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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

While electronic communications in clinical care might appeal to medical leaders and especially patients (No commuting! No waiting time!) physicians aren’t as likely to welcome it unless different payment models emerge, according to a study from Weill Cornell Medical College.

Considered efficient and cost-effective, enabling doctors to email test results to patients or manage clinical conditions without a time-consuming and costly visit, doctors are still unwilling to adopt e-communications until patient workloads are reduced or they are paid for the time they spend phoning and emailing patients, both during and after office hours. Their biggest complaint? A work day that never ends, with anywhere from five to 50 emails to respond to daily. Physicians are looking for compensation for e-communications in ways other than traditional fee-for-service (FFS); more details inside.

We highlight another cost-effective method this week: the use of electronic health records (EHRs) to automate reporting of quality measures. According to a new study from Kaiser Permanente, the method reduced reporting time by nearly 50 percent in surgical care improvements.

Of the six Total Joint Commission measure sets — acute myocardial infarction (AMI), emergency department (ED) patient flow, immunizations, the surgical care improvement project (SCIP), pneumonia and VTE prophylaxis — Kaiser Permanente observed a 50 percent reduction in reporting time for the surgical care improvement project (SCIP), a national quality partnership of organizations interested in improving surgical care by significantly reducing surgical complications.

Given this improvement, researchers say that time savings are likely achievable on a broader scale. Like electronic communications, automated quality reporting allows for immediate access to data, which can more quickly lead to improved care for patients.

Improving the quality of healthcare for all in the United States isn't about finding the right mix of rewards (“carrots”) and punishments (“sticks”) for patients and clinicians, according to a new report from the Health Care Incentives Improvement Institute, Inc. (HCI3®), in conjunction with the Robert Wood Johnson Foundation (RWJF). It is about finding an approach that allows each party to make good decisions on their own about healthcare.

Contrary to conventional wisdom, external incentives designed to change simple behaviors, like improving productivity in rote tasks, do not work for more complex behaviors. In fact, they can actually be harmful, undermining assets like creativity and drive, which are essential to the success of health professionals and workers in other fields.

Instead, the researchers argue that healthcare reform should focus on finding internal motivations that doctors and patients share when delivering or seeking the best care. Most health professionals enter training with the same goal that their patients enter the doctor’s office with: to improve patients’ health. But, as doctors begin to practice and patients begin to pay, they encounter a whole host of conflicting external forces that distort their once shared goal, explained in this issue.

Improving patient care is also the goal of Aetna’s recent accountable care agreements with five major health systems in Maine. Under each agreement, the providers will become part of a coordinated healthcare network and receive information about medical care and medications a patient may be receiving. By having access to information about the patient’s range of healthcare interactions, providers can better coordinate their patient’s care, reducing duplicate testing and appointments, and making the healthcare experience simpler for the patient.

This care will be supported by changes in the way these hospitals and providers are reimbursed for care with certain payments based on the achievement of mutually agreed upon measures of quality, efficiency and patient outcomes.

And lastly, are you participating in an accountable care organization (ACO)? As the number of public and private accountable care organizations nears 500, participants and pundits alike are looking more closely at the ACO model's structure, challenges and benefits. Take HIN's third annual survey on ACOs by September 6, 2013 and receive a free executive summary of the compiled results. Your responses will be kept 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

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August 12, 2013
Vol. XV, No. 30

Marcus Evans Health Care Executives Summit Sponsored by:

marcus evans Healthcare Executives Summit

The National Healthcare CXO event is an invitation-only event held for approximately 90 attendees and is closed to the public. Delegates include CEOs, CAOs and COOs. The topics include: thoughts on the transformation of our healthcare system, cultivating a healthy hospital-physician relationship, quality measurement, techniques and redesigning the care process for improved results, patient satisfaction and experience programs to boost engagement and communication, and reducing costs by investing in outpatient care.

Click here to visit the conference Web site.


This week's industry news:

  1. Patients Welcome Widespread Electronic Communications Use; Physicians Wary
  2. Guide to Physician Engagement
  3. Improved Care Coordination, Patient Engagement Key to Aetna’s New ACO Agreements in Maine
  4. Population Health Management Tools for ACOs
  5. Healthcare Business White Paper: Medication Adherence in 2013
  6. EHRs Save Up to 50 Percent of Time in Quality Measures
  7. New Chart: What's the Greatest Challenge Posed by a PHM Approach?
  8. 2012 Benchmarks in Patient Registry Use for Accountable Care
  9. New Report Challenges Basic Assumptions About Healthcare Payment Reform
  10. Blueprint for Bundled Payments
  11. Videoconferencing, Virtual Visits and Smartphones Lead Telehealth Use
  12. 2013 Healthcare Benchmarks: Telehealth & Telemedicine
  13. Infographic: Realizing the Value of Health IT
  14. A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings
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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Take our monthly e-survey:
Accountable Care Organizations in 2013

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

Interested in all open surveys? Review them here.


