Dear Healthcare Intelligence Network Client,
In an attempt to pare down the nearly $16 billion Medicaid spent on prescription drugs in 2009, CMS is proposing three cost-cutting measures, one of which includes increasing rebates paid by drug manufacturers that participate in Medicaid. All of the measures are intended to increase transparency for states and taxpayers as well. The comment period for the proposed rule will close on April 2nd. CMS plans to issue a final rule in 2013.
Cutting healthcare costs is the NQF’s goal also; they are targeting diabetes, CV disease and primary care costs with four new resource use measures which have been approved for endorsement. This is the NQF’s first effort at endorsing measures that evaluate how resources are used in care delivery.
Aetna has launched a national PCMH program that will reward primary care physicians on a quarterly basis for selected care coordinated tasks, as long as the PCPs meet eligibility requirements. Connecticut and New Jersey are the first states to host this program. Aetna is the latest private payor to revamp the medical home funding model; you can read more about the others in our featured blog in this issue.
Hospitals are doing something right: according to the latest study from Press Ganey hospitals’ overall patient satisfaction scores have improved since July 2011, when the value-based purchasing period began. The new VBP criteria will affect hospitals’ performance-based Medicare payments.
P.S. By the time this newsletter publishes Monday, let’s hope the Giants did something right Sunday night and won the Super Bowl. Go Giants!
Your colleague in the business of healthcare,Cheryl Miller
Editor, Healthcare Business Weekly Update
Please send comments, questions and replies to cmiller@hin.com.
Associate Editor:
Jessica Papay, jpapay@hin.com
Publisher:
Melanie Matthews, mmatthews@hin.com
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February 6, 2012
Vol. XIV, No. 5
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Telephonic Case Management: Protocols for Behavioral Healthcare Patients
This week's industry news:
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This week's industry news
1.) High Patient Satisfaction Marks Indicate Hospitals Better Prepared for Value-Based Purchasing: Study
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Third Annual Case Management Benchmark Survey
Hospitals’ overall patient satisfaction scores have improved following the start of the initial value-based purchasing (VBP) performance period in July 2011, according to Press Ganey.
Get the full
story.
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2.) 2011 Benchmarks in Patient Satisfaction Strategies: Improving the Healthcare Consumer Experience
This 60-page analysis, based on the responses of 146 organizations to the Healthcare Intelligence Network May 2011 survey on Improving Patient Satisfaction and the Patient Experience, presents the all-new data in more than 45 easy-to-follow graphs and tables, on industry efforts to enhance the patient experience and levels of satisfaction with their care.
Learn more about this resource.
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3.) Aetna National Medical Home Program Offers Quarterly Coordination of Care Payments
Aetna has launched a national PCMH program that will reward eligible primary care physicians (PCP) on a quarterly basis for select care coordination tasks.
Get the full story.
>>Return to this week's industry news
4.) Medical Home Reimbursement ABCs: Funding Care Delivery through ACOs, Bundled Payments and Concrete Contracts
This resource provides a primer on emerging reimbursement models that are getting payors' and providers' attention while delivering cost savings. This 50-page report profiles three healthcare organizations that are redefining healthcare reimbursement with their pilots of new payment models and contracting strategies.
Learn more about this resource.
>>Return to this week's industry news
5.) Healthcare Business White Paper: 2011 Benchmarks in Registry Use for Quality Improvement
Registries are a straightforward tool for creating realistic views of clinical practices, patient outcomes, safety and comparative effectiveness. Results from the Healthcare Intelligence Network August 2011 e-survey on Using Registries for Quality Improvement captures current and planned uses of registries by 105 healthcare organizations and registries' impact on healthcare quality, efficiency and cost.
Download this complimentary white paper.
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6.) Top 5 Healthcare Delivery Models for 2012
With a respectable 30 percent rating, patient-centered medical homes topped the list of healthcare delivery models most likely to cut costs and improve care in the coming year, according to the Healthcare Intelligence Network’s eighth annual Healthcare Trends and Forecasts survey.
Get the full story.
>>Return to this week's industry news
7.) New Chart: Who Belongs on the Medical Home Team?
The patient-centered medical home (PCMH) model of care is heavily supported in the Affordable Care Act, a favored model of integrated care delivery and a cornerstone of accountable care. We wanted to see which health professionals besides physicians are part of the PCMH team.
Click here to view the chart.
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8.) 46 Healthcare Metrics to Boost Profitability: Charting 2012 Trends
This 70-page resource is designed exclusively for the busy healthcare executive who seeks a high-level summary of industry trends and benchmarks. It delivers charts and tables on 46 actionable metrics carefully curated from 2011 market research data by the Healthcare Intelligence Network.
Learn more about this resource.
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9.) 3 Ways Proposed CMS Rule Could Cut Costs, Increase Transparency in Medicaid Prescription Drug Pricing
A proposed rule to cut costs and increase transparency in Medicaid prescription drug pricing could save states and taxpayers an estimated $17.7 billion over five years, CMS administrators say.
Get the full story.
>>Return to this week's industry news
10.) 2011 Benchmarks in Improving Medication Adherence
This resource provides actionable information from 162 healthcare organizations on their efforts to improve medication adherence and compliance in their populations. This second annual analysis of medication adherence programs documents the impact of these programs on adherence levels, medication costs, ER visits, hospital and nursing home admissions, risk of death and other areas of concern.
Learn more about this resource.
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11.) NQF Endorses 4 Resource Use Measures Aimed at Diabetes, CV Disease
Designed to cut diabetes, cardiovascular (CV) disease and primary care costs, the National Quality Forum (NQF) Board of Directors has approved for endorsement four measures on healthcare resources use and costs.
Get the full story.
>>Return to this week's industry news
12.) Diabetes Management in the Medical Home
The chief operations officer at Hudson River HealthCare (HRHC) shares the inside details on HRHC’s diabetes management program and the program's impact on its diabetic patients. The program, in place for over 12 years, combines attributes from both the Institute for Health Improvement and the Wagner Chronic Care Model, to manage diabetic care for more than 3,400 adults.
Learn more about this resource.
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13.) New Payor Medical Homes Put More Dollars in Physician Pockets
Revamped medical home programs from private payors offer participating physicians a range of financial incentives, including payment for some non-visit tasks like the preparation of care plans.
Read this blog post.
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14.) HealthSounds Podcast: Fifth Annual Medical Home Benchmarks — PCMH Stepping Stone to ACO
HIN's fifth annual survey on the patient-centered medical home (PCMH) recorded the highest PCMH adoption levels to date, reports Melanie Matthews in this benchmarks podcast. A substantial number of medical homes expect to participate in an accountable care organization (ACO); Ms. Matthews also shares key metrics from the 2011 survey, including time required for medical home conversion and the PCMH effect on medication adherence and patient satisfaction.
The survey also identified an impressive jump in the embedding of case managers in medical homes. Dr. Bruce Nash, senior VP of medical affairs and CMO for CDPHP, where embedded case managers are at the heart of CDPHP's clinical transformation, describes what sets his program apart from other medical home pilots.
Listen to this podcast.
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