HIN logo
From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Technological problems might hinder aspects of tomorrow's rollout of the new health insurance exchanges — both at the state and federal level. According to New York Times reports late yesterday, some aspects of the eagerly awaited exchanges in several states, including Oregon, Colorado, District of Columbia and Nevada, may not be fully operational for weeks and even months, with some officials referring to October as a "soft launch" period.

Last week, the Obama administration acknowledged it will not be ready to accept online applications from small businesses when the program officially launches October 1st.

Once fully operable, the exchanges, one-stop online shopping sites for consumers’ health insurance needs, will enable consumers to comparison shop for health benefits much like they do now for airline tickets or hotel rooms, and see if they qualify for tax credits. Plans are categorized according to levels of coverage and co-pays, and no one can be denied coverage because of preexisting conditions. There will be a six-month open enrollment period that runs through March 2014, and coverage should begin as early as January 1st.

Smart phones can now diagnose abnormal heart rhythms, act as ultrasound devices, or function as the "central command" for a glucose meter used by a person with insulin-dependent diabetes. To ensure that patients' safety isn't compromised for the sake of technological innovation, the FDA is clamping down on those apps considered dangerous. The agency has cleared about 100 mobile medical applications over the past decade; about 40 of those were cleared in the past two years.

The costs of patient care after heart attacks, continues to climb, according to a new study from the University of Michigan (U-M) Frankel Cardiovascular Center. Despite advancements in cardiac care and increases in less invasive procedures to treat symptoms, including more angioplasty instead of open heart surgery,hospital stays have decreased by just one day. Medicare spending to treat heart attack patients rose by 16.5 percent between 1998 and 2008, with the majority of costs incurred weeks after patients left the hospital.

According to researchers from the NYU School of Medicine, elderly nursing home residents with advanced dementia who were enrolled in a Medicare managed care insurance plan were more likely to have do-not-hospitalize orders and less likely to be hospitalized for acute illness than those residents enrolled in traditional Medicare. The frail elderly received more nursing home-based primary care visits every 90 days, and more nursing home-based nurse practitioner visits in general. The extra individual attention precluded the need for more acute treatment, and resulted in less aggressive, more humane end-of-life care.

And lastly, 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 for the development of 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

>>Return to top

HIN podcasts
HIN blog
HIN videos
New HIN products

Contact HIN:
www.hin.com
(888) 446-3530
(732) 449-4468
Fax: (732) 449-4463
Email: info@hin.com

This week's featured download:

Accountable Care Organizations in 2013 — ACO Leadership Shifts to Physician-Hospital Organizations

Featured download










For advertising and sponsorship opportunities in the Healthcare Business Weekly Update, please e-mail sales@hin.com or call 888-446-3530

>>Return to top

September 30, 2013
Vol. XV, No. 36

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


This week's industry news:

  1. Managed Care Reduces Hospitalizations in Nursing Home Residents with Advanced Dementia
  2. Case Management for Advanced Illness
  3. Significant Choice and Lower than Expected Premiums Available in New Health Insurance Marketplace
  4. Healthcare Trends & Forecasts in 2014
  5. Healthcare Business White Paper: Medication Adherence in 2013
  6. Medicare Spending on Heart Attack Patients Jumps 16 Percent in Last Decade
  7. New Chart: Top 5 Care Coordinators for Dually Eligible
  8. Guide to Reducing Medicare Readmissions, Vol. II
  9. Some Mobile Medical Apps to Face Closer FDA Scrutiny
  10. 2013 Healthcare Benchmarks: Mobile Health
  11. 7 Barriers to Effective SNF-Hospital Care Transitions
  12. Accountable Care Strategies to Improve Hospital-SNF Care Transitions
  13. HINfographic: How an Integrated SNF Network Supports Accountable Care
  14. A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings
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.

Missed the last issue? Read it here.

Join our Online Communities:

Twitter Facebook LinkedIn YouTube Pinterest


Take our monthly e-survey:
Health Risk Assessments in 2013

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

Interested in all open surveys? Review them here.


This week's industry news

1.) Managed Care Reduces Hospitalizations in Nursing Home Residents with Advanced Dementia

Elderly nursing home residents with advanced dementia who were enrolled in a Medicare managed care insurance plan were more likely to have do-not-hospitalize orders and less likely to be hospitalized for acute illness than those residents enrolled in traditional Medicare, according to a study from the NYU School of Medicine, and published by JAMA Internal Medicine, a JAMA Network publication.

Get the full story.

>>Return to this week's industry news


2.) Case Management for Advanced Illness: Best Practices in End-of-Life Care

Case Management for Advanced Illness This resource examines Aetna’s Compassionate Care program, a case management approach for this population. The payor’s initiative breaks down barriers commonly encountered in this highly sensitive stage of the health continuum while positively impacting both healthcare utilization and spend.


Learn more about this resource.

>>Return to this week's industry news


3.) Significant Choice and Lower than Expected Premiums Available in New Health Insurance Marketplace

Increased competition in the health insurance marketplace, which is effective October 1st, will lead to multiple and affordable choices for consumers, according to the U.S. Department of Health & Human Services.

Get the full story.

