HIN logo
From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Healthcare costs have plummeted, due to an unprecedented drop in diabetes, heart failure and other preventable chronic diseases. Readmission rates are historically low, patient safety and satisfaction, and proper care transitions at all time highs. The majority of doctors and hospitals' payments are tied to performance, and medical trainees are using federally imposed extra hours to sleep, without jeopardizing training time, patient handoff errors, or patient safety. And healthcare claims costs have significantly decreased despite the influx of nearly 32 million enrollees post-ACA, given that high-risk individuals and pools are virtually non-existent.

April Fools!

Unfortunately we have a long ways to go until this scenario occurs; as our stories indicate this week, diabetes, heart failure and other chronic diseases continue to rise, and only 11 percent of payments to doctors and hospitals are tied to value-centered patient care, according to the Catalyst for Payment Reform (CPR); the remainder pay providers for every test and procedure they perform regardless of necessity or outcome, or in bundled, capitated, or partially capitated payments without quality incentives.

Healthcare claims costs could increase by a third in four years, given that enrollment in the individual market is projected to be almost 115 percent larger, including a majority of higher-risk individuals impacting costs, according to a study from the Society of Actuaries (SOA).

Reducing the number of continuous hours medical interns work can increase the number of potentially dangerous patient handoffs from one trainee to another, new research from Johns Hopkins suggests. Contrary to initial expectations, the reduction in work hours in 2011 from 30 to 16 also failed to increase the amount of sleep trainees get, but decreased their amount of training time, researchers found.

But the news isn't all bleak: a new ACO designed to enable primary care doctors to more easily manage patients' healthcare visits and transitions has been launched by Coastal Medical and UnitedHealthcare.

And one way you can help is by participating in our third survey on managing care transitions in 2013: proper care transitions have the potential to dramatically hasten patients' return to optimal health, as well as reduce the likelihood of a return ER visit or readmission. The quality of transitional care is also shaping up to be a critical factor in value-based reimbursement, as federal and private payors ask patients to rate the quality of the transitional care they receive.

And if you share your organization's efforts to improve care transitions by Friday, April 12, you'll receive a free executive summary of the compiled results, and entry into a drawing for a complimentary registration to our April 24th webinar, "Care Transition Management: Strategies for Effective Patient Handoffs," a $119 value! No joke!

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

>>Return to top

HIN podcasts
HIN blog
HIN videos
New HIN products

Contact HIN:
www.hin.com
(888) 446-3530
(732) 449-4468
Fax: (732) 449-4463
Email: info@hin.com

This week's featured download: Mobile Health in 2013 — Diabetes, Heart Disease Top Targets for Technologies

Mobile Health in 2013 — Diabetes, Heart Disease Top Targets for Technologies

Featured download










For advertising and sponsorship opportunities in the Healthcare Business Weekly Update, please e-mail sales@hin.com or call 888-446-3530

>>Return to top

April 1, 2013
Vol. XV, No. 12

Sponsored by:
A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings


This week's industry news:

  1. Healthcare Claims Costs to Increase by a Third by 2017; Wide Variability Among States
  2. AISís Directory of Health Plans: 2013
  3. Improving Care Transitions Key to new ACO from Coastal Physicians and UnitedHealthcare
  4. Population Health Management Tools for ACOs
  5. Healthcare Business White Paper: 2012 Benchmarks in Reducing Avoidable ER Visits
  6. Reducing Work Hours for Medical Interns Increases Patient Handoff Risks
  7. New Chart: Top 5 Measurements of PHM Program Effectiveness
  8. Care Transition Management: Strategies for Effective Patient Handoffs
  9. Only 11 Percent of Payment to Doctors, Hospitals is Tied to Performance: Study
  10. Guide to Physician Performance-Based Reimbursement
  11. 2 Standards for Enhanced Patient-Centered Care Models
  12. 33 Metrics for Care Transition Management
  13. Infographic: Stay Out of CMS Penalty Box for PQRS and eRX
  14. Medical Center Uses Mobile Health to Improve Care Transitions
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.

Missed the last issue? Read it here.

Join our Online Communities:

Twitter Facebook LinkedIn YouTube Pinterest


Take our monthly e-survey:
Managing Care Transitions in 2013

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

Interested in all open surveys? Review them here.


This week's industry news

1.) Healthcare Claims Costs to Increase by a Third by 2017; Wide Variability Among States

Healthcare claims costs could increase by as much as 32 percent nationally by 2017, with wide variability among states given ACA-fueled provisions, according to new research published by the Society of Actuaries (SOA).

Get the full story.

>>Return to this week's industry news


2.) AISís Directory of Health Plans: 2013

AISís Directory of Health Plans: 2013 This resource contains enrollment data for all types of health plans, including commercial HMOs/PPOs/POS, Medicare and Medicaid HMOs, state government-run plans such as Medicaid FFS, PCCM, PCIP, SCHIP and other local community plans.


Learn more about this resource.

>>Return to this week's industry news


3.) Improving Care Transitions Key to new ACO from Coastal Physicians and UnitedHealthcare

Designed to enable primary care doctors to more easily manage patientsí healthcare visits and transitions, Coastal Medical and UnitedHealthcare have announced a new ACO in Rhode Island.

Get the full story.

