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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Successful management of chronic disease can reduce healthcare spend and utilization. To that end, this week's issue offers both technologies and tactics to manage and prevent chronic disease.

With few Americans walking around without a cell phone, it makes sense that healthcare has tapped into the power of mobile health. In new benchmarks from our first annual Mobile Health survey, we describe the mHealth habits of 150 healthcare companies who took the survey, including adoption rates, favored mHealth tools, and chief hurdles.

And while not yet mobile, CMS recently has created its own Web-based tool that allows users to dig into Medicare data on the prevalence, utilization and spend associated with multiple chronic conditions. Users of the Medicare Chronic Conditions Dashboard can sort data on any of 15 chronic conditions — from Alzheimers to osteoporosis — drilling down to state- and gender-specific statistics, among other findings.

On the subject of Alzheimers, a new study published the New England Journal of Medicine found that the cost of dementia — which includes Alzheimer's disease and other disorders — now tops that of heart disease or cancer. The $157 billion price tag that the Rand Corporation study affixed to dementia reflects the cost of providing institutional and home-based long-term care for these patients rather than medical services.

Care coordination may be one path to reversing this trend. This issue also underscores the effect of embedded case management on the quality and efficiency of care provided by the patient-centered medical home model, based on new findings from University of Connecticut researchers. For those ready to co-locate care coordinators in primary care, CDPHP's director of case management shares five considerations for picking physician practices for the embedded staffing model.

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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April 8, 2013
Vol. XV, No. 13

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


This week's industry news:

  1. Dementia More Costly to Nation than Heart Disease or Cancer
  2. Case Management for Advanced Illness
  3. Mobile Health Goes Mainstream: Diabetes, Heart Disease Top Targets of mHealth Technologies
  4. 2013 Healthcare Benchmarks: Mobile Health
  5. Healthcare Business White Paper: Diabetes Management in 2012
  6. Study: 2 Key Factors That Improve Medical Home Quality, Efficiency
  7. New Chart: What's the Average Monthly Case Load of a Health Coach?
  8. New Models in the Patient-Centered Medical Home
  9. Medicare Dashboard Tracks Spending, Utilization for Multiple Chronic Conditions
  10. 38 Disease Management Metrics
  11. 5 Criteria for Selecting Practices for Embedded Case Managers
  12. Guide to Embedded Case Management
  13. Payment Bundling Requires Suspension of FFS State of Mind
  14. Physician Hospital Organizations
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This week's industry news

1.) Dementia More Costly to Nation than Heart Disease or Cancer

The monetary cost of dementia in the United States ranges from $157 billion to $215 billion annually, making the disease more costly to the nation than either heart disease or cancer, according to a new RAND Corporation study.

Get the full story.

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

Case Management for Advanced Illness This resource examines Aetna’s Compassionate Care program, a case management approach for this population. The payor’s initiative breaks down barriers commonly encountered in this highly sensitive stage of the health continuum while positively impacting both healthcare utilization and spend.


Learn more about this resource.

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3.) Mobile Health Goes Mainstream: Diabetes, Heart Disease Top Targets of mHealth Technologies

Healthcare is most ‘apped’ to use mobile health to manage or prevent disease, according to new market research on mHealth adoption from the Healthcare Intelligence Network.

Get the full story.

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4.) 2013 Healthcare Benchmarks: Mobile Health

2013 Healthcare Benchmarks: Mobile Health This resource delivers a snapshot of mobile health (mHealth) trends, including current and planned mHealth initiatives, types and purpose of mHealth interventions, targeted populations and health conditions, and challenges, impact and results from mHealth efforts at 150 healthcare companies.


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.) Study: 2 Key Factors That Improve Medical Home Quality, Efficiency

An EmblemHealth project found evidence that use of the Patient-Centered Medical Home (PCMH) model results in modest but promising reductions in ED visits and improved quality of care. The findings, reported in an independent study by University of Connecticut (UConn) researchers, were published online last month by the Journal of General Internal Medicine.

Get the full story.

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7.) New Chart: What's the Average Monthly Case Load of a Health Coach?

New Chart: What's the Average Monthly Case Load of a Health Coach? Health coaching is a critical tool in population health management, helping to boost self-management of disease and reduce risk and associated cost across the health continuum. We wanted to see the average monthly case load for a health coach.

Click here to view the chart.

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8.) New Models in the Patient-Centered Medical Home: Incentives, Infrastructure and IT to Support Accountable Care

New Models in the Patient-Centered Medical Home Beginning with an overview of 2012 PCMH trends, this 57-page special report offers snapshots of three thriving medical home initiatives and their particular area of focus.



Learn more about this resource.

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9.) Medicare Dashboard Tracks Spending, Utilization for Multiple Chronic Conditions

A new chronic conditions dashboard from CMS allows users to obtain current data on prevalence, utilization and Medicare spending for Medicare beneficiaries with chronic conditions.

Get the full story.

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10.) 38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care

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


Learn more about this resource.

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11.) 5 Criteria for Selecting Practices for Embedded Case Managers

One of the most challenging but important criteria when choosing practices in which to embed or colocate case managers is physician willingness, explains Charlene Schlude, RN, CCM, director of case management at Capital District Physicians Health Plan (CDPHP). While it is financially beneficial, many physicians are not comfortable allowing someone else on their team.

Get the full story.

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12.) Guide to Embedded Case Management

Guide to Embedded Case Management This resource provides a primer on the development and implementation of a co-located case management effort, with advice on startup, launch and operations from Aetna, Bon Secours and CDPHP on their embedded case management programs and the benefits they have derived from on-site case management.


Learn more about this resource.

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13.) Payment Bundling Requires Suspension of FFS State of Mind

Four hundred healthcare providers — about a tenth of all those in the United States — can't be wrong, can they? That's the number signed on to participate in a Medicare payment bundling pilot run by CMS, their biggest payor. And while it's too early to know if the reimbursement concept will stick, one thing's for certain, noted Jay Sultan during a recent webinar on Moving Forward with Payment Bundling: there's a growing body of proof that the payment model works.

Read this blog post.

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14.) Physician Hospital Organizations: Developing a Collaborative Structure for Shared Savings Agreements

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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