HIN logo
From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Smokers cost more.

Thatís the bottom line from a new report from Ohio State University, the first study to take a comprehensive look at the financial burden for companies that employ smokers.

According to the study, U.S. businesses pay almost $6,000 per year extra for each employee who smokes, compared to the costs for employing workers who never smoked. Broken down, researchers estimated that lost productivity from smoke breaks cost employers more than $3,000 a year, by far, the largest drain on resources; extra healthcare costs for self-insured smokers came to $2,056; absenteeism from smoking cost $517 a year, and even presenteeism, or reduced productivity related to the effects of nicotine addition, cost $462 annually.

The study focuses solely on economics and does not address ethical and privacy issues related to the adoption of workplace policies covering employee smoking. Increasingly, businesses have adopted tobacco-related policies that include requiring smokers to pay premium surcharges for their healthcare benefits or simply refusing to hire people who identify themselves as smokers. And while researchers acknowledge that providing smoking-cessation programs is an added cost for employers, they stress that employers recognize how difficult it is to quit smoking.

More bad news for smokers: those who otherwise maintain a healthy lifestyle will die sooner than those who do not.

According to a new study from Johns Hopkins University, exercising regularly, eating a healthy Mediterranean-style diet, maintaining a normal weight and, most importantly, not smoking can help improve heart health and reduce the risk of death.

Researchers found that adopting those four lifestyle behaviors protected against coronary heart disease as well as the early buildup of calcium deposits in heart arteries, and reduced the chance of death from all causes by 80 percent over an eight-year period.

Of all the lifestyle factors, researchers found that smoking avoidance played the largest role in reducing the risk of coronary heart disease and mortality. Smokers who adopted two or more of the healthy behaviors still had lower survival rates after 7.6 years than did nonsmokers who were sedentary and obese.

The findings corroborate recent recommendations by the American Heart Association, which call for maintaining a diet rich in vegetables, fruits, nuts, whole grains and fish, keeping a Body Mass Index (BMI) of less than 25, being physically active and not smoking, researchers note.

Some bad news, or food for thought, for those policymakers not planning on expanding Medicaid in their states: they will leave millions of their residents without health insurance and increase spending, at least in the short term, on the cost of treating uninsured residents, according to a new RAND Corporation study.

If 14 states decide not to expand Medicaid under the ACA as intended by their governors, those state governments collectively will spend $1 billion more on uncompensated care in 2016 than they would if Medicaid is expanded, researchers say. In addition, those 14 state governments would forgo $8.4 billion annually in federal payments and an additional 3.6 million people will be left uninsured.

States that do not expand Medicaid will not receive the full benefit of the savings that will result from providing less uncompensated care, researchers note. But they will be subject to taxes, fees and other revenue provisions of the ACA.

And lastly, commercial payors arenít offering as many upside-only payment structures that are most popular among early accountable care organizations (ACOs), according to an analysis by the Premier Healthcare Alliance.

The study of 85 payor arrangements found that more than one-third were for upside-only shared savings, most of which fall within the Medicare Shared Savings Program (MSSP) or Medicare Advantage (57 percent).

Other upside-only options were reported with Medicaid (7 percent), provider-owned plans (7 percent) and self-insured employers (7 percent).

However, upside arrangements are lacking in commercial markets. Among the ACOs analyzed, only 21 percent of commercial arrangements offer upside shared savings, and these were clustered in just four markets. In addition, agreements tended to be smaller in scope, usually for 5,000 covered lives or less.

Donít forget to fill out our third comprehensive e-survey on Telehealth. More than 10 million Americans directly benefited from a telemedicine service during the past year, likely double the number from just three years ago, according to American Telemedicine Association estimates. Telehealth's broad reach encompasses telemedicine — the use of telecommunications technology to deliver clinical diagnosis, services and patient consultations — as well as the exploding field of mobile health.

Tell us how you're applying telehealth by June 30, 2013 and receive a free executive summary of the compiled results.

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

>>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: Accountable Care Organizations in 2012 — ACO Participation Doubles in 12 Months

Accountable Care Organizations in 2012 — ACO Participation Doubles in 12 Months

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

June 10, 2013
Vol. XV, No. 21

Sponsored by:
Health Coachingís Value in Accountable Care and Medical Homes


This week's industry news:

  1. Study: Companies Pay Almost $6,000 Extra Annually for Employees That Smoke
  2. 2012 Healthcare Benchmarks: Health & Wellness Incentives
  3. 4 Healthy Behaviors Will Reduce Risk of Death, Heart Disease
  4. 38 Disease Management Metrics
  5. Healthcare Business White Paper: Care Transitions in 2013
  6. States That Donít Expand Medicaid Will Increase Costs Treating Uninsured Residents: Study
  7. New Chart: Greatest Challenges of mHealth
  8. 5 Interventions to Reduce Avoidable ER Use by the Medicaid Population
  9. Commercial Payors Lag Behind Medicare in Offering ACOs Shared Savings Agreements
  10. Guide to Physician Performance-Based Reimbursement
  11. Can We Talk? Pharmacists Playing Key Role in Improving Medication Adherence
  12. Guide to Improving Medication Adherence
  13. Infographic: Practice Profitability
  14. Physician Hospital Organizations
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 Online Communities:

Twitter Facebook LinkedIn YouTube Pinterest


Take our monthly e-survey:
Telehealth in 2013

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

Interested in all open surveys? Review them here.


