Top CV Concerns Survey: Results and Quick Tips - Part 1

Posted by: MedAxiom Consulting on Thursday, January 4, 2018
Top CV Concerns Survey: Results and Quick Tips

In a recent survey of MedAxiom members and other cardiovascular health care leaders—both administrators and clinicians—we asked about top CV concerns. Basically, we wanted to know what keeps you up at night. Many of your answers were what one might expect, taken from the health care headlines we read every day, and others were somewhat surprising.

Knowing the problems is important, and having a way to address them is even more so. Here, our MedAxiom Consulting team—the nation’s top CV consulting experts—share valuable “quick tips” for approaching the issues we face. (For more information on each issue and answer, contact the specific consultant listed below.)

As always, our goal is to provide you with proven and practical advice for moving your organization toward sustainable success at every level. Here’s to a very hopeful, happy and healthy New Year!

Comprehensive Strategy

Strategy planning has become increasingly important. CV programs must continue to evolve in a tougher and tougher environment confounded by drops in reimbursement, pressures around market share, and the push to provide the highest quality of care all while maintaining a high level of patient satisfaction. Developing a comprehensive strategy needs to include review of all of the above areas. Understanding current state and then defining what the future state needs to look like is the foundation of a strong strategic plan; then allow the leadership team to develop the ‘how’ to get from here to there. A 1-, 3-, 5- and even 10- year plan will create vision for your program. Through that vision, a common objective is developed that all can and should rally around; this will then have an impact on stakeholder engagement and performance.
– Ginger Biesbrock,

Patient Experience

The patient experience should be at the center of all that we do as we approach any initiative in health care. In fact, the Institute for Healthcare Improvement (IHI) included patient experience (including satisfaction and quality) as part of the Triple Aim framework to optimize health system performance. The IHI urges systems to focus on patients and families and use measures, such as CAHPS and likelihood to recommend, to evaluate progress. As you are starting out with your process improvement initiatives, keep the patient and family at the center of all that you do. Walk through workflows to eliminate waste that is not value-added from the patient and family perspective. Finally, consider utilizing patient and family advisory committees to get feedback on how your practice, hospital, or system is achieving a truly patient-centered focus.
– Jacob Turmell,

APP Utilization

Effective APP utilization begins with a defined clinical strategy – whether that be patient panel support, specialty care support, or acute care support. Understanding what the focus and objective should be is essential to effectively build out what is required from both a clinical and operational structure. In addition, a performance management and governance strategy will assure a high-performing team with a positive culture all coming together for a common cause – the patient.
– Ginger Biesbrock,

Staffing/Operational Efficiencies

This is defined by your organization’s capacity to deliver services to its patients in the most cost-effective manner while still ensuring the highest quality of care. One way to do that is understanding your staffing model and where you have major variations, like too many MAs and not enough RNs so that your providers end up doing a lot of work that a licensed nurse could provide. Or you have physicians seeing all of your return patients and no spots lefts for new patients. In reality, you could have APPs seeing routine follow-up patients, which would allow physicians to see more new patients. You are still proving high-quality care to the routine patient but at a much lower cost, and you are also opening the access to the clinic.
– Lori Walsh,

Developing an Ambulatory Strategy

This should be a top priority for your CVSL. Here are some good reasons to add this topic to your 2018 plan; patients prefer an ambulatory location to the acute care center, ambulatory programs provide care at a lower cost point and more payers are seeing ambulatory sites as preferred locations.
– Anne Beekman,

Future Physician Leader Development

When you look around the room at any meeting with physician leaders, you see a lot of older physicians. There has never been a better time than right now to start a formal physician leadership development process to create greater strength and diversity; it should include broad-based learning, exposure to key issues, and inclusion on key decisions. There are many great resources for this, including the MedAxiom physician leader list-serve, blog posts and, of course, attending MedAxiom meetings.
– Larry Sobal,

Physician Compensation Plan

In the volume-based economy, designing a provider compensation plan was pretty straightforward; reward production and the economics around reimbursement were aligned. The value economy, which is now upon us, makes alignment much more challenging. Organizations must reward appropriate value-oriented behaviors, even when these behaviors run contrary to production, in order to succeed under the Triple Aim. Further, as our health care system becomes accountable to caring for entire populations, plan design will need to consider and reward the appropriate value levers.
– Joel Sauer,

Reducing Cost of CV Care

As we continue to evolve into a more value-based environment – program leaders need to be very much aware of both their internal costs to provide care and the overall utilization rates, which equate into the costs of the payer or patients who are receiving care in our programs. Program dashboards that include financial, operational and quality outcomes are extremely important in understanding and managing to both of these tensions. Programs that are constantly evaluating and monitoring have the ability to make impactful changes that allow them to continue to provide the highest quality care while remaining competitive in a tight financial environment.
– Ginger Biesbrock,

Tune in next Thursday for Part 2 of this blog post! We will share more expert “quick tips” on your top concerns including MIPS, Bundled Payments and Workforce Planning!


llustration: Lee Sauer

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MedAxiom Consulting is the nation’s leading cardiovascular-specific consulting group, working with a range of private practices, hospitals and health systems across the country to improve the delivery of CV health care. To learn more about our team, please visit our website.                     




2018 will be the year of the connected patient. Smart phone, text, and email are all it takes to make patients successful at communicating with the office and generating CCM reimbursements between $42 and $141 per patient per month WITHOUT a single additional office visit. Right now, cardio practices are changing the game by monitoring patients between office visits. halting disease progression earlier, preventing adverse visits, improving patient care and satisfaction, and re-establishing community impressions on leadership in the field. Proud to be a MedAxiom endorsed member. You can download my book Automated Chronic Care Management for Cardiology at
Posted by: Matt Ethington on January 8, 2018 @4:48:32 pm

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