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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

There is no place like home visits to address safety issues, and patient care concerns. Despite the explosion of mobile and telehealth technologies, there is no substitute for person-to-person contact — at least when it comes to populations at high risk of hospital admission or readmission, the results of the Healthcare Intelligence Networkís inaugural Home Visits study indicate. Three-fourths of healthcare organizations visit some percentage of their patients or health plan members in their homes in order to keep patients safer and healthier and to keep readmissions and costly utilizers at bay.

But there is a time and place for telehealth technology, and new research in the journal Medical Care shows that diabetics who used an online patient portal to refill medications and schedule their appointments, among other tasks, increased their medication adherence and improved their cholesterol levels by 6 percent, compared to occasional users or non-users. Researchers say the current study provides new evidence that patient portals may help patients adhere to their medications and achieve improved health outcomes.

About one-quarter of Americans potentially eligible for health coverage visited insurance marketplaces by December, up from 17 percent in October, according to a new Commonwealth Fund survey. Forty percent of these visitors were young adults; three-quarters said they were in good health; and more than half said they are likely to try to enroll by the March 2014 deadline. The survey, conducted between December 11 and 29, 2013, is the second in a series aimed at tracking Americansí experiences with the marketplaces in the ACA's first open enrollment period. The first Commonwealth Fund survey, conducted in October, found that 17 percent of people potentially eligible for coverage had visited the marketplaces during the first month.

Despite increasing scrutiny on hospital pricing practices, some U.S. hospitals are charging more than 10 times their cost, or nearly $1200 for every $100 of their total costs, according to new data released by National Nurses United (NNU) and the Institute for Health and Socio-Economic Policy (IHSP).

The 100 most expensive hospitals listed charge 765 percent and higher, more than double the national average of 331 percent, the report says. Fourteen U.S. hospitals charge more than $1,000 for every $100 of their total costs (a charge to cost ratio of 1,000 percent) topped by Meadowlands Hospital Medical Center in Secaucus, NJ, which has a charge-to-cost ratio of 1,192 percent. California, with a statewide average of 451 percent charge to cost ratio, ranks third overall in the United States. The detailed report includes the most expensive hospitals, the top 10 for each state, and the 50 most expensive hospital systems.

Discussions about end-of-life care for adults are never easy; they are even more difficult when they concern children. The National Institute of Nursing Research (NINR) has launched a new campaign, Palliative Care: Conversations Matter, that is designed to help children and families navigate a serious illness, and better inform them of supportive resources. A component of the National Institutes of Health (NIH), it brings together parents and palliative care clinicians, scientists, and professionals, who give their input and expertise on what they feel is needed in the field. Donít miss the video which tells one motherís story about her daughterís bout with neuroblastoma and how palliative care helped them through it.

You can share your organizationís work in palliative care in our current e-survey: 10 Questions on Palliative Care. With more organizations focusing on palliative care as a means to enhance the patient experience during advanced or terminal illness, many are strategizing new ways to assess and address patients' needs at this time, from consultations in the ED to face-to-face evaluations in outpatient clinics. Describe your organization's efforts in palliative care by February 7, 2014 and you will receive a free summary of survey results once it is compiled.

Our congratulations to one of our survey participants, Timothy Price, a market research analyst with Caresource, who was randomly selected as the winner of our training DVD from our 10th annual Healthcare Trends & Forecasts webinar.

Your colleague in the business of healthcare,
Cheryl Miller
Editor, Healthcare Business Weekly Update

Please send comments, questions and replies to cmiller@hin.com.

HIN Associate Editor Jessica Fornarotto
Associate Editor:
Jessica Fornarotto, jfornarotto@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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January 13, 2014
Vol. XVI, No. 2

Sponsored by:
Managing Risk in Population Health Management


This week's industry news:

  1. Some Hospitals Set Charges at More Than 10 Times their Costs
  2. Guide to Value-Based Reimbursement
  3. National Health Spending Growth Remains Low for 4th Straight Year
  4. Healthcare Trends & Forecasts in 2014
  5. Healthcare Business White Paper: Accountable Care Organizations in 2013
  6. New Pediatric Palliative Care Campaign Helps Seriously Ill Children and Families Cope
  7. New Table: 3 Impacts of ACA Marketplaces on Health Plans in 2014
  8. Case Management for Advanced Illness
  9. Patient Portal Use Improved Medication Adherence, Health Outcomes
  10. 2013 Healthcare Benchmarks: Improving Medication Adherence
  11. There's No Place Like Home Visits to Address Safety, Care Concerns
  12. 2013 Healthcare Benchmarks: Home Visits
  13. Infographic: Best Social Media Tools For Healthcare Goals
  14. A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings
Please pass this along to any of your colleagues or, better yet, have them sign up to receive their own copy and learn about our other news services.

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Take our monthly e-survey:
10 Questions on Palliative Care in 2014

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Interested in all open surveys? Review them here.


This week's industry news

1.) Some Hospitals Set Charges at More Than 10 Times their Costs

Despite increasing scrutiny on hospital pricing practices, some U.S. hospitals are charging more than 10 times their cost, or nearly $1200 for every $100 of their total costs, according to new data released by National Nurses United (NNU) and the Institute for Health and Socio-Economic Policy (IHSP).

