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Evolution of the Industry and eHDS Solutions

  Fee for Volume   Evolving Healthcare Model in Response to Better Care Needs   Coordinated Care World  
  • BBA of 1997 changed reimbursement from cost-based to PPS and established 44 RUG groups, providing challenges to long-term care providers
  • Wide range of HCIT products/services available but small growth in adoption of EMR systems
  • RUGs III in 2006 and RUGS IV in 2010 provide incentives to build infrastructure to treat higher acuity patients
  • Challenged pricing environment and reimbursement uncertainty
  • Post-acute providers viewed as a real solution to the cost of hospital readmissions
  • Focus on quality outcomes, increased reporting requirements
  • The 2009 HITECH Act subsidizes the purchase of electronic health records with $ incentives for the “meaningful use” of certified EHR technology
  • 2010 The Patient Protection and Affordable Care Act (PPACA) expands health coverage to uninsured population
  • “ACOs” / Bundles drive post acute providers to reduce readmissions
  • Reimbursement increasingly tied to clinical outcomes for 60/90 day episodes; risk shifting to providers
  • Importance of IT to develop and demonstrate clinically differentiated care
  • Provider networks narrowed to top tier organizations
  1997-2006   2007-2012   2013 and Beyond >  
  1997-2006   2007-2012   2013 and beyond  
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