“Population Health” has remained an enigmatic term often used to create intrigue but lacking the substance necessary to command true meaning. In this session we will contrast two popular interpretations of the term and establish an operating definition that incorporates the many considerations necessary to reduce the cost of care in the United States while increasing access to the appropriate care at the best time. We will likewise explore Value in the context of health care and what it means to operate from a patient-centric, outcomes-driven orientation. From an established definition of both Population Health and Value, we will discuss the impact Population Health Management (PHM) programs have on the future state of health care and what organizations are doing today to promote quality, reduce preventable care, and manage the overall cost of care through better technology, analytics, and service orientation. The success of these programs is directly correlated to the effective transition from fee-for service (by volume) payment models to fee-for-value, i.e. cost and quality accountable, models. To transition to Value-based Care and navigate the challenges of concurrently supporting two payment models, health care systems must have meaningful and actionable analytics along with population health management tools to highlight descriptive data (what was) and predictive data (a range of what is expected) to help optimize future information capture and clinical practices. Health care systems need to evolve to take advantage of the rapidly accelerating use of better data and develop improved health care quality practices at a greater value for their patients.
1.0 CEU – Revenue Cycle Management
Moshe Starkman is the Senior Director, Value-Based Reimbursement at nThrive, specializing in value-based reimbursements with an emphasis on MACRA and bundled payments. He is an accomplished small business owner and popular public speaker. He has over 20 years of experience as a software architect and has developed solutions for several medical societies, the United States Postal Service, a team of former FBI investigators, and two leading presidential campaigns. Between his knowledge of the industry and his technology savvy, Moshe is a sought-after leader in the transition to value-driven health care throughout the U.S.