This week's industry news

1.) Study: Companies Pay Almost $6,000 Extra Annually for Employees That Smoke

U.S. businesses pay almost $6,000 per year extra for each employee who smokes compared to the costs for employing workers who never smoked, according to a new study from Ohio State University published in the journal Tobacco Control.

Get the full story.

>>Return to this week's industry news


2.) 2012 Healthcare Benchmarks: Health & Wellness Incentives

2012 Healthcare Benchmarks: Health & Wellness Incentives This resource provides actionable information from 136 healthcare organizations on the use of incentives to promote health behavior change. Now in its fourth year, this report is designed to meet business and planning needs of health plans, employers, human resource executives, managed care organizations, hospitals and others by providing critical benchmarks in incentives use and impact.

Learn more about this resource.

>>Return to this week's industry news


3.) 4 Healthy Behaviors Will Reduce Risk of Death, Heart Disease

Exercising regularly, eating a healthy Mediterranean-style diet, maintaining a normal weight and, most importantly, not smoking can help improve heart health and reduce the risk of death, according to a new study from Johns Hopkins University.

Get the full story.

>>Return to this week's industry news


4.) 38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care

38 Disease Management Metrics This resource provides a series of 38 graphs and charts, diving deep into several years of market research to document the role and outcomes of disease management in 11 key areas, as well as the high-focus diseases and health conditions of obesity, weight and diabetes management initiatives.

Learn more about this resource.

>>Return to this week's industry news


5.) Healthcare Business White Paper: Care Transitions in 2013 — Interventions Surge in Response to Payor Scrutiny; Home-Grown Approaches Trump Traditional Models

Care Transitions in 2013 In its third annual e-survey on Care Transition Management, the Healthcare Intelligence Network (HIN) captured efforts by 86 organizations to strive for Triple Aim goals of better care at improved cost during transitions of care. Conducted in April 2013, the survey measures existing and planned programs, targeted transitions and populations, transition team members and responsibilities, and much more. This HINtelligence Report provides data highlights on care transition program components, the most successful tools for care transition management, results and ROI; and much more.

Download this complimentary white paper.

>>Return to this week's industry news


6.) States That Donít Expand Medicaid Will Increase Costs Treating Uninsured Residents: Study

States that choose not to expand Medicaid under federal healthcare reform will leave millions of their residents without health insurance and increase spending, at least in the short term, on the cost of treating uninsured residents, according to a new RAND Corporation study.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Greatest Challenges of mHealth

New Chart: Greatest Challenges of mHealth The use of mobile health (mHealth) technologies to monitor health is revolutionizing the exchange and consumption of healthcare data. From mobile apps that monitor blood sugar and heart rhythms to text-based medication reminders, mHealth technologies could save from $1.96 billion to $5.83 billion in healthcare costs by the year 2014, some studies indicate. We wanted to see the greatest challenges of mHealth implementation.

Click here to view the chart.

>>Return to this week's industry news


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

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


Learn more about this resource.

>>Return to this week's industry news


9.) Commercial Payors Lag Behind Medicare in Offering ACOs Shared Savings Agreements

Commercial payors arenít offering as many upside-only payment structures that are most popular among early accountable care organizations (ACOs), according to an analysis by the Premier Healthcare Alliance.

Get the full story.

>>Return to this week's industry news

10.) 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 in use; physician incentive payments and program outcomes.

Learn more about this resource.

>>Return to this week's industry news


11.) Can We Talk? Pharmacists Playing Key Role in Improving Medication Adherence

The role of the retail pharmacist as hovering behind a counter unaccessible to all is a distant memory, says Dr. Janice Pringle, director of the program evaluation research unit at the University of Pittsburgh School of Pharmacy. The pharmacist is progressively becoming a key part of the movement to improve medication adherence by communicating more with patients and conducting screening and brief intervention (BI) techniques, as a way to detect potential non-adherence issues.

Get the full story.

>>Return to this week's industry news


12.) Guide to Improving Medication Adherence

Guide to Improving Medication Adherence This 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. Additionally, Connie Commander, past president of the Case Management Society of America and president of Commanders Premier Consulting Corporation, shares a case managerís take on whatís needed to move individuals toward medication compliance.

Learn more about this resource.

>>Return to this week's industry news


13.) Infographic: Practice Profitability

Physicians are almost two-thirds more likely to see their practice profitability trending down in the next year, according to new report, the Practice Profitability Index. An infographic based on the report data describes the key reasons practice profitability is trending down, including declining reimbursements, rising costs and coding and billing challenges, as well as the impact felt by practices from the Affordable Care Act.

Read this blog post.

>>Return to this week's industry news


14.) Physician Hospital Organizations: Developing a Collaborative Structure for Shared Savings Agreements

Greg Mertz Travis Ansel Physician-hospital organizations have been around before, but it's the emphasis on quality that sets today's PHO apart from the 80's version. In PHO 2.0, where healthcare value is favored over volume, clinical integration of participating physicians is a prerequisite, agree Greg Mertz, director of Healthcare Strategy Group, and Travis Ansel, its manager of strategic services. In this interview, they talk about the essential first steps of PHO creation and the perennial challenges of physician engagement and clinical leadership in this emerging collaborative model.

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 1997-2013 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