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Dear Healthcare Intelligence Network Client,

This week we offer some out-of-the-box thinking that's getting results: health coaching for seniors that reduces Medicare claims (Danielle Butin of SecureHorizons says you can teach an old dog new tricks), creative connections with hard-to-reach Medicaid members, and re-thinking patients who don't fit neatly into prescribed clinical measures when launching pay-for-performance programs.

We hope these ideas inspire innovation. If an unconventional approach is working for your organization, there's a good chance it can succeed elsewhere. Share your innovations by emailing editor@hin.com, or post a comment to our blog at http://blog.hin.com.

Your colleague in the business of healthcare,
Patricia Donovan
Editor, Healthcare Business Weekly Update

Please pass this along to any of your colleagues or, better yet, have them sign up to receive their own copy at http://www.hin.com/freenews2.html where you can also learn about our other news services.


Healthcare Business Weekly Update
Volume VIX, No. 25
August 13, 2007

Sponsored by: Pursuing Perfect Care: Improving Chronic Care Outcomes by Treating the Whole Patient

During Pursuing Perfect Care: Improving Chronic Care Outcomes by Treating the Whole Patient, a 90-minute audio conference on August 22, 2007, you'll hear from organizations who are implementing perfect care processes in heart failure and medication management with details on how they've implemented their programs and the results they are achieving.

For more information, please visit:
http://store.hin.com/product.asp?itemid=3725


Table of Contents
  1. P4P In Medicaid Managed Care: Money Talks, But Only If Thereís Enough Of It
  2. Ensuring the Benefits of Public Reporting and Pay-for-Performance Programs Outweigh the Unintended Consequences
  3. Outpatient Growth is Key in Improving Quality and Efficiency
  4. How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments
  5. Featured Healthcare Business White Paper: Pay for Performance: Improving Quality and Efficiency of Healthcare Delivery
  6. Telephone Coaching Benefits Problem Drinkers
  7. Coaching in the Healthcare Continuum: Models, Methods, Measurements and Motivation
  8. Reducing Medicare Claims with Health Coaching
  9. Coordinating Care Transitions for the Elderly and Dually Eligible: Fostering Self-Management and Reducing Readmissions
  10. New Jersey Explores Home Healthcare for Veterans
  11. Documentation and Reimbursement for Home Care and Hospice Programs
  12. Worth Repeating: 25 Creative Solutions for Reaching the Medicaid Population
  13. The Medicaid Population: Identifying, Locating and Engaging a Hard-to-Reach Population for Disease Management Success


1. P4P In Medicaid Managed Care: Money Talks, But Only If Thereís Enough Of It

Pay-for-performance can work in a Medicaid managed care setting, but only if plans place enough dollars at stake and communicate well with providers, researchers from Mathematica Policy Research reported. In work supported by the California HealthCare Foundation (CHCF), the Mathematica authors describe the results of a 2003-05 P4P demonstration aimed at improving the timeliness of well-baby care. The demonstration, the Local Initiative Rewarding Results (LIRR) Collaborative Demonstration, funded by CHCF and the Robert Wood Johnson Foundation, involved seven California Medicaid managed care plans operating in different regions. The plans requested anonymity.

To read this story in its entirety, go to:
http://www.hin.com/sw/Hindustry_MC081307.html



2. Ensuring the Benefits of Public Reporting and Pay-for-Performance Programs Outweigh the Unintended Consequences

During this 45-minute roundtable audio conference, we will examine some of the unintended consequences from pay-for-performance programs that may put patients in harm's way and how healthcare organizations can circumvent these problems. Industry expert Dr. Dale Bratzler, QIOSC medical director, Oklahoma Foundation for Medical Quality Inc., will provide a brief overview of the potential unintended consequences of public reporting that could lead to patient harm in both direct and indirect ways.

For more information and to listen to pre-conference comments:
http://store.hin.com/product.asp?itemid=3729



3. Outpatient Growth is Key in Improving Quality and Efficiency

Growing outpatient services is a crucial component to the speed and consistency in which hospitals improve, according to the Thomson 100 Top Hospitals: Performance Improvement Leaders study by Thomson Healthcare. The study looked at the performance of 2,897 U.S. hospitals in clinical, financial, and operational areas and named the top 100 hospitals that showed the most improvement from 2001 to 2005.

To read this story in its entirety, go to:
http://www.hin.com/sw/hospital_HSmanagement081307.html



4. How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments

How to Structure a Healthcare Performance Improvement Process That Results in Incentive Payments, an April 18, 2007 audio conference on CD-ROM, presents case studies from three hospitals whose quality improvement efforts have paid off. Cleveland County Healthcare System, Hackensack University Medical Center and Memorial Medical Center described the performance improvement programs at their respective organizations that yielded bonus quality incentive payments from the Centers of Medicare and Medicaid Services (CMS) under the Premier Hospital Quality Improvement Demonstration program.

For more information on, please visit:
http://store.hin.com/product.asp?itemid=3639



Please Forward This Issue

If you havenít already done so, please forward this issue to one or two of your business associates. Thanks so much.

