HIN logo
From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Employers will have more time to comply with the ACA mandate on insurance coverage, according to a White House blog posted by Valerie Jarrett, senior advisor and assistant to the president for Intergovernmental Affairs and Public Engagement.

In response to concern from employers with more than 50 employees working more than 30 hours a week that they would not have enough time to comply with the ruling by 2014, the administration has extended it by a year, and will simplify the reporting process. Plans to open health insurance exchanges on October 1 are still going forward, the administration says. More details can be found inside.

Kidney transplant patients who use specialty pharmacies as opposed to retail pharmacies report lower healthcare costs, according to a study published in the Journal of Managed Care Pharmacy.

The one-year study conducted by Optum found that those transplant patients using individualized services provided by the pharmacies, including adherence and clinical management programs, member education, and counseling services provided by pharmacists trained in transplant pharmacology, showed 30 percent lower post-transplant-related medical costs and 13 percent lower overall healthcare costs.

Medication adherence is one area of transplant medicine that needs improvement, researchers state. While the rate of non-adherence is highest at one to three years post-transplant, it may happen at any point during lifelong therapy.

Personal time and contact with patients during care transitions — before and after their hospital discharge — significantly reduces readmission rates, according to a study conducted by the Bronx Collaborative, a group of hospitals and health insurers in the Bronx, N.Y.

Among 500 patients who received two or more of four interventions by nurse care transition managers in a special program to manage the transition between hospital and home, only 17.6 percent were readmitted to the hospital within 60 days of discharge versus 26.3 percent among a comparison group of 190 patients who received the current standard of care, the data showed.

Another 85 patients who received only one intervention for a variety of reasons had an overall readmission rate of 22.8 percent.

More inside on the four interventions.

And, if you have the time, please take our latest 10 question survey on Managing the Dually Eligible. Tell us how you're managing this population, which constitutes about 9 million individuals who are eligible for both Medicaid and Medicare in the United States, 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

>>Return to top

HIN podcasts
HIN blog
HIN videos
New HIN products

Contact HIN:
www.hin.com
(888) 446-3530
(732) 449-4468
Fax: (732) 449-4463
Email: info@hin.com

This week's featured download: Medication Adherence in 2013 — Closer Look at Compliance During Care Transitions

Medication Adherence in 2013 — Closer Look at Compliance During Care Transitions

Featured download










For advertising and sponsorship opportunities in the Healthcare Business Weekly Update, please e-mail sales@hin.com or call 888-446-3530

>>Return to top

July 8, 2013
Vol. XV, No. 25

Sponsored by:
Performance Quality Measurement and Reporting for Accountable Care


This week's industry news:

  1. New Funding Will Enhance Care Coordination, Beneficiary Experience of Dually Eligible
  2. Dual Eligibles: The New Growth Opportunities Ahead for Health Plans
  3. Patient Contact Pre- and Post-Hospitalization Significantly Lowers Hospital Readmission Rates
  4. Avoiding the Readmissions Penalty Zone
  5. Healthcare Business White Paper: ACOs in 2012
  6. Specialty Pharmacies Pivotal in Improving Healthcare Outcomes, Lowering Costs
  7. New Chart: Top 5 Ways to Identify Individuals for Case Management
  8. Guide to Improving Medication Adherence
  9. White House Gives Employers More Time to Comply with Coverage Mandate
  10. 46 Healthcare Metrics to Boost Profitability
  11. Value of Case Management Collaboration with Home Health, SNFs and Long-Term Care
  12. 33 Metrics for Care Transition Management
  13. Infographic: Where Does Healthcare Money Go?
  14. Moving Forward with Payment Bundling
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.

Join our Online Communities:

Twitter Facebook LinkedIn YouTube Pinterest


Take our monthly e-survey:
10 Questions on Managing the Dually Eligible

You'll be emailed a synopsis of the survey results.

Interested in all open surveys? Review them here.


This week's industry news

1.) New Funding Will Enhance Care Coordination, Beneficiary Experience of Dually Eligible

New funding from the CMS and the Administration for Community Living (ACL) will improve coordination of care for Medicare-Medicaid enrollees. This funding will support states in developing independent ombudsman programs, helping dually eligible beneficiaries in the demonstration have a positive care experience.

Get the full story.

>>Return to this week's industry news


2.) Dual Eligibles: The New Growth Opportunities Ahead for Health Plans

Dual Eligibles: The New Growth Opportunities Ahead for Health Plans This resource examines the initiatives being developed by CMSí Federal Coordinated Health Care Office to fund large-scale state care-integration demonstrations for dual eligibles, as well as statesí efforts to more effectively coordinate care for these patients.



Learn more about this resource.

>>Return to this week's industry news


3.) Patient Contact Pre- and Post-Hospitalization Significantly Lowers Hospital Readmission Rates

Personal contact with patients during care transitions — before and after their hospital discharge — significantly reduced readmission rates, according to a study conducted by the Bronx Collaborative, a group of hospitals and health insurers in the Bronx, N.Y.

Get the full story.

