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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

More and more Americans are using the Internet as their second — and even first — opinion for medical conditions.

That's the latest word from a new survey from Pew Research Center's Internet & American Life Project.

Researchers also found that when these people ran their online diagnoses by their clinicians, the majority of them found the diagnoses to be correct.

But the news isn't rendering physicians obsolete yet. When faced with a serious condition, whether for themselves or someone else, the majority of respondents — more than 3000 — said they still sought the advice of their physicians.

And physicians are leading a new surge of ACOs; according to the HHS, nearly half of the 106 newly established CMS ACOs are physician-led organizations. Since passage of the ACA, more than 250 ACOs have been created, and the new ACOs represent a diverse cross-section of physician practices across the country serving 10,000 beneficiaries. One out of five ACOs represent community health centers, rural health centers and critical access hospitals that serve low-income and rural communities. Federal savings from this initiative is estimated to be significant: up to $940 million over four years, CMS officials say.

If you're sick, and a member of the UPMC Health Plan, don't even think about using the ER as your primary care provider. If you do, you're likely to get a visit from the health plan's community teams of nurses and social workers to perform assessments and care management. This is one of the ways the UPMC is reducing the rates of avoidable ER use. The Pittsburgh-based health organization has also placed patient navigators in the ER to educate patients on appropriate ER use. Costs from this program could be significant, officials say.

Savings from using EHRs could be significant as well, and healthcare providers and hospitals are being offered up to $27 billion in federal financial incentives to use them in ways that improve quality of care. But a new report from Weill Cornell Medical College reveals how inconsistent they are, and how challenging it is to measure quality in an electronic era, because while many measures are accurate, some need refinement.

The cost of medication non-adherence is great: in 2009, the New England Healthcare Institute estimated that medication non-adherence is responsible for $290 billion in 'otherwise avoidable medical spending' in the United States alone each year. Describe how your organization is improving medication adherence in the populations you serve by February 5, 2013 and you will receive a free executive summary of the third annual survey results once they are 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 21, 2013
Vol. XV, No. 3

Sponsored by:
Physician Hospital Organizations — Developing a Collaborative Structure for Shared Savings Agreements


This week's industry news:

  1. Modernizing Medicare, Medicaid Could Reduce Debt and Improve Care for Dual Eligibles
  2. Care Coordination for Dual Eligibles
  3. Inconsistencies of Quality Care Measures Prevalent with EHRs: Study
  4. 2012 Benchmarks in Patient Registry Use for Accountable Care
  5. Healthcare Business White Paper: Asthma Management in 2012
  6. Half of New CMS ACOs are Physician-Led
  7. New Chart: Top 5 Incentive-Based Health Improvement Programs
  8. Physician-Owned ACOs
  9. 1 in 3 Americans Admit to Going Online for Medical Advice: Survey
  10. Pursuing the Triple Aim
  11. Home Visits Curb Avoidable ER Use
  12. 46 Healthcare Metrics to Boost Profitability
  13. Infographic: Hospital-Acquired Infections
  14. Creating a Physician Hospital Organization
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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Improving Medication Adherence in 2013

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This week's industry news

1.) Modernizing Medicare, Medicaid Could Reduce Debt and Improve Care for Dual Eligibles

Modernizing Medicare and Medicaid could improve patient health and save the federal government $542 billion over the next ten years, according to a new report by UnitedHealth Groupís Center for Health Reform & Modernization.

Get the full story.

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2.) Care Coordination for Dual Eligibles: A Results-Oriented Approach

Care Coordination for Dual Eligibles This webinar provides details on SCAN Health Planís strategic approach to serving the dual eligible market from Dr. Timothy Schwab, chief medical officer.


Learn more about this resource.

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3.) Inconsistencies of Quality Care Measures Prevalent with EHRs: Study

Researchers from the Weill Cornell Medical College have identified ways to improve the quality of measurements from EHRs, which are designed to document clinical care of individual patients.

Get the full story.

