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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

An alarming new statistic has been released by the American Heart Association: the rate of women having strokes while pregnant and immediately afterwards has increased by more than 50 percent over the past dozen years. Risk factors like high blood pressure and obesity are the culprits. This finding maps to our recent story from the Robert Wood Johnson Foundation and the Trust for America's Health revealing that almost a third of people in 12 states were obese in 2010.

In other news, prescription drug spending has slowed by almost 2 percent in 2010, according to new data released by CMS and reported in Health Affairs. Increases in generic dispensing rates is just one of the reasons for the slowdown.

In a move designed to improve quality and reduce healthcare costs, Blue Shield of California and SJHS are launching an ACO. The healthcare entities will work together to share clinical and case management information and coordinate comprehensive healthcare services.

And, midway through our Patient Registries Survey we find that three-fourths of our respondents see diabetes patients as the principal targets of registries. Want to weigh in on your organization's use of registries? You have a few more days to complete the survey online, and you'll receive a free executive summary of the survey results once they are compiled, providing key benchmarks and metrics for using registries to improve reimbursement and patient outcomes.

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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This week's featured download: 2011 Benchmarks in the Patient-Centered Medical Home

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August 8, 2011
Vol. XIII, No. 29

Sponsored by:
Embedded Case Management in the Primary Care Practice: Program Design and Results

This week's industry news:

  1. Blue Shield CA-St. Joseph ACO Hopes to Improve Quality, Reduce Cost
  2. Assessing ACO Business Opportunities in the Medicare and Commercial Markets
  3. Hospitalist Cost Savings Offset by Frequent Readmissions
  4. Guide to Reducing Medicare Readmissions, Vol. II
  5. Healthcare Business White Paper: Clinical Case Management
  6. Rate of Stroke Increasing Among Women During, Soon After Pregnancy
  7. New Chart: Top 5 Reimbursable Services for Weight Management
  8. 2011 Benchmarks in Obesity and Weight Management
  9. Study Credits PBM Tools with Reducing Prescription Drug Spending Growth
  10. Improving Adherence and Containing Rx Costs
  11. Two Steps to Reduce Acute Utilization with Disease Management
  12. Prescription for Profitability
  13. HealthSounds Video: 2011 Trends & Metrics in Healthcare Case Management
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.

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Using Registries for Quality Improvement

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This week's industry news

1.) Blue Shield CA-St. Joseph ACO Hopes to Improve Quality, Reduce Cost

Blue Shield of California and St. Joseph Health System (SJHS) are collaborating on a coordinated care model they hope will improve quality and reduce healthcare costs.

Get the full story.

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2.) Assessing ACO Business Opportunities in the Medicare and Commercial Markets

Assessing With CMS’ long-awaited proposed rule governing the Medicare Shared Savings (ACO) program now on the table, healthcare organizations can analyze the opportunities that exist with the program and take advantage of the commercial ACO opportunity. This 45-minute webinar replay provides a critical analysis of CMS's final rule on Medicare Shared Savings and how it will impact commercial ACOs.

Learn more about this resource.

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3.) Hospitalist Cost Savings Offset by Frequent Readmissions

Despite the cost savings associated with hospitalists, their patients' frequent readmissions are actually increasing healthcare costs, according to a new study published in the Annals of Internal Medicine.

Get the full story.

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4.) Guide to Reducing Medicare Readmissions, Vol. II

Guide to Reducing Medicare Readmissions, Vol. II This guide examines innovative interventions to reduce preventable admissions, rehospitalizations and ER visits by high-utilizing Medicare beneficiaries. This guide looks at four multidisciplinary collaborative interventions aimed at key factors fueling readmissions in this population — and that support an accountable care vision.

Learn more about this resource.

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5.) Healthcare Business White Paper: Clinical Case Management — A Common Platform for Managing Health and Productivity

As economic connections between employee health and workforce productivity have been more clearly delineated, employers are considering health and productivity management as a business strategy that can increase corporate earnings. Integrating the management of their benefit programs is one option for such strategies, but certainly not the only means of achieving this goal.

Download this complimentary white paper.

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6.) Rate of Stroke Increasing Among Women During, Soon After Pregnancy

The stroke rate for pregnant women and those who recently gave birth increased more than 50 percent over the past dozen years, according to research reported in Stroke: Journal of the American Heart Association.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Reimbursable Services for Weight Management

Reimbursable Services for Weight Management Despite early indicators of success on the management front, obesity is still tied to an estimated $117 billion in healthcare costs. We wanted to see which obesity and weight management services are reimbursable for adult populations.


Click here to view the chart.

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8.) 2011 Benchmarks in Obesity and Weight Management

2011 Benchmarks in Obesity and Weight Management This 25-page resource takes a comprehensive look at efforts in the healthcare industry to manage obesity and weight, based on recent market research by the Healthcare Intelligence Network. Researchers found that weight management is one of the top five disease management efforts for which financial and benefit-based incentives are offered. Healthcare reform is also rewarding prevention-focused programs, and this resource captures the efforts of more than 130 organizations in the prevention and reduction of obesity and related conditions and costs in their populations.

Learn more about this resource.

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9.) Study Credits PBM Tools with Reducing Prescription Drug Spending Growth

Prescription drug spending growth slowed by nearly 2 percent in 2010, according to new data released by CMS and reported in Health Affairs.

Get the full story.

>>Return to this week's industry news


10.) Improving Adherence and Containing Rx Costs: New Health Plan/PBM Strategies

Improving Adherence and Containing Rx Costs This resource examines the pharmacy benefit management strategies that health plans, PBMs and payors have found most successful at reducing costs, improving adherence and maximizing formulary value. Packed with case studies, relevant data and thorough analysis, this report details a variety of strategies health plans and PBMs have tested to combat poor adherence.

Learn more about this resource.

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11.) Two Steps to Reduce Acute Utilization with Disease Management

Conducting a needs assessment and patient identification are crucial first steps in a 6-step process to reduce acute utilization with disease management developed by Ariel Linden, Dr. P.h., M.S., president of Linden Consulting Group, and Julia Adler-Milstein.

Get the full story.

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12.) Prescription for Profitability: 50 Ideas to Stimulate Healthcare Savings

 Infection Prevention Manual for Long-Term Care This 35-page resource delivers cutting-edge advice on key programs funded for pilots, demos and incentives in healthcare reform — the patient-centered medical home, health coaching, care transitions, hospital readmissions, medication management and innovative payment models like the accountable care organization (ACO). This resource provides a quick-reference on key programs and innovations that can help to put money back on the table for stakeholders by improving the quality of healthcare and curtailing avoidable utilization and cost.

Learn more about this resource.

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13.) HealthSounds Video: 2011 Trends & Metrics in Healthcare Case Management

>Healthcare Case Management How are more than 200 health plans, hospitals, physician practices and others utilizing case managers in today's challenging healthcare environment? Get the latest trends and metrics on the changing role of the healthcare case manager in this new video, narrated by Melanie Matthews of the Healthcare Intelligence Network, with commentary by Toni Cesta, senior vice president of operational efficiency and capacity management at Lutheran Medical Center. This data is based on HIN's second annual survey on healthcare case management.

Watch the video.

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