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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

"Perhaps the most underutilized technology in modern medicine is the telephone," says Michael Erikson, vice president of primary care services for Group Health Cooperative. To compensate, the health plan targeted call management as a primary strategy driving its Group Health Medical Home pilot, as we report on this week.

In related news, Group Health was one of the top ten performers on NCQA’s annual health plan ranking list, as published by Consumer Reports. Nonprofit health plans topped the list, which ranks plans according to 32 clinical performance measures. The NCQA found that contrary to the telephone, one of the most over-utilized technology tests was for lower back pain, despite evidence that they could be harmful, exposing patients to needless radiation while often leading to further tests and treatments and sometimes unecessary surgery, Consumer Reports notes.

And despite research showing that observation units in hospitals could save the United States over $3 billion a year, less than one third of hospitals in the country have such units, according to a study from Brigham and Women's Hospital (BWH). When used as an alternative to inpatient admissions, the units are dedicated to caring for patients, usually for a 24-hour period, who have been discharged from the ED but are not ready to safely leave the hospital. Previous research has shown that care in these units is equal or better in quality compared to inpatient care for certain patient populations, BWH says.

And a recent survey revealed that physicians and pharmacists’ roles in diabetes treatment are not always aligned. At the recent Diabetes Innovation 2012 conference, delegates representing diabetes care and prevention stakeholders revealed conflicting opinions on key issues, such as the roles physicians and pharmacists should play with diabetes patients; how important pharmaceutically assisted innovations are to obesity management, and how important adherence and future screening should be for diabetics.

Don’t forget to voice your opinion on our new Healthcare Trends for 2013 survey — 2012 was a year in which the United States Supreme Court upheld the constitutionality of the Affordable Care Act and the chief champion of the law nicknamed "Obamacare" fought for a second term in the White House. Please tell us about the last 12 months and how your organization is preparing for 2013 by completing HIN's eighth annual survey on Healthcare Trends by November 5, 2012. You'll receive a free executive summary of the compiled results, and your responses will be kept strictly confidential. One respondent will win a training DVD of the 2013 Healthcare Trends and Forecasts webinar recorded on October 17, 2012.

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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October 1, 2012
Vol. XIV, No. 36

Sponsored by:
Improving Population Health Management Through Effective, Efficient Data Analytics


This week's industry news:

  1. 3 Essentials in Comprehensive Primary Care from Group Health Cooperative
  2. Case Studies in Comprehensive Primary Care
  3. Healthcare Quality Improvement Costs on the Rise
  4. 2012 Healthcare Benchmarks: Reducing Avoidable ER Visits
  5. Healthcare Business White Paper: Health & Wellness Incentives in 2012
  6. Hospital Observation Units Could Save the Healthcare System $3.1 Billion
  7. New Table: Highlights of Highmark's Physician Pay-for-Performance Program
  8. Hospital Discharge Improvement Guide
  9. Consumer Reports: In Annual Health Plan Rankings, Nonprofits Leading the Pack
  10. Futurescan 2012
  11. Physicians, Pharmacists Not Always Aligned on Emerging Diabetes Trends
  12. 2012 Healthcare Benchmarks: Diabetes Management
  13. Is Choosing Healthcare Coverage Really Harder Than Parenting?
  14. Healthcare Trends & Forecasts in 2013
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.) 3 Essentials in Comprehensive Primary Care from Group Health Cooperative

"Perhaps the most underutilized technology in modern medicine is the telephone," says Michael Erikson, MSW, vice president of primary care services for Group Health Cooperative. So, enabling telephone visits to happen in a more "robust way," or Call Management, was one of the three primary strategies driving Group Health’s Medical Home pilot.

Get the full story.

>>Return to this week's industry news


2.) Case Studies in Comprehensive Primary Care: Guidance from Group Health Cooperative and Geisinger Health System

Case Studies in Comprehensive Primary Care This resource takes a look at the successful patient-centered approaches by two industry innovators, sharing key strategies and lessons learned from program implementation.



Learn more about this resource.

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3.) Healthcare Quality Improvement Costs on the Rise

Health insurers spent more than $5.042 billion on healthcare quality improvement expenses in 2011, compared to $4.936 billion in 2010, according to a new report by Mark Farrah Associates (MFA).

Get the full story.

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4.) 2012 Healthcare Benchmarks: Reducing Avoidable ER Visits

2012 Healthcare Benchmarks: Reducing Avoidable ER Visits This resource meets the business and planning needs of hospitals, health plans, physician practices and others by providing critical benchmarks that show how the industry is working to reduce avoidable hospital emergency department visits.


