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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

It looks like good surgeons are, literally, a cut above the rest, at least according to a new study from Harvard School of Public Health.

Quality surgical care is strongly linked to hospital readmission rates, a somewhat surprising new statistic given that much of policy focus has been on reducing readmissions after hospitalizations for medical conditions, such as heart failure and pneumonia.

Readmissions for medical conditions are primarily driven by how sick the patients are and whether they live in poor or better-off communities; the link between hospital quality and readmissions is less clear. The study sought to find out if there was a relationship between readmission rates after surgery and the quality of surgical care in that hospital; more details inside.

Poor healthcare quality does not discriminate. According to a new study from the Commonwealth Fund scorecard, access to affordable, quality healthcare varies greatly for low and high-income people based on where they live.

The report finds that higher-income people living in states that lag far behind the top scoring states are often worse off than low-income people in states that rank at the very top of the scorecard. The scorecard provides the first state-by-state comparison of the healthcare experiences of the 39 percent of Americans with incomes less than 200 percent of the federal poverty level, and compares their experiences with higher income families.

Lower-income families, particularly those on Medicaid, have grown increasingly more dependent on using the emergency room, despite widely held assumptions that uninsured patients are high ER utilizers, according to a study from the University of California, San Francisco. In order to investigate recent trends between insurance coverage and ED use, researchers analyzed California ED visits by adults aged 19 to 64 years old from 2005 to 2010, and found that the number of visits to California EDs by adults overall increased by 13.2 percent, with Medicaid beneficiaries leading the pack. This study has wide implications with upcoming ACA reforms; many uninsured people are expected to transition to Medicaid, and as a result, overall ED use may increase because Medicaid patients have higher rates of ED use.

Physician-hospital organizations (PHOs) have taken the accountable care organization (ACO) reins from physicians over the last year, according to our 2013 market data. PHO leadership of ACOs almost doubled in the last 12 months; in 2012, one-quarter of ACOs were physician-led, a trend that replaced the hospital-administered ACOs that dominated in 2011.

As ACOs continue to evolve, the composition of the care delivery model will shift as well, with hospice, long-term care and home health entering the fray.

Lastly, don't forget to take our Health Risk Assessments in 2013 survey — sophisticated analytics behind today's health risk assessments or health risk appraisals (HRAs) provide employers, payors and providers an aggregate view of population health and the raw material to develop prevention and lifestyle change programs. Tell us how your organization uses HRAs to improve population health by October 15, 2013 and get a FREE executive summary of the compiled results.

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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September 23, 2013
Vol. XV, No. 35

Sponsored by:
Dual Eligibles: Closing Care Gaps and Engaging Members in Self-Management


This week's industry news:

  1. Hospital Readmission Rates Linked with Quality of Surgical Care
  2. Avoiding the Readmissions Penalty Zone
  3. Affordable, Quality Healthcare Varies Due to Income, Geography
  4. Service Delivery for Vulnerable Populations, New Directions in Behavioral Health
  5. Healthcare Business White Paper: Dual Eligibles Care Management in 2013
  6. ACO Leadership by Physician-Hospital Organizations Doubles
  7. New Chart: What's Required Training for the Care Transition Team?
  8. 2013 Healthcare Benchmarks: Accountable Care Organizations
  9. Adult Medicaid Beneficiaries in California Have Highest Increase in ED Visits: Study
  10. Reducing Avoidable ER Visits by Medicaid Patients Through Quality-Based Interventions
  11. Disease-Specific Medical Homes Help Deliver Value-Based Healthcare
  12. 46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends
  13. Infographic: A Short Look at Long-term Care for Seniors
  14. Managing Population Health with Integrated Registries and Effective Patient Touchpoints
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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This week's industry news

1.) Hospital Readmission Rates Linked with Quality of Surgical Care

Quality surgical care is strongly linked to hospital readmission rates, according to a study from Harvard School of Public Health (HSPH), which appears in the New England Journal of Medicine.

Get the full story.

>>Return to this week's industry news


2.) Avoiding the Readmissions Penalty Zone: Population Health Management for High-Risk Populations

Avoiding the Readmissions Penalty Zone This resource delivers winning process improvements and interventions that can help organizations make measurable progress toward reducing readmissions in high-risk populations, including a look at a health system-SNF network that has curbed rehospitalizations and length of stay for participants.


Learn more about this resource.

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3.) Affordable, Quality Healthcare Varies Due to Income, Geography

Access to affordable, quality healthcare varies greatly for low-income people based on where they live, according to a new Commonwealth Fund report scorecard.

Get the full story.

