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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

How to deal with end-of-life care continues to concern healthcare professionals, as a new study from Brown University reveals. Results from a decades-long study show that the proportion of dying seniors using hospice doubled from 2000 to 2009 (42 percent), while the proportion of seniors undergoing aggressive treatment in the ICU increased from 24.3 percent in 2000 to 29.2 percent in 2009. Researchers suggest that hospice is being increasingly seen as an "add on" to aggressive patterns of care during the last days of life, and it is unclear whether such aggressive care is what patients want, or their families/caregivers want.

In addition, the majority of seniors spend three days or less in hospice, not long enough to provide them with the support hospice is intended to provide.

One way to resolve this situation is to indulge in shared decision-making, say researchers from RAND Corporation. Patients and doctors need to decide together what medical decisions are right for each patient, and then act on them. But efforts to do so aren't easily implemented, given a healthcare system plagued with overworked physicians, insufficient provider training and deficient medical information systems, researchers note.

A collaboration between the Highmark Foundation and Accenture — the introduction of patient navigators — might offer a solution. Designed to connect patients to primary care and cut down on no-show rates, unecessary admissions and ER visits, patient navigation utilizes low-cost, trained community members to connect patients to primary care, helping patients to better navigate the healthcare system, and improve patient/doctor relationships and reduce overall healthcare costs. Accenture and the Highmark Foundation are working together to create an infrastructure for patient navigation both locally and within the individual hospitals.

Mhealth is another area in which healthcare can encourage responsible self-care, and a new application programming interface (API) from Walgreens is hoping to do just that. The chain’s new prescription refill technology will enable mobile app users to order a prescription refill by scanning the barcode on a Walgreens prescription bottle. Officials say this will help patients to easily refill prescriptions and properly take their medication. Eleven percent of hospital admissions and 40 percent of nursing home admissions are attributable to medication non-adherence, which has been estimated to cost the U.S. healthcare system $290 billion annually.

Speaking of apps, when was the last time you used one to manage your health? Chances are, your patients and health plan members are adept at these tools, too. If your organization isn't at least thinking about mHealth, it might be missing the boat. Please take a few minutes to answer our 10 Questions on mHealth survey. You'll receive a free executive summary of survey results once it is compiled — via e-mail or an mHealth-powered text message.

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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February 11, 2013
Vol. XV, No. 6

Sponsored by:
The Role of Case Managers in Emerging Care Delivery Models


This week's industry news:

  1. API Program Allows Mobile App Developers to Leverage Prescription Refill Technology
  2. 2013 Healthcare Benchmarks: Improving Medication Adherence
  3. Study: Rise in Short-Term Hospice Visits by Way of ICU
  4. Case Management for Advanced Illness
  5. Healthcare Business White Paper: Diabetes Management in 2012
  6. Shared Decision-Making Between Patients and Doctors Will Require Investment by Health Systems
  7. New Chart: Top 5 Health Professionals on the PHM Team
  8. Patient Engagement in the Patient-Centered Medical Home
  9. Patient Navigators Key to New Pilot Aimed at Decreasing Costs, ER Visits
  10. Essentials of Embedded Case Management
  11. Keys to Caring For Dual Eligibles
  12. Population Health Management for Dual Eligibles
  13. Infographic: Rx Abuse and Pharmacy Fraud
  14. Care Coordination for Dual Eligibles
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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This week's industry news

1.) API Program Allows Mobile App Developers to Leverage Prescription Refill Technology

A new application programming interface (API) that allows third-party mobile app developers to integrate Walgreens’ prescription refill technology is now available, Walgreens officials report.

Get the full story.

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2.) 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.

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3.) Study: Rise in Short-Term Hospice Visits by Way of ICU

Hospice care is being increasingly seen as an “add on” to aggressive patterns of care during the last days of life, and it is unclear whether such aggressive care is what patients want, or their families/caregivers want, according to a study in the Journal of the American Medical Association (JAMA).

Get the full story.

