HIN logo
From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

An increasing number of hospitals, health plans and other healthcare organizations are using case managers to coordinate care and utilization of healthcare services, according to our 2nd annual Healthcare Case Management e-survey. From overseeing an ER visit or hospital admission/discharge to visits to the patient's home or as a team member in the physician practice, case managers are a key player in achieving patient-centered care. Highlights from this year’s survey are included in this week’s issue. Complete analysis in the 2011 Healthcare Case Management Benchmarks will be available on May 5th. Pre-order your copy today.

New data from CMS last week on its Physician Quality Reporting System illustrates the impact that physician-driven care coordination, accountability and enhanced reimbursement can have on office visits. You’ll also learn the details of a new PCHM pilot set to launch in June that will provide enhanced reimbursement to physicians to fund patient-centered practice transformation.

Your colleague in the business of healthcare,
Patricia Donovan
Editor, Healthcare Business Weekly Update

Please send comments, questions and replies to pdonovan@hin.com.

HIN Associate Editor Jessica Papay
Associate Editor:
Jessica Papay, jpapay@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: 2011 Benchmarks in Healthcare Case Management

2011 Benchmarks in Healthcare Case Management

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 25, 2011
Vol. XIII, No. 16

Sponsored by:
Patient Registries — A Cornerstone in Creating and Delivering Accountable Care

This week's industry news:

  1. PCMH Pilot Program to Improve Care Coordination, Communication Among Physicians
  2. Medical Home Case Studies
  3. Growing Number of Case Managers Oversee Hospital Discharge Process
  4. 2011 Benchmarks in Healthcare Case Management
  5. Healthcare Business White Paper: Medical Tourism
  6. CDC Study Finds Suicide Rates Rise and Fall with Economy
  7. New Chart: What's the ROI from Case Management?
  8. Emergency Room Triage of the Mental Health Patient
  9. Updated Alzheimer's Diagnostic Guidelines Help Diagnose, Treat Disorder Earlier
  10. Identifying Functional Decline in Chronic Care Patients
  11. Participation Growth in Pay-for-Reporting Programs Signals Positive Trend in Quality of Care for Medicare
  12. Guide to Physician Performance-Based Reimbursement
  13. HealthSounds Podcast: A Multi-Faceted Approach for Elderly Patients with Functional Decline
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 Community: Twitter Facebook LinkeIn


Take our monthly e-survey:
Fifth Annual Survey on Patient-Centered Medical Homes

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


This week's industry news

1.) PCMH Pilot Program to Improve Care Coordination, Communication Among Physicians

Highmark Inc. is designing a patient-centered medical home (PCMH) pilot program that encourages physicians to take greater accountability for coordinating care for their patients.

Get the full story.

>>Return to this week's industry news


2.) Medical Home Case Studies: Profiles in the Patient-Centered Approach

Medical Home Case Studies This 100-page special report profiles the efforts of 11 healthcare organizations as they explore the benefits, opportunities and challenges of the patient-centered medical home model from the viewpoints of payor, hospital, physician, nurse practitioner, case manager and C-suite executive. Supplemented with key graphs and data, these case studies provide details on: Disease-specific medical home approaches; multi-payor pilots and collaborations; early ROI in the form of reduced hospital readmissions and healthcare utilization; and much more.

Learn more about this resource.

>>Return to this week's industry news


3.) Growing Number of Case Managers Oversee Hospital Discharge Process

Targeted case management interventions across the health continuum are resulting in more efficient and appropriate care coordination and utilization of healthcare resources. According to HIN’s second annual Healthcare Case Management e-survey conducted in January 2011, while more than a third of case managers work in health plan offices, hospitals are seeing their fair share of these professionals.

Get the full story.

>>Return to this week's industry news


4.) 2011 Benchmarks in Healthcare Case Management: Responsibilities, Results & ROI

2011 Benchmarks in Healthcare Case Management This all-new follow-up to the best-selling 2010 edition provides actionable information from 201 healthcare organizations on the prominence, placement and responsibilities of case managers as well as case management-driven results in healthcare utilization, cost and compliance. This resource contains comparative 2010-over-2011 data on key activities, including the latest ways case managers communicate with the individuals whose care they manage; new metrics on case manager caseload; and much more.