To subscribe, please visit:
http://www.hin.com



5. Featured Healthcare Business White Paper: Pay for Performance: Improving Quality and Efficiency of Healthcare Delivery

This white paper examines the history of the pay-for-performance healthcare reimbursement model, defines measures of performance, challenges for healthcare organizations planning to implement pay-for performance systems, and the implications of pay-for-performance programs for healthcare IT.

To download this complimentary white paper, please visit:
http://www.hin.com/library/registerppi.html



6. Telephone Coaching Benefits Problem Drinkers

Researchers from the University of Wisconsin suggest that telephonic counseling could be an effective treatment for hard-to-reach patients struggling with alcoholism. Previous research shows that a few short discussions with a health professional can help a problem drinker. However, often patients are reluctant or unable to physically meet with a counselor, making telephone counseling an easier means, requiring fewer resources than face-to-face meetings as well.

To read this story in its entirety, go to:
http://www.hin.com/sw/behavioral_health081307.html



7. Coaching in the Healthcare Continuum: Models, Methods, Measurements and Motivation

Tapping health coaches to empower at-risk individuals to adopt healthier lifestyles -- via telephonic, Web-based or other coaching support -- is scoring improved outcomes and reducing healthcare expenditures.

For more information on, please visit:
http://store.hin.com/product.asp?itemid=3631



8. Reducing Medicare Claims with Health Coaching

Danielle Butin, director of Northeast Health Services for SecureHorizons, a division of UnitedHealthcare, describes how health coaching is changing behaviors among Medicare members:

A number of years ago, we recognized the need for access to health coaches that goes way beyond the primary care physician or the specialty physician visit. When we ran focus groups, we found that Medicare members had unanswered questions. They said that their doctors didnít respond in helpful ways to questions regarding exercise, alternative medicine or nutrition areas that could improve their ability to care for themselves. We also went to physicians and asked what areas are most frustrating and difficult to manage in providing effective care to the Medicare population. Physicians reiterated the same response as the patients being served in that practice. They recognized that they didnít learn enough about exercise, alternative medicine or nutrition in medical school and needed ancillary help and support. They had no idea where to turn.

To read this story in its entirety, go to:
http://www.hin.com/sw/long_term_care081307.html


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Healthcare Daily Data Bytes put at your fingertips each day a "Data Byte" from the healthcare industry -- facts, figures, statistics and percentages on healthcare spending, costs, utilization and performance. You can also register for free access to Healthcare Daily Data Byte archives. .

Health Management Career Center Update is a free bi-monthly email newsletter for healthcare management professionals seeking new career opportunities and healthcare organizations that are seeking to fill health management positions within their companies.

To sign up for our free email newsletters, please visit
http://www.hin.com/freenews2.html



9. Coordinating Care Transitions for the Elderly and Dually Eligible: Fostering Self-Management and Reducing Readmissions

When the elderly and dually eligible populations transition from one healthcare setting to another, care gaps are most likely to occur during movement from primary to specialty care, from the emergency department to the surgical floor, from hospital to home or from in-patient to long-term care. Closing care transition gaps for these populations is the focus of "Coordinating Care Transitions for the Elderly and Dually Eligible: Fostering Self-Management and Reducing Readmissions."

For more information, please visit:
http://store.hin.com/product.asp?itemid=3685



10. New Jersey Explores Home Healthcare for Veterans

Qualified veterans in New Jersey may one day be eligible for home healthcare aides. The New Jersey Department of Military and Veterans Affairs will evaluate the resources, costs and benefits of providing home healthcare aides for qualified veterans, following legislation signed by N.J. Governor Jon S. Corzine. Following the evaluation, the departmentís Adjutant General will submit a report to the Legislature detailing specific recommendations.

For more information, please visit:
http://www.hin.com/sw/healthLaw_regulation081307.html



11. Documentation and Reimbursement for Home Care and Hospice Programs

This resource gives you real-world, practical insight targeted at all levels of professional HIM expertise in home care and hospice service. She is a respected HIM consultant who has planned and organized record and quality management systems for home health and hospice providers since 1988. Documentation and Reimbursement for Home Care and Hospice Programs was written with the goal of making work life easier for home care clinicians.

For more information, please visit:
http://store.hin.com/product.asp?itemid=2940



12. Worth Repeating: 25 Creative Solutions for Reaching the Medicaid Population

In this excerpt from a July 25, 2007 audio conference, a novel cell phone loaner program helps Horizon New Jersey Health stay in touch with Medicaid participants in a pre-natal care program. The program, outlined by Dr. Philip Bonaparte, Horizonís chief medical officer, was one of 25 suggested strategies for locating and maintaining contact with this hard-to-reach population offered during the conference.

To finish reading this transcript excerpt, please visit:
http://www.hin.com/sw/worth_repeating081307.html



13. The Medicaid Population: Identifying, Locating and Engaging a Hard-to-Reach Population for Disease Management Success

One of the greatest challenges organizations face when administering disease management programs for the Medicaid population is locating members and initiating contact with them. Compounded by what is often outdated information from state agencies with the transient nature of the Medicaid population, initial outreach to this population is difficult at best. Once identified, the next step in an effective Medicaid disease management program is a set of engagement strategies used in a variety of scientific and human service ways to effectively engage clients and get them involved in the program.

For more information on this audio conference and to listen to pre-conference comments, please visit:
http://store.hin.com/product.asp?itemid=3716


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