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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Community health centers across the country are waging intensive efforts to find and enroll eligible and uninsured patients and community residents, but are being hampered by states that are resistant to healthcare reform, according to the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services.

While their preponderance in the healthcare marketplace has led to hopes that ACOs will be able to improve patient care and offset costs, they have not yet developed the capabilities they need to leverage optimal medication use to achieve those goals, according to a study in the Journal of Managed Care Pharmacy.

CMS and the state of Maryland have launched a new initiative designed to modernize Marylandís unique all-payor rate-setting system for hospital services aimed at improving patient health and reducing costs.

Patient-centered medical homes (PCMH) are having a significant impact on reducing costs of care, unnecessary emergency department (ED) and hospital visits, as well as increasing the provision of preventive services and improving population health, according to a new analysis from the Patient-Centered Primary Care Collaborative (PCPCC).

How to reduce readmissions? First step is to identify who they are, says Susan Horton, DNP, APRN, CHFN, VP of peri-operative services at Central Maine Medical Center and executive director of the Central Maine Heart and Vascular Institute.

And lastly, describe your organization's efforts in palliative care in our online survey by February 7, 2014 and you will receive a free summary of survey results once it is compiled.

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 20, 2014
Vol. XVI, No. 3

Sponsored by:
Managing Risk in Population Health Management


This week's industry news:

  1. ACOs' Medication Readiness Falling Short of Quality, Cost Goals
  2. Accountable Care Reimbursement Models
  3. CMS, Maryland Work to Modernize State's Healthcare System
  4. Essential Guide to Physician-Hospital Organizations
  5. Healthcare Business White Paper: Healthcare Trends in 2014
  6. States' Restrictions on ACA Implementation Hinder Access to Coverage
  7. New Chart: Top Incentives for HRA Completion
  8. Managed Medicare and Medicaid Factbook: 2014
  9. Medical Homes Reduce Healthcare Costs, Utilization, and Improve Health: Study
  10. Guide to the Patient-Centered Medical Home
  11. Identifying High Utilizers First Step in Reducing Readmissions
  12. New Horizons in Healthcare Home Visits
  13. Infographic: What You Need to Know About Affordable Healthcare
  14. Medicare Pioneer ACO Year One: Lessons from a Top-Performer
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

You'll be emailed a synopsis of the survey results.

Interested in all open surveys? Review them here.


This week's industry news

1.) ACOs' Medication Readiness Falling Short of Quality, Cost Goals

Accountable Care Organizations (ACOs) have not yet developed the capabilities to leverage optimal medication use to achieve quality care and reduce overall costs, according to a study by researchers from the National Pharmaceutical Council (NPC), the American Medical Group Association (AMGA) and Premier, Inc. and appearing in the Journal of Managed Care Pharmacy.

Get the full story.

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2.) Accountable Care Reimbursement Models: Moving from Productivity to Population-Based Incentives

Accountable Care Reimbursement Models This webinar will provide advice from Cynthia Kilroy, senior vice president of provider strategy and business development at Optum, as she explores the key structure, issues and challenges in these evolving reimbursement models.

Learn more about this resource.

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3.) CMS, Maryland Work to Modernize State's Healthcare System

CMS and the state of Maryland have launched a new initiative designed to modernize Maryland's unique all-payor rate-setting system for hospital services aimed at improving patient health and reducing costs.

Get the full story.

>>Return to this week's industry news


4.) Essential Guide to Physician-Hospital Organizations: 7 Key Elements for PHO Success

Essential Guide to Physician-Hospital Organizations This resource describes the seven critical areas of PHO development, from defining the PHO mission to creating a data environment conducive to registry use, analytics and active patient management.



Learn more about this resource.

