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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

Functional decline often triggers high healthcare utilization in the elderly. A new program at Fallon Community Health Plan profiled in this issue identifies early signs of functional decline with the intent of reducing avoidable utilization in this population.

Dr. Barbara Walters, Dartmouth Hitchcock senior medical director, returned to HIN last week to describe Dartmouth Hitchcock's path from medical home to accountable care organization, a journey aided by participation in the CMS Physician Group Practice (PGP) demo. Read the highlights in the HIN blog.

Can't get no (patient) satisfaction? Take this month's e-survey on improving patient satisfaction and learn how your colleagues are enhancing the patient experience.

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 Editors:
Jessica Papay, jpapay@hin.com

Cheryl Miller,
cmiller@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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This week's featured download: 2011 Benchmarks in Accountable Care Organizations

2011 Benchmarks in Accountable Care Organizations

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June 6, 2011
Vol. XIII, No. 21

Sponsored by:
Reducing Avoidable ER Visits by Medicaid Patients Through Quality-Based Interventions

This week's industry news:

  1. National Study to Examine Best Practices in Home Health to Reduce Re-Hospitalizations
  2. Reducing Readmissions
  3. Technology Firm Announces EHR For Locally Forming ACOs
  4. Blueprint for ACO Success
  5. Healthcare Business White Paper: 2011 Benchmarks in Health & Wellness Incentives
  6. Identifying Functional Decline in High-Utilizing Medicare Advantage Patients
  7. New Chart: Who Generates Unnecessary ED Visits?
  8. Guide to Reducing Medicare Readmissions, Vol. II
  9. John Hopkins Medicine, Walgreens Collaborate on Population-Based Research and Chronic Disease Patient Protocols
  10. Disease Management and Wellness in the Post-Reform Era
  11. HHS to Reduce Premiums, Simplify Enrollment for Individuals with Pre-Existing Conditions
  12. Health Reform 2011
  13. HealthSounds Podcast: Leveraging Population Health Management To Meet ACO Efficiency Metrics
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.) National Study to Examine Best Practices in Home Health to Reduce Re-Hospitalizations

Delta Health Technologies is launching a national study to identify best practices being used by homecare’s most successful agencies in reducing unplanned hospital readmissions.

Get the full story.

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2.) Reducing Readmissions: Interventions, Incentives and Infrastructure

Reducing Readmissions: Interventions, Incentives and Infrastructure This essential 50-page special report presents case studies from three healthcare organizations whose efforts have significantly reduced avoidable hospital readmissions in high-risk populations and include the alignment of financial incentives to readmission rates.

Learn more about this resource.

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3.) Technology Firm Announces EHR For Locally Forming ACOs

Soren Technology will support several locally forming Accountable Care Organizations (ACOs) with its EHR system in order to improve patient care and communication.

Get the full story.

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4.) Blueprint for ACO Success: Clinical, Quality and Compliance Considerations for an Accountable Care Organization

Blueprint for ACO Success This 40-page resource will prepare healthcare organizations considering an ACO for clinical and regulatory success. Areas covered include anticipating the mandates of the CMS Shared Savings program; achieving and maintaining compliance with state and federal regulations governing healthcare while positioning for possible changes; developing a multi-disciplinary compliance approach; and creating policies and procedures for ongoing compliance monitoring.

Learn more about this resource.

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5.) Healthcare Business White Paper: 2011 Benchmarks in Health & Wellness Incentives

Benefit-based incentives are proving most successful at effecting positive health behavior change, according to the third annual Health & Wellness Incentives e-survey conducted by the Healthcare Intelligence Network. This white paper summarizes responses from 156 healthcare organizations to the March 2011 survey.

Download this complimentary white paper.

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6.) Identifying Functional Decline in High-Utilizing Medicare Advantage Patients

Fallon Community Health Plan's Home Run program provides care for high-utilizing Medicare Advantage patients at home, with the goal of reducing preventable hospital SNF admissions, readmissions and ER visits, according to Pat Zinkus, FCHP director of case management, and Susan Legacy, FCHP senior manager of case management.

Get the full story.

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7.) New Chart: Who Generates Unnecessary ED Visits?

Who Generates Unnecessary ED Visits? As consumers and payors take on greater responsibility for the efficiency of the healthcare system, healthcare organizations are targeting avoidable emergency room use. We wanted to see which populations hold the biggest responsibility for unnecessary ED visits.

Click here to view the chart.

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

Guide to Reducing Medicare Readmissions The Guide to Reducing Medicare Readmissions, Vol. II examines winning strategies to reduce preventable admissions, rehospitalizations and ER visits by high-utilizing Medicare beneficiaries. In particular, this guide details interventions launched at critical patient handoffs, a program to identify functional decline in the elderly, one of the hallmarks of high utilization, and an effort to improve medication adherence through community pharmacists.

Learn more about this resource.

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9.) John Hopkins Medicine, Walgreens Collaborate on Population-Based Research and Chronic Disease Patient Protocols

Johns Hopkins Medicine (JHM) and Walgreens are to develop large scale population-based research ideas and protocols to improve the outcomes of patients with diseases like asthma, diabetes, high blood pressure, obesity and heart disease.

Get the full story.

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10.) Disease Management and Wellness in the Post-Reform Era

Disease Management and Wellness This valuable resource charts the rapidly changing course care management and health promotion programs will take over the next several years, as they adjust to reform-law requirements and new tools like social marketing Web sites. This 164-page guide includes chapters on health reform, medical homes, wellness incentives, behavior change, social media, outcomes measurement, behavioral economics, coordinated care, build-versus-buy decisions, building internal disease management programs, improving Medicare star quality ratings, and more.

Learn more about this resource.

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11.) HHS to Reduce Premiums, Simplify Enrollment for Individuals with Pre-Existing Conditions

Americans with pre-existing health conditions will now have an easier time getting health insurance. HHS has announced plans to reduce premiums and make it easier for Americans to enroll in the pre-existing condition insurance plan (PCIP).

Get the full story.

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12.) Health Reform 2011: Impact on Health Plans, Hospitals, Providers and Purchasers

Health Reform 2011 In this valuable resource, insiders close to HHS and in leadership positions at health plans, provider organizations and PBMs identify the strategic impact of the reform law across all sectors of the industry, and the business implications and compliance issues raised by new rules covering dozens of topics — from dependent coverage expansions and high-risk pools to bans on pre-existing condition exclusions and annual and lifetime limits.

Learn more about this resource.

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13.) HealthSounds Podcast: Leveraging Population Health Management To Meet ACO Efficiency Metrics

>Dr. Barbara Walters As one of 10 participants in the CMS Physician Group Practice Demonstration, Dartmouth-Hitchcock has developed a competency in population health management that is being deployed in current and planned ACO pilots. Dr. Barbara Walters, Dartmouth-Hitchcock’s senior medical director, describes how the CMS demo experience provided the building blocks for an ACO, the impact of its pilots on Medicare utilization and costs, and the critical elements in managing population health in an ACO.

Listen to this podcast.

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