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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Addressing what families and caregivers consider to be most important during a hospital stay is the impetus behind a new guide from the Agency for Healthcare Research and Quality (AHRQ).

The Guide to Patient and Family Engagement in Hospital Safety and Quality provides four evidence-based strategies that hospitals can use to implement patient and family-centered care practices. Each strategy includes educational tools and resources for patients and families, training materials for healthcare professionals and real-world examples that show how strategies are being implemented in hospital settings.

The strategies describe the ways patients and families can work more effectively with hospital staff, including promoting patient engagement and better communication at the bedside to improve quality.

Patient engagement is one of five key components when creating a patient-centered medical home (PCHM) model, as we discuss in two of our stories this week. If you don’t focus on engaging your patient in the model, it simply won’t be as successful as expected, explains Jay Driggers, director of consumer engagement at Horizon BCBS-NJ. Four other components, including payment reform, round out this story.

Health centers have gotten a payment boost to guide uninsured Americans toward affordable health coverage, according to the Department of Health & Human Services (HHS). The agency has allocated $150 million in grants to 1,159 health centers to help them with enrollment assistance. Health centers are expected to hire an additional 2,900 outreach and eligibility assistance workers to assist millions nationwide with enrollment into affordable health coverage.

Of those already insured, Medicaid recipients in Michigan were the most satisfied with their healthcare coverage in 2012, according to a report from The Center for Healthcare Research & Transformation (CHRT), while those with individual coverage were the least satisfied. These findings predict how consumers may react once health insurance marketplaces go into effect in 2014.

The survey, conducted with the Institute for Public Policy and Social Research at Michigan State University, found that those with individually purchased insurance had more negative experiences (61 percent) than those with other types of insurance. Their negative experiences related to services that were not covered by benefits, or having to pay out-of-pocket for services that cost above what their insurance would pay. This group was also the least concerned about losing their coverage.

In comparison, Medicaid recipients were the least likely to report a negative experience with their coverage (41 percent) and yet were the most concerned about losing their coverage. Researchers attributed this to Medicaid recipients' gratitude at having coverage, given their health needs.

Population health management of dual eligibles — the 9 million Americans eligible for both Medicaid and Medicare — presents unique challenges. Public and private payors are now tailoring care coordination strategies for Medicare-Medicaid beneficiaries that are both geared to their medical, social and functional needs and cost-efficient. Describe your organization's approach to care coordination of dual eligibles on our survey by July 31, 2013 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 Fornarotto
Associate Editor:
Jessica Fornarotto, jfornarotto@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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July 15, 2013
Vol. XV, No. 26

Sponsored by:
Performance Quality Measurement and Reporting for Accountable Care


This week's industry news:

  1. New AHRQ Hospital Guide Offers 4 Strategies to Engage Patients, Clinicians
  2. Patient Engagement and Provider Collaborations Across the Healthcare Continuum to Improve Care Transitions
  3. Patient-Centered Medical Home Saves Michigan Blues $155 Million Over Three Years
  4. 2012 Healthcare Benchmarks: Reducing Avoidable ER Visits
  5. Healthcare Business White Paper: Care Transitions in 2013
  6. Medicaid Recipients Most Satisfied with Insurance Coverage; Individually Insured Least Satisfied
  7. New Chart: Top 5 Health Coaching Promotion Tools
  8. Guide to Physician Engagement
  9. Health Centers Get Boost to Guide Uninsured Americans Toward Affordable Health Coverage
  10. Health Insurance Exchanges
  11. 5 Core Elements of the Patient-Centered Medical Home
  12. New Models in the Patient-Centered Medical Home
  13. Infographic: Medical Cost Trend — Behind the Numbers 2014
  14. Health and Wellness Incentives: Positioning for Outcome-Based Rewards
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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Care Coordination of Dual Eligibles in 2013

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This week's industry news

1.) New AHRQ Hospital Guide Offers 4 Strategies to Engage Patients, Clinicians

A new guide designed to help hospitals improve their patients’ care by bridging communication gaps among patients, families and healthcare providers is now available from HHS’ Agency for Healthcare Research and Quality (AHRQ).

Get the full story.

>>Return to this week's industry news


2.) Patient Engagement and Provider Collaborations Across the Healthcare Continuum to Improve Care Transitions

Patient Engagement and Provider Collaborations Across the Healthcare Continuum to Improve Care Transitions This webinar, now available for replay, shares the lessons learned from the 14 communities that participated in the CMS care transition demonstration project and details on how the program is being rolled out in 400 communities and to over 12 million Medicare beneficiaries across the country.

Learn more about this resource.

