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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Almost 3 million Medicare patients hospitalized for heart failure (HF), heart attack, or pneumonia were readmitted to the hospital within 30 days, and almost two-thirds were readmitted within 15 days, according to a study from Columbia University Medical Center and published in JAMA.

Hospital readmissions are common and can be a marker of poor healthcare quality and efficiency. To lower readmission rates, CMS began publicly reporting 30-day risk-standardized readmission rates for these conditions after these measures were endorsed by the National Quality Forum.

CMS also began penalizing hospitals with high readmission rates; one way to avoid these readmissions penalties is by arming yourself with as much of your own readmissions data as possible, says Amy Boutwell, MD, MPP, president of Collaborative Healthcare Strategies, and co-founder of the IHI STAAR (State Action on Avoidable Rehospitalizations) initiative. Too many hospitals and healthcare organizations are relying on data from vendors and secondary information sources. Hiring a quality analyst to run your discharge data can be very helpful. Ms. Boutwell elaborates on this and several other recommendations adapted from the IHI STAAR initiative.

Another way to avoid readmission penalities is to increase the use of telehealth solutions. Telehealth could reach as many as 1.8 million patients worldwide by 2017; studies show that an estimated 308,000 patients were remotely monitored by their healthcare provider for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, hypertension and mental health conditions worldwide in 2012. The majority of these patients were post-acute patients who had been hospitalized and discharged.

One area where high costs arenít impacting professional decisions is in the use of expensive imaging tests. Despite evidence to the contrary, a new study from Johns Hopkins University School of Medicine shows that price transparency doesnít influence the way physicians order imaging tests; instead, when it comes to expensive tests like MRIs, it seems that doctors have already decided they need to know the information regardless of their cost.

But the high costs of medication non-adherence are too great to ignore: in 2009, the New England Healthcare Institute estimated that medication non-adherence was responsible for $290 billion in 'otherwise avoidable medical spending' in the United States alone. Describe how your organization is improving medication adherence in the populations you serve by January 31, 2013 and you will receive a free executive summary of the third annual survey results once they are compiled. Your responses will be kept strictly confidential.

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 28, 2013
Vol. XV, No. 4

Sponsored by:
Health and Wellness Incentives — Positioning for Outcome-Based Rewards


This week's industry news:

  1. Price Transparency Doesnít Influence How Physicians Order High-Cost Medical Tests: Study
  2. 38 Disease Management Metrics
  3. 1 Out of 3 Patients Hospitalized for Heart Conditions, Pneumonia Readmitted Within 15 Days
  4. Guide to Reducing Medicare Readmissions, Vol. II
  5. Healthcare Business White Paper: Health & Wellness Incentives in 2012
  6. Most States Enhancing Technology to Streamline Medicaid Eligibility, Modernize Enrollment Systems
  7. New Chart: What's the ROI from Diabetes Management Programs?
  8. Medicaid Compliance Strategies for Hospitals and Other Providers
  9. Telehealth to Reach 1.8 Million Patients by 2017; Diabetes Cases in Majority
  10. Telemedicine Technologies
  11. 3 Recommendations for Avoiding Readmissions Penalties
  12. Avoiding the Readmissions Penalty Zone
  13. Infographic: 2013ís Most Significant Healthcare Issues
  14. Healthcare Performance Benchmarks: Diabetes Management
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.) Price Transparency Doesnít Influence How Physicians Order High-Cost Medical Tests: Study

Doctors donít let the high cost of some medical tests influence their decisions to use them, according to a study from Johns Hopkins University School of Medicine.

Get the full story.

>>Return to this week's industry news


2.) 38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care

38 Disease Management Metrics This resource dives deep into several years of market research to document the role and outcomes of disease management in 11 key areas, as well as the high-focus diseases and health conditions of these initiatives.



Learn more about this resource.

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3.) 1 Out of 3 Patients Hospitalized for Heart Conditions, Pneumonia Readmitted Within 15 Days

Almost 3 million Medicare patients hospitalized for heart failure (HF), heart attack, or pneumonia were readmitted to the hospital within 30 days, and a majority were readmitted within 15 days, according to a study from Columbia University Medical Center and published in JAMA.

Get the full story.

>>Return to this week's industry news


4.) Guide to Reducing Medicare Readmissions, Vol. II

Guide to Reducing Medicare Readmissions, Vol. II This resource examines innovative interventions to reduce preventable admissions, rehospitalizations and ER visits by high-utilizing Medicare beneficiaries. It looks at four multidisciplinary collaborative interventions aimed at key factors fueling readmissions in this population — and that support an accountable care vision.

