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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Hospitals are getting a raise, of sorts. CMS has proposed a rule that would update Medicare payment policies and increase rates for inpatient stays at general acute care and long term care hospitals. The ruling, if finalized, is designed to strengthen patient care and promote quality over volume, CMS officials say. Included are quality measures regarding hospital-acquired infections, and a new HCAHPS survey measure regarding care transitions. Public input will be accepted until June 25th.

Care transitions is the subject of a new report from Avalere Health for the Alliance of Community Health Plans. It proposes five ways to enhance the transition from hospital to home. Among them: engaging patients early on in their transition period, prior to discharge, and encouraging providers to become program partners. Health systems whose transition programs are perceived favorably are also mentioned in the report; details in this issue.

The chronically ill are the target of a new Commonwealth Fund report, which seeks to launch a care plan over the next 12 months in 50 to 100 communities around the country that have significant concentrations of patients with multiple chronic conditions and high medical costs. Such a plan could save $184 billion in health spending over the next 10 years, commission officials say.

Text message reminders to parents about flu vaccinations may help boost the number of children vaccinated, according to a recent report from Columbia University Medical Center and New York-Presbyterian Hospital. Texting is considered an effective tool given its ability to reach large numbers of people, researchers say. The study focused on hard-to-reach, low-income, urban children and adolescents, because they are more at risk for acquiring influenza due to their crowded living conditions. And while a higher percentage of families receiving the message did vaccinate their children, overall, vaccination rates remain low.

This might be good news to a group of Vermont-based residents advocating against a law that would make vaccinations in their state mandatory. According to a recent story from ABC World News the debate over the bill has divided Vermont's families over the benefits and risks of vaccines. It has also pitted the state House — whose majority voted down the bill — against the state Senate, which voted to approve it. The debate will most likely continue, lawmakers say.

And lastly, if you havenít already, please take part in our second annual Accountable Care Organizations survey. The last 12 months have been a hotbed of ACO activity. In addition to the many private pilots of this collaborative care model, CMS kicked off its Medicare Shared Savings Program on April 1. Participants get a FREE executive summary of the compiled results and year-over-year ACO trends.

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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April 30, 2012
Vol. XIV, No. 16

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

This week's industry news:

  1. Commonwealth Plan to Improve Care For Chronically Ill Could Save $184 Billion Over Next 10 Years
  2. Comorbidity Care Models
  3. 5 Key Practices of Successful Hospital-to-Home Transitions
  4. Leveraging Case Management Tools and Technology to Improve Outcomes
  5. Healthcare Business White Paper: 2011 Benchmarks in Accountable Care Organizations
  6. Text Message Reminders May Get More Parents to Vaccinate Kids Against Flu
  7. New Chart: Ways to Curb Avoidable ER Visits by Recently Discharged Patients
  8. Three Pillars of Health Coaching
  9. Case Managers Migrating to Primary Care Offices in Greater Numbers, Finds Survey
  10. 2012 Healthcare Benchmarks: Healthcare Case Management
  11. CMS Proposes Increased Hospital Fees for Improved Patient Care; HAI Reduction Key Incentive
  12. Guide to Reducing Medicare Readmissions, Vol. II
  13. New HCAHPS Measure Would Evaluate Quality of Care Transitions
  14. HealthSounds Podcast: Reducing Avoidable Medicaid ER Visits With a Community Partnership Approach
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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This week's industry news

1.) Commonwealth Plan to Improve Care For Chronically Ill Could Save $184 Billion Over Next 10 Years

A new community-based plan targeting the chronically ill with care quality improvement efforts could save $184 billion in health spending over the next 10 years, says the Commonwealth Fund.

Get the full story.

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2.) Comorbidity Care Models: Integrated Action Plans for Complex Healthcare Needs

Comorbidity Care Models In this 38-page special report, two industry thought leaders, including Dr. Chad Boult, present Guided Care, an emerging model of care for older multi-morbid patients that is demonstrating early success in improving quality of life and efficiency of healthcare utilization for this population.

Learn more about this resource.

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3.) 5 Key Practices of Successful Hospital-to-Home Transitions

Hospital-to-home transitions can be improved by encouraging coordination among providers and health plans, and directly engaging with patients early in the transition process, says a new report from Avalere Health for the Alliance of Community Health Plans (ACHP).

