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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

The hip bone’s connected to the thigh bone...the thigh bone’s connected to the...cranial bone?

That’s how this old children’s song might be rewritten today, given the results of a new study from Oregon State University linking physical ailments to mental healthcare.

While mental health issues like depression alone are not enough to make people seek help, depression stemming from back pain or chronic diseases like diabetes are sending people to their nearest mental health practitioner. And this is good news in a way, say researchers, because early mental healthcare can significantly lower healthcare costs in the long run.

More good news on ways to lower healthcare costs: a global budget program, an alternative to traditional fee-for-service (FFS) reimbursement models, can lower the costs of medical spending and improve care quality for patients, according to a study from Harvard Medical School's Department of Health Care Policy.

The study, based on two years of claims data from Blue Cross Blue Shield of Massachusetts’ (BCBSMA) Alternative Quality Contract (AQC), found that healthcare provider groups participating in the AQC spent nearly 2 percent less than FFS groups in the first year, and more than 3 percent less in the second year. Reduced spending was attributed to changing referral patterns, among other things, and quality of care improvements were also greater in the second year than in the first.

Care quality is at issue when it comes to hospitals' risk-standardized stroke-care rankings; they can be unfairly impacted if the severity of strokes are not considered, says a new study from UCLA.

Hospitals and medical centers must report their quality-of-care and risk-standardized outcomes for stroke and other common medical conditions. But reporting models for mortality that don't consider stroke severity may unfairly skew these results. And this could have worse implications for patient care if hospitals start turning away those with more severe strokes or transferring them to other hospitals after they've been assessed by the ED to avoid being misclassified as having a higher mortality risk, researchers note.

Participation in ACOs continues to grow; CMS has announced 15 new ACOs that will receive advance payments to help them with care coordination costs. The advanced payment model is designed to support physician-based and rural ACOs who will provide coordinated high quality care to Medicare patients.

You can find more information on ACOs in our latest video, which documents their growth in the last year, based on our market research.

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 Papay
Associate Editor:
Jessica Papay, jpapay@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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July 23, 2012
Vol. XIV, No. 27

Sponsored by:
Patient Engagement in the Patient Centered-Medical Home: A Continuum Approach

This week's industry news:

  1. Physical Health Problems Spur More Patients to Seek Mental Health Services
  2. 38 Disease Management Metrics
  3. Alternative Payment Model Lowers Medical Spending, Improves Care
  4. Aligning Physician Incentives for Shared Risk and Reward
  5. Healthcare Business White Paper: 2012 Trends in Embedded Case Management: Putting a Face on Care Coordination
  6. Hospitals' Stroke-Care Rankings Must Include Stroke Severity: Study
  7. New Chart: How to Reduce Avoidable ER Visits by the Recently Discharged
  8. 27 Interventions to Reduce Avoidable ER Use
  9. CMS Announces 15 New Advance Payment ACOs
  10. 2012 Healthcare Benchmarks: Accountable Care Organizations
  11. 3 Ways to Assess Patients for Medication Adherence
  12. Pharmacists and Medication Adherence: Brief Interventions, Motivational Interviewing and Telepharmacy
  13. Are Payment Tides Turning for Primary Care?
  14. New Video Documents ACO Activity: Accountable Care Doubles in Last Year
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This week's industry news

1.) Physical Health Problems Spur More Patients to Seek Mental Health Services

People who experience physical health problems are three times more likely to seek mental health services than those who have no physical ailments, according to a new study from Oregon State University (OSU).

Get the full story.

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2.) 38 Disease Management Metrics

38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care In 38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care, several years of market research documenting the role and outcomes of disease management in 11 key areas are examined, as well as the high-focus diseases and health conditions of initiatives including obesity and weight management, diabetes management, medication adherence, reducing hospital readmissions, health coaching, and more.

Learn more about this resource.

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3.) Alternative Payment Model Lowers Medical Spending, Improves Care

A global budget program, an alternative to traditonal fee-for-service reimbursement models, can lower the costs of medical spending and improve care quality for patients, according to a study from Harvard Medical School’s Department of Health Care Policy.

