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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Medication non-adherence drives the largest avoidable healthcare costs in the United States at an estimated $105 billion a year.

Delaying evidence-based treatments to patients comes in second with a whopping $40 billion price tag.

These are just two of six areas of medication misuse that cost the country more than $200 billion a year, representing 8 percent of the country’s total annual healthcare expenditures, according to a new study released by the IMS Institute for Healthcare Informatics.

While strides have been made to deflate these costs — an estimated 95 percent of patients now receive lower-cost generic alternatives to branded medications, when available, and medication adherence among large populations of patients with hypertension, hyperlipidemia and diabetes has improved 3 to 4 percent since 2009 — much more needs to be done. Researchers point out significant opportunities to ensure that patients receive the right medicines at the right time, and take them in the right way, in our detailed story.

Incentives might be one way to improve medication adherence, and is one of the four “I’s” that spell success for a population health management program, says Patricia Curran, principal in Buck Consultants’ National Clinical Practice; the ‘I’s’ of information, in its various forms, is a second important element. The population you’re trying to manage needs to know ‘What’s in it for me? What do I have to do?’ she stresses, and need to have the proper information to answer those questions.

Not enough public information exists for patients seeking to compare prices for out-of-pocket healthcare services, according to a new study in the Journal of the American Medical Association (JAMA).

While the federal government recently released hospitals’ charges for procedures and services, that kind of information doesn't help consumers trying to compare their healthcare options. An analysis of 62 publicly available state Web sites that aim to help patients estimate or compare prices for healthcare services found that most sites only reported billed charges, not what patients were actually expected to pay, or focused on reporting prices for in-hospital services that are often used to treat urgent, sometimes life-threatening conditions. Patients with the time to research price and quality of routine, outpatient treatments need more consumer friendly Web sites, similar to one featured in our story.

Here’s some consumer-friendly news: six out of 10 states will offer consumers more options in state-run insurance exchanges.

The number of carriers offering non-group, or individual, insurance plans to consumers this fall in state-run health insurance exchanges will increase substantially, according to an analysis from the Robert Wood Johnson Foundation (RWJF), pointing to an increased competition among health plans in the non-group marketplace, researchers say, a market that currently offers limited options and little information to guide consumer choice.

Despite the millions of newly insured Americans expected under the ACA in 2014, healthcare spending is expected to drop to 6.5 percent in 2014, according to PwC’s Health Research Institute.

The slowdown in the healthcare growth rate defies historical post-recession patterns, and signals progress in attempts to bend the cost curve. It also presents financial challenges for the industry as it attempts to adjust to a rapidly changing environment. According to HRI, while structural changes within the industry are helping to contain costs and deliver care more efficiently, consumers who are paying a greater share of the cost are making spending adjustments, including delaying care, using fewer services and choosing less expensive options such as retail clinics, urgent care centers and telehealth services like mobile health devices.

Are you capitalizing on the telehealth movement? 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.

Our third e-survey on Telehealth ends soon; respond by June 30, 2013 and receive a free executive summary of the compiled results. Your responses will be kept strictly confidential.

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

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June 24, 2013
Vol. XV, No. 23

Sponsored by:
Performance Quality Measurement and Reporting for Accountable Care


This week's industry news:

  1. Historic Slowdown in Healthcare Spending Projected for 2014
  2. Healthcare Trends & Forecasts in 2013
  3. Consumers Need Better Online Cost Data to Compare Routine, Outpatient Services
  4. Moving Forward with Payment Bundling
  5. Healthcare Business White Paper: Medication Adherence in 2013
  6. Improvements in 6 Key Areas of Medication Use Could Save More Than $200 Billion Annually
  7. New Chart: Opportunities to Improve Medication Adherence
  8. Patient-Centered Diabetes Management
  9. 6 Out of 10 States Will Offer Consumers More Options in State-Run Insurance Exchanges
  10. Health Insurance Exchanges
  11. The 4 'I's' of Successful Population Health Management
  12. Profiting from Population Health Management
  13. Infographic: Employee Choice in Health Benefit Selection
  14. Motivational Interviewing by Ochsner Health Coaches Drives Results in 4 Key Areas
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.

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Take our monthly e-survey:
Telehealth in 2013

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This week's industry news

1.) Historic Slowdown in Healthcare Spending Projected for 2014

Healthcare spending is expected to drop to 6.5 percent in 2014, despite millions of newly insured expected under the ACA in 2014, according to PwC’s Health Research Institute (HRI).

Get the full story.

