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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

However difficult, end-of-life care issues need to become an integral part of the public health agenda, according to a new article from the American Journal of Public Health by two Johns Hopkins Bloomberg School of Public Health faculty, advance directives are a critical part of this agenda.

Despite being free, legally binding and readily available, however, too few Americans have completed an advance directive. They need to become routine parts of the conversation between doctors, nurses, and other key health providers and their patients, and viewed as another aspect of preventive care, the authors note.

End-of-life care consumes an estimated 30 percent of Medicare expenditures, and the impact on Medicaid and commercial insurance costs is substantial as well. Increasing the rate of completion of advance directives could conceivably lower these expenses and would do so by respecting patients’ values and wishes.

Want to know what your hospital bill is really charging you for? CMS has now launched a new Web site with detailed information on the charges for services that may be provided during the 100 most common Medicare inpatient stays. The data shows significant variations across the country and within communities in what hospitals charge for these services, CMS officials warn. Even within the same geographic area, hospital charges for similar services can vary significantly. The Web site is part of a new three-part program from the agency to give healthcare consumers more price transparency.

Today's Medicare patients are sicker and have more chronic illnesses, and are driving up the costs of emergency department (ED) care, according to a new report by the American Hospital Association (AHA).

Between 2006 and 2010, the severity of illness of beneficiaries receiving services in the ED increased, as did the rate of use, driving up the intensity of ED care and resources. The report outlines a number of factors that are contributing to this trend, and are detailed in our story.

A proposed Medicare plan that combines hospital, physician, and prescription drug coverage with private supplemental coverage into one health plan could produce savings of $180 billion over a decade and improve care for beneficiaries, according to a new study by researchers at The Johns Hopkins Bloomberg School of Public Health and The Commonwealth Fund.

Under the proposed plan, called "Medicare Essential," Medicare beneficiaries could save a total of $63 billion between 2014 and 2023, with total premium and out-of-pocket costs for beneficiaries estimated to be 17 percent to 40 percent lower than current costs.

According to the article, Medicare Essential would create financial incentives for beneficiaries to select high-quality, cost-effective healthcare services — also known as value-based benefit design. Beneficiaries would be encouraged to choose a primary care physician and providers who meet standards of high value. Beneficiaries selecting such providers would pay lower deductibles and co-pays.

Achieving real cost containment or quality improvement is difficult unless patients and consumers become more active, informed and engaged. How to achieve this? Tailoring your approach towards your low-activation patients and understanding their needs is one way to monitor and create better patient engagement, explains Dr. Judith Hibbard, the professor of health policy at the University of Oregon and the developer of PAM, the Patient Activation Measure®.

And lastly, don’t forget to take our latest e-survey, Healthcare Case Management 2013. Care coordination by healthcare case managers is helping to drive clinical and financial outcomes in population health management and bolster emerging models of care such as the patient-centered medical home and the accountable care organization. Share your organization's case management strategies by May 17 and receive a free executive summary of the compiled results. Your responses will be kept strictly confidential.

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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May 13, 2013
Vol. XV, No. 18

Sponsored by:
Patient Engagement and Provider Collaborations Across the Healthcare Continuum to Improve Care Transitions


This week's industry news:

  1. More Advance Directives Could Better Manage End of Life Care, Medical Costs
  2. Case Management for Advanced Illness
  3. Consumers Beware: Hospital Data Exposes Cost Variations Across Country, Within Communities
  4. Futurescan 2013
  5. Healthcare Business White Paper: Diabetes Management in 2012
  6. Report: Rising Severity of Illness Among Medicare Patients Treated in EDs
  7. New Chart: For Which Primary Diagnosis Is Case Management Most Effective?
  8. 2012 Healthcare Benchmarks: Reducing Avoidable ER
  9. Proposed ‘Medicare Essential’ Plan Could Save Billions, Simplify Benefits and Lower Premiums
  10. Improving Medication Adherence Through the Medical Home Model
  11. Impact of Tailored Coaching on Patient Activation
  12. Guide to Health Coaching
  13. Infographic: How Budget Cuts and New Taxes Affect Med Tech
  14. Care Coordination for Dual Eligibles
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.) More Advance Directives Could Better Manage End of Life Care, Medical Costs

End-of-life care issues need to become an integral part of the public health agenda, according to a new article from the American Journal of Public Health by two Johns Hopkins Bloomberg School of Public Health faculty.

Get the full story.