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3.) Patient-Centered Medical Home Saves Michigan Blues $155 Million Over Three Years

Blue Cross Blue Shield of Michigan saved an estimated $155 million in prevented claims costs over the first three years of its Patient-Centered Medical Home (PCMH) program, according to an analysis published in the Health Services Research Journal.

Get the full story.

>>Return to this week's industry news


4.) 2012 Healthcare Benchmarks: Reducing Avoidable ER Visits

2012 Healthcare Benchmarks: Reducing Avoidable ER Visits This resource delivers actionable information from 134 healthcare organizations on their efforts to reduce inappropriate ED visits, and presents year-over-year trends and suggests how to engage the primary care physician, urgent care centers and patient education tools in these efforts.


Learn more about this resource.

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5.) Healthcare Business White Paper: Care Transitions in 2013 — Interventions Surge in Response to Payor Scrutiny; Home-Grown Approaches Trump Traditional Models

Care Transitions in 2013 In its third annual e-survey on Care Transition Management, the Healthcare Intelligence Network (HIN) captured efforts by 86 organizations to strive for Triple Aim goals of better care at improved cost during transitions of care. Conducted in April 2013, the survey measures existing and planned programs, targeted transitions and populations, transition team members and responsibilities, and much more. This HINtelligence Report provides data highlights on care transition program components, the most successful tools for care transition management, results and ROI; and much more.

Download this complimentary white paper.

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6.) Medicaid Recipients Most Satisfied with Insurance Coverage; Individually Insured Least Satisfied

Medicaid recipients in Michigan were the most satisfied with their healthcare coverage in 2012, while those with individual coverage were the least satisfied, according to a report from The Center for Healthcare Research & Transformation (CHRT). These findings predict how consumers may react once health insurance marketplaces go into effect in 2014.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Health Coaching Promotion Tools

New Chart: Top 5 Health Coaching Promotion Tools More than half — 59 percent — of healthcare companies use their corporate Web site to promote health coaching, according to HIN's latest Health Coaching survey. We wanted to identify other ways these respondents market their health coaching programs.

Click here to view the chart.

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8.) Guide to Physician Engagement

Guide to Physician Engagement This resource deconstructs the physician culture and suggests tactics for converting reluctant physicians into champions for healthcare improvement. Q&A chapter answers more than 40 questions on the engagement of physicians.


Learn more about this resource.

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9.) Health Centers Get Boost to Guide Uninsured Americans Toward Affordable Health Coverage

Over 1100 health centers across the country have received funds to enroll uninsured Americans in new health coverage options made available by the ACA, according to the Department of Health & Human Services (HHS).

Get the full story.

>>Return to this week's industry news

10.) Health Insurance Exchanges: Product Design, Promotion and Positioning

Health Insurance Exchanges This resource features insights from key industry consultants, state regulators and health insurers on the primary issues that will affect product designs for state health insurance exchanges.



Learn more about this resource.

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11.) 5 Core Elements of the Patient-Centered Medical Home

When creating a patient-centered medical home (PCHM) model, it is only as strong as your patient engagement component, says Jay Driggers, director of consumer engagement at Horizon BCBS-NJ. If you don’t focus on engaging your patient in the model, you won’t be as successful as you need to be.

Get the full story.

>>Return to this week's industry news


12.) New Models in the Patient-Centered Medical Home: Incentives, Infrastructure and IT to Support Accountable Care

New Models in the Patient-Centered Medical Home This resource begins with an overview of 2012 PCMH trends, and offers snapshots of thriving medical home initiatives and their particular area of focus.




Learn more about this resource.

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13.) Infographic: Medical Cost Trend — Behind the Numbers 2014

2014 brings uncertainty in the healthcare industry as millions more Americans are expected to gain coverage through Medicaid or new online marketplaces. Medical needs of enrolling populations are unknown, however it is unlikely that these changes will affect medical costs. Healthcare will continue to move out of the hospital and physician offices, and more care will be delivered via non-traditional channels at a lower cost, according to a new infographic from PWC. This infographic shows rates of readmission, health plan statistics, trends of prescription drug cost and more.

Read this blog post.

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14.) Health and Wellness Incentives: Positioning for Outcome-Based Rewards

John Riedel Outcomes-based rewards have a place in an overall incentives offering, notes John Riedel, president, Riedel & Associates Consultants, Inc., but despite the growth in these offerings, companies should keep their incentive options open. To maximize effectiveness, programs should include something for all: simple items like gift cards and tee shirts for sign-on, progress-based rewards to move individuals along, and outcomes-based incentives for individuals who take their health seriously. Reidel examines the staying power of extrinsic incentives and suggests eight questions companies should ask themselves to determine whether they’ve truly constructed a culture of health for the population they serve.

Listen to this podcast.

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