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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

It takes a village to help those suffering from depression. Even a barber shop.

According to a new study from the RAND Corporation, when community-based support groups such as churches, substance abuse counselors, and yes, even barber shops, offered support to lower-income people suffering from depression, the patients’ mental health improved, their level of physical activity increased, and their hospitalizations decreased.

Researchers targeted lower-income neighborhoods because help is frequently unavailable or hard to find. Many suffering from depression also go undiagnosed; called the “silent monster,” it affects almost one out of five people from all cultural groups at some point in their lives. You can find more details in our story.

It takes a value-based benefits plan, and a disease management program, to help diabetics better control their health.

According to a new study from Truven Health Analytics™ and the Florida Health Care Coalition, patients enrolled in value-based benefit design in conjunction with a disease management program showed higher adherence to both brand and generic oral medications and a higher uptake of insulin over the three-year study period.

The study, Value-Based Design and Prescription Drug Utilization Patterns Among Diabetes Patients, which appears in the May/June issue of The American Journal of Pharmacy Benefits, examined the three-year effect of value-based design and disease management programs on diabetes patients. Value-based insurance design is a medical benefit plan design that reduces patient out-of-patient costs for treatments that are known to be effective, and increases out-of-pocket prices for lower value services.

It takes a combination of factors, including financial hardship and disability or old age to meet the criteria that defines dual eligibles, a population that nears 9 million in the United States.

You can find these facts and more in our new HINfographic, Defining the Dually Eligible: 16 Things to Know for Population Health Management, which illustrates a wealth of metrics on the dual eligibles population. Managing this population successfully is key to keeping healthcare costs low; and the HINfographic lists six keys to successful management of duals, including medication management and patient education.

Lastly, we’d like to ask you to take some time to fill out our third e-survey on Telehealth.

A clear majority of healthcare organizations are using telehealth in clinical and non-clinical settings, according to preliminary results from survey. Your response will be kept strictly confidential and will only be used in the aggregate. You may complete the survey online 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 Fornarotto
Associate Editor:
Jessica Fornarotto, jfornarotto@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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This week's featured download: Care Transitions in 2013 — Interventions Surge in Response to Payor Scrutiny; Home-Grown Approaches Trump Traditional Models

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July 1, 2013
Vol. XV, No. 24

Sponsored by:
Performance Quality Measurement and Reporting for Accountable Care


This week's industry news:

  1. Study Links Pairing of Value-Based Benefits and Disease Management to Better Results, Controlled Costs
  2. Disease Management and Wellness in the Post-Reform Era
  3. Defining the Dually Eligible: 16 Things to Know for Population Health Management
  4. Population Health Management for Dual Eligibles
  5. Healthcare Business White Paper: Health & Wellness Incentives in 2012
  6. Lower Income Depressed Patients Benefit from Community Support: Study
  7. New Chart: What's the ROI from Medical Home Programs?
  8. Depression Management Benchmarks
  9. ACO’s Health IT, Care Coordination Improve Care, Lower Costs for Medicare Fee-for-Service Beneficiaries
  10. Guide to Accountable Care Organizations
  11. Case Loads for Case Managers
  12. Case Management Answer Book Vol. I
  13. HINfographic on Defining the Dually Eligible
  14. Medicare Pioneer ACO
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.) Study Links Pairing of Value-Based Benefits and Disease Management to Better Results, Controlled Costs

Diabetes treatment is more effective when paired with both value-based benefit design and disease management programs, according to a joint study from Truven Health Analytics™ and the Florida Health Care Coalition.

Get the full story.

>>Return to this week's industry news


2.) Disease Management and Wellness in the Post-Reform Era

Disease Management and Wellness in the Post-Reform Era This resource charts the rapidly changing course care management and health promotion programs will take over the next several years, as they adjust to reform-law requirements and new tools like social marketing websites.



Learn more about this resource.

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3.) Defining the Dually Eligible: 16 Things to Know for Population Health Management

Nine million individuals in the United States are eligible for both Medicare and Medicaid, as a new HINfographic from the Healthcare Intelligence Network (HIN) illustrates.

Get the full story.