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

Case Management for Advanced Illness This resource looks at case management approaches to best care for this growing population; Aetna’s Dr. Joseph Agostino details the organizations’s Compassionate Care program, and case manager Sheryl Riley shares her years of experience in care and case management of oncology patients.


Learn more about this resource.

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5.) Healthcare Business White Paper: Diabetes Management in 2012 — Certified Diabetes Educators Getting Results

Diabetes Management in 2012 An overwhelming majority of respondents to the December 2011 "10 Questions" e-survey are using a disease-specific approach to manage diabetes. Responses to the latest Healthcare Intelligence Network survey provided qualitative data on strategies and tactics for management of this disease, program components and challenges, and outcomes, metrics and ROI, which are summarized in this white paper.

Download this complimentary white paper.

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6.) Shared Decision-Making Between Patients and Doctors Will Require Investment by Health Systems

Patients and doctors should decide together what medical decisions are right for each patient, according to a RAND Corporation study published in the journal Health Affairs.

Get the full story.

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7.) New Chart: Top 5 Health Professionals on the PHM Team

New Chart: Top 5 Health Professionals on the PHM Team Case managers are the health professionals found most frequently on a population health management (PHM) team, say nearly 64 percent of healthcare companies who responded to HIN's first annual survey on Population Health Management. We wanted to see which other health professionals are part of the PHM team.

Click here to view the chart.

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8.) Patient Engagement in the Patient-Centered Medical Home: A Continuum Approach

Patient Engagement in the Patient-Centered Medical Home This webinar provides details from Jay Driggers, director of consumer engagement at Horizon BCBS, on how Horizon approaches engagement, including seven key consumer engagement objectives, and the impact of stand-alone pilots on consumer engagement, from iPhone apps to telemonitoring.


Learn more about this resource.

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9.) Patient Navigators Key to New Pilot Aimed at Decreasing Costs, ER Visits

Designed to connect patients to primary care and cut down on no-show rates, unecessary admissions and ER visits, a new patient navigation pilot has been launched by the Highmark Foundation and Accenture at two hospitals in western Pennsylvania: St. Vincent Health System in Erie and Allegheny Valley in Pittsburgh, according to Accenture.

Get the full story.

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10.) Essentials of Embedded Case Management: Hiring, Training, Caseloads and Technology for Practice-Based Care Coordinators

Essentials of Embedded Case Management This resource documents the experiences of two industry leaders, Aetna and Bon Secours, in the recruitment, education, workload management and IT support of practice-based case managers.




Learn more about this resource.

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11.) Keys to Caring For Dual Eligibles

Key to caring for dual eligibles, who constitute about 9 million individuals in the United States, is, among other things, designing a care management plan that identifies local needs, says Dr. Timothy Schwab, chief medical officer of SCAN Health Plan. The not-for-profit California-based health plan has developed a multi-pronged, member-specific approach to reaching dual eligibles that has earned kudos from the healthcare industry.

Get the full story.

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12.) Population Health Management for Dual Eligibles: Blueprint for Care Coordination

Population Health Management for Dual Eligibles This resource details SCAN’s unique care management model for duals, which focuses on prevention and early intervention, particularly in the area of medication management.




Learn more about this resource.

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13.) Infographic: Rx Abuse and Pharmacy Fraud

In the United States, prescription drug overdoses kill more than 15,000 people and result in 1.2 million emergency room visits each year. Abuse of these medications is deadlier than cocaine and heroin combined, reveals Express Scripts in a new infographic.

Read this blog post.

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

Dr. Timothy Schwab SCAN Health Plan's Interdisciplinary Care Team for dual eligibles is a diverse multiprofessional group encompassing many geriatric specialists, explains Dr. Timothy Schwab, chief medical officer of SCAN Health Plan. Dr. Schwab describes some of the challenges of risk stratification in a dual eligible population, and details case management support for the percentage of dual eligibles that require support for disabilities.

Listen to this podcast.

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