表组成的董事会. The Board Chairperson is usually a physician.
CIN的成立是为了对特定人群的患者承担财务和质量表现的唯一上行风险. 收益(储蓄)由成员共享,有时成员可以与保险公司承担风险,以弥补潜在的损失.
- Why do health systems and physician leadership form a CIN?
卫生系统和社区医生希望优化他们在当前和未来基于价值的报销方面取得成功的能力. An organized CIN is the preferred vehicle to achieve this. 虽然目前, the reimbursement model is still primarily fee for service, 新的报销模式包括基于成本效益和质量结果的额外报销. CIN可以为其医生和医院成员提供资源,帮助他们个人和集体在基于价值的护理和报销方面取得成功.
- CIN的结构是怎样的? Will Physicians really have a voice in how it organized and operated?
CIN的法律结构通常是一个有限责任公司(LLC),医院是唯一的成员. CIN的管理通常是一个由大多数医生和少数医院代表组成的董事会.
- How do “value added” reimbursement payments figure into the CIN?
Unlike a Medicare down-side risk sharing arrangement, CIN协商合同,为实现低成本和高质量的供应商提供补偿, without the risk of paying for cost increases. 然而, gain sharing will only occur when there is both a cost savings, and successful achievement of the quality measures.
- 除了与医院员工人口健康计划签订合同外,CIN未来的潜在机会是什么?
The CIN can market its services to all insurers, and large self-insured community employers, 和医疗保险优势计划,并形成一个负责任的医疗组织,与医疗保险和医疗补助服务中心签订合同. 医院员工人口是学习人口管理的一个极好的起点,风险很小. 然后,CIN也有机会形成一个负责任的医疗组织,与医疗保险和医疗补助服务中心签订合同.
- What are the differences between ACO and CIN?
CIN是问责医疗组织(ACO)的一种商业和私人付款形式。. CIN和ACO都签署了一个提供者网络,组成CIN临床团队, and will include community physicians and hospital-employed physicians. CIN initiatives are selected by local providers, whereas ACO initiatives are selected by CMS and the government. CINs通常只有上行风险,而ACOs在与CMS签订合同的后几年将承担下行金融风险.