Learn more about this resource.

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5.) Healthcare Business White Paper: Health & Wellness Incentives in 2012 — Rewarding Risk Assessment, Lifestyle Changes

Health & Wellness Incentives in 2012 New market research from the Healthcare Intelligence Network has determined that the completion of a health risk assessment (HRA) remains the most heavily incented health improvement activity for the fourth consecutive year, say two-thirds of respondents to HIN's annual Health & Wellness Incentives Survey. This HINtelligence Report provides data highlights on health and wellness incentive program components, results, and ROI; as well as the most successful strategies for health and wellness incentives use.

Download this complimentary white paper.

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6.) Most States Enhancing Technology to Streamline Medicaid Eligibility, Modernize Enrollment Systems

Nearly all states are taking steps to develop faster, streamlined Medicaid enrollment systems, even if they choose to opt out of Medicaid expansion, according to a report from the Kaiser Family Foundationís Commission on Medicaid and the Uninsured.

Get the full story.

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7.) New Chart: What's the ROI from Diabetes Management Programs?

New Chart: What's the ROI from Diabetes Management Programs? Proper control of diabetes goes beyond prescribed pills and injections to encouraging individuals with diabetes to self-manage their condition, paying ongoing attention to weight, diet, glucose levels, blood pressure and other clinical metrics. We wanted to see the ROI generated by diabetes management programs.

Click here to view the chart.

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8.) Medicaid Compliance Strategies for Hospitals and Other Providers: How to Prepare for Federal Health Reform Mandates and State Initiatives

Medicaid Compliance Strategies for Hospitals and Other Providers This resource is filled with articles that will help Medicaid providers understand what to expect when state or federal auditors come calling, and show how certain facilities handled major cases and settlements.



Learn more about this resource.

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9.) Telehealth to Reach 1.8 Million Patients by 2017; Diabetes Cases in Majority

Telehealth could reach as many as 1.8 million patients worldwide by 2017, as more and more healthcare organizations use it as a means toward reducing readmission rates and tracking disease progression, according to a report from InMedica, a division of IMS Research.

Get the full story.

>>Return to this week's industry news

10.) Telemedicine Technologies: Information Technologies in Medicine and Telehealth

Telemedicine Technologies This resource focuses on how medical information can be reliably transmitted through wireless communication networks. It explains how they can be optimized to carry medical information in various situations by utilizing readily available traditional wireless local area network (WLAN) and broadband wireless access (BWA) systems.


Learn more about this resource.

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11.) 3 Recommendations for Avoiding Readmissions Penalties

Arming yourself with as much of your own readmissions data as possible is the first step in reducing readmissions and avoiding penalties, says Amy Boutwell, MD, MPP, president of Collaborative Healthcare Strategies, and co-founder of the IHI STAAR (State Action on Avoidable Rehospitalizations) initiative, from which these recommendations are adapted.

Get the full story.

>>Return to this week's industry news


12.) Avoiding the Readmissions Penalty Zone: Population Health Management for High-Risk Populations

Avoiding the Readmissions Penalty Zone This resource opens with cross-continuum tactics to lessen the financial impact of the CMS Readmission Penalty program from Amy Boutwell, MD, MPP, president of Collaborative Healthcare Strategies, who draws on her experience as co-founder of the IHI STAAR (State Action on Avoidable Rehospitalizations) Initiative.


Learn more about this resource.

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13.) Infographic: 2013ís Most Significant Healthcare Issues

More than two years after it was passed, healthcare reform topped the list of the most significant issues facing the healthcare industry in 2013, according to a poll of 2,800 LinkedIn users from the healthcare industry. As illustrated in this infographic from Zurich Insurance, 50 percent identified healthcare reform as the most significant issue, followed by the financial impact of reform (39 percent) and physician integration (5 percent).

Read this blog post.

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14.) Healthcare Performance Benchmarks: Diabetes Management

Melanie Matthews The use of a disease-specific approach to improve health outcomes and self-management for patients with diabetes is utilized by 77 percent of organizations, according to HIN's 2011 survey on diabetes management programs. In this podcast, Melanie Matthews shares key metrics from the survey, including the role of the case manager, the use of incentives, the staff member responsible for diabetes management and the greatest challenge associated with the control of diabetes.

Also, Kathy Brieger, Hudson River HealthCare chief operating officer, describes HRHC's four-pronged approach to weight management for the 3,400 adult patients it serves.

Listen to this podcast.

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