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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Physicians have them; so do nurses, and even teachers. So why not case managers?

Aides, or extenders, could be one of several new key trends for case managers, says case manager Teri Treiger. Because they are often faced with large amounts of administrative work in addition to clinical assignments, aides can help take care of details and allow case managers to be much more efficient.

Efficiency and collaboration could help the widespread number of preventable hospital readmissions among Medicare beneficiaries, according to researchers at Penn State, the Weill Cornell Medical College and the University of Pennsylvania. But it will take time, more time than many healthcare professionals originally anticipated, time that is costing the nation nearly $18 billion annually, because of the lack of collaborative relationships among providers in different care settings, researchers say.

A majority of hospitals are in agreement that ACOs are key to remaining competitive. According to a new study from L.E.K. Consulting, over 80 percent of surveyed hospitals are making future plans to join or are already participating in an ACO.

Hospital executives also intend to invest significantly on information technology (IT) and facilities over the next five years in order to stay ahead, researchers found. Hospitals are investing in mechanisms that will help them improve quality metrics and outcomes and gain a competitive advantage in the marketplace, researchers note. Researchers also found that there will be major changes in purchasing dynamics, as we detail in our story.

Nearly half of adult residents living in the metropolitan Texas area are uninsured, making it the highest area of uninsured adults in the metro United States for the second year in a row, according to the Gallup-Healthways Well-Being Index.

This is nearly three times the national average of 16.9 percent; a percentage which has remained the same since 2011, but jumped by two percent in 2008. Metropolitan areas in Vermont, Massachusetts and New Hampshire had the lowest uninsured rates. Geographically, these rates havenít changed; and demographically, one group in particular, Hispanics, remains uninsured.

Researchers expect these figures to change, however, as healthcare reforms take effect.

And lastly, young adults under 26 insured on their parents' health insurance plans due to federal mandate are more likely to be treated for depression, substance abuse and pregnancy, according to new research from the nonpartisan Employee Benefit Research Institute (EBRI). This report is the first to identify the major treatments the coverage is used for, researchers note.

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 22, 2013
Vol. XV, No. 15

Sponsored by:
Care Transition Management — Strategies for Effective Patient Handoffs


This week's industry news:

  1. The ACO Model Figures in Most Hospitalsí Futures
  2. A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings
  3. Better Coordination, Data Needed to Reduce Hospital Readmission Rates
  4. Guide to Reducing Medicare Readmissions, Vol. II
  5. Healthcare Business White Paper: Mobile Health in 2013
  6. More Than 1 in 5 Americans Remains Uninsured Across U.S. Metro Areas
  7. New Chart: Top 5 Mobile Health Technologies
  8. Healthcare Trends & Forecasts in 2013
  9. Young Adults on Parentsí Insurance Most Likely Treated for Depression, Substance Abuse and Pregnancy
  10. Emergency Room Triage of the Mental Health Patient
  11. Case Management Extenders 1 of 3 Emerging Trends
  12. Case Management in Value-Based Healthcare
  13. Infographic: Workplace Wellness
  14. Moving Forward with Payment Bundling
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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Healthcare Case Management in 2013

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This week's industry news

1.) The ACO Model Figures in Most Hospitalsí Futures

Over 80 percent of surveyed hospitals are making future plans to join or are already participating in an accountable care organization (ACO), according to a new study from L.E.K. Consulting, a global strategy consulting firm.

Get the full story.

>>Return to this week's industry news


2.) A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings

A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings This 45-minute webinar shares how to stratify and prioritize strategies to improve quality ratings and insight into the future direction of the CMS Star Quality program, and is presented by Joseph Johnson, vice president of L.E.K. Consulting.


Learn more about this resource.

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3.) Better Coordination, Data Needed to Reduce Hospital Readmission Rates

Achieving widespread reductions in preventable hospital readmissions among Medicare beneficiaries may take longer than many healthcare professionals originally anticipated, according to researchers at Penn State, the Weill Cornell Medical College and the University of Pennsylvania.

