Navigating health care and all the facets of payment reform can be an overwhelming journey. However, understanding these concepts, at even a basic level, can empower you and your organization to implement programs that can benefit everyone: patients, providers and payers.
HCI3 has constructed various online courses specific to PROMETHEUS Payment, ECR Analytics and Bridges to Excellence implementation and use. The courses range from basic overview to advanced and/or technical levels.
It is recommended you take the courses in each topic in sequential order to ensure the best understanding of each topic.
101 Part 1: Improving Incentives in Health Care: The Case for Motivating Good Behavior
101 Part 2: Improving Incentives in Health Care: A Framework for Motivating Good Behavior
These courses examine some of the toxic incentives that drive high costs and poor quality and propose a framework for improving incentives in health care.
Episodes of Care
102 Part 1: Episodes of Care Basics: Consumers, Providers and Payers
102 Part 2: Episodes of Care Basics: The Essentials of Good Design
These courses review the basic ideas informing episode of care design, and to answer the question, why do episodes of care matter for health care reform?
201 Part 1 and 2: The Anatomy of Buliding an Episode
These courses provide a better understanding of how HCI3’s episodes are defined. While HCI3 has built numerous episodes to date, these courses will also help equip you with the knowledge to get started on creating your own by guiding you through the HCI3 episode definition process, being specific to the requirements for using ECR Analytics.
202 Part 1 and 2: Using Episodes of Care for Informed Decision Making
These courses examine practical, real world examples of various analytic techniques that you can apply to medical claims data employing episodes analysis.
ECRs and Bundled Payment
103 Part 1: Episode of Care Payment: The Tragedy of the Commons
103 Part 2: Episode of Care Payment: Solving the Medical Commons
These courses review how episode of care payment forms a powerful solution to America’s “health care commons” with a description of what a commons is, why it is so problematic, and how bundled payment and benefts better allocates scarce resources.
203: The Bundled Payment Budget Creation and Reconciliation Process
This course provides an overview of how to build a budget for bundled payment implementations and how to “true-up” that budget during the financial reconciliation period for payment purposes.
303: A Detailed Guide for Engine Vendors
This course is designed to provide vendors, and interested payers and providers, with an overview of the technical details required to operate a claims engine for bundled payment.
Bundled Payment Implementation
104 Part 1: Bundled Payment Implementation: Common Themes
104 Part 2: Bundled Payment Implementation: Step-by-Step Guide
These courses focus on developing strategic themes around building episode of care contracts and concentrate on assembling the high-level structural items common to bundled payment implementations.
107: Risk Adjustment: Basic Concepts and Methods
This course is part one of a three part overview of episodes of care and severity-adjustment. It introduces the concepts and methods for creating patient-centered risk adjustment modules. See Class 207 and 307 for the additional risk adjustment overviews.
207 Part 1 and 2: Risk Adjustment: Intermediate Method and Techniques
These courses are part two of a three part overview of episodes of care and severity-adjustment. It introduces the techniques and models used to create patient-centered risk adjustment models.
305: Provider Attribution
This course provides an overview of how patients and their episodes can be appropriately attributed to providers, whether they are individual physicians, groups of physicians, health systems, or facilities.
307 Part 1 and 2: Risk Adjustment: Vignette of Modeling Process
These courses are the final part of three part overview of episodes of care and severity-adjustment. It demonstrates creating a real-world adjustment model.
Assessing Quality of Care
105 Part 1: Assessing Clinical Quality: Basic Design Considerations
105 Part 2: Assessing Clinical Quality: Bridges to Excellence
These courses review the basic ideas information the design of clinical performance assessment programs including a look at the HCI3 Bridges to Excellence Clinican Recognition program and examines why the assessment of clinical quality matters for health care reform.
205: Reporting on Provider Price and Quality: What Do Consumers Need?
This course examines best practices to consider when presenting health care price and quality information to consumers
Using Claims Data
206: Super Utilizers
This course examines the origins of super utilizers, who they are, the program parameters, population distributions and the saving opportunies availaby by accurately identifying super utilizers.