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HCM-401 Kemal Erkan, FACHE

Principles of Healthcare Management. HCM-401 Kemal Erkan, FACHE. HCM-401 Week I. Syllabus Overview Group Project Case Study Midterm and Final Pre-test Group Project Outline Kyle Bain EMR Incentive Presentation Meaningful Use Core Measure Week I presentation by Kemal Erkan.

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HCM-401 Kemal Erkan, FACHE

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  1. Principles of Healthcare Management HCM-401 Kemal Erkan, FACHE

  2. HCM-401 Week I • Syllabus Overview • Group Project • Case Study • Midterm and Final • Pre-test • Group Project Outline • Kyle Bain • EMR Incentive Presentation • Meaningful Use Core Measure • Week I presentation by Kemal Erkan Changing the Behavior

  3. Changing The Behavior of Responsible Parties Changing the Behavior

  4. Changing the Behavior

  5. Changing the Behavior

  6. United Medical Community Model PATIENT ONE Hospitals CCHS Bayhealth AI DuPont Beebe CHART • Advanced Surgery • Cardiology • Dermatology • Family Practice • Gastroenterology • Hospitalists • Internal Medicine • Nephrology • OB/GYN • Ophthalmology • Optometrist • Pediatrics • Psychiatry • Physical Pain & Rehab • Podiatry • Pulmonary Disease • Radiology • Rheumatology • Sports Medicine • Urology United Medical Network DHIN Labs Other DHIN Organizations • Patient Demographics • Medication History • Allergies • Progress Notes • Flow Charts • Immunizations • All Other Patient Related Records Changing the Behavior

  7. United Medical ACO Qualifications based on CMS ACO Guidelines • ACOs must have a formal legal structure to receive and distribute shared savings to participating providers. • Each ACO must employ enough primary care professionals to treat their beneficiary population (minimum of 5,000 beneficiaries) as deemed sufficient by CMS. • Each ACO must agree to at least three years of participation in the program. • Each ACO will have to develop sufficient information about their participating health care professionals to support beneficiary assignment and for the determination of payments for shared savings. • ACOs will be expected to include a leadership and management structure that includes clinical and administrative systems. • Each ACO will be expected to have defined processes to promote evidence-based medicine, report on quality and cost measures, and coordinate care. • ACOs will also be required to produce reports demonstrating the adoption of patient-centered care. Changing the Behavior

  8. 30 DAY READMISSION COST STUDY Estimated # of Total Readmissions in 12 months 5,437 Average Length of stay (4 days: 5437*4) 21,748 # of Total Discharges 5,437 Total Encounters-Days 32,622 Average payment per encounter $ 80.00 Total Payment for professional Services $ 2,609,760.00 (=32,622*80.00) Total Payment for Hospital Stay $ 150,789,758.00 (=5,437*27,734.00) This Estimate study does not take the reduction on the initial admissions in consideration but only focuses on 30 day Readmissions. Changing the Behavior

  9. Organizational Structure Board of Partners Executive Committee (EC) Doctors & Directors Executive Director Accounting Operations Legal

  10. Changing the Behavior

  11. Old Method Of Reporting Sample Changing the Behavior

  12. United Medical ACO EHR Screen Shot for Patient Health Maintenance Changing the Behavior

  13. Changing the Behavior

  14. Changing the Behavior

  15. Changing the Behavior

  16. Changing the Behavior

  17. Changing the Behavior

  18. Balance Sheet 2011 Changing the Behavior

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