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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Geisinger, Bon Secours and Baptist Medical Center, all frequent contributors to HIN, have facilities named to the list of top 100 hospitals in Thomson Reutersí annual study. Determined by publicly available information from such sites as the CMS Hospital Compare Web site, and judged on such factors as patient safety and satisfaction, profitability, adherence to clinical standards of care and readmission rates, the top 100 facilities were selected from nearly 3,000 short-term, acute-care, non-federal hospitals.

Those readmission rates may be misleading, however. According to a new report from the UCSF Medical Center, publicly reported all-cause hospital readmission rates include scheduled readmissions and readmissions that have nothing to do with the original admission. This finding is particularly troubling for spinal surgeons, who often have to stage multiple surgeries to ensure safety and healing. Researchers hope the inaccuracies, which can affect hospital ratings and public perception, donít adversely affect surgeons as well. More in this issue.

Also publicly available is a new consumer assessment tool from CMS. On the Home Health Care Web site, consumers can now review patientsí responses to the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey about care they received in Medicare-certified home health agencies. Data on overall care, their providersí communication skills, and safety will be updated every 4 months.

And lastly, Medicare Part D beneficiaries with CV conditions falling between the cracks, or ďdonut holeĒ of financial coverage between 2006 and 2007 generally stopped taking their medications, instead of buying cheaper, generic alternatives, as opposed to those with consistent drug coverage, says a new study from Harvard University, Brigham and Womenís Hospital and CVS Caremark. Researchers stated that CV medications account for the largest proportion of spending and volume in the Part D program. The effects of this discontinuation are twofold: the short-term effects of stoppage didnít result in any negative impacts; but the long-term effects were unclear.

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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Reducing Avoidable ER Visits 2012

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April 23, 2012
Vol. XIV, No. 15

Sponsored by:
Recruiting, Training and Case Load Management Strategies for Embedded Case Managers

This week's industry news:

  1. 30-Day Hospital Readmission Rates Inaccurate: Study
  2. Population Health Management Tools for ACOs
  3. Medicare "Donut Hole" Leads to Sharp Drop in CV Medication Adherence: Study
  4. Guide to Improving Medication Adherence
  5. Healthcare Business White Paper: Diabetes Management in 2012
  6. 3 Key Questions to Ask ED Patients to Reduce Utilization
  7. New Chart: Incentive Milestones in Health Coaching
  8. 5 Interventions to Reduce Avoidable ER Use by the Medicaid Population
  9. CMS Publishes Patient Responses to Home Health Agency Surveys
  10. Care Transitions Toolkit
  11. Geisinger, Bon Secours, Baptist Among Thomson Reuters' Top Hospitals
  12. Case Study in Bundled Payments
  13. Patient Interaction Key to Evidence-Based Health Coaching
  14. HealthSounds Podcast: Embedded Case Management at Bon Secours
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This week's industry news

1.) 30-Day Hospital Readmission Rates Inaccurate: Study

Publicly reported all-cause hospital readmission rates may be inaccurate because they do not distinguish between planned and unplanned surgeries for complications, according to a recent report from the UCSF Medical Center.

Get the full story.

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

Population Health Management Tools for ACOs This 40-page resource examines the building blocks of population health management that drive improvements in healthcare quality and efficiency in ACOs — while positioning healthcare organizations for core measure improvement and increased reimbursement.


Learn more about this resource.

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3.) Medicare "Donut Hole" Leads to Sharp Drop in CV Medication Adherence: Study

Medicare Part D beneficiaries with cardiovascular (CV) conditions whose coverage ended during the "donut hole" period in 2006 and 2007 were 57 percent more likely to discontinue their CV medications than those beneficiaries who had consistent drug coverage, according to researchers from Harvard University, Brigham and Women's Hospital and CVS Caremark.

Get the full story.

