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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Beginning this week, I'm taking the reins of the HBWU.

In a move that could redefine the quality measurement landscape and increase transparency for stakeholders, CMS has proposed rules that will grant qualified organizations access to patient-protected Medicare data for use in provider performance reports. These vetted companies will combine Medicare claims data from CMS with private sector claims data to help consumers more easily identify hospitals and doctors providing the highest quality, cost-effective care.

We also report this week on a project that could transform patients' perceptions of cellphone use — a new mobile application to encourage simple lifestyle changes through personalized expert guidance for individuals with diabetes and pre-diabetes. The mobile device is transformed into a virtual coach that personally guides users to better health through healthier nutrition, fitness, weight loss and tips on self-management. Itís part of an emerging mHealth technology that has important implications for healthcare not just here, but in the developing world as well. You can read more about it here, and in our HIN blog.

And to get employees away from their phones, we've published the results of our third annual Health and Wellness Incentives Use e-survey, which shows that benefits-based incentives, like offering to reduce employees' health premiums, will encourage them to adopt healthier behaviors. And a gift card to Starbucks wouldn't hurt, either.

Lastly, if you've been waiting to make any move at all toward applying for CMS' Pioneer ACO Model, procrastinators take note: you get a few more weeks to file your applications. CMS has extended its deadlines, so you now have an additional month — until August 19th — to submit your applications. More details here.

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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June 13, 2011
Vol. XIII, No. 22

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

This week's industry news:

  1. CMS Clarifies Pioneer ACO Model, Extends Application Dates
  2. Health Insurance Exchanges
  3. App Transforms Mobile Device into Virtual Coach for Diabetes and Prediabetes Patients
  4. Health Coaching Benchmarks, 2010 Edition
  5. Healthcare Business White Paper: An Integrated Care Program For Chronically Ill and High-Cost Patients
  6. CMS Redefines Quality Measurement with Proposed Release of Medicare Claims Data
  7. New Chart: Top 5 Behavior Change Models in Health Coaching
  8. Healthcare Performance Improvement
  9. New Market Research Finds Benefit-Based Incentives Best for Behavior Change
  10. Benchmarks in Health & Wellness Incentives, 2011 Edition
  11. One-Third of Employers Could Drop Healthcare Coverage in 2014
  12. Healthcare Trends & Forecasts in 2011
  13. HealthSounds Podcast: Ohio Collaborative Reduces Avoidable ER Visits Among Medicaid Population
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.) CMS Clarifies Pioneer ACO Model, Extends Application Dates

CMS has clarified the Pioneer Accountable Care Organization (ACO) model, and extended the deadlines for the program's required letter of intent and application.

Get the full story.

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2.) Health Insurance Exchanges: Strategies and Stakeholders

Health Insurance Exchanges: Strategies and Stakeholders More than any other provision of the reform law, state health insurance exchanges will forever change the way individuals and small businesses purchase health insurance by making coverage more of a retail commodity. And while there are huge risks, the potential rewards are unprecedented. In this valuable resource, youíll read about the hurdles states are facing in developing models and establishing exchanges. It will provide you with timely insights on how they may operate, what the products will look like, which health insurers will participate and who will enroll.

Learn more about this resource.

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3.) App Transforms Mobile Device into Virtual Coach for Diabetes and Prediabetes Patients

Four organizations will test an innovative mHealth approach to lifestyle and self-management of diabetes and prediabetes — a new mobile application to encourage simple lifestyle changes through personalized expert guidance.

Get the full story.

>>Return to this week's industry news


4.) Health Coaching Benchmarks, 2010 Edition: Operations and Performance Data for Optimal Program ROI and Participant Health Status

Health Coaching Benchmarks, 2010 Edition This follow-up to the 2009 edition is packed with actionable new data on health coaching activity, with the latest metrics on the prevalence of health coaching, favored delivery methods, targeted populations and lifestyle conditions, preferred behavior change models, coaching case loads and much, much more.

Learn more about this resource.

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5.) Healthcare Business White Paper: An Integrated Care Program For Chronically Ill and High-Cost Patients Aims For Better Health Outcomes

McKesson Corporation and CMS Health Integrated are providing CoverColorado with the nationís first integrated care program for high-risk health plan participants. More than 3,000 people with chronic and high-cost health conditions now have access to an around-the-clock, integrated care program that includes both disease management and case management services.

Download this complimentary white paper.

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6.) CMS Redefines Quality Measurement with Proposed Release of Medicare Claims Data

CMS has proposed rules that will grant qualified organizations access to patient-protected Medicare data for use in provider performance reports, a move that could redefine the quality measurement landscape and increase transparency for stakeholders.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Behavior Change Models in Health Coaching

Top 5 Behavior Change Models in Health Coaching To reduce the economic and clinical burden of lifestyle factors such as smoking, poor eating habits and physical inactivity, the healthcare industry is banking on the behavior change that can be facilitated by health coaching programs. We wanted to see what techniques and models of behavior change are most often utilized in health coaching programs.

Click here to view the chart.

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8.) Healthcare Performance Improvement: Exceeding Core Measure Targets for Value-Based Reimbursement

Healthcare Performance Improvement This 45-minute webinar on July 20, 2011 will share practical strategies for improving core measures, as well as modeling techniques to illustrate the impact of a hospital's failure to meet the measures, before the CMS value-based purchasing system becomes effective in October 2012.

Learn more about this resource.

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9.) New Market Research Finds Benefit-Based Incentives Best for Behavior Change

A gift card to Starbucks just might encourage employees to spend more time on the treadmill, but reducing their health premiums is a better long-term strategy.

Get the full story.

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10.) Benchmarks in Health & Wellness Incentives, 2011 Edition: Data to Drive Health Promotion, Compliance and ROI

Benchmarks in Health & Wellness Incentives, 2011 Edition This resource provides actionable information from 156 healthcare organizations on the use of incentives to promote health behavior change. This report has been compiled from an analysis of responses to HIN's third annual survey on the use of health & wellness incentives, administered in March 2011, and is packed with actionable new data on current and planned incentives activity, presented in more than 65 easy-to-follow graphs and tables.

Learn more about this resource.

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11.) One-Third of Employers Could Drop Healthcare Coverage in 2014

About 30 percent of 1300 employers surveyed say they will most likely stop offering workers employer-sponsored insurance (ESI) health insurance beginning in 2014, according to a recent McKinsey & Company survey.

Get the full story.

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12.) Healthcare Trends & Forecasts in 2011: Performance Expectations for the Healthcare Industry

Healthcare Trends & Forecasts in 2011 Feeling the squeeze from softening service demands, growing competition, reimbursement cuts and increased regulatory oversight, the healthcare industry is ripe for financial relief. In this 35-page resource, two key thought leaders look ahead to healthcare reform 2.0 — implementation and rollout and craft a healthcare reform strategy checklist, putting the smart money on models of consolidation and clinical integration that will not only increase throughput and market share but also reduce unnecessary utilization and cost.

Learn more about this resource.

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13.) HealthSounds Podcast: Ohio Collaborative Reduces Avoidable ER Visits Among Medicaid Population

>Dr. Mina Chang An Ohio collaborative of Medicaid plans is using a rapid cycle quality improvement approach to reduce avoidable ER visits by its Medicaid beneficiaries. One of the five regions targeted by the collaborative is Toledo, Ohio — known for having the highest emergency department utilization in the nation. Mina Chang, Ph.D., of the Bureau of Health Services Research for the Ohio Department of Job & Family Services, outlines the framework of the collaborative. She explains its population-based and patient-centered approach and describes some of the priority populations targeted by the collaborative's interventions.

Listen to this podcast.

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