Get the full story.

>>Return to this week's industry news


4.) Leveraging Case Management Tools and Technology to Improve Outcomes

Leveraging Case Management Tools and Technology to Improve Outcomes During this webinar, Karen Black, RN, HIPAAP, quality improvement coordinator for Arkansas Blue Cross Blue Shield, shared how two Web-based tools fit into the case manager's workflow and the key features that are directly attributed to improvements in patient care delivery.

Learn more about this resource.

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5.) Healthcare Business White Paper: 2011 Benchmarks in Accountable Care Organizations

A significant segment of the healthcare industry is reframing its care delivery structure as an accountable care organization (ACO) or will do so in the near future, according to new market research by the Healthcare Intelligence Network. This white paper summarizes awareness of and readiness for ACOs at 228 healthcare organizations, based on their responses to a February 2011 ACO Readiness Assessment. This research was conducted before CMS released its proposed rule governing ACOs.

Download this complimentary white paper.

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6.) Text Message Reminders May Get More Parents to Vaccinate Kids Against Flu

Text message reminders to parents about flu vaccinations may help boost the number of children vaccinated, according to researchers at Columbia University Medical Center and New York-Presbyterian Hospital. But overall vaccination rates remain low.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Ways to Curb Avoidable ER Visits by Recently Discharged Patients

Ways to Curb Avoidable ER Visits by Recently Discharged Patients Programs to help reduce avoidable ER visits are up 3 percent over 2010, according to a recent Healthcare Intelligence Network survey on this topic. We wanted to see which strategies organizations are using to curb avoidable ER visits by recently discharged patients.

Click here to view the chart.

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8.) Three Pillars of Health Coaching: Patient Activation, Motivational Interviewing and Positive Psychology

Three Pillars of Health Coaching This 57-page report provides the fundamentals of three essential tools that health coaches can use to measure and monitor activation levels, elicit behavior change, move clients along the path to self-management and have a positive impact on health outcomes and utilization.

Learn more about this resource.

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9.) Case Managers Migrating to Primary Care Offices in Greater Numbers, Finds Survey

The third annual Healthcare Case Management e-survey by the Healthcare Intelligence Network probed for specifics in three new areas: trends in embedded case management, including work locations of co-located case managers and the greatest challenges and benefits of embedding case manager at the point of care; clinical conditions targeted by case managers, and preferred case management certifications.

Get the full story.

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10.) 2012 Healthcare Benchmarks: Healthcare Case Management

2012 Healthcare Benchmarks: Healthcare Case Management This 60-page, third annual analysis of healthcare case management trends provides actionable information from 152 healthcare organizations on the prominence, placement and responsibilities of case managers as well as case management-driven results in healthcare utilization, cost and compliance.

Learn more about this resource.

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11.) CMS Proposes Increased Hospital Fees for Improved Patient Care; HAI Reduction Key Incentive

In a move designed to improve patient care and reduce overall Medicare spending, CMS is proposing to update Medicare payment policies and increase rates for inpatient stays at general acute care and long-term care hospitals.

Get the full story.

>>Return to this week's industry news


12.) Guide to Reducing Medicare Readmissions, Vol. II

Guide to Reducing Medicare Readmissions, Vol. II This 100-page 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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13.) New HCAHPS Measure Would Evaluate Quality of Care Transitions

Beginning in January, patients discharged from the hospital could be asked three key questions to assess the quality of their care transitions, as part of a proposed new measure in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey.

Read this blog post.

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14.) HealthSounds Podcast: Reducing Avoidable Medicaid ER Visits With a Community Partnership Approach

Laura Linebach Anxiety caused by the wait for a non-urgent appointment or lack of awareness that they are assigned a primary care physician are just two barriers to appropriate ER utilization by a diverse Medicaid population, explains Laura Linebach, director of quality improvement at L.A. Care Health Plan. As part of a health plan-hospital collaboration with a goal of reducing non-acute ER use by children ages 1 to 19, L.A. Care Health Plan has launched a Nurse Advice Line and developed a range of materials to educate parents about appropriate use of the ER. Ms. Linebach describes these tools as well as a metric in L.A. Care Health Plan's pay for performance program that measures group providers' appropriate resource use.

Listen to this podcast.

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