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

Population Health Management for Dual Eligibles This resource details SCAN Health Plan’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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5.) Healthcare Business White Paper: Health & Wellness Incentives in 2012 — Rewarding Risk Assessment, Lifestyle Changes

Health & Wellness Incentives in 2012 New market research from the Healthcare Intelligence Network has determined that the completion of a health risk assessment (HRA) remains the most heavily incented health improvement activity for the fourth consecutive year, say two-thirds of respondents to HIN's annual Health & Wellness Incentives Survey. This HINtelligence Report provides data highlights on health and wellness incentive program components, results, and ROI; as well as the most successful strategies for health and wellness incentives use.

Download this complimentary white paper.

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6.) Lower Income Depressed Patients Benefit from Community Support: Study

Depressed people in lower-income communities — areas where help is frequently unavailable or hard to find — benefit when community groups such as churches and even barber shops lend support, according to a new study from the RAND Corporation.

Get the full story.

>>Return to this week's industry news


7.) New Chart: What's the ROI from Medical Home Programs?

New Chart: What's the ROI from Medical Home Programs? The patient-centered medical home (PCMH) model has been called a stepping stone to accountable care. The most recent market data from the Healthcare Intelligence Network found that 59 percent of existing medical homes are now or soon will be part of an accountable care organization (ACO). We wanted to see what ROI has been generated by PCMH programs.

Click here to view the chart.

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8.) Depression Management Benchmarks: Trends in Integration of Behavioral and Physical Health

Depression Management Benchmarks This resource provides actionable information from 260 organizations on their progress in targeting depression in disease management, plus lessons learned from early adopters of an integrated approach to mental and physical health.



Learn more about this resource.

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9.) ACO’s Health IT, Care Coordination Improve Care, Lower Costs for Medicare Fee-for-Service Beneficiaries

Aetna and Bon Secours Health System (BSHSI) have launched a new accountable care agreement that will use technology and care coordination services from Aetna subsidiary Healthagen to help coordinate healthcare for Medicare beneficiaries.

Get the full story.

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10.) Guide to Accountable Care Organizations

Guide to Accountable Care Organizations This resource lays the groundwork for an ACO program, delivering a comprehensive set of 2012 ACO benchmarks from 200 companies; a framework for clinical integration, a key ACO prerequisite that puts participating providers on the same performance and payment page, and much more.

Learn more about this resource.

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11.) Case Loads for Case Managers

How do you determine the optimal numbers of patients for case managers to manage? Perhaps one of the most frequently asked and debated questions in the industry, ultimately experience and the level of patient comorbidity help determine the answer, say Jan Van Der Mei, RN, MS, ACM, continuum case management director at Sutter Health Sacramento Sierra Region, and Rebecca Ramsay, BSN, MPH, senior manager of care support and clinical programs at CareOregon.

Get the full story.

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12.) Case Management Answer Book Vol. I: FAQs on Risk Reduction, Care Coordination and Co-Location

Case Management Answer Book Vol. I This resource provides industry thought leaders’ answers to more than 50 questions on the practicalities of case management, from required skill sets for newly hired case managers to engaging non-compliant patients to supporting a case manager embedded in a hospital emergency room.


Learn more about this resource.

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13.) HINfographic on Defining the Dually Eligible: 16 Things to Know for Population Health Management

This HINfographic on dual eligibles illustrates 16 things to know for population health management, including criteria for dual eligibility, specific health and financial characteristics of the population, differences between the duals and Medicare population, and keys to successfully managing dual eligibles.

Read this blog post.

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14.) Medicare Pioneer ACO: Case Study on Atrius Health’s Focus on the Triple Aim

Emily Brower A core desire to create a single population-focused model of care for all Medicare beneficiaries, rather than multiple payor-driven approaches, drives Atrius Health’s participation in the CMS Pioneer ACO program, explains Emily Brower, executive director of accountable care programs at Atrius Health. The success of the Atrius ACO hinges on several preferred partnerships it has cultivated, including a collaboration with skilled nursing facilities, as well as outreach by population health managers, who guide patients in the management of chronic illness and prevention.

Listen to this podcast.

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