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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

In light of ongoing healthcare reform there is a push for clarity, as several of our stories illustrate this week. Medicare claims forms have been redesigned so that beneficiaries and their caregivers can better understand them, check for important facts and potential fraud. The subject of fraud is particularly timely given the story that has been circulating for the last week involving the arrest of a physician, the office manager of his medical practice, and five owners of home health agencies. They’ve been charged with allegedly participating in a nearly $375 million healthcare fraud scheme involving fraudulent claims for home health services.

When given the option of choosing a high or low cost health plan, consumers will most likely choose the higher cost plan because they associate it with better quality, says a new study funded by the AHRQ. But researchers caution that this isn’t necessarily true: higher costs could be attributed to unnecessary services or inefficiencies. A push is underway to simplify public physician and hospital report cards, and make them clearer for consumers to understand (not unlike the redesigned Medicare claim forms) so consumers can make better informed decisions about their health coverage.

The Robert Wood Johnson Foundation and Group Health Research Institute have launched a new national project intended to shed light on what makes a successful health practice tick. Designed in response to the burgeoning shortage of primary care practices, the project will identify successful practices that improve patient and practice outcomes, and share the information so they can be replicated.

And lastly, a study debunks the long held belief that HIT will improve cost savings by reducing the need for diagnostic testing; instead, the study shows that having computerized access to EHRs in the ambulatory setting, could result in a 40 to 70 percent increase in testing.

Don’t forget to take our latest survey: Physician Reimbursement Models. Describe the physician reimbursement models in place at your organization by April 15th 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 Papay
Associate Editor:
Jessica Papay, jpapay@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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March 12, 2012
Vol. XIV, No. 9

Sponsored by:
Physician Pay-for-Performance: Refining the Bonus Structure To Meet Market Realities

This week's industry news:

  1. Consumers Choose High-Value Providers When Given Good Cost, Quality Information
  2. 2011 Benchmarks in Patient Satisfaction Strategies
  3. Care Transitions and the Continuum of Care
  4. Guide to Reducing Medicare Admissions, Volume II
  5. Healthcare Business White Paper: 2011 Benchmarks in Healthcare Case Management
  6. HIT May Drive Costs Up in Ambulatory Setting: Study
  7. New Chart: What's the Biggest Challenge in Reducing Avoidable ER Visits?
  8. Keys to EMR / EHR Success, Second Edition
  9. New RWJ Program Targets Primary Care Practices’ Accessibility, Effectiveness
  10. Physician Practice Redesign Essentials
  11. 6 Features of CMS's Redesigned Medicare Summary Notice
  12. 2011 Benchmarks in Improving Medication Adherence
  13. Appropriate ER Use May Be Only a Phone Call Away
  14. HealthSounds Podcast: Physician Incentives at Highmark
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.) Consumers Choose High-Value Providers When Given Good Cost, Quality Information

Consumers will choose a higher priced healthcare provider if they think they will receive better quality and care, according to a new study funded by the AHRQ, that appears in Health Affairs.

Get the full story.

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2.) 2011 Benchmarks in Patient Satisfaction Strategies: Improving the Healthcare Consumer Experience

2011 Benchmarks in Patient Satisfaction Strategies In this 60-page analysis, based on the responses of 146 organizations to the Healthcare Intelligence Network May 2011 survey on Improving Patient Satisfaction and the Patient Experience, presents the all-new data in more than 45 easy-to-follow graphs and tables.


Learn more about this resource.

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3.) Care Transitions and the Continuum of Care

Ensuring proper hand-offs and care transitions depends on maintaining effective communication between all members of the transition team, from the primary care doctors to the specialty care consultants, says Dr. Stuart Levine, MD, MHA, corporate medical director for Healthcare Partners Medical Group of California.

Get the full story.

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4.) Guide to Reducing Medicare Admissions, Volume II

Guide to Reducing Medicare Admissions, Volume II This resource examines innovative interventions to reduce preventable admissions, rehospitalizations and ER visits by high-utilizing Medicare beneficiaries. This guide 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: 2011 Benchmarks in Healthcare Case Management

Not only are more organizations utilizing healthcare case managers, but the practice of embedding case managers at the point of care is becoming de rigueur, according to the second annual Healthcare Case Management e-survey conducted by the Healthcare Intelligence Network. This white paper documents the details of contemporary case management and the evolving responsibilities of today’s case manager from the 201 healthcare organizations that responded to HIN's January 2011 survey.

Download this complimentary white paper.

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6.) HIT May Drive Costs Up in Ambulatory Setting: Study

Despite widely held beliefs that HIT will improve cost savings by reducing the need for diagnostic testing, a new report in Health Affairs states that having computerized images at hand is linked to 40 to 70 percent increase in testing.

Get the full story.

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7.) New Chart: What's the Biggest Challenge in Reducing Avoidable ER Visits?

Biggest Challenge in Reducing Avoidable ER Visits Programs to help reduce avoidable ER visits are up 3 percent over 2010, according to a recent Healthcare Intelligence Network survey on this topic. We wanted to see the biggest challenge for healthcare organizations in reducing avoidable ER visits.

Click here to view the chart.

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8.) Keys to EMR / EHR Success, Second Edition

Keys to EMR / EHR Success, Second Edition This 292-page resource provides a proven path medical practices can follow with ease, and the confidence they're making the right decisions about features, vendors, integration with the practice management system, and other critical factors.


Learn more about this resource.

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9.) New RWJ Program Targets Primary Care Practices’ Accessibility, Effectiveness

Robert Wood Johnson Foundation (RWJF) and Group Health Research Institute have launched a new national project to identify and study efficient, effective primary care practices (PCP) with the intent to replicate and adopt them.

Get the full story.

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10.) Physician Practice Redesign Essentials: A Transformation Roadmap

Physician Practice Redesign Essentials In this four-volume set, you’ll learn from leading practice transformation experts on adopting a culture of change, choosing a physician performance measurement set, using flowcharts, checklists and diagrams, increasing practice revenue through PQRI, creating actionable information on patient needs and driving improvements in outcomes for patients and practices.

Learn more about this resource.

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11.) 6 Features of CMS's Redesigned Medicare Summary Notice

Medicare claims forms have been redesigned to make information clearer, more accessible, and easier for beneficiaries and their caregivers to understand.

Get the full story.

>>Return to this week's industry news


12.) 2011 Benchmarks in Improving Medication Adherence

2011 Benchmarks in Improving Medication Adherence This resource provides actionable information from 162 healthcare organizations on their efforts to improve medication adherence and compliance in their populations. This second annual analysis of medication adherence programs documents the impact of these programs on adherence levels, medication costs, ER visits, hospital and nursing home admissions, risk of death and other areas of concern.

Learn more about this resource.

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13.) Appropriate ER Use May Be Only a Phone Call Away

Want to reduce avoidable emergency room visits? Pick up the phone, say respondents to our latest Reducing Avoidable ER Visits e-survey — either to respond to callers to your health advice line or to contact patients following an ER visit or hospital stay.

Read this blog post.

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14.) HealthSounds Podcast: Physician Incentives at Highmark

Julie Hobson In its 15-year existence, Highmark's Quality Blue physician pay for performance program has evolved from one strictly based on clinical measures to a payment model shaped by practices' needs, explains Julie Hobson, Highmark's manager of provider engagement, performance and partnership. Hobson describes how feedback from physicians resulted in its Best Practice quality improvement project, what CMS's recently announced stage 2 proposal for meaningful EHR use means for Quality Blue, and some lessons Highmark has learned about engaging physicians in pay for performance.

Listen to this podcast.

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