Dear Healthcare Intelligence Network Client,

School's almost out, and we're awaiting final report cards at my house. In this week's news, report cards also went out to many hospitals, health plans and nursing homes. The AMA issued its first National Health Insurer Report Card on claims processing to Medicare and seven national commercial health insurers, in an effort to hold health insurance companies accountable for "timeliness, transparency and accuracy of claims processing." Also, CMS reported dramatic improvements in the performances of the 250 hospitals in its Premier Hospital Quality Incentive Demonstration (HQID). The 112 top performers share $7 million in incentive payments for "substantial and continual advancement in quality of care."

We also learned that nursing homes will be subject to greater scrutiny by CMS, which by year's end will activate a five-star system on its Nursing Home Compare Web site to rank quality of care. CMS already assigns stars to health and prescription drug plans available to Medicare beneficiaries.

Depending on the grades, some summer work may be in order for hospitals, insurers and nursing homes that don't want to be left behind.

Your colleague in the business of healthcare,
Patricia Donovan
Editor, Healthcare Business Weekly Update

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Healthcare Business Weekly Update
Volume X, No. 13
June 23, 2008

Sponsored by: Essential Keys To Success for Consumer-Directed Health Plans

During Essential Keys To Success for Consumer-Directed Health Plans, a 90-minute webinar on June 26, 2008, industry experts will describe these elements and how this translates to increased adoption and results.

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Table of Contents
  1. AMA Unveils Health Insurer Report Card on Claims Processing
  2. Toward Transparency in Healthcare: Competing for Quality and Consumers
  3. In-Patient Care Improves Dramatically at 250 Hospitals in Third Year of HQID Demo
  4. How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments
  5. Featured Healthcare Business White Paper: How the New PQRI Will Affect Emergency Department Provider Documentation
  6. Four–fifths of EDs Routinely “Board” Psychiatric Patients
  7. For Emergency Use Only: Curbing Unnecessary Emergency Room Use Through Education, Accountability and Physician Engagement
  8. CMS to Launch Five-Star System to Rate Nursing Homes
  9. From Quality to Excellence: Using Comparative Data to Improve Health Care Performance
  10. United States and China Make Progress on Food and Feed Safety
  11. Foodborne Illnesses - Inservice program
  12. Worth Repeating: Growing a Nation of Active Physicians
  13. Driving Improvements in Health Coaching Outcomes Through Physician Collaboration and Coordination


1. AMA Unveils Health Insurer Report Card on Claims Processing

To help reduce the substantial administrative burden of ensuring accurate insurance payments for physician services, AMA has launched the Cure for Claims campaign and unveiled the first AMA National Health Insurer Report Card on claims processing.

To read this story in its entirety, go to:
http://www.hin.com/sw/Hindustry_MC062308.html



2. Toward Transparency in Healthcare: Competing for Quality and Consumers

In this special report, a panel of experts discusses the challenges of incorporating public reporting as part of an integrated strategy, collaborating with providers and developing objective metrics and reliable data.

For more information, please visit:
http://store.hin.com/product.asp?itemid=3694



3. In-Patient Care Improves Dramatically at 250 Hospitals in Third Year of HQID Demo

Latest results of the Premier Hospital Quality Incentive Demonstration (HQID) show dramatic across-the-board improvement in the performance of participating hospitals. Launched in October 2003 by CMS and the Premier Inc. Healthcare Alliance, HQID involves about 250 hospitals in 36 states.

To read this story in its entirety, go to:
http://www.hin.com/sw/hospital_HSmanagement062308.html



4. How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments

This audio conference on CD-ROM presents case studies from three hospitals whose quality improvement efforts have paid off. Cleveland County Healthcare System, Hackensack University Medical Center and Memorial Medical Center described the performance improvement programs at their respective organizations that yielded bonus quality incentive payments from CMS under the Premier HQID program.

For more information, please visit:
http://store.hin.com/product.asp?itemid=3639



Please Forward This Issue

If you haven’t already done so, please forward this issue to one or two of your business associates. Thanks so much.