This week's industry news

1.) Patients Welcome Widespread Electronic Communications Use; Physicians Wary

While patients and health organizations favor the use of electronic communications in clinical care, primary care physicians are not likely to adopt it unless different payment models emerge, according to a study from Weill Cornell Medical College.

Get the full story.

>>Return to this week's industry news


2.) 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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3.) Improved Care Coordination, Patient Engagement Key to Aetna’s New ACO Agreements in Maine

Aetna has announced five new accountable care agreements in Maine that will align payment for medical services at major health systems in the state with improved quality, efficiency and patient experiences.

Get the full story.

>>Return to this week's industry news


4.) Population Health Management Tools for ACOs: Technologies and Tactics to Support Accountable Care

Population Health Management Tools for ACOs This examines the building blocks of population health management that drive improvements in healthcare quality and efficiency in ACOs — while positioning healthcare organizations for core measure improvement and increased reimbursement.



Learn more about this resource.

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5.) Healthcare Business White Paper: Medication Adherence in 2013 — Closer Look at Compliance During Care Transitions

Medication Adherence in 2013 In its third annual Medication Adherence e-survey conducted in January 2013, HIN captured emerging trends in efforts to improve medication adherence (MA) among more than 100 healthcare organizations. According to 75 percent of survey respondents, complex patients remain the most common targets of MA programs. This HINtelligence Report provides data highlights on MA program components, the most successful tools for improving MA, and more.

Download this complimentary white paper.

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6.) EHRs Save Up to 50 Percent of Time in Quality Measures

Using electronic health records (EHRs) to automate reporting of quality measures reduced reporting time by nearly 50 percent in surgical care improvements, according to a new study from Kaiser Permanente, published in the Journal of the American Medical Informatics Association.

Get the full story.

>>Return to this week's industry news


7.) New Chart: What's the Greatest Challenge Posed by a PHM Approach?

New Chart: What's the Greatest Challenge Posed by a PHM Approach? According to nearly 43 percent of respondents to HIN's first annual survey on Population Health Management (PHM), the greatest challenge posed by a PHM approach is patient engagement. We wanted to see what other challenges exist for PHM programs.

Click here to view the chart.

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8.) 2012 Benchmarks in Patient Registry Use for Accountable Care

2012 Benchmarks in Patient Registry Use for Accountable Care This resource provides actionable data from more than 100 healthcare companies on their current and planned use of registries and the impact of registry use on healthcare quality, efficiency and cost.



Learn more about this resource.

>>Return to this week's industry news


9.) New Report Challenges Basic Assumptions About Healthcare Payment Reform

Improving the quality and affordability of healthcare in the United States isn’t about finding the right mix of rewards and punishments for patients and clinicians, according to a new report from the Health Care Incentives Improvement Institute, Inc. (HCI3®), in conjunction with the Robert Wood Johnson Foundation (RWJF).

Get the full story.

>>Return to this week's industry news

10.) Blueprint for Bundled Payments: Strategies for Payors and Providers

Blueprint for Bundled Payments This resource provides perspectives on payment bundling, including definitions of key elements, advice for payors and providers, what’s ahead in bundled payments for primary care, and examples of the payment model at work in one organization.


Learn more about this resource.

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11.) Videoconferencing, Virtual Visits and Smartphones Lead Telehealth Use

Smartphones are in; landlines are out, according to the latest survey on Telehealth in 2013 from the Healthcare Intelligence Network. Telehealth continues to lead the way in healthcare, by targeting all populations with solutions that enable remote consultations.

Get the full story.

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12.) 2013 Healthcare Benchmarks: Telehealth & Telemedicine

2013 Healthcare Benchmarks: Telehealth & Telemedicine This resource provides actionable new information from more than 125 healthcare organizations on their utilization of telehealth and telemedicine. In its third year, it documents trends and metrics on current and planned telehealth and telemedicine initiatives and includes a year-over-year comparison of telehealth trends from 2009 to present.

Learn more about this resource.

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13.) Infographic: Realizing the Value of Health IT

Health information technology (IT) not only affects hospital processes, but also directly improves patient care. Health IT has generated a 118 percent increase in patient satisfaction, according to a healthcare organization featured in a new infographic from Healthcare Information and Management Systems Society (HIMSS). The infographic identifies five kinds of benefits of health IT to patients, healthcare providers and communities.

Read this blog post.

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14.) A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings

Jim Bellows Low scores on patient outcomes measures within the CMS Star Quality ratings program — metrics CMS weights most heavily in its assignment of stars — can typically be traced to poor provider and member engagement, notes Joseph Johnson, vice president of L.E.K. Consulting. Johnson suggests ways to enlist support from these two stakeholder groups, and describes how MA plans should prepare for the possible display in 2014 of CAHPS care coordination ratings along with with its star scores (though the care coordination ratings will not be factored into star ratings).

Listen to this podcast.

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