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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

The number of obese adults, along with related disease rates and healthcare costs, could increase dramatically in every state in the country over the next 20 years, according to a new report from Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

Thirteen states in particular could see obesity increases upwards of 60 percent if things don’t change, with Mississippi set to have the highest numbers. The number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis could increase 10 times between 2010 and 2020and double again by 2030. Medical costs associated with treating these diseases could increase by $48 billion to $66 billion per year in the United States, and the loss in economic productivity could be between $390 billion and $580 billion annually by 2030.

But if Americans reduced their average body mass index (BMI) by just 5 percent by 2030, the rates of obesity-related diseases and healthcare costs could be significantly reduced, the report claims. Every state could help thousands or millions of people avoid obesity-related diseases, while saving billions of dollars in healthcare costs.

“We need more effective interventions with the population as a whole,” says Dr. Dennis Richlin, chief medical director and wellness officer for HealthFitness, an integrated health coaching program, in a recent HIN webinar. “There is a whole sub-population within employers, and some have taken on employees with programs that have resulted in risk reductions, cost savings and weight change,” he said. “We can make a difference, but it’s not a quick fix...but we could start to see significant changes over the next five years.”

Patient satisfaction could be one of the most significant changes among those involved in health and wellness programs, according to our currently running Population Health Management survey. But getting patients to embark on and remain engaged in such a program remains the greatest challenge for those considering launching one, say nearly half of our respondents at this point in the survey.

In other news, another way to lower healthcare costs could be by extending physician office hours. A new study links the two, finding that patients whose usual source of care offers extended hours by remaining open during evening and weekend hours had less use of and lower associated expenditures for office visits, prescription medications, ED visits and hospitalizations than patients without such access.

And one way to use those extended hours in the waiting room could be by reviewing healthcare benefits, because, according to a new survey from Aetna, choosing them is the second most difficult decision to make behind savings for retirement. In fact, choosing benefits is considered to be tougher than purchasing a car, making decisions about medical tests or treatments, parenting, and selecting homeowners, renters or auto insurance. The main problem is complicated, conflicting information.

But there is some uncomplicated good news for Medicare Advantage members: it continues to remain strong, with a projected enrollment increase of 11 percent in the next year, and no increase in premiums, according to the CMS.

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 24, 2012
Vol. XIV, No. 35

Sponsored by:
Population Health Management — Achieving Results in a Value-Based Healthcare System


This week's industry news:

  1. Enrollment in Medicare Advantage Program to Increase by 11 Percent in the Next Year
  2. Medicare Advantage News
  3. Hospitals Focus on Care Transitions to Curb Excessive Readmissions
  4. 2012 Healthcare Benchmarks: Reducing Hospital Readmissions
  5. Healthcare Business White Paper: ACOs in 2012
  6. Study Links Extended Physician Office Hours with Lower Healthcare Costs
  7. New Chart: Which Reimbursement Models are Funding the Medical Home?
  8. 27 Interventions to Reduce Avoidable ER Use
  9. Healthcare Benefits Second Most Difficult Decision for Consumers: Survey
  10. Next-Generation Insurance Benefit Design and Marketing
  11. HEDIS Releases 35 New Measures for ACOs
  12. Population Health Management Tools for ACOs
  13. Guest Post: Healthcare Management Enters 21st Century via EMR, Point of Care Technology
  14. Improving Population Health Management Through Effective, Efficient Data Analytics
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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Population Health Management in 2012

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This week's industry news

1.) Enrollment in Medicare Advantage Program to Increase by 11 Percent in the Next Year

Medicare Advantage (MA) continues to remain strong, with a projected enrollment increase of 11 percent in the next year, and no increase in premiums, according to the CMS.

Get the full story.

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2.) Medicare Advantage News

Medicare Advantage News This resource is a bi-weekly, 8-page newsletter packed with business insights on who is doing what in both managed Medicare and Medicaid, and how those strategies are impacting their bottom line.