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http://www.hin.com



5. Featured Healthcare Business White Paper: How the New PQRI Will Affect Emergency Department Provider Documentation

This white paper provides practical and actionable information on the changes in documentation and reporting involving physicians, physician assistants and nurse practitioners working in emergency care. The PQRI documentation standards, voluntary at present, are incentivized by financial bonuses from CMS. Providers and/or groups that are able to report data on at least 80 percent of qualified patients for each of at least three emergency medicine-related quality measures during calendar 2008, will receive the bonus.

To download this complimentary white paper, please visit:
http://www.hin.com/library/registerhtn.html



6. Four–fifths of EDs Routinely “Board” Psychiatric Patients

People with psychiatric illnesses, including children, who are admitted to the hospital from the ED can wait 24 hours or longer for an inpatient bed, principally because of a lack of psychiatric beds. The findings of a survey of ED directors are reported by the American College of Emergency Physicians (ACEP).

To read this story in its entirety, go to:
http://www.hin.com/sw/behavioral_health062308.html



7. For Emergency Use Only: Curbing Unnecessary Emergency Room Use Through Education, Accountability and Physician Engagement

This special report provides a blueprint for health plans, hospitals and providers desiring to address and reduce unnecessary ED utilization in their populations.

For more information, please visit:
http://store.hin.com/product.asp?itemid=3566



8. CMS to Launch Five-Star System to Rate Nursing Homes

CMS will soon launch a ground-breaking ranking system of America’s nursing homes, giving each a “star” rating. The ratings will be posted on the agency’s Nursing Home Compare Web site by the end of this year.

To read this story in its entirety, go to:
http://www.hin.com/sw/long_term_care062308.html


There are other free email newsletters available from HIN!

HealthCoach Huddle, a monthly e-newsletter, brings you the most up-to-date news on health coaching, from coaching strategies to interviews and quotables from the industry's leading health coaches.

Medical Home Monitor tracks the construction of medical homes around the country and their impact on healthcare access, quality, utilization and cost. As providers and payors reframe care delivery, this monthly e-newsletter will cover the pilots, practice transformations, tools and technology that will guide healthcare organizations toward clinical excellence.

To sign up for our free email newsletters, please visit
http://www.hin.com/freenews2.html


9. From Quality to Excellence: Using Comparative Data to Improve Health Care Performance

In this book, readers will learn how to incorporate comparative measurement data into their organization's quality and patient safety improvement strategies. Readers will discover how to select credible data sources to determine if their performance measures up to that reported by other organizations. Plus they'll find out how to gain cooperation from practitioners and dig deeper to find the causes of variation.

For more information, please visit:
http://store.hin.com/product.asp?itemid=3385



10. United States and China Make Progress on Food and Feed Safety

HHS’ Secretary Mike Leavitt signed a joint progress statement with China’s minister of the general administration of quality supervision, inspection, and quarantine (AQSIQ) that outlines steps taken by both nations to improve food and feed safety.

To read this story in its entirety, go to:
http://www.hin.com/sw/healthLaw_regulation062308.html



11. Foodborne Illnesses - Inservice program

This program targets foodborne illnesses, categorizing them by type of agent and the various types of illnesses caused by each. Its primary focus is to provide information on the biological pathogens of highest concern, including the foods each is most likely found in, signs and symptoms of infection, and prevention and treatment measures.

For more information, please visit:
http://store.hin.com/product.asp?itemid=3658



12. Worth Repeating: Growing a Nation of Active Physicians

In this excerpt from a May 15, 2008 audio conference, Dr. Edward Phillips, director of outpatient medical services at Spaulding Rehabilitation Hospital Network, advocates a change in the practice paradigm to get physicians to promote health self-responsibility in patients.

To finish reading this transcript excerpt, please visit:
http://www.hin.com/sw/worth_repeating062308.html



13. Driving Improvements in Health Coaching Outcomes Through Physician Collaboration and Coordination

During Driving Improvements in Health Coaching Outcomes Through Physician Collaboration and Coordination, a 90-minute webinar on CD-ROM, three health coaching experts provided the inside details on how to maximize the physician-patient relationship in health coaching programs to improve results.

For more information on this audio conference and to listen to pre-conference comments, please visit:
http://store.hin.com/product.asp?itemid=3790


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