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5.) Healthcare Business White Paper: Healthcare Trends in 2014 — Putting Money on Population Health, Care Coordination and Integrated Care Delivery

Healthcare Trends in 2014 Respondents to HIN's tenth annual Healthcare Trends and Forecasts survey identified a trifecta of value-based priorities for the coming year, deeming population health management (56 percent), care coordination (51 percent) and integrated care delivery (42 percent) initiatives most worthy of their attention in 2014. Download this HINtelligence report to learn more about how 136 healthcare companies fared in 2013 and what trends they expect to emerge in 2014. Included in this report are data highlights on the top business areas affected by economic conditions in 2013, successful programs and services launched in 2013, the impact of the accountable care act in 2014, and much more.

Download this complimentary white paper.

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6.) States' Restrictions on ACA Implementation Hinder Access to Coverage

Community health centers across the country are waging intensive efforts to find and enroll eligible and uninsured patients and community residents, but are hampered by states resistant to healthcare reform, according to the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top Incentives for HRA Completion

New Chart: Top Incentives for HRA Completion Combined with other 'big data' analytics, aggregate results from health risk assessments or health risk appraisals (HRAs) become the building blocks of population health management programs designed to bend the healthcare cost curve. We wanted to see which incentives healthcare companies offer for HRA completion.

Click here to view the chart.

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8.) Managed Medicare and Medicaid Factbook: 2014

Managed Medicare and Medicaid Factbook: 2014 This resource provides practical data and strategic information and convenient access to up-to-date enrollment data so readers can easily evaluate market share, make plan-by-plan or state-by-state comparisons, identify opportunities and develop strategies.


Learn more about this resource.

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9.) Medical Homes Reduce Healthcare Costs, Utilization, and Improve Health: Study

Patient-centered medical homes (PCMH) are having a significant impact on reducing costs of care, unnecessary emergency department (ED) and hospital visits, as well as increasing the provision of preventive services and improving population health, according to a new analysis from the Patient-Centered Primary Care Collaborative (PCPCC).

Get the full story.

>>Return to this week's industry news

10.) Guide to the Patient-Centered Medical Home: Metrics, Models and Engagement

Guide to the Patient-Centered Medical Home This resource provides an overview of PCMH adoption and results and examines nuances of the model that have emerged in recent years — including the embedding of case managers on medical home teams.



Learn more about this resource.

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11.) Identifying High Utilizers First Step in Reducing Readmissions

Businesses do it all the time — analyze their repeat customers, and market to them, says Susan Horton, DNP, APRN, CHFN, VP of peri-operative services at Central Maine Medical Center and executive director of the Central Maine Heart and Vascular Institute. Healthcare professionals need to take a similar course: analyze their repeat or readmitted customers, in order to ensure they don't remain so.

Get the full story.

>>Return to this week's industry news


12.) New Horizons in Healthcare Home Visits

New Horizons in Healthcare Home Visits This resource profiles two home visit interventions that are helping to reduce hospital readmissions and emergency room visits while enhancing the patient experience in this 30-page special report.



Learn more about this resource.

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13.) Infographic: What You Need to Know About Affordable Healthcare

The very name of the Affordable Care Act (ACA) insinuates affordability, yet many consumers in this economy are still unable to afford health insurance premiums, according to a new infographic from Care Pilot. The cost of physician care, to insurance and patients, has risen 1.3 percent during the past year, the infographic shows. The infographic also outlines the prevalence of high healthcare costs even with insurance and a breakdown of healthcare costs, including hospital care, drug use, doctor visits and lifestyle factors.

Read this blog post.

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14.) Medicare Pioneer ACO Year One: Lessons from a Top-Performer

Colin LeClair Lauded for its care coordination service, Monarch had to overcome a few challenges when retrofitting the Naylor Transition of Care (TOC) model for the ACO — among them insufficient patient access, patient skepticism and resource limitations. By focusing on readmissions reductions and four disease management conditions — ESRD, COPD, CHF and diabetes — and creating a care coordination team that included the newly created care navigator, case managers, and pharmacist, the organization has improved patient compliance, reduced negative drug interactions and hospital days and improved patients access to community services.

Listen to this podcast.

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