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

Mobile Health in 2013 The use of mobile health (mHealth) technologies has transformed the exchange of healthcare data, with mobile apps monitoring everything from blood sugar to medication adherence, and text-based reminders urging smokers not to give into that craving. In its first mHealth e-survey conducted in March 2013, the Healthcare Intelligence Network (HIN) captured current trends in emerging mHealth technologies. Nearly 150 healthcare organizations describe the technologies they use, the conditions and populations they target, and the challenges and successes they've encountered along the way.

Download this complimentary white paper.

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6.) More Than 1 in 5 Americans Remains Uninsured Across U.S. Metro Areas

Nearly half of adult residents living in the McAllen-Edinburg-Mission, Texas metro area are uninsured, making it the highest area of uninsured adults in the metro U.S. for the second year in a row, according to the Gallup-Healthways Well-Being Index.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Mobile Health Technologies

New Chart: Top 5 Mobile Health Technologies The use of mobile health (mHealth) technologies to monitor health is revolutionizing the exchange and consumption of healthcare data. From mobile apps that monitor blood sugar and heart rhythms to text-based medication reminders, mHealth technologies could save from $1.96 billion to $5.83 billion in healthcare costs by the year 2014, some studies indicate. We wanted to see which mHealth technologies are most popular among healthcare organizations.

Click here to view the chart.

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8.) Healthcare Trends & Forecasts in 2013: Performance Expectations for the Healthcare Industry

Healthcare Trends & Forecasts in 2013 This resource highlights the challenges that will continue to consume the healthcare executive in the year ahead. Now in its ninth year of providing healthcare executives with a look ahead to help shape strategic plans, this yearís resource covers how the economic environment is continuing to impact the healthcare industry, in terms of the unemployment rate, the uninsured and underinsured, access to credit and soft volume for healthcare services, among other issues.


Learn more about this resource.

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9.) Young Adults on Parentsí Insurance Most Likely Treated for Depression, Substance Abuse and Pregnancy

Young adults under 26 who are covered on their parentsí health insurance plans are more likely to be treated for depression, substance abuse and pregnancy, according to new research from the nonpartisan Employee Benefit Research Institute (EBRI).

Get the full story.

>>Return to this week's industry news

10.) Emergency Room Triage of the Mental Health Patient: Pilot Projects in Reducing ED Diversion

Emergency Room Triage of the Mental Health Patient This resource examines how two emergency department veteransí backup plans are sometimes necessary to manage the flow of behavioral health patients in the emergency room.



Learn more about this resource.

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11.) Case Management Extenders 1 of 3 Emerging Trends

If Mrs. Smith, a diabetic, needs a special diet provided by Meals on Wheels, why not assign that task to a case management extender, asks Teresa M. Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, CCP, president of Ascent Care Management. Like nursesí aides or administrative assistants, extenders can take on the smaller tasks, allowing case managers to concentrate on the clinical details and be a stronger part of the collaborative team experience.

Get the full story.

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12.) Case Management in Value-Based Healthcare: Trends, Team-Building and Technology

Case Management in Value-Based Healthcare This resource delivers advice for the profession on surviving and thriving in the post-reform healthcare landscape from Teresa M. Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, CCP, president of Ascent Care Management and a familiar voice on the case management scene.


Learn more about this resource.

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13.) Infographic: Workplace Wellness

More than 81 percent of employers with 50 or more employees have a workplace wellness program, according to a new infographic by Medifit. The infographic details the benefits of workplace wellness programs, along with data on risk reductions achieved.

Read this blog post.

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14.) Moving Forward with Payment Bundling

Jay Sultan Since the idea of payment bundling was first introduced 10 years ago, justification for the episode-based reimbursement model has shifted from quality and innovation gains to its proven ability to reduce the total cost of healthcare, notes Jay Sultan, associate vice president and chief product portfolio architect for TriZetto®. Healthcare entities testing bundled payments should keep two key factors in mind when trying to engage physicians in the model, Sultan adds, describing the type of message most likely to foster provider support. And finally, Sultan also identifies the major decision primary care must make now that CMS has introduced bundled payments for care coordination tasks.

Listen to this podcast.

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