>>Return to this week's industry news


4.) 2012 Benchmarks in Patient Registry Use for Accountable Care

2012 Benchmarks in Patient Registry Use for Accountable Care This resource provides actionable data from more than 100 healthcare companies on their current and planned use of registries and the impact of registry use on healthcare quality, efficiency and cost.



Learn more about this resource.

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5.) Healthcare Business White Paper: Asthma Management in 2012 — Action Plans, Coaching Help Patients To Breathe Easier

Asthma Management in 2012 New market research from the Healthcare Intelligence Network has determined that asthma action plans and health coaching are key components of an effective asthma management program. Download this HINtelligence report to learn how 71 healthcare companies are helping individuals with asthma to manage their disease more effectively, reducing the likelihood of ER visits and hospitalizations by this population.

Download this complimentary white paper.

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6.) Half of New CMS ACOs are Physician-Led

Nearly half of the 106 newly established CMS ACOs are physician-led organizations, according to the HHS. The new ACOs represent a diverse cross-section of physician practices across the country serving 10,000 beneficiaries.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Incentive-Based Health Improvement Programs

New Chart: Top 5 Incentive-Based Health Improvement Programs Rewarding lifestyle behavior change over participation, heavier use of texting and social networks to promote programs — just a few of the findings from HIN's fourth annual market analysis of incentives use in population health management in 2012. We wanted to see which health improvement programs healthcare companies incent most often.

Click here to view the chart.

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8.) Physician-Owned ACOs: Overcoming the Legal and Regulatory Compliance Challenges

Physician-Owned ACOs This webinar provides details from Jeffrey R. Ruggiero, Esq., a Partner in the law firm of Arnold & Porter LLP, who advised the Queens County Medical Society on their ACO development approach.

Learn more about this resource.

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9.) 1 in 3 Americans Admit to Going Online for Medical Advice: Survey

The Internet has become a second medical opinion for many Americans, and even a first for some, according to a recent survey from the Pew Research Centerís Internet & American Life Project.

Get the full story.

>>Return to this week's industry news

10.) Pursuing the Triple Aim: Seven Innovators Show the Way to Better Care, Better Health, and Lower Costs

Pursuing the Triple Aim This resource examines how leading organizations in the United States are pursuing the ďTriple AimĒ: improving the individual experience of care, improving the health of populations, and reducing the per capita cost of care.



Learn more about this resource.

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11.) Home Visits Curb Avoidable ER Use

Treating the emergency room as your primary care provider? If youíre a UPMC Health Plan member, you can expect a home visit from the health planís community teams of nurses and social workers. Community teams visit these members at home to perform assessments and care management. Thatís one of the ways UPMC Health Plan is reducing the rates of avoidable ER use, explains Debra Smyers, senior director of program development at UPMC Health Plan.

Get the full story.

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12.) 46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends

46 Healthcare Metrics to Boost Profitability This resource is HINís second annual graphic compendium of performance benchmarks in key areas of healthcare activity and growth, a desktop reference for the healthcare C-suite that distills emerging trends into easy-to-digest charts and tables.


Learn more about this resource.

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13.) Infographic: Hospital-Acquired Infections

Hospital-acquired infections (HAIs) can have a substantial effect on patients, staff or anyone else that enters through the doors of a hospital or medical center, and significantly impacts healthcare costs. For example, the annual cost of an HAI is $25,000 per person. The number of deaths resulting from HAIs can be reduced by implementing a few simple suggestions from this infographic published by CHG Hospital Beds.

Read this blog post.

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14.) Creating a Physician Hospital Organization: An Emerging Collaborative Model

Greg Mertz Travis Ansel Physician-hospital organizations have been around before, but it's the emphasis on quality that sets today's PHO apart from the 80's version. In PHO 2.0, where healthcare value is favored over volume, clinical integration of participating physicians is a prerequisite, agree Greg Mertz, director of Healthcare Strategy Group, and Travis Ansel, its manager of strategic services. In this interview, they talk about the essential first steps of PHO creation and the perennial challenges of physician engagement and clinical leadership in this emerging collaborative model.

Listen to this podcast.

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