>>Return to this week's industry news


4.) Healthcare Trends & Forecasts in 2014: A Strategic Planning Session

Healthcare Trends & Forecasts in 2014 This webinar will provide a roadmap to the key issues, challenges and opportunities for healthcare providers and payors in 2014, including the launch of health insurance exchanges, cuts in the Medicare Advantage program and the challenge of meeting the care coordination needs of the dual eligible population.

Learn more about this resource.

>>Return to this week's industry news


5.) Healthcare Business White Paper: Medication Adherence in 2013 — Closer Look at Compliance During Care Transitions

Medication Adherence in 2013 In its third annual Medication Adherence e-survey conducted in January 2013, HIN captured emerging trends in efforts to improve medication adherence (MA) among more than 100 healthcare organizations. According to 75 percent of survey respondents, complex patients remain the most common targets of MA programs. This HINtelligence Report provides data highlights on MA program components, the most successful tools for improving MA, and more.

Download this complimentary white paper.

>>Return to this week's industry news


6.) Medicare Spending on Heart Attack Patients Jumps 16 Percent in Last Decade

Medicare spending to treat heart attack patients rose by 16.5 percent between 1998 and 2008, with the majority of costs incurred weeks after patients left the hospital, according to a study from the University of Michigan (U-M) Frankel Cardiovascular Center.

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Care Coordinators for Dually Eligible

New Chart: Top 5 Care Coordinators for Dually Eligible 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 group’s unique medical, social and functional needs in a coordinated and cost-efficient manner. We wanted to see which healthcare professionals are responsible for the care coordination of dual eligibles.

Click here to view the chart.

>>Return to this week's industry news


8.) Guide to Reducing Medicare Readmissions, Vol. II

Guide to Reducing Medicare Readmissions, Vol. II This resource examines innovative interventions to reduce preventable admissions, rehospitalizations and ER visits by high-utilizing Medicare beneficiaries. This guide looks at four multidisciplinary collaborative interventions aimed at key factors fueling readmissions in this population — and that support an accountable care vision.

Learn more about this resource.

>>Return to this week's industry news


9.) Some Mobile Medical Apps to Face Closer FDA Scrutiny

Designed to protect consumer safety while supporting innovation, the U.S. Food and Drug Administration (FDA) issued final guidance for developers of mobile medical applications, or apps.

Get the full story.

>>Return to this week's industry news

10.) 2013 Healthcare Benchmarks: Mobile Health

2013 Healthcare Benchmarks: Mobile Health This resource delivers a snapshot of mobile health (mHealth) trends, including current and planned mHealth initiatives, types and purpose of mHealth interventions, targeted populations and health conditions, and challenges, impact and results from mHealth efforts.


Learn more about this resource.

>>Return to this week's industry news


11.) 7 Barriers to Effective SNF-Hospital Care Transitions

A lack of quality information from nursing facilities when a patient was transferred to an ED was one barrier task force members tackled when developing their skilled nursing facility (SNF) care coordination network, explains Mike Demagall, LNHA, LPN, administrator with Bath Manor and Windsong Care Center, and Carolyn Holder, MSN, RN, GCNS-BC, manager of transitional care for Summa Health System.

Get the full story.

>>Return to this week's industry news


12.) Accountable Care Strategies to Improve Hospital-SNF Care Transitions

Accountable Care Strategies to Improve Hospital-SNF Care Transitions This resource provides a look at a health system-SNF network that has curbed rehospitalizations and length of stay for participants. The hospital-to-SNF transition is one of the top three care transitions addressed by healthcare organizations, behind hospital-to-home and hospital-to-SNF.

Learn more about this resource.

>>Return to this week's industry news


13.) HINfographic: How an Integrated SNF Network Supports Accountable Care

In the future, SNF readmission rates could be subject to penalties similar to those CMS has put in place for hospitals, such as when SNF readmissions to a hospital occur for certain conditions, within a particular timeframe. To avoid this, many hospitals and health systems are collaborating with SNF providers to improve care and reduce unplanned 30-day readmissions. Reducing fragmentation and redundancy of care and reclaiming revenue from diverted admissions are just two reasons to integrate SNF networks into a post-acute strategy, according to a new HINfographic from the Healthcare Intelligence Network.

Read this blog post.

>>Return to this week's industry news


14.) A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings

Joseph Johnson Low scores on patient outcomes measures within the CMS Star Quality ratings program — metrics CMS weights most heavily in its assignment of stars — can typically be traced to poor provider and member engagement, notes Joseph Johnson, vice president of L.E.K. Consulting. Johnson suggests ways to enlist support from these two stakeholder groups, and describes how MA plans should prepare for the possible display in 2014 of CAHPS care coordination ratings along with with its star scores (though the care coordination ratings will not be factored into star ratings).

Listen to this podcast.

>>Return to this week's industry news


Thank you for your readership! Please urge your colleagues to subscribe by forwarding this email or visiting http://www.hin.com/freenews2.html or by calling (888) 446-3530 or visiting the HIN Web site.

While we encourage you to forward this email to your colleagues, these articles may not be redistributed in any other publication, reproduced for publication in any form, distributed on an intranet or network or by e-mail distribution or distributed for commercial purposes without the expressed written permission of the Healthcare Intelligence Network.


Copyright 1997-2013 Healthcare Intelligence Network. All rights reserved.
Healthcare Intelligence Network
Gateway to Healthcare Business Information on the Internet
800 State Highway 71, Suite 2, Sea Girt, N.J. 08750