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Healthcare Valuation Book

Accountable Care Organizations Book
In this issue
Criminal Healthcare Cyberattacks on the Rise
Healthcare data breaches have occurred more frequently over the past few years. With the cyberattacks over the last year on Premera Blue Cross, Community Health Systems, Anthem Inc., and CareFirst, millions of Americans have had their information potentially exposed to hackers. Not only have the cyberattacks occurred more frequently, but the number of patients exposed has also grown exponentially. In January 2015 alone, two different healthcare cyber security breaches were discovered, affecting more than 90 million Americans, compared to only two million affected individuals in the entirety of 2012. Even more troubling, the number of criminally motivated breaches, in contrast to employee negligence breaches, has risen to its highest level yet, and now accounts for 45% of all healthcare data breaches.

PDF Icon Small The Next Generation ACO Model
On March 10, 2015, the Center for Medicare & Medicaid Services announced a new classification of Accountable Care Organizations (ACO), known as the Next Generation model, which is aimed at providing coordinated, efficient, and high quality care to patients and reimbursing providers for the quality of care they provide, rather than the quantity of care they provide, to patients.
Toward that end, the Next Generation model is designed to build upon the successes of previous ACO models, while making some significant modifications. While the Next Generation model will use the same two-step algorithm as the Pioneer ACO model to determine beneficiary alignment, it will also offer the opportunity for the beneficiary to voluntarily align with a particular ACO. Next Generation ACOs will be able to control and predict their costs by building a guaranteed attributable patient base and engaging beneficiaries through the voluntary alignments that supersede the claims-based attribution assignment the beneficiary may have been designated by the algorithm - an attempt to fix a common complaint of the Pioneer ACO model. (Read more...)

PDF Icon New Healthcare Index Developed
Healthcare spending has increased dramatically in the U.S. over the last few decades. Although the U.S. spends more on its healthcare than any other developed nation, the quality of healthcare that patients in the U.S. receive is lower than that of other developed nations that spend considerably less. However, in the past four years, there has been a historically low rate of healthcare spending growth. the U.S. News & World Report recently developed the U.S. News Health Care Index, which uses data pulled from the the Centers for Medicare & Medicaid Services, the Bureau of Labor Statistics, the Centers for Disease Control, the U.S. Department of Health and Human Services, the National Center for Educational Statistics, and the World Health Organization, to "examine trends in specific health areas from 2000 to 2013." (Read more...)

PDF Icon Improving Physician Efficiency for Patient-Centered Care
The mounting pressure from professional boards and government payors as a result of the shift from volume-based care to value-based care has encouraged many healthcare organizations to review their organizational structure and best practices. By emphasizing improvements and incentivizing physicians to participate, patient-centered care and cost-savings can be achieved by healthcare organizations. To enhance patient care, physicians working in healthcare organizations have a variety of options available to them that can improve the efficiency of both the individual physician and the entire organization, such as balancing physician guidance with individual judgment, improving physician satisfaction, increasing communication of patient information, and promoting low-tech therapies (e.g., physical therapy and counseling). (Read more...)

PDF Icon Telemedicine Considerations
Traditional medicine can limit access to healthcare for many individuals who live in rural communities with fewer healthcare providers. It can also limit access for people who cannot afford to see or wait for a specialist. In many communities, there is a deficit of both specialty physicians and nurses who can diagnose and treat certain ailments. These problems are not restricted to rural areas, as large, overpopulated cities often experience these same problems. However, since the emergence of telemedicine, many of these problems have been minimized. Telemedicine has benefited patients by providing greater access to healthcare services, while improving the quality of care provided in those facilities that use electronic communications to supplement physician and nursing services. (Read more...)

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