>>Return to this week's industry news


4.) Service Delivery for Vulnerable Populations, New Directions in Behavioral Health

Population Health Management for Dual Eligibles This resource provides students and professionals in healthcare and service delivery with innovative programs and models to address the needs of vulnerable populations with such health issues as substance abuse, mental illness, and poverty.



Learn more about this resource.

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5.) Healthcare Business White Paper: Dual Eligibles Care Management in 2013 — Case Management, Education Boost Compliance, Satisfaction

Dual Eligibles Care Management in 2013 Education and engagement are key to managing the health of dual eligibles but also the most formidable challenges, say a third of respondents to a new survey on Care Management of Dually Eligible by the Healthcare Intelligence Network. Care coordination of the 9 million Americans eligible for both Medicare and Medicaid is a growing priority for the nation’s payors who wish to address this population's unique medical, social and functional needs in a coordinated and cost-efficient manner. Download this HINtelligence report for more data on dual eligibles as reported by 72 healthcare companies in HIN's 10 Questions on Care Coordination of Dual Eligibles Survey, including dual eligible care coordination program components, results and ROI, and successful care coordination strategies for dual eligibles in respondents' own words.

Download this complimentary white paper.

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6.) ACO Leadership by Physician-Hospital Organizations Doubles

Physician-hospital organizations (PHOs) have taken the accountable care organization (ACO) reins from physicians over the last year, according to 2013 market data from the Healthcare Intelligence Network.

Get the full story.

>>Return to this week's industry news


7.) New Chart: What's Required Training for the Care Transition Team?

New Chart: What's Required Training for the Care Transition Team? Motivational interviewing (MI) tops the list of care transition team training areas, say 60 percent of healthcare organizations who responded to HIN's third annual e-survey on Managing Care Transitions. We wanted to see which other training is needed by care transition teams.

Click here to view the chart.

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8.) 2013 Healthcare Benchmarks: Accountable Care Organizations

2013 Healthcare Benchmarks: Accountable Care Organizations This resource documents the numerous ways in which accountable care is transforming healthcare delivery, particularly in the area of care coordination, where the ACO model has had the greatest impact for this year’s respondents.


Learn more about this resource.

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9.) Adult Medicaid Beneficiaries in California Have Highest Increase in ED Visits: Study

While uninsured patients are often thought of as high emergency department (ED) utilizers, insured patients, particularly those with Medicaid coverage, have come to rely more frequently on EDs, according to a study from the University of California, San Francisco.

Get the full story.

>>Return to this week's industry news

10.) Reducing Avoidable ER Visits by Medicaid Patients Through Quality-Based Interventions

Reducing Avoidable ER Visits by Medicaid Patients Through Quality-Based Interventions This webinar shares specifics from a collaborative effort among five regions of Ohio that targeted the key reasons for avoidable ER visits among Medicaid beneficiaries and rolled out test interventions in a rapid cycle quality improvement approach.


Learn more about this resource.

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11.) Disease-Specific Medical Homes Help Deliver Value-Based Healthcare

One way HealthCare Partners Medical Group of California maintains the lowest hospital readmission rates in its history is by risk-stratifying their patients before placing them in a medical home that best suits their needs, explains Dr. Stuart Levine, corporate medical director.

Get the full story.

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12.) 46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends

46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends This resource delivers charts and tables on 46 actionable metrics carefully curated from 2012 market research data by the Healthcare Intelligence Network.




Learn more about this resource.

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13.) Infographic: A Short Look at Long-term Care for Seniors

Under the ACA, there are provisions for states to expand Medicaid to help people receive long-term care (LTC) services. Still, as baby boomers age, the need for LTC increases. Thirty-five percent of U.S. adults 40 years or older say they have set aside money for their long-term needs, according to a new infographic from the Journal of the American Medical Association.

Read this blog post.

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14.) Managing Population Health with Integrated Registries and Effective Patient Touchpoints

Dr. Jim Bellows A patient might expect a reminder about a missed colonoscopy during a primary care visit, but during a trip to the dermatologist? Providing health plan members with “consistent and ubiquitous reminders” via multiple touchpoints in their healthcare journey is one of Kaiser Permanente’s key population health management strategies, reports Jim Bellows, PhD, senior director of evaluation and analytics for Kaiser Permanente.

Another is the vigorous use of registries — more than 50 in all, at last count — even for relatively rare diseases. Dr. Bellows defines the criteria for registry creation, expands on the choice and availability of patient touchpoints and explains the evolution of other Web-based PHM tools in use by Kaiser Permanente.

Listen to this podcast.

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