Care Redesign

We help our clients make a smooth transition towards higher-value care.

As reimbursement models change, providers must strategically rethink how they approach care delivery. This can be a daunting task, but it’s essential for organizations that want to secure their market position and seize opportunities for improved financial success.

 

An expertly planned and managed care redesign effort can yield a better market position, a more effective care team, improved clinical outcomes, higher levels of patient and provider satisfaction, and reduced use and costs. That’s the good news. The more difficult message is this: achieving the benefits of a care redesign effort requires transforming strategy and approach. It’s easy to get off track or to simply delay starting.

 

We can help. Our approach is built on almost two decades of proven strategies developed by Geisinger, an organization nationally recognized for effective innovations in care delivery. With a practical, real-world base of expertise, we can strategically accelerate your care redesign process so you achieve the desired outcomes faster, more efficiently, and more reliably than with other approaches.

 

We help you get started on care redesign by developing an understanding of your strategic objectives. We then perform a systematic baseline assessment of your current state. This assessment allows us to identify critical gaps that will inform our action plan.

 

Once we agree on next steps, the focus is all about practical implementation.

In the acute care environment (see ProvenCare Acute), this includes the following:

 

  • Documenting the appropriateness of care;
  • Establishing evidence- or consensus-based best practice elements;
  • Redesigning complex clinical systems that embed behaviors into everyday patient flow;
  • Using the electronic health record when appropriate;
  • Activating patients and families to engage them in the care processes;
  • Providing a bundled payment price for the episode of care; and
  • Establishing a bundled payment that transfers risk for financial effects of preventable complications to the provider and the health system.

 

In the chronic and preventive care environment, (see ProvenCare Chronic & Prevention), implementation includes the following:

 

  • “All or None” performance measures that track the patient population’s compliance with a set of nationally recognized performance measures based on the patient’s age and gender;
  • Health management reminders as part of a patient-specific prevention plan;
  • Evidence-based alerts to help the care team make complex care decisions;
  • Frequent coaching sessions between clients and xG Health experts; and
  • Detailed and accurate technical manuals.

 

In our advanced patient-centered medical home environment (see ProvenHealth Navigator), implementation focuses on the following:

 

  • Comprehensive care meeting most of each patient’s physical and mental healthcare needs, including prevention and wellness and acute and chronic care, delivered by a team of care providers.
  • Patient-centered care recognizing patients and family members as core care team members.
  • Coordinated care encompassing all elements of the broader healthcare system, including specialty care, hospitals, home healthcare, and community services. Such coordination is particularly critical during transitions from one care site to another.
  • Accessible services offering shorter wait times for urgent needs, enhanced in-person hours, around-the-clock telephone or electronic access to the care team, and alternative methods of communication such as email and telephone care.
  • Quality and safety relying on evidence-based medicine and clinical decision-support tools, performance measurement and improvement, patient satisfaction measurement, and population health management.

We’re proud of our track record of success in care redesign. It’s the core of who we are and why we’re viewed as the differentiated leaders in healthcare transformation.

For more information about our care redesign services, contact Andrew Blackmon.

Rocky Edmondson RN, BSN, MBA, CCRN
Senior Director, Bundled Payments, Care Redesign and Management Advisors, xG Health Solutions

Rocky Edmondson is the Senior Director of Bundled Payments for Care Redesign and Management Advisors at xG Health Solutions. Rocky has been involved in workflow redesign, program implementation, and analytic evaluation of Bundled Payment Programs across the country, and he coaches Hospitals, Health Systems, Post-Acute Providers, and Physician Groups on how to successfully implement care redesign in the Bundled Payment for Care Improvement (BPCI) and CJR Programs.

Rocky’s passion is helping people to understand the intricacies of Bundled Payment Programs. He has a talent for teaching people how to cut through all the noise and just do the things that matter to be successful in these programs.

Rocky holds an Associate’s Degree in Nursing from the University of Hawaii Maui, and a Bachelor’s Degree in Nursing and a Master’s Degree in Business Administration (MBA) from Boise State University.

Prior to joining xG Health Solutions, Rocky was the Southeast Region Director of Clinical Operations for Remedy Partners, overseeing program design, implementation and analytic evaluations for Bundled Payment Programs. Prior to embarking on a career in Bundled Payments, Rocky was a Registered Nurse for 18 years, working in a number of positions within Critical Care. Before becoming a Nurse, Rocky was an Institutional Broker at Merrill Lynch and advised a number of healthcare systems and large corporations on cash management strategies. In addition, Rocky has started several businesses and provided consulting for small business startups. Rocky served in the U.S. Marine Corps as a Recon Marine.