>>Return to this week's industry news


2.) Healthcare Trends & Forecasts in 2013: Performance Expectations for the Healthcare Industry

Healthcare Trends & Forecasts in 2013 This resource is HIN’s ninth annual industry forecast, and provides sector-specific guidance for the next 12 months from three key thought leaders, highlighting the challenges that will continue to consume the healthcare executive in the year ahead.



Learn more about this resource.

>>Return to this week's industry news


3.) Consumers Need Better Online Cost Data to Compare Routine, Outpatient Services

Not enough public information exists for patients seeking to compare prices for out-of-pocket healthcare services, according to a new study in the Journal of the American Medical Association (JAMA).

Get the full story.

>>Return to this week's industry news


4.) Moving Forward with Payment Bundling

Moving Forward with Payment Bundling This webinar provides perspectives on the emerging bundled payment trend, including an overview of payment bundling rationale, trends, and outcomes, specific administrative and organizational challenges created with bundled payment programs for healthcare payors, and much more.

Learn more about this resource.

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5.) Healthcare Business White Paper: Medication Adherence in 2013 — Closer Look at Compliance During Care Transitions

Medication Adherence in 2013 In its third annual Medication Adherence e-survey conducted in January 2013, HIN captured emerging trends in efforts to improve medication adherence (MA) among more than 100 healthcare organizations. According to 75 percent of survey respondents, complex patients remain the most common targets of MA programs. This HINtelligence Report provides data highlights on MA program components, the most successful tools for improving MA, and more.

Download this complimentary white paper.

>>Return to this week's industry news


6.) Improvements in 6 Key Areas of Medication Use Could Save More Than $200 Billion Annually

Irresponsible use of medicine, including non-adherence and medication errors, costs the United States more than $200 billion a year, representing 8 percent of the country’s total annual healthcare expenditures, according to a new study released by the IMS Institute for Healthcare Informatics.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Opportunities to Improve Medication Adherence

New Chart: Opportunities to Improve Medication Adherence According to the more than 100 healthcare companies who responded to HIN's latest medication adherence (MA) e-survey, nearly 58 percent say that telephonic follow-up provides an opportunity to improve MA. We wanted to see which other care points offer a chance to improve MA.

Click here to view the chart.

>>Return to this week's industry news


8.) Patient-Centered Diabetes Management: Driving Outcomes with Education and Behavior Change

Patient-Centered Diabetes Management This resource takes an in-depth look at three patient-centered programs for diabetes management that are improving clinical outcomes and bending the cost curve for program participants.



Learn more about this resource.

>>Return to this week's industry news


9.) 6 Out of 10 States Will Offer Consumers More Options in State-Run Insurance Exchanges

The number of carriers offering non-group, or individual, insurance plans to consumers this fall in state-run health insurance exchanges will increase substantially, according to an analysis from the Robert Wood Johnson Foundation (RWJF).

Get the full story.

>>Return to this week's industry news

10.) Health Insurance Exchanges: Preparing for the Brave New Marketplace Ahead

Health Insurance Exchanges This resource provides timely insights from industry consultants, state lawmakers and regulators, scholars and other key industry observers on how state health insurance exchanges 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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11.) The 4 'I's' of Successful Population Health Management

Forcing mandates like smoke-free campuses and safety regulations like mandatory seat belts are imperatives — one of the four I’s — that ultimately help to build a successful population health management program, says Patricia Curran, principal in Buck Consultants’ National Clinical Practice.

Get the full story.

>>Return to this week's industry news


12.) Profiting from Population Health Management: Applying Analytics in Accountable Care

Profiting from Population Health Management This resource provides both a primer in population health management (PHM), identifying the challenges and opportunities of a robust PHM program, and an advanced case study in the use of analytics in PHM.



Learn more about this resource.

>>Return to this week's industry news


13.) Infographic: Employee Choice in Health Benefit Selection

As employees share a greater portion of employer-sponsored healthcare costs, employers are offering a defined contribution option in which employees select a health plan, including those created by private exchanges.

Alegeus Technologies examines how this trend evolved and offers predictions on the number of individuals who will receive health coverage through exchanges.

Read this blog post.

>>Return to this week's industry news


14.) Motivational Interviewing by Ochsner Health Coaches Drives Results in 4 Key Areas

Alicia Vail When health coaches employ motivational interviewing during patient encounters, expect upticks in medication adherence, weight loss, HbA1c levels and overall engagement, notes Alicia Vail, RN health coach for Ochsner Health System. Ochsner’s eight health coaches focus on patients with diabetes, hypertension and obesity who have come to their attention by way of physician referrals, health screenings and pre-chart reviews.

In this podcast, Ms. Vail describes how Ochsner Health System incorporates health coaches in its clinic structure and describes the benefits that result from the coaching intervention.

Listen to this podcast.

>>Return to this week's industry news


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