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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Three cost-saving programs make headlines this week; the first, a new study by Dartmouth researchers showing that accountable care organizations can slow the cost of treating dual eligibles. The results from a similar payment reform model, Medicareís Physician Group Practice Demonstration (PGPD), showed that the PGPD trimmed the cost of serving this part of the population $532 annually (after adjustment for inflation), almost five times more than the $114 per beneficiary savings generated in the general Medicare population primarily by reducing acute care hospitalizations and readmissions.

In another cost-saving exercise, using data from nearly 250,000 U.S. physicians serving commercially insured patients nationwide, a new report from UnitedHealth Groupís Center for Health Reform & Modernization shows that high-quality medical care can be about 14 percent more affordable on average, with significant local variations. The report examines care quality and medical costs for episodes of care and emphasizes four strategies to accelerate care provider payment reform to improve patient care.

More than $34 million in healthcare costs was saved with a nationwide patient safety project aimed at reducing the rate of central line-associated bloodstream infections (CLABSIs) in ICUs. The project, funded and reported by the AHRQ, used a customizable toolkit program called the Comprehensive Unit-based Safety Program (CUSP) to help doctors, nurses, and other members of the clinical team understand how to identify safety problems. Overall, it reduced CLABSIs in ICUs by 40 percent, prevented more than 2,000 CLABSIs, and saved more than 500 lives.

Contrary to these cost-savings measures, the federal Pre-Existing Condition Insurance Plan, the high-risk health insurance pool established by the ACA, is succeeding as a transition program but failing as a long-term solution given the cost of running it, according to a new Commonwealth Fund report. Currently, the plan provides coverage options for people with pre-existing health conditions until they are eligible to purchase insurance through the new state exchanges in 2014, with much of their costs subsidized. But the programís high costs and low enrollment numbers make it untenable for the long term. One reason: the federal high risk pool often attracts the sickest whose premiums are capped at certain levels, and their premiums fall short of paying for their treatment.

And lastly, donít forget to take our Population Health Management in 2012 survey. Improvement of population health is a tenet of the Institute for Healthcare Improvement's Triple Aim, along with enhancing the patient experience and curbing per capita health costs. Describe your organization's efforts in population health management by September 30 and you will be e-mailed a free executive summary of survey results once it is compiled. Your responses will be kept strictly 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 Papay
Associate Editor:
Jessica Papay, jpapay@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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September 17, 2012
Vol. XIV, No. 34

Sponsored by:
Integrated Health Coaching — The Next Generation in Health Behavior Change Management


This week's industry news:

  1. Significant Potential for ACOs to Improve Care, Lower Costs for Dual Eligibles
  2. 2012 Healthcare Benchmarks: Accountable Care Organizations
  3. 4 Reasons to Develop an SNF Care Coordination Network
  4. Care Transitions Toolkit
  5. Healthcare Business White Paper: Asthma Management in 2012
  6. High Costs, Low Enrollment Demonstrate High-Risk Pools as Untenable Long-Term Solution
  7. New Chart: Top 5 Targeted Conditions to Reduce Readmissions
  8. Health Insurance Exchanges
  9. AHRQ Patient Safety Project Reduces Bloodstream Infections by 40 Percent
  10. Infection Prevention Manual for Long Term Care, 2012 Edition
  11. High-Quality Care Can Be 14 Percent More Affordable on Average, But with Local Variations
  12. Case Study in Physician Practice and Payment Transformation
  13. 11 Ways to Engage Consumers in Patient Portals
  14. Population Health 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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Take our monthly e-survey:
Population Health Management in 2012

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

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This week's industry news

1.) Significant Potential for ACOs to Improve Care, Lower Costs for Dual Eligibles

Accountable care organizations can slow the cost of treating the sickest, costliest patients in the healthcare system, according to a new study by Dartmouth researchers.

Get the full story.

>>Return to this week's industry news


2.) 2012 Healthcare Benchmarks: Accountable Care Organizations

2012 Healthcare Benchmarks: Accountable Care Organizations This resource documents the numerous ways in which accountable care is transforming healthcare delivery, population health management, reimbursement for care and, most importantly to this yearís survey respondents, the patient experience.



Learn more about this resource.