Janet Comrey RN, BSN, MHSA
Director, Population Health Solutions, Geisinger Health System

Janet Comrey, RN, BSN, MHSA has over 30 years of diversified nursing and leadership experience at Geisinger Health system and currently serves as Director of a small department embedded within Population Health. One of her key roles is managing the Bundle Payment for Care Improvement (BPCI) program since January 2014 earning an overall positive net payment reconciliation to date. Janet also serves as the coordinator for Project Achieve at Geisinger which is a national PCORI funded study related to patient’s perceptions of transitions of care.

Janet received her nursing education through Geisinger’s diploma program, her BSN through Bloomsburg University, and later earned her graduate degree from Marywood University. During her tenure at Geisinger she taught quality improvement methodology and facilitated improvement teams the Geisinger Quality Institute. She is currently enrolled in the Institute for Healthcare Improvement Advisory program.

Professional memberships include Sigma Theta Tau, Phi Kappa Phi, American Society for Quality.

Andrew Blackmon, MBA, MHS
Chief Sales and Business Development Officer

Chief Sales and Business Development Officer Andrew Blackmon, MBA, MHS, has more than 18 years of experience in healthcare product sales, marketing, and strategy.

Before joining xG Health, Andrew was vice president of sales for population health and risk management solutions at McKesson. He came to McKesson through acquisition of MedVentive, an early population health vendor. Before MedVentive, he served as vice president of enterprise solutions development at MedAssets. He is a past president of the Georgia chapter of HIMSS, and he has held strategy and planning positions at PricewaterhouseCoopers and Orlando Health.

Andrew has an MBA and a Master’s of Health Science from the University of Florida Warrington, College of Business, and a Bachelor of Arts degree in Psychology from Rollins College.

Holly Barbella, RN, MBA

Risk Coordinator, Geisinger Health System

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Earl P. Steinberg, MD, MPP
Chief Executive Officer

Earl P. Steinberg, MD, MPP, is a nationally recognized expert in healthcare quality improvement and serves as xG Health’s chief executive officer. Earl also is an adjunct professor of Medicine and of Health Policy and Management at Johns Hopkins University and a member of Blue Cross/Blue Shield Association’s National Medical Advisory Panel.

Before joining xG Health, Earl was executive vice president of Innovation & Dissemination, and chief, Healthcare Solutions Enterprise at Geisinger Health System.

Before joining Geisinger, he was senior vice president for Clinical Strategy, Quality & Outcomes at WellPoint, Inc., the largest commercial health insurer by membership in the US, and president and CEO of Resolution Health Inc. (RHI), a leading healthcare data analysis company that provides innovative quality improvement and cost reduction services to health plans, employers, pharmacy benefit managers, and disease management companies.

Before joining RHI, Earl spent six years as vice president of Covance Health Economics and Outcomes Services Inc., director of its Quality Assessment and Improvement Systems Division, and co-director of its Outcomes Studies Group. He also spent 12 years on the full-time faculty at Johns Hopkins University, where he was professor of Medicine and of Health Policy and Management and director of the Johns Hopkins Program for Medical Technology and Practice Assessment, and four years on the Federal Physician Payment Review Commission. He co-chaired the Institute of Medicine’s panel on Standards for Development of Trustworthy Practice Guidelines.

Earl has received many awards, including the Henry J. Kaiser Family Foundation Faculty Scholar Award in General Internal Medicine (1984), the “Outstanding Young Investigator” Award from the Association for Health Services Research (1988), and a Special Presidential Visionary Award from the National Kidney Foundation (NFK) (2004) for his work as the scientific director of the NKF’s landmark Kidney Disease Outcomes and Quality Initiative, which produced more than 250 clinical practice guidelines for management of patients with end-stage renal disease. He also is a fellow of both the American College of Physicians and AcademyHealth, and he has published more than 125 articles in peer-reviewed journals.

Earl received his AB from Harvard College (summa cum laude), his medical degree from Harvard Medical School, and a Master of Public Policy from the Kennedy School of Government. He performed his residency training in internal medicine at Massachusetts General Hospital.