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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Congratulations to all CMS PGP Demonstration participants, especially Geisinger Health Systems and Dartmouth-Hitchcock, both of whom have shared their strategies for population health management with HIN.

Early on in the PGP demo, DH targeted patients with CHF, CAD, and diabetes; it then developed two 'super registries' to monitor both chronic disease markers and preventive care needs in its population. It created training for new roles for nurses and case managers, focusing on health coaching, motivational interviewing and bridging care across transitions. DH then created reports comparing its MDs’ performance with those of their peers. In the end, they received about $13 million in shared savings from CMS.

Says Barbara Walters, senior medical director, “What did we do to make a difference? It was our admission rate, cost of care for CHF patients and our clinical quality compared to the comparison group. We didn’t even realize it but we had created a medical home, which is a very important cornerstone for all of this."

And Geisinger achieved 100 percent on the PGP program's quality measures, the only one of the 10 organizations to do so for the last four years of the demonstration. “By focusing on improving quality, we were able to reduce the total costs of treating Medicare beneficiaries. Our costs at Geisinger rose only 1.4 percent, compared to the typical 4 to 6 percent increase observed nationwide,” said Thomas Graf, M.D., associate chief medical officer, Population Health; chairman, community practice, Geisinger Health System.

We look forward to charting the progress of all of the organizations involved in the transitional program.

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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August 15, 2011
Vol. XIII, No. 30

Sponsored by:
Case Management Answer Book Vol. I — FAQs on Risk Reduction, Care Coordination and Co-Location

This week's industry news:

  1. Geisinger, Dartmouth-Hitchcock to Continue in CMS PGP Transitions Demo
  2. Health Management Tools for Accountable Care Organizations
  3. Staff Buy-in, Reimbursement Biggest Challenges for PCMH Adoption
  4. 2011 Medical Home Performance Benchmarks
  5. Healthcare Business White Paper: Healthcare Transparency
  6. CMS Hospital Compare Now Tracks 30-Day Mortality, Readmissions for Key Conditions
  7. New Chart: What's the ROI from Reducing Readmissions?
  8. 27 Interventions to Reduce Avoidable ER Use
  9. Healthcare Costs Double for Kids with Poorly Controlled Asthma
  10. Improving Medication Adherence Benchmarks
  11. 1 in 7 ED Patients Receive CT Scans
  12. 2010 Healthcare Benchmarks: Patient Education & Outreach
  13. HealthSounds Podcast: The Patient Experience
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This week's industry news

1.) Geisinger, Dartmouth-Hitchcock to Continue in CMS PGP Transitions Demo

Geisinger Health System and Dartmouth-Hitchcock are among 10 physician groups that will continue to participate in CMS's Physician Group Practice Transitions Demonstration (PGP TD).

Get the full story.

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2.) Health Management Tools for Accountable Care Organizations

Health This guide examines the building blocks of population health management that drive improvements in healthcare quality, efficiency and reimbursement in ACOs. Learn how CMS Physician Group Practice participant Dartmouth-Hitchcock has developed a competency in population health management that it deploys in ongoing ACO pilots with Medicare and private payors.

Learn more about this resource.

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3.) Staff Buy-in, Reimbursement Biggest Challenges for PCMH Adoption

Despite continued challenges that include staff buy-in and reimbursement, patient-centered medical home (PCMH) models of care are heavily supported in the Affordable Care Act, a favored model of integrated care delivery and a cornerstone of accountable care.

Get the full story.

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4.) 2011 Medical Home Performance Benchmarks: Adoption, Utilization and Results

2011 Medical Home Performance Benchmarks This resource is the Healthcare Intelligence Network's latest annual in-depth analysis of medical home awareness, adoption, tools, technologies, challenges, benefits and outcomes. This exclusive 65-page report analyzes the responses of 115 healthcare organizations to HIN's fifth annual industry survey on the PCMH, and delivers the latest metrics and measures on current and planned PCMH initiatives, providing actionable data on PCMH effectiveness, targeted populations and conditions, medical home team members, health IT in use, reimbursement, ROI and much more.

Learn more about this resource.

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5.) Healthcare Business White Paper: Healthcare Transparency — Cost and Quality Report Cards

The concept of public disclosure of quality assessment information has become a highly reliable and valid tool for not only attracting the discerning consumer but also for sizing up the competition. In a May 2007 online survey, the Healthcare Intelligence Network (HIN) polled health plans and hospitals on their quality performance data publishing efforts and asked consumers to discuss their usage of and satisfaction with such measures.

Download this complimentary white paper.

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6.) CMS Hospital Compare Now Tracks 30-Day Mortality, Readmissions for Key Conditions

CMS has expanded its Hospital Compare Web site to include inpatient and outpatient data and launched an enhanced quality initiative tool designed to empower healthcare consumers.

Get the full story.

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7.) New Chart: What's the ROI from Reducing Readmissions?

Reducing Readmissions ROI From payors to providers to CMS, avoidable hospital readmissions are receiving national attention as a way to glean savings from the healthcare system and improve the quality of care that patients receive. We wanted to see the ROI generated by programs focused on reducing readmissions.


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 This 45-page resource details 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. Five interventions target these sub-populations: asthma patients, those recently discharged from the hospital, non-network patients, nursing home and assisted living residents and dual-eligibles.

Learn more about this resource.

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9.) Healthcare Costs Double for Kids with Poorly Controlled Asthma

Ineffective management of asthma in children more than doubles healthcare costs and increases their school absences, according to researchers at National Jewish Health, as reported in the Archives of Allergy, Asthma & Immunology.

Get the full story.

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10.) Improving Medication Adherence Benchmarks Through Community Pharmacist Interventions

Improving Medication Adherence Benchmarks A patient-centered approach to pharmacy visits combined with motivational interviewing by community pharmacists is improving medication adherence rates for members of Highmark Blue Cross Blue Shield. The pilot program, a collaborative between Highmark, the University of Pittsburgh School of Pharmacy, and Rite Aid pharmacies, is training pharmacists to use motivational interviewing techniques with patients at risk of medication non-adherence.

Learn more about this resource.

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11.) 1 in 7 ED Patients Receive CT Scans

The use of computed tomography, or CT scans to diagnose illnesses in emergency departments has increased by more than 50 percent, a University of Michigan Health System study finds.

Get the full story.

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12.) 2010 Healthcare Benchmarks: Patient Education & Outreach

Patient Education & Outreach This resource provides actionable information from 134 healthcare organizations on their efforts to educate patients and put them on the road to self-management. This 24-page resource documents trends and metrics on patient education programs that are taking shape in the primary care office, the ER, at hospital discharge and in the patient's home.

Learn more about this resource.

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13.) HealthSounds Podcast: The Patient Experience — How to Keep the Healthcare Customer Satisfied

>The Patient Experience Spiritual support, in-room WIFI access, improved housekeeping and valet parking are just a few of the perks hospitals have added to boost patient satisfaction ratings. In this month's healthcare benchmarks podcast, Melanie Matthews from the Healthcare Intelligence Network describes how 146 healthcare organizations rank their own efforts to improve patient satisfaction. She also shares key metrics from the 2011 survey on Improving Patient Satisfaction and Experience, including the most important aspect of the care delivery experience and preferred formats for patient surveys.

Patient satisfaction is an important driver of core measurement scores. Dr. Steven Berkowitz, president of SMB Consulting, shares his formula for achieving 100 percent performance on core measures and describes an incentive program for drivers of the quality measures.

Need more data from this survey? Download a complimentary executive summary.

Listen to this podcast.

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