>>Return to this week's industry news


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

Case Management for Advanced Illness: Best Practices in End-of-Life Care This resource examines the barriers commonly encountered in this highly sensitive stage of the health continuum from the points of view of two industry leaders in the field, and how their programs positively impacted both healthcare utilization and spend.


Learn more about this resource.

>>Return to this week's industry news


3.) Consumers Beware: Hospital Data Exposes Cost Variations Across Country, Within Communities

Consumers can now get an up close look at what hospitals are charging them, according to a new three-part initiative from CMS designed to give healthcare patients more price transparency.

Get the full story.

>>Return to this week's industry news


4.) Futurescan 2013: Healthcare Trends and Implications 2013-2018

Futurescan 2013 This resource highlights eight key trends affecting the nation’s healthcare organizations. The expert insight in these pages is supported by data from a survey of 625 healthcare leaders across the country.



Learn more about this resource.

>>Return to this week's industry news


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.

>>Return to this week's industry news


6.) Report: Rising Severity of Illness Among Medicare Patients Treated in EDs

Today’s Medicare patients are sicker and have more chronic illnesses, and are driving up the costs of emergency department (ED) care, according to a new report by the American Hospital Association (AHA).

Get the full story.

>>Return to this week's industry news


7.) New Chart: For Which Primary Diagnosis Is Case Management Most Effective?

New Chart: For Which Primary Diagnosis Is Case Management Most Effective? According to 29 percent of healthcare companies who responded to HIN's third annual case management survey, diabetes is the top primary diagnosis for which case management is most effective. We wanted to see which other diagnoses case managers are effective at helping patients to manage.

Click here to view the chart.

>>Return to this week's industry news


8.) 2012 Healthcare Benchmarks: Reducing Avoidable ER

2012 Healthcare Benchmarks: Reducing Avoidable ER This resource delivers actionable information from 134 healthcare organizations on their efforts to reduce inappropriate ED visits, and is designed to meet business and planning needs of hospitals, health plans, physician practices and others by providing critical benchmarks that show how the industry is working to reduce avoidable hospital emergency department visits.

Learn more about this resource.

>>Return to this week's industry news


9.) Proposed ‘Medicare Essential’ Plan Could Save Billions, Simplify Benefits and Lower Premiums

A proposed Medicare plan that combines hospital, physician, and prescription drug coverage with private supplemental coverage into one health plan could produce savings of $180 billion over a decade and improve care for beneficiaries, according to a new study by researchers at The Johns Hopkins Bloomberg School of Public Health and The Commonwealth Fund, and published in the May edition of Health Affairs.

Get the full story.

>>Return to this week's industry news

10.) Improving Medication Adherence Through the Medical Home Model

Improving Medication Adherence Through the Medical Home Model This resource prescribes effective tactics and disease-specific success stories for in-house management of medication therapy — from the use of technology to drafting a pharmacist — virtual or co-located — to the medical home team.


Learn more about this resource.

>>Return to this week's industry news


11.) Impact of Tailored Coaching on Patient Activation

Achieving real cost containment or quality improvement is difficult unless patients and consumers become more active, informed and engaged, says Dr. Judith Hibbard, the professor of health policy at the University of Oregon and the developer of PAM, the Patient Activation Measure.

Get the full story.

>>Return to this week's industry news


12.) Guide to Health Coaching

Guide to Health Coaching This resource lays the groundwork for a health coaching initiative, delivering a comprehensive set of 2013 health coaching benchmarks from 150 companies; an examination of integrated coaching’s toolbox of interventions, and much more.


Learn more about this resource.

>>Return to this week's industry news


13.) Infographic: How Budget Cuts and New Taxes Affect Med Tech

Repeated budget cuts and new taxes are affecting the field of MedTech, according to this infographic from the Advanced Medical Technology Association (AdvaMed). This graphic highlights the benefits that MedTech delivers as well as the costly burdens this sector faces, such as a $30 billion medical device excise tax and proposed further cuts to Medicare that would harm patient access to life-changing, life-enhancing medical technology.

Read this blog post.

>>Return to this week's industry news


14.) Care Coordination for Dual Eligibles: A Results-Oriented Approach

Dr. Timothy Schwab SCAN Health Plan's Interdisciplinary Care Team for dual eligibles is a diverse multiprofessional group encompassing many geriatric specialists, explains Dr. Timothy Schwab, chief medical officer of SCAN Health Plan. Dr. Schwab describes some of the challenges of risk stratification in a dual eligible population, and details case management support for the percentage of dual eligibles that require support for disabilities.

Listen to this podcast.

>>Return to this week's industry news


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