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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Jackie Lyons

As costs of dual-eligible beneficiaries grow, so do the concerns of federal and state policymakers. In 2009, the federal and state governments spent more than $250 billion on healthcare benefits for the 9 million low-income elderly or disabled people who are jointly enrolled in Medicare and Medicaid. There are also concerns about the appropriateness of the care that the beneficiaries receive and the ways in which the separate structures of Medicare and Medicaid may affect costs and care. In this week’s issue, learn how federal lawmakers propose better care coordination for dual-eligibles.

A study from Health Care Incentives Improvement Institute™, Inc. (HCI3), highlighted in this week’s issue, shows progress on other efforts to change the way healthcare providers are compensated in the U.S. These efforts will shift compensation from fee-for-service to payment for a bundled set of services.

Addressing the changing healthcare industry, as dozens of new public and private insurance exchanges become available, a white paper from Truven Health Analytics™, identifies the challenges health plans will face. The white paper also provides a path to developing effective go-to-market and consumer strategies.

One tool that enables healthcare providers to evaluate financial benefits of technologies for patients with chronic heart disease analyzes the ROI for remote patient monitoring (RPM) technologies. The Center for Connected Health (CCH) and the Center for Technology and Aging (CTA) collaborated on the tool’s development. Read about the results from HealthCare Partner’s interactive voice response (IVR) program.

Another shift positively impacting healthcare providers is reviewing raw numbers of hospital readmissions rather than just the percentage. This strategy can make the process of managing rehospitalizations more manageable, according to Joshua Brewster, director of care management at Regions Hospital, a HealthPartners hospital.

Don’t 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. 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,
Jackie Lyons
Editor, Healthcare Business Weekly Update

Please send comments, questions and replies to jlyons@hin.com.

HIN Associate Editor Jessica Fornarotto
Associate Editor:
Jessica Fornarotto, jfornarotto@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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This week's featured download: Healthcare Trends in 2013 — Industry Shows More Faith in Healthcare Reform

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June 17, 2013
Vol. XV, No. 22

Sponsored by:
Health Coaching’s Value in Accountable Care and Medical Homes


This week's industry news:

  1. Dual-Eligible Beneficiaries of Medicare and Medicaid: Characteristics, Healthcare Spending, and Evolving Policies
  2. Population Health Management for Dual Eligibles
  3. Best Practices to Help Health Plans Succeed in the Insurance Exchange Marketplace
  4. AIS’s Directory of Health Plans: 2013
  5. Healthcare Business White Paper: Case Management in 2013
  6. HCI3 Releases Report on Bundled Payment Healthcare Reimbursement Progress
  7. New Table: High-Risk Patient Roster in Atrius Health Geriatric Care Model
  8. Blueprint for Bundled Payments
  9. New Web-based ROI Tool Demonstrates Return on Investment of Remote Patient Monitoring Programs
  10. 2013 Healthcare Benchmarks: Mobile Health
  11. What Raw Numbers of Hospital Readmissions Reveal
  12. Rethinking Readmissions
  13. QIO Advice for Improving Care Transitions: Dig Deep Into Local Data
  14. Benefits of Incorporating Health Coaches in the Care Process
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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Telehealth in 2013

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This week's industry news

1.) Dual-Eligible Beneficiaries of Medicare and Medicaid: Characteristics, Healthcare Spending, and Evolving Policies

In 2009, the federal and state governments spent a total of more than $250 billion on healthcare benefits for the 9 million low-income elderly or disabled people who are jointly enrolled in Medicare and Medicaid. A report by CBO examines the characteristics and costs of dual-eligible beneficiaries, focusing on 2009, the most recent year for which comprehensive data were available when CBO began this analysis.

Get the full story.

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2.) Population Health Management for Dual Eligibles: Blueprint for Care Coordination

Population Health Management for Dual Eligibles This resource details SCAN’s unique care management model for duals, which focuses on prevention and early intervention, particularly in the area of medication management.



Learn more about this resource.

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3.) Best Practices to Help Health Plans Succeed in the Insurance Exchange Marketplace

Consumer Engagement: The Key to a Successful Exchange, a white paper from Truven Health Analytics™, identifies the challenges health plans will face as dozens of new public and private exchanges become available, and provides a path to developing effective go-to-market and consumer strategies for this new ecosystem.

Get the full story.