>>Return to this week's industry news


4.) Population Health Management Tools for ACOs: Technologies and Tactics to Support Accountable Care

Population Health Management Tools for ACOs This resource examines the building blocks of population health management that drive improvements in healthcare quality and efficiency in ACOs ó while positioning healthcare organizations for core measure improvement and increased reimbursement.


Learn more about this resource.

>>Return to this week's industry news


5.) Healthcare Business White Paper: 2012 Benchmarks in Reducing Avoidable ER Visits — Pain Management Patients on Rise

2012 Benchmarks in Reducing Avoidable ER Visits With consensus widespread that much of emergency room use is avoidable and preventable, this white paper details how 134 healthcare organizations are working to staunch the flow and expense of avoidable emergency department use and point low-acuity patients in the direction of appropriate care.

Download this complimentary white paper.

>>Return to this week's industry news


6.) Reducing Work Hours for Medical Interns Increases Patient Handoff Risks

Reducing the number of continuous hours medical interns work can increase the number of potentially dangerous patient handoffs from one trainee to another, new research from Johns Hopkins suggests.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Measurements of PHM Program Effectiveness

New Chart: Top 5 Measurements of PHM Program Effectiveness Clinical outcomes is the metric most often evaluated to measure and improve population health management (PHM) program effectiveness, say 78 percent of healthcare companies who responded to HIN's first annual survey on Population Health Management. We wanted to see which other metrics are reviewed to monitor a program's effectiveness.

Click here to view the chart.

>>Return to this week's industry news


8.) Care Transition Management: Strategies for Effective Patient Handoffs

Care Transition Management: Strategies for Effective Patient Handoffs This 60-minute webinar to air on April 24th at 1:30 p.m. Eastern, will share two industry expertsí insights on the effect of patient handoffs on care transition management programs.

Learn more about this resource.

>>Return to this week's industry news


9.) Only 11 Percent of Payment to Doctors, Hospitals is Tied to Performance: Study

Just 11 percent of payments made to doctors and hospitals today are value-oriented, or tied to how well they deliver care or create incentives for both improving quality and reducing waste, according to the first annual National Scorecard on Payment Reform from the Catalyst for Payment Reform (CPR).

Get the full story.

>>Return to this week's industry news

10.) Guide to Physician Performance-Based Reimbursement: Payoffs from Incentives, Data Sharing and Clinical Integration

Guide to Physician Performance-Based Reimbursement This resource explores newly minted reimbursement formulas at two health plans and two independent practice associations (IPAs), providing payor and provider perspectives on the formula development process; clinical, quality and efficiency measures in use; physician incentive payments and program outcomes.

Learn more about this resource.

>>Return to this week's industry news


11.) 2 Standards for Enhanced Patient-Centered Care Models

"If we canít understand our patients, and they canít understand what we are telling them, then we canít get them care or help," says Kathy Brieger, RD, CDE, chief operations officer for Hudson River HealthCare (HRHC), explaining why having a medical phone line that allows for translation is one of the tools that are critical for a successful patient care model.

Get the full story.

>>Return to this week's industry news


12.) 33 Metrics for Care Transition Management

33 Metrics for Care Transition Management This resource contains HINís graphic compendium of performance benchmarks in key areas impacting care transitions ó from key tasks performed at hospital discharge to the prevalence of home visits in programs to improve medication adherence.


Learn more about this resource.

>>Return to this week's industry news


13.) Infographic: Stay Out of CMS Penalty Box for PQRS and eRX

Unless healthcare organizations take certain key steps this year, their Medicare reimbursement level in 2015 could be cut 2 percent or more. Thatís because among other areas, the CMS Physician Quality Reporting System (PQRS) and ePrescribing (eRX) programs are shifting from bonus to penalty programs to insure compliance. More than 80 percent of Medicare providers will face penalties for failing to meet quality thresholds if current performance trends continue. This infographic from Medical Billing highlights these changes and what healthcare entitities need to do to protect their practices.

Read this blog post.

>>Return to this week's industry news


14.) Medical Center Uses Mobile Health to Improve Care Transitions

Cheryl Bailey The initial goal of Cullman Regional Medical Center's "Good to Go" program was to reduce readmissions. But CRMC didn't anticipate the effect that recording discharge instructions and sharing them with patients via phone and computer would have on the patient experience. Cheryl Bailey, CRMC's vice president of patient care services, talks about the unexpected benefit of the award-winning initiative, the minimal investment required to get "Good to Go" off the ground, and planned expansion for the initiative that is bridging the patient communication gap.

Listen to this podcast.

>>Return to this week's industry news


Thank you for your readership! Please urge your colleagues to subscribe by forwarding this email or visiting http://www.hin.com/freenews2.html or by calling (888) 446-3530 or visiting the HIN Web site.

While we encourage you to forward this email to your colleagues, these articles may not be redistributed in any other publication, reproduced for publication in any form, distributed on an intranet or network or by e-mail distribution or distributed for commercial purposes without the expressed written permission of the Healthcare Intelligence Network.


Copyright 1997-2013 Healthcare Intelligence Network. All rights reserved.
Healthcare Intelligence Network
Gateway to Healthcare Business Information on the Internet
800 State Highway 71, Suite 2, Sea Girt, N.J. 08750