>>Return to this week's industry news


4.) Avoiding the Readmissions Penalty Zone: Population Health Management for High-Risk Populations

Avoiding the Readmissions Penalty Zone This resource delivers winning process improvements and interventions that can help organizations make measurable progress toward reducing readmissions in high-risk populations, including a look at a health system-SNF network that has curbed rehospitalizations and length of stay for participants.


Learn more about this resource.

>>Return to this week's industry news


5.) Healthcare Business White Paper: ACOs in 2012 — ACO Participation Doubles in 12 Months

Accountable Care Organizations in 2012 Participation in accountable care initiatives has more than doubled in the last 12 months, according to 200 healthcare companies who completed the second annual Healthcare Intelligence Network survey on Accountable Care Organizations (ACOs). The typical ACO is smaller, too, as the number of active ACOs with 100 to 500 physicians dropped almost 50 percent in the last 12 months. This yearís survey provided new data on other healthcare professionals in the ACO, ACO reimbursement models, and ACO impact.

Download this complimentary white paper.

>>Return to this week's industry news


6.) Specialty Pharmacies Pivotal in Improving Healthcare Outcomes, Lowering Costs

Kidney transplant patients who went to specialty pharmacies as opposed to retail pharmacies showed 30 percent lower post-transplant-related medical costs and 13 percent lower overall healthcare costs, according to a study published in the Journal of Managed Care Pharmacy.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Ways to Identify Individuals for Case Management

New Chart: Top 5 Ways to Identify Individuals for Case Management Care coordination by healthcare case managers is helping to drive clinical and financial outcomes in population health management and bolster emerging models of care such as the patient-centered medical home and the accountable care organization. We wanted to see how individuals are identified for case management.

Click here to view the chart.

>>Return to this week's industry news


8.) Guide to Improving Medication Adherence

Guide to Improving Medication Adherence This resource analyzes trends in improving medication adherence at more than 160 healthcare companies, and takes an in-depth look at pioneering efforts by Kaiser Permanente Colorado and CIGNA Pharmacy Management to improve medication compliance levels in their populations.


Learn more about this resource.

>>Return to this week's industry news


9.) White House Gives Employers More Time to Comply with Coverage Mandate

Employer concerns about adhering to ACAís health insurance mandate by the January 2014 deadline have prompted the White House to extend the deadline and change the reporting process, according to a White House blog posted by Valerie Jarrett, senior advisor and assistant to the president for Intergovernmental Affairs and Public Engagement.

Get the full story.

>>Return to this week's industry news

10.) 46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends

46 Healthcare Metrics to Boost Profitability This resource provides HINís second annual graphic compendium of performance benchmarks in key areas of healthcare activity and growth, a desktop reference for the healthcare C-suite that distills emerging trends into easy-to-digest charts and tables.


Learn more about this resource.

>>Return to this week's industry news


11.) Value of Case Management Collaboration with Home Health, SNFs and Long-Term Care

One of the keys to success in following patients within the continuum of care is building a collaboration and relationship with them, and that includes having a case manager available, say Diane Littlewood, director of population management operations with Geisinger Health Plan; and Joann Sciandra, director of case management strategic development at Geisinger Health Plan.

Get the full story.

>>Return to this week's industry news


12.) 33 Metrics for Care Transition Management

33 Metrics for Care Transition Management This resource is HINís graphic compendium of performance benchmarks in key areas impacting care transitions — from key tasks performed at hospital discharge to the prevalence of home visits in programs to improve medication adherence.


Learn more about this resource.

>>Return to this week's industry news


13.) Infographic: Where Does Healthcare Money Go?

Healthcare in the United States accounts for trillions of dollars in spending, both by governments and private individuals. Almost half of Americans take at least one prescription drug, according to a new infographic by Best Masters in Healthcare. The spending for these prescription drugs is on the rise. The infographic also details per capita healthcare spending, a look at healthcare billing departments, industry jobs on the rise and more.

Read this blog post.

>>Return to this week's industry news


14.) Moving Forward with Payment Bundling

Jay Sultan Since the idea of payment bundling was first introduced 10 years ago, justification for the episode-based reimbursement model has shifted from quality and innovation gains to its proven ability to reduce the total cost of healthcare, notes Jay Sultan, associate vice president and chief product portfolio architect for TriZetto®. Healthcare entities testing bundled payments should keep two key factors in mind when trying to engage physicians in the model, Sultan adds, describing the type of message most likely to foster provider support. And finally, Sultan also identifies the major decision primary care must make now that CMS has introduced bundled payments for care coordination tasks.

Listen to this podcast.

>>Return to this week's industry news


Thank you for your readership! Please urge your colleagues to subscribe by forwarding this email or visiting http://www.hin.com/freenews2.html or by calling (888) 446-3530 or visiting the HIN Web site.

While we encourage you to forward this email to your colleagues, these articles may not be redistributed in any other publication, reproduced for publication in any form, distributed on an intranet or network or by e-mail distribution or distributed for commercial purposes without the expressed written permission of the Healthcare Intelligence Network.


Copyright 1997-2013 Healthcare Intelligence Network. All rights reserved.
Healthcare Intelligence Network
Gateway to Healthcare Business Information on the Internet
800 State Highway 71, Suite 2, Sea Girt, N.J. 08750