Learn more about this resource.

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3.) Hospitals Focus on Care Transitions to Curb Excessive Readmissions

As CMS prepares to impose penalties next month for what it deems ‘excessive’ hospital readmission rates, 75 percent of healthcare companies have launched programs to reduce avoidable hospital readmissions.

Get the full story.

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4.) 2012 Healthcare Benchmarks: Reducing Hospital Readmissions

2012 Healthcare Benchmarks: Reducing Hospital Readmissions This resource identifies the key strategies, challenges, target populations and health conditions of 119 healthcare organizations to reduce avoidable rehospitalizations.



Learn more about this resource.

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5.) Healthcare Business White Paper: ACOs in 2012 — ACO Participation Doubles in 12 Months

Accountable Care Organizations in 2012 Participation in accountable care initiatives has more than doubled in the last 12 months, according to 200 healthcare companies who completed the second annual Healthcare Intelligence Network survey on Accountable Care Organizations (ACOs). The typical ACO is smaller, too, as the number of active ACOs with 100 to 500 physicians dropped almost 50 percent in the last 12 months. This year’s survey provided new data on other healthcare professionals in the ACO, ACO reimbursement models, and ACO impact.

Download this complimentary white paper.

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6.) Study Links Extended Physician Office Hours with Lower Healthcare Costs

Total healthcare costs for patients with extended access to their PCPs were 10.4 percent lower than for patients without expanded access, according to a new study from the Center for Healthcare Policy and Research at the University of California Davis School of Medicine.

Get the full story.

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7.) New Chart: Which Reimbursement Models are Funding the Medical Home?

Which Reimbursement Models are Funding the Medical Home? The patient-centered medical home model has been called a stepping stone to accountable care. The most recent market data from the Healthcare Intelligence Network found that 59 percent of existing medical homes are now or soon will be part of an accountable care organization (ACO). We wanted to see what type of reimbursement model healthcare organizations include in their medical homes.

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 In this resource, 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 are all examined.



Learn more about this resource.

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9.) Healthcare Benefits Second Most Difficult Decision for Consumers: Survey

Choosing healthcare benefits is the second most difficult major life decision for American consumers behind saving for retirement, according to a new survey from Aetna.

Get the full story.

>>Return to this week's industry news

10.) Next-Generation Insurance Benefit Design and Marketing

Next-Generation Insurance Benefit Design and Marketing This resource looks at how insurers are working to refine their benefit design and marketing strategies by creating narrower provider networks, offering more high-deductible account-based options, launching private insurance exchanges, and engaging customers in adopting healthy lifestyles.


Learn more about this resource.

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11.) HEDIS Releases 35 New Measures for ACOs

HEDIS has released 35 new technical specifications for ACOs for 2013, detailed guidance that will help ACOs collect and report their quality performance in standardized ways, according to the NCQA, which published the measures.

Get the full story.

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

Population Health Management Tools for ACOs This resource 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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13.) Guest Post: Healthcare Management Enters 21st Century via EMR, Point of Care Technology

In today’s post, guest blogger Cheryl Jacque tackles the pros and cons of implementing electronic medical records (EMRs) and point-of-care technology and whether or not they can improve efficiency of patient care without increasing costs to patients.

Read this blog post.

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14.) Improving Population Health Management Through Effective, Efficient Data Analytics

Improving Population Health Management Through Effective, Efficient Data Analytics Enhanced reporting and efficiency, significant reductions in readmissions in congestive heart failure patients and added leverage at contract negotiation are just a few advantages Bon Secours is deriving from its EHR-based data collection tools, explains Robert Fortini, vice president and chief clinical officer at Bon Secours. Fortini talks about the health system's shift from home-grown methodologies to the sophisticated IT knowledge base powering its population health management program, resulting in data that has a "compelling" effect at contract time.

Listen to this podcast.

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