Learn more about this resource.

>>Return to this week's industry news


5.) Healthcare Business White Paper: Medical Tourism — Implications for Participants in the US Health Care System

Medical tourism presents opportunities and threats for health plans, employers, pharmaceutical and device companies, providers, payers and patients. Those who understand the emerging market will be well-positioned to take the initiative and to benefit as the field evolves. The industry is still in a very early stage — and significant changes will transpire over the next few years. The purpose of this white paper is to lay out the issues that US players should begin addressing now and to provide the context in which to evaluate them.

Download this complimentary white paper.

>>Return to this week's industry news


6.) CDC Study Finds Suicide Rates Rise and Fall with Economy

The overall suicide rates rise and fall in connection with the economy, according to a new CDC study. The study is the first to examine the relationships between age-specific suicide rates and business cycles.

Get the full story.

>>Return to this week's industry news


7.) New Chart: What's the ROI from Case Management?

What's the ROI from Case Management? Post-reform redesign of clinical care delivery and supporting reimbursement models reflects the healthcare case manager's dual roles as care coordinator and utilization manager for high-risk, high-cost patients. We wanted to see the ROI generated by case management programs.


Click here to view the chart.

>>Return to this week's industry news


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

Emergency Room Triage of the Mental Health Patient In this resource, one industry expert explains how the community mental health center's system-wide daily conference call helps to balance work and patient flow, encourages creative problem-solving and dramatically reduces staff time spent on diversion of psychiatric ER patients to other facilities. A second expert describes a pilot program placing a psychiatric nurse in the ED, along with the impact of the program on hospital admits, discharges and resource allocation, and ED staff satisfaction and morale.

Learn more about this resource.

>>Return to this week's industry news


9.) Updated Alzheimer's Diagnostic Guidelines Help Diagnose, Treat Disorder Earlier

Clinical diagnostic criteria for Alzheimer’s disease dementia have been revised, and research guidelines for earlier stages of the disease have been characterized to reflect a deeper understanding of the disorder to help diagnose and treat the disease earlier and more effectively.

Get the full story.

>>Return to this week's industry news


10.) Identifying Functional Decline in Chronic Care Patients To Reduce Preventable Healthcare Utilization

Identifying Functional Decline in Chronic Care Patients By identifying changes in functional status, which lead to decline among the elderly population who have various chronic illnesses, healthcare organizations can intervene to prevent emergency room visits and hospital inpatient stays. Fallon Community Health Plan (FCHP), along with the Fallon Clinic, are not only reducing healthcare utilization through this strategy, but also maintaining optimal function and preventing or delaying further decline for these patients and reporting a healthy return on investment on program costs. During this webinar, two experts from FCHP will discuss how they identify Medicare Advantage members at risk of high utilization, the strategies they’ve implemented to reduce this utilization and the outcomes and cost savings achieved by FCHP.

Learn more about this resource.

>>Return to this week's industry news


11.) Participation Growth in Pay-for-Reporting Programs Signals Positive Trend in Quality of Care for Medicare

The increases in participation rates and incentive payment amounts for two Pay-for-Reporting programs show the commitment healthcare providers have in improving the quality and safety of care Medicare beneficiaries receive, according to a new CMS report.

Get the full story.

>>Return to this week's industry news


12.) 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; physician incentives and payments; and program outcomes. This 60-page special report also examines the collection and sharing of physician performance data by these four organizations.

Learn more about this resource.

>>Return to this week's industry news


13.) HealthSounds Podcast: A Multi-Faceted Approach for Elderly Patients with Functional Decline

Patricia Zinkus Susan Legacy Functional decline in an elderly person can be the first indicator of a chronic condition ready to snowball out of control. Patricia Zinkus, director of case management at Fallon Community Health Plan, and Susan Legacy, FCHP’s senior manager of case management, describe how their collaborative multidisciplinary intervention monitors for these changes, and why the program's social component is just as critical as home visits and case management outreach.

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 1997-2011 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