>>Return to this week's industry news


4.) AIS’s Directory of Health Plans: 2013

AIS’s Directory of Health Plans: 2013 This resource contains enrollment data for all types of health plans, including commercial HMOs/PPOs/POS, Medicare and Medicaid HMOs, state government-run plans such as Medicaid FFS, PCCM, PCIP, SCHIP and other local community plans, managed FFS plans, and other types of primary medical insurance plans offered in the U.S. as of year-end 2012, so you can track trends in product design, funding and market sectors.

Learn more about this resource.

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5.) Healthcare Business White Paper: Case Management in 2013 — Achieving Results with Cardiovascular Disease; Long-Term Care Next Frontier for Embedded Case Managers

Case Management in 2013 New market research from the Healthcare Intelligence Network found that 57 percent of healthcare companies will add case managers in the coming year (up from 27 percent in 2012). Download this HINtelligence report to learn more about case management trends for 2013 as told by 118 healthcare companies in HIN's fourth annual Healthcare Case Management Survey. This HINtelligence Report provides data highlights on case management program components, results, and ROI; as well as improvements and innovations from embedded case management.

Download this complimentary white paper.

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6.) HCI3 Releases Report on Bundled Payment Healthcare Reimbursement Progress

Efforts to change the way healthcare providers are compensated in the U.S. from fee-for-service to payment for a bundled set of services are well underway according to a new study released at the National Bundled Payment Summit.

Get the full story.

>>Return to this week's industry news


7.) New Table: High-Risk Patient Roster in Atrius Health Geriatric Care Model

New Table: High-Risk Patient Roster in Atrius Health Geriatric Care Model By applying an "ACO magnifying glass" to high-risk patients and high-cost events, and using an organizational background in rapid cycle improvement, Atrius Health's focused interventions hit Triple Aim goals within its Medicare's Pioneer ACO model. We wanted to share Atrius Health's roster review of high-risk patients.

Click here to view the table.

>>Return to this week's industry news


8.) Blueprint for Bundled Payments: Strategies for Payors and Providers

Blueprint for Bundled Payments: Strategies for Payors and Providers This resource provides perspectives on payment bundling, including definitions of key elements, advice for payors and providers, and examples of the payment model at work in one organization.



Learn more about this resource.

>>Return to this week's industry news


9.) New Web-based ROI Tool Demonstrates Return on Investment of Remote Patient Monitoring Programs

The Center for Connected Health (CCH) and the Center for Technology and Aging (CTA) have collaborated on the development of a tool for analyzing the ROI for remote patient monitoring (RPM) technologies, enabling healthcare providers to evaluate the financial benefit of these technologies for patients with chronic heart disease.

Get the full story.

>>Return to this week's industry news

10.) 2013 Healthcare Benchmarks: Mobile Health

2013 Healthcare Benchmarks: Mobile Health This resource delivers a snapshot of mobile health (mHealth) trends, including current and planned mHealth initiatives, types and purpose of mHealth interventions, targeted populations and health conditions, and challenges, impact and results from mHealth efforts.

Learn more about this resource.

>>Return to this week's industry news


11.) What Raw Numbers of Hospital Readmissions Reveal

Reviewing raw numbers of hospital readmissions rather than just the percentage can make the process of managing rehospitalizations more manageable, notes Joshua Brewster, director of care management at Regions Hospital, a HealthPartners hospital.

Get the full story.

>>Return to this week's industry news


12.) Rethinking Readmissions: Patient-Centered Collaborations in Care Transition Management

Rethinking Readmissions: Patient-Centered Collaborations in Care Transition Management This resource examines the data analytics driving the CMS Care Transitions Demonstration Project as well as some home-grown programs that are supporting patients’ seamless transitions back into their communities.


Learn more about this resource.

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13.) QIO Advice for Improving Care Transitions: Dig Deep Into Local Data

There is no cookbook or recipe for improving care transitions.

Instead, the first step for any healthcare organization and community-based healthcare provider is to conduct a root cause analysis of readmission data, which can vary from community to community, says Alicia Goroski, MPH, senior project director for care transitions for the Colorado Foundation for Medical Care (CFMC), the Medicare Quality Improvement Organization (QIO) for Colorado.

Read this blog post.

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14.) Benefits of Incorporating Health Coaches in the Care Process

William Appelgate Primary care and the patient-centered medical home offer a great opportunity for health coaches to become allies with patients in improvement of their health, notes William Appelgate, executive director of the Iowa Chronic Care Consortium. Individuals with the highest health risks should be given priority, but those on the cusp of a serious health event also merit coaching assistance, he says. For providers new to the coaching conversation, Appelgate shares three benefits of incorporating health coaches in the care process — including the upping of their ‘outcomes game.’

Listen to this podcast.

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