>>Return to this week's industry news


3.) 4 Reasons to Develop an SNF Care Coordination Network

Fragmented transitional care processes and increasing lengths of stays in readmissions were two of the problems that prompted Summa Health System to develop a care coordination network of skilled nursing facilities, explains Carolyn Holder, its manager of transitional care.

Get the full story.

>>Return to this week's industry news


4.) Care Transitions Toolkit

Care Transitions Toolkit This resource examines current and emerging trends in care transition management, providing actionable data and case studies from industry thought leaders on key elements of their care transition programs.



Learn more about this resource.

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5.) Healthcare Business White Paper: Asthma Management in 2012 — Action Plans, Coaching Help Patients To Breathe Easier

Asthma Management in 2012 New market research from the Healthcare Intelligence Network has determined that asthma action plans and health coaching are key components of an effective asthma management program. Download this HINtelligence report to learn how 71 healthcare companies are helping individuals with asthma to manage their disease more effectively, reducing the likelihood of ER visits and hospitalizations by this population.

Download this complimentary white paper.

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6.) High Costs, Low Enrollment Demonstrate High-Risk Pools as Untenable Long-Term Solution

The federal Pre-Existing Condition Insurance Plan, the high-risk health insurance pool established by the ACA, is succeeding as a transition program but failing as a long-term solution, according to a new Commonwealth Fund report.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Targeted Conditions to Reduce Readmissions

Top 5 Targeted Conditions to Reduce Readmissions Anxious to avoid October's financial penalties for excessive hospital readmissions, healthcare organizations have tightened coordination of care and management of care transitions for Medicare beneficiaries at risk of rehospitalization. We wanted to see which conditions are targeted in reducing readmissions.

Click here to view the chart.

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8.) Health Insurance Exchanges: Preparing for the Brave New Marketplace Ahead

Health Insurance Exchanges In this resource, youíll read about the hurdles state lawmakers and stakeholders are facing in developing models and establishing exchanges.




Learn more about this resource.

>>Return to this week's industry news


9.) AHRQ Patient Safety Project Reduces Bloodstream Infections by 40 Percent

A nationwide patient safety project reduced the rate of central line-associated bloodstream infections (CLABSIs) in ICUs by 40 percent, preventing more than 2,000 CLABSIs, saving more than 500 lives and avoiding more than $34 million in healthcare costs, according to the AHRQ, which funded the project.

Get the full story.

>>Return to this week's industry news

10.) Infection Prevention Manual for Long Term Care, 2012 Edition

Infection Prevention Manual for Long Term Care, 2012 Edition This resource provides facilities with a comprehensive resource for policies and procedures reflecting the most current standards for infection prevention.




Learn more about this resource.

>>Return to this week's industry news


11.) High-Quality Care Can Be 14 Percent More Affordable on Average, But with Local Variations

High-quality medical care can be about 14 percent more affordable on average, with significant local variations, according to a new report from UnitedHealth Groupís Center for Health Reform & Modernization.

Get the full story.

>>Return to this week's industry news


12.) Case Study in Physician Practice and Payment Transformation: The CDPHP Experience

Case Study in Physician Practice and Payment Transformation This resource chronicles the clinical and financial journeys of this network model health plan, sharing practical strategies and lessons learned from this two part-process.




Learn more about this resource.

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13.) 11 Ways to Engage Consumers in Patient Portals

Patient portals are an ideal way to boost patient engagement, a metric getting lots of attention in stage 2 of the federal government's incentive plan for meaningful use of EHRs. Stage 2, which will begin as early as 2014, increases health information exchange between providers and promotes patient engagement by giving patients secure online access to their health information.

Read this blog post.

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14.) Population Health Management: Achieving Results in a Value-Based Healthcare System

Population Health Management Before shifting from a disease-focused to population health management (PHM) approach, healthcare organizations need to do their homework, advises Patricia Curran, principal in Buck Consultants' National Clinical Practice — from researching the population's culture to examining its patterns of healthcare usage and cost trends. In this interview, Ms. Curran describes the four key research areas, as well as some of the barriers encountered along the road to population health management. She also predicts what the no- or low-health-risk populations can expect in a population health management world that spans the health risk continuum — from incentives to provider and payor contact.

Listen to this podcast.

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