Learn more about this resource.

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5.) Healthcare Business White Paper: Health & Wellness Incentives in 2012 — Rewarding Risk Assessment, Lifestyle Changes

Health & Wellness Incentives in 2012 New market research from the Healthcare Intelligence Network has determined that the completion of a health risk assessment (HRA) remains the most heavily incented health improvement activity for the fourth consecutive year, say two-thirds of respondents to HIN's annual Health & Wellness Incentives Survey. This HINtelligence Report provides data highlights on health and wellness incentive program components, results, and ROI; as well as the most successful strategies for health and wellness incentives use.

Download this complimentary white paper.

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6.) Hospital Observation Units Could Save the Healthcare System $3.1 Billion

Despite research showing that observation units in hospitals could save the United States over $3 billion a year, less than one third of hospitals in the country have such units, according to a study from Brigham and Women’s Hospital (BWH).

Get the full story.

>>Return to this week's industry news


7.) New Table: Highlights of Highmark's Physician Pay-for-Performance Program

Highlights of Highmark's Physician Pay-for-Performance Program In existence for 15 years, the Highmark Inc. physician pay-for-performance program, Quality Blue, which continues to evolve, provides its 6,300 enrolled primary care physicians the opportunity to earn bonus payments across six measure sets, from clinical and quality measures to prescribing habits, access to care and level of technology use. We wanted to review Highmark's restructured pay-for-performance program that includes Phase 1 Meaningful Use measures.

Click here to view the table.

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8.) Hospital Discharge Improvement Guide: How to Close Six Key Care Gaps and Reduce Readmissions

Hospital Discharge Improvement Guide In this resource, Susan Shepard, director of patient safety education at The Doctors Management Company, suggests skills and interventions that health plans, hospitals and physician practices can use to improve each critical area of the hospital discharge process.


Learn more about this resource.

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9.) Consumer Reports: In Annual Health Plan Rankings, Nonprofits Leading the Pack

Nonprofit health plans topped the annual health plan ranking list from the NCQA, according to Consumer Reports, which published the list. For the third straight year, the nonprofit Harvard Pilgrim Health Care’s HMO in New England was the leading health plan.

Get the full story.

>>Return to this week's industry news

10.) Futurescan 2012: Healthcare Trends and Implications 2012-2017

Futurescan 2012: Healthcare Trends and Implications 2012-2017 This resource highlights eight key trends affecting the nation’s healthcare organizations, and each chapter identifies the implications of the trend and helps providers prepare for them. In this era of constant change, every healthcare leader can benefit from this report.


Learn more about this resource.

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11.) Physicians, Pharmacists Not Always Aligned on Emerging Diabetes Trends

Physicians and pharmacists are not always aligned when it comes to how public policy, new drugs and devices, and structural changes in the healthcare system should impact diabetes, according to a new survey from WorldOne and Joslin Diabetes Center.

Get the full story.

>>Return to this week's industry news


12.) 2012 Healthcare Benchmarks: Diabetes Management

2012 Healthcare Benchmarks: Diabetes Management This resource provides actionable data from 83 organizations on current diabetes management programs and their impact on population health outcomes and healthcare spend.



Learn more about this resource.

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13.) Is Choosing Healthcare Coverage Really Harder Than Parenting?

My husband and I have (nearly) raised two teenagers, and a year ago, I might have chuckled at this finding from Aetna's Empowered Health Index Survey. Aetna determined that Americans rank choosing healthcare benefits as the second most difficult major life decision behind saving for retirement — more difficult than purchasing a car, making decisions about medical tests or treatments, parenting, and selecting homeowners, renters or auto insurance.

Read this blog post.

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14.) Healthcare Trends & Forecasts in 2013: A Strategic Planning Session

Healthcare Trends & Forecasts in 2013: A Strategic Planning Session Healthcare Trends & Forecasts in 2013: A Strategic Planning Session Healthcare Trends & Forecasts in 2013: A Strategic Planning Session A presidential election, more post-ACA milestones and a remodeling of healthcare funding and delivery will no doubt make for an exciting year ahead in healthcare. In this preview of their October 17, 2012 strategic planning session for healthcare executives, Dennis Eder and Hank Osowski, managing directors of Strategic Health Group, and Steven Valentine, president of the Camden Group, predict the direction of physician reimbursement, trends in ACO administration, the technology to embrace in the year to come, and the industry's response to a softened demand for service.

Listen to this podcast.

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