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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

More than 11.4 million Americans are covered by health savings account (HSA)-eligible insurance plans, an increase of more than 14 percent since last year, according to a new census from America’s Health Insurance Plans (AHIP). New healthcare reform laws could pose concerns for HSA policyholders, in particular, restrictions on over-the-counter (OTC) medications, medical loss ratio (MLR) regulation, and the minimum actuarial value requirement, which will go into effect in 2014.

Healthcare reform laws are also the impetus for the partnership between Scripps Health and North American Medical Management, California, Inc. (NAMM), who will jointly develop an integrated healthcare network. In discussion are commercial and Medicare/Medi-Cal ACOs, bundled payments, capitation and other quality incentive models.

Also in step with the changing face of healthcare, St. Christopher’s Hospital for Children has launched a mobile application that puts ER wait times, a list of frequently called hospital numbers, and even maps and directions right at patients’ fingertips, while ironically, a new HIMSS survey on clinical transformation shows that only 35 percent of today’s hospital and healthcare system executives have easy access to electronic data.

Today is the last day to respond to our Patient Satisfaction Survey. Let us know what you’re doing to improve patients' and members' experience and satisfaction with their care, and you will receive a free summary of survey results once it is compiled.

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 20, 2011
Vol. XIII, No. 23

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

This week's industry news:

  1. St. Christopher's Hospital for Children's New Mobile App Tracks ER Wait Times, Personal Data
  2. Evaluating Health and Wellness Incentive Programs for Behavior Change
  3. Scripps Health and North American Management Forming Integrated Delivery Network/ACO
  4. 2011 Benchmarks in Accountable Care Organizations
  5. Healthcare Business White Paper: 2010 Benchmarks in Reducing Avoidable ER Visits
  6. Poor Electronic Data Access Hindering Hospital Quality Efforts
  7. New Chart: What's the ROI from Case Management?
  8. Guide to Physician Performance-Based Reimbursement
  9. Health Savings Account Enrollment Reaches 11.4 Million
  10. AIS's Directory of Health Plans: 2011
  11. Lessons and Benefits from a Virtual Coaching Environment
  12. Health Coach Hiring, Training and ROI
  13. HealthSounds Podcast: 2011 Metrics in Healthcare Case Management
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.) St. Christopher's Hospital for Children's New Mobile App Tracks ER Wait Times, Personal Data

In a move designed to improve medical care and communication, St. Christopher’s Hospital for Children has launched a mobile application that will connect the hospital to community members and increase access to health-related information.

Get the full story.

>>Return to this week's industry news


2.) Evaluating Health and Wellness Incentive Programs for Behavior Change

Evaluating Health and Wellness Incentive Programs During this webinar, the director of member engagement at Premera Blue Cross shared his organization's techniques and strategies to increase engagement in and results from health and wellness programs.

Learn more about this resource.

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3.) Scripps Health and North American Management Forming Integrated Delivery Network/ACO

Healthcare reform has fueled a partnership between Scripps Health and North American Medical Management, California, Inc. (NAMM), who will jointly develop an integrated healthcare network.

Get the full story.

>>Return to this week's industry news


4.) 2011 Benchmarks in Accountable Care Organizations: Metrics from Early ACO Adopters

2011 Benchmarks in Accountable Care Organizations This 40-page resource delivers actionable data from 228 healthcare companies that responded to HIN's February 2011 ACO readiness assessment. The result? A comprehensive snapshot of ACO awareness, participation, administration, targeted populations, payment models and much more from healthcare companies already immersed in the ACO architecture.

Learn more about this resource.

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5.) Healthcare Business White Paper: 2010 Benchmarks in Reducing Avoidable ER Visits

As consumers and payors take on greater responsibility for the efficiency of the healthcare system, healthcare organizations are targeting avoidable emergency room use. This white paper captures the steps that 90 healthcare organizations are taking to reduce avoidable use of the hospital ER, including the three most effective programs to prevent inappropriate use. These benchmarks are based on organizations' responses to the Healthcare Intelligence Network July 2010 e-survey on reducing avoidable ER use.

Download this complimentary white paper.

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6.) Poor Electronic Data Access Hindering Hospital Quality Efforts

A new HIMSS survey on clinical transformation finds that only 35 percent of respondents have easy access to electronic data.

Get the full story.

>>Return to this week's industry news


7.) New Chart: What's the ROI from Case Management?

What's the ROI from Case Management? Post-reform redesign of clinical care delivery and supporting reimbursement models reflects the healthcare case manager's dual roles as care coordinator and utilization manager for high-risk, high-cost patients. We wanted to see the ROI generated by case management programs.

Click here to view the chart.

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8.) 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; physician incentives and payments; and program outcomes. This 60-page resource also examines the collection and sharing of physician performance data by these four organizations.

Learn more about this resource.

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9.) Health Savings Account Enrollment Reaches 11.4 Million

An estimated 11.4 million Americans are covered by health savings account (HSA)-eligible insurance plans, an increase of more than 14 percent since last year, according to a new census from America’s Health Insurance Plans (AHIP).

Get the full story.

>>Return to this week's industry news


10.) AIS's Directory of Health Plans: 2011

AIS's Directory of Health Plans: 2011 This invaluable 535-page resource is well-regarded throughout the industry for providing enrollment data in a consistent, comparable manner. The completely updated 2011 edition covers all companies operating in the U.S. as of year-end 2010. More than a simple “phone book” kind of directory, the listings cover national and state-level enrollment data by company, national enrollment by company, by sector, company contact information and ownership information, types of primary care products offered and key executives by job function.

Learn more about this resource.

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11.) Lessons and Benefits from a Virtual Coaching Environment

There are pros and cons of doing telephonic health coaching in a virtual environment, according to Darcy Hurlbert, M.P.H., formerly a health and wellness product specialist at Ceridian LifeWorks.

Get the full story.

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12.) Health Coach Hiring, Training and ROI: Profiting from Behavior Change

Health Coach Hiring, Training and ROI This 50-page resource provides a blueprint for staffing and supporting a successful health coaching program as well as measuring and maximizing the behavioral, health and financial outcomes that result. It provides strategies for the screening, hiring, training, mentoring, certification and continued educational support of health coaches, as well as metrics for evaluating the success of an online, telephonic or in-person coaching effort and maximizing program ROI.

Learn more about this resource.

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13.) HealthSounds Podcast: 2011 Metrics in Healthcare Case Management

>Melanie Matthews
Has the practice of embedding case managers at the point of care grown since 2010? In this month's healthcare performance benchmarks podcast, Healthcare Intelligence Network's Melanie Matthews analyzes trends in contemporary case management and the evolving responsibilities of today's case manager derived from HIN's January 2011 survey results.

Toni Cesta, senior vice president of operational efficiency and capacity management at Lutheran Medical Center and Jan Van der Mei, the regional director of Sutter Health Sacramento Sierra Regions care management programs, supplement this data with commentary on the case manager's role in their organizations.

Listen to this podcast.

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