Get the full story.

>>Return to this week's industry news


2.) Guide to Value-Based Reimbursement: Profiting from Payment Bundling, PHO Shared Savings, and Pay for Performance

Guide to Value-Based Reimbursement This resource explores emerging models of episode-based payments, physician-hospital organizations and physician bonus structures.




Learn more about this resource.

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3.) National Health Spending Growth Remains Low for 4th Straight Year

Slower growth in prescription drug, nursing home, private health insurance, and Medicare expenditures contributed to low overall healthcare costs for the fourth consecutive year, according to the CMS's office of the Actuary.

Get the full story.

>>Return to this week's industry news


4.) Healthcare Trends & Forecasts in 2014: Performance Expectations for the Healthcare Industry

Healthcare Trends & Forecasts in 2014 This resource is HIN's ninth annual industry forecast. It provides both a handle on what's keeping healthcare CEOs up at night and a dream prescription for sounder program management this year.



Learn more about this resource.

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5.) Healthcare Business White Paper: Accountable Care Organizations in 2013 — ACO Leadership Shifts to Physician-Hospital Organizations

Accountable Care Organizations in 2013 The number of accountable care organizations led by a physician-hospital organization (PHO) nearly doubled over the last year, according to the third annual ACO survey conducted by the Healthcare Intelligence Network. As the ACO model finds its feet, administration has changed hands from hospitals in 2011 to physician-led in 2012 to PHOs in 2013 — a year when the number of public and private ACOs in the country swelled to almost 500. Almost one in three ACOs is PHO-led. Download this HINtelligence report for more data on ACO trends in 2013 as reported by 138 healthcare companies, including ACO program components, results and ROI, and the greatest successes achieved by accountable care organizations in respondents' own words.

Download this complimentary white paper.

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6.) New Pediatric Palliative Care Campaign Helps Seriously Ill Children and Families Cope

Sadly, palliative care isn't just for the elderly. Families of children diagnosed with serious illnesses can benefit from conversations with their medical providers, and information on supportive resources.

Get the full story.

>>Return to this week's industry news


7.) New Table: 3 Impacts of ACA Marketplaces on Health Plans in 2014

New Table: 3 Impacts of ACA Marketplaces on Health Plans in 2014 Sustained growth in emerging reimbursement models, including accountable care, bundled payments and shared savings, will continue to impact innovation within the healthcare industry in 2014 as providers and payors struggle to find more ways to reduce costs within their systems and better manage the care they provide. We wanted to see the impact of ACA's health insurance marketplaces on health plans in 2014.

Click here to view the table.

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8.) Case Management for Advanced Illness: Best Practices in End-of-Life Care

Case Management for Advanced Illness This resource examines Aetna's Compassionate Care program, a case management approach for the advanced illness population, and breaks down barriers commonly encountered in this highly sensitive stage of the health continuum while positively impacting both healthcare utilization and spend.


Learn more about this resource.

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9.) Patient Portal Use Improved Medication Adherence, Health Outcomes

Diabetics who used an online patient portal to refill medications increased their medication adherence and improved their cholesterol levels, according to a new study in the journal Medical Care.

Get the full story.

>>Return to this week's industry news

10.) 2013 Healthcare Benchmarks: Improving Medication Adherence

2013 Healthcare Benchmarks: Improving Medication Adherence This resource provides actionable information from more than 100 healthcare organizations on efforts to improve medication adherence and compliance in their populations.



Learn more about this resource.

>>Return to this week's industry news


11.) There's No Place Like Home Visits to Address Safety, Care Concerns

Three-fourths of healthcare organizations visit some percentage of their patients or health plan members in their homes, according to new market data from the Healthcare Intelligence Network, in order to keep patients safer and healthier and to keep readmissions and costly utilizers at bay.

Get the full story.

>>Return to this week's industry news


12.) 2013 Healthcare Benchmarks: Home Visits

2013 Healthcare Benchmarks: Home Visits This resource examines the latest trends in home visits for medical purposes, from the populations visited to top health tasks performed in the home to results and ROI from home interventions.



Learn more about this resource.

>>Return to this week's industry news


13.) Infographic: Best Social Media Tools For Healthcare Goals

From patient education to physician support, choosing the correct social media platform can enhance or decrease outreach efforts. To be a reliable source of healthcare information and self-help, a blog or YouTube account are the best social media outlets for healthcare organizations, while LinkedIn and Pinterest are not as successful, according to a new infographic from AniccaMedia.com. This infographic shows the most effective social media tools to fit 12 different healthcare goals.

Read this blog post.

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14.) A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings

Joseph Johnson Low scores on patient outcomes measures within the CMS Star Quality ratings program — metrics CMS weights most heavily in its assignment of stars — can typically be traced to poor provider and member engagement, notes Joseph Johnson, vice president of L.E.K. Consulting. Johnson suggests ways to enlist support from these two stakeholder groups, and describes how MA plans should prepare for the possible display in 2014 of CAHPS care coordination ratings along with with its star scores (though the care coordination ratings will not be factored into star ratings).

Listen to this podcast.

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