Get the full story.

>>Return to this week's industry news


4.) Aligning Physician Incentives for Shared Risk and Reward

Aligning Physician Incentives for Shared Risk and Reward In Aligning Physician Incentives for Shared Risk and Reward Across the Healthcare Continuum, Babette Apland, senior vice president of health and care management for HealthPartners, shares how HealthPartners aligned physician incentives and shared savings with pay-for-performance programs and a total cost of care initiative.



Learn more about this resource.

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5.) Healthcare Business White Paper: 2012 Trends in Embedded Case Management: Putting a Face on Care Coordination

Despite challenges ranging from physician and practice buy-in to recruitment and retention, the number of healthcare companies embedding or co-locating case managers in care sites continues to rise. Just over half of respondents to the Healthcare Intelligence Network's third annual Healthcare Case Management e-survey, conducted in February 2012, said they embed case managers at the point of care; of those 2012 respondents, nearly 60 percent cited the primary care practice as the most likely work site for an on-site case manager.

Download this complimentary white paper.

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6.) Hospitals' Stroke-Care Rankings Must Include Stroke Severity: Study

Hospitals’ risk-standardized stroke-care rankings can be unfairly impacted if the severity of strokes are not considered, says a new study from UCLA.

Get the full story.

>>Return to this week's industry news


7.) New Chart: How to Reduce Avoidable ER Visits by the Recently Discharged

How to Reduce Avoidable ER Visits by the Recently Discharged In today's value-based healthcare sphere, there are many motivators to reduce avoidable ER visits: quality improvement, core measure metrics, reimbursement and incentives, cost trend, accreditation and recognition of ACOs and medical homes, to name just a few. We wanted to see how healthcare organizations reduce avoidable ER visits by patients recently discharged from the hospital.

Click here to view the chart.

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8.) 27 Interventions to Reduce Avoidable ER Use

27 Interventions to Reduce Avoidable ER Use In 27 Interventions to Reduce Avoidable ER Use, provider- and patient-focused interventions that target the high numbers of avoidable visits, high and ultra-high utilizers and the sub-populations noted for frequent ER use.


Learn more about this resource.

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9.) CMS Announces 15 New Advance Payment ACOs

Fifteen new ACOs will receive monthly payments to help them with care coordination costs, according to the CMS.

Get the full story.

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10.) 2012 Healthcare Benchmarks: Accountable Care Organizations

2012 Healthcare Benchmarks: Accountable Care Organizations In 2012 Healthcare Benchmarks: Accountable Care Organizations, the numerous ways in which accountable care is transforming healthcare delivery, population health management, reimbursement for care and, most importantly to this year’s survey respondents, the patient experience, are documented.


Learn more about this resource.

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11.) 3 Ways to Assess Patients for Medication Adherence

Borrowing from therapeutic alliance formulas in other healthcare areas, pharmacists are increasingly using methods like motivational interviewing and brief interventions to successfully screen and evaluate patients for medication adherence, says Janice Pringle, PhD, director of the Program Evaluation Research Unit (PERU) and an associate professor at the University of Pittsburgh School of Pharmacy.

Get the full story.

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12.) Pharmacists and Medication Adherence: Brief Interventions, Motivational Interviewing and Telepharmacy

Pharmacists and Medication Adherence Pharmacists and Medication Adherence: Brief Interventions, Motivational Interviewing and Telepharmacy describes a number of interventions in which pharmacists help to guide patients and health plan members to higher levels of medication adherence — programs that take place in the pharmacy, in the physician practice, or virtually.



Learn more about this resource.

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13.) Are Payment Tides Turning for Primary Care?

Several indicators this month point to more dollars flowing into primary care offices, either in the form of higher provider salaries, increased reimbursement, or both. And new market data finds physicians leading the majority of accountable care organizations (ACO).

Read this blog post.

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14.) New Video Documents ACO Activity: Accountable Care Doubles in Last Year

ACO Growth Documented in New Video Along with bundled payments, the accountable care organization would be the healthcare model to watch in 2012, predicted healthcare consultant Steven T. Valentine late last fall.

Watch this video.

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