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4.) Guide to Improving Medication Adherence

Guide to Improving Medication Adherence This 150-page resource analyzes trends in improving medication adherence at more than 160 healthcare companies, and takes an in-depth look at pioneering efforts by Kaiser Permanente Colorado and CIGNA Pharmacy Management to improve medication compliance levels in their populations.

Learn more about this resource.

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5.) Healthcare Business White Paper: 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.) 3 Key Questions to Ask ED Patients to Reduce Utilization

Establishing when a patient first had problems, and when they needed to go to the ED, are two questions that help physicians establish a timetable, a particularly valuable tool with the Medicaid population, who utilize the ED twice as often as their insured counterparts, largely because of primary care access barriers, says Mina Chang, Ph.D., chief of the health services research and program development section of the Bureau of Health Services Research for the Ohio Department of Job and Family Services.

Get the full story.

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7.) New Chart: Incentive Milestones in Health Coaching

Incentive Milestones in Health Coaching Health and wellness coaching services allow payors, employers and even healthcare providers the chance to engage individuals in self-management of chronic illness, reducing healthcare spend and improving health outcomes and productivity in the process. We wanted to see for which actions incentives are offered in health coaching programs.

Click here to view the chart.

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8.) 5 Interventions to Reduce Avoidable ER Use by the Medicaid Population

5 Interventions to Reduce Avoidable ER Use by the Medicaid Population This 25-page resource looks at the collaborative effort among five regions of Ohio to target the key reasons for avoidable ER visits among Medicaid beneficiaries and roll out test interventions in a rapid cycle quality improvement approach. It describes the 18-month population-based and patient-centered pilot to curtail wasteful healthcare utilization in Ohio ERs, especially by those Medicaid beneficiaries identified as "Ultra Utilizers."

Learn more about this resource.

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9.) CMS Publishes Patient Responses to Home Health Agency Surveys

Consumers can now compare results from home health agencies' patient surveys, according to the CMS. Results from the national survey on the efficacy of Medicare-certified home health agencies are available on CMS's Quality Care Finder Web site.

Get the full story.

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10.) Care Transitions Toolkit

Care Transitions Toolkit This valuable resource examines current and emerging trends in care transition management, providing actionable data and case studies from industry thought leaders on key elements of their care transition programs.

Learn more about this resource.

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11.) Geisinger, Bon Secours, Baptist Among Thomson Reuters' Top Hospitals

Geisinger Medical Center, Bon Secours Health Systems and Baptist Medical Center are among the top 100 hospitals in the country for organizational performance, according to Thomson Reuters' annual 100 Top Hospitals® study.

Get the full story.

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12.) Case Study in Bundled Payments: The Baptist Health System Experience

Case Study in Bundled Payments This 24-page report documents the care payment experience of Baptist Health System in the CMS ACE demonstration pilot, which aligned payment for services delivered across episodes of care or "bundled" care. ACE focused on the cardiac and orthopedic diagnosis-related group (DRGs), two of the public payor's most frequent and largest cost disease areas.


Learn more about this resource.

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13.) Patient Interaction Key to Evidence-Based Health Coaching

How a health coach interacts with and engages their clients can affect their compliance and outcomes, explains Melinda Huffman, partner in Miller and Huffman Outcome Architects, co-founder of the National Society of Health Coaches, and a cardiovascular clinical specialist, writer and author. We recently spoke with Melinda about what led her into the field of health coaching, how itís changed over the years, and some of the trends she will lock onto for 2012.

Read this blog post.

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14.) HealthSounds Podcast: Embedded Case Management at Bon Secours

Irene Zolotorofe When looking for new hires for its embedded case management program, Bon Secours Health System looks for critical thinking skills and previous roles that are transferable, such as work with chronic disease patients, explains Irene Zolotorofe, administrative director of clinical operations at Bon Secours. Zolotorofe also describes the importance of matching personalities when placing a case manager in a physician practice, how to build a trusting relationship between an embedded case manager and the physician and Bon Secour's embedded case manager training process.

Listen to this podcast.

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