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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

To help primary care doctors better coordinate care for Medicare patients, CMS has announced the Medicare Comprehensive Primary Care program. CMS will work with commercial and state health insurance plans to offer additional support to primary care doctors in disease self-management, care access, preventive services, patient engagement and care coordination. This collaboration is modeled after innovative practices developed by large employers and leading private health insurers in the private sector. The voluntary initiative will begin as a demonstration project in five to seven healthcare markets across the country. Interested public and private healthcare payors must submit a letter of intent by November 15, 2011. You can read the full story on this here.

As new uses for digital health information emerge and access to confidential patient information expands, a majority of healthcare organizations are not prepared to protect patient privacy and secure data, says a new report from the Health Research Institute (HRI) at PwC US. And medical identity theft is on the rise; according to a recent PwC HRI survey, theft accounted for two thirds of total reported health data breaches over the past two years. Healthcare organizations need to update practices and adopt a more integrated approach to ensure that patient information doesn’t fall into the wrong hands, the report advises. We report on this story at length in this issue.

Annual premiums for employer-sponsored family health coverage increased to $15,073 this year, up 9 percent from last year, according to a recent Employer Health Benefits survey from the Kaiser Family Foundation/Health Research & Educational Trust (HRET). Premiums increased significantly faster than workers’ wages and general inflation.

To help its members navigate healthcare services and costs, BCBSF has introduced a new transparency tool, “Know Before You Go.” Designed to help its members navigate through the healthcare system, it provides information based on hospital data reported by CMS. The tool is customized to a member’s benefits and takes into account deductibles, copays and/or coinsurance amounts and estimates how much a treatment or procedure will cost.

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 3, 2011
Vol. XIII, No. 36

Sponsored by:
Evaluating CMS' Bundled Payment Initiative: Operational, Financial and Clinical Considerations

This week's industry news:

  1. Health Industry Not Prepared to Protect Patient Privacy
  2. Health IT in Care Management
  3. Interventions Help to Ground ED "Frequent Flyers"
  4. 27 Interventions to Reduce Avoidable ER Use
  5. Healthcare Business White Paper: Embedded Case Managers in 2011
  6. Average Annual Premiums for Family Health Benefits Top $15,000
  7. New Chart: Top 5 Ways to Engage Patients in Medical Homes
  8. Health Plan Strategies for the Individual Market
  9. Integrating Hospitalist Physicians into the ICU Team Requires "Best Practices" Training
  10. Hospitalists
  11. New Healthcare Cost and Quality Estimator Tool Available from Blue Cross/Blue Shield of Florida
  12. Healthcare Trends & Forecasts in 2011
  13. 10 Ways Cancer Patients and Physicians Can Better Communicate
  14. HealthSounds Podcast: Patient Registries
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Reducing Avoidable Emergency Room Visits in 2011

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This week's industry news

1.) Healthcare Industry Not Prepared to Protect Patient Privacy; Risk of Data Breaches Rising

A majority of healthcare organizations are not prepared to protect patient privacy and secure data as new uses for digital health information emerge and access to confidential patient information expands, says a new report from the Health Research Institute (HRI) at PwC US.

Get the full story.

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2.) Health IT in Care Management to Improve Health and Effect Behavior Change

Health This 35-page report describes how technology has enhanced patient engagement and self-management in specific populations. It provides the prerequisites for using technologies to engage patients in chronic disease improvement programs, setting the scene for care management and behavior change.

Learn more about this resource.

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3.) Interventions Help to Ground ED "Frequent Flyers"

Kaiser Permanente has used narcotics contracts effectively to reduce avoidable ED use by "high utilizers" and redirect patients to more cost-effective care venues, explains Sara Tracy, M.S.P.H., senior manager of emergency services at Kaiser Foundation Health Plan of Colorado.

Get the full story.

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4.) 27 Interventions to Reduce Avoidable ER Use

27 Interventions to Reduce Avoidable ER Use This resource describes 27 separate initiatives launched by Kaiser Foundation Health Plan and WellPoint around the country that are effectively reducing avoidable emergency department use and redirecting patients to more cost-effective care venues.

Learn more about this resource.

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5.) Healthcare Business White Paper: Embedded Case Managers in 2011 — Co-Location Catches On Across Healthcare Continuum

Learn how today’s healthcare case managers are colocated with primary care practices, emergency room staff and hospital admissions and discharge teams to identify and manage high-risk patients and members and reduce avoidable utilization of services. This white paper documents the evolution of embedded case managers at Geisinger Health System, Bon Secours, CDPHP and Lutheran Medical Center.

Download this complimentary white paper.

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6.) Average Annual Premiums for Family Health Benefits Top $15,000, More than Growth in Worker’s Wages

Annual premiums for employer-sponsored family health coverage increased to $15,073 this year, up 9 percent from last year, according to a recent Employer Health Benefits survey from the Kaiser Family Foundation/Health Research & Educational Trust (HRET).

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top 5 Ways to Engage Patients in Medical Homes

Engage Patients in Medical Homes The patient-centered medical home (PCMH) model of care is heavily supported in the Affordable Care Act, a favored model of integrated care delivery and a cornerstone of accountable care. We wanted to see how healthcare companies engage and educate patients in their medical homes.

Click here to view the chart.

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8.) Health Plan Strategies for the Individual Market

Health Plan Strategies for the Individual Market This report features recent enrollment data on individual/non-group plans, exclusive insight from executives at Blue Cross and Blue Shield plans, Aetna, CIGNA and others on balancing premiums against rising medical costs, and detailed analysis of coverage rescission issues.

Learn more about this resource.

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9.) Integrating Hospitalist Physicians into the ICU Team Requires "Best Practices" Training and Tele-ICU Back-Up

Hospitalists can be an integral part of the ICU team if they are trained in ICU best practices and have access to a tele-ICU with round the clock availability, according to a recent webinar at the Society for Critical Care Medicine (SCCM.)

Get the full story.

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10.) Hospitalists

Hospitalists This 45 page report includes policies and procedures to develop a practical and physician-friendly hospitalists program — designed to improve and streamline patient care from the ER through discharge and transitional care period. Credentialing criteria and example job description for hospitalist physicians, along with references and resources, are also included.

Learn more about this resource.

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11.) New Healthcare Cost and Quality Estimator Tool Available from Blue Cross/Blue Shield of Florida

Blue Cross/Blue Shield members can now compare the cost and quality of health services before they receive them.

Get the full story.

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12.) Healthcare Trends & Forecasts in 2011: Performance Expectations for the Healthcare Industry

Healthcare Trends & Forecasts in 2011 The responses of more than 70 healthcare organizations to the seventh annual HIN Healthcare Trends and Forecasts survey, in which respondents ranked top-of-mind concerns for the year ahead and reported their organization's best and worst business decisions in 2010, are documented in this resource.

Learn more about this resource.

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13.) 10 Ways Cancer Patients and Physicians Can Better Communicate

Talking with doctors about cancer and cancer treatments can feel like learning a new language, and people facing cancer diagnoses often need help to understand their treatment options, and the risks and benefits of each choice.

Read this blog post.

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14.) HealthSounds Podcast: Patient Registries — A Cornerstone in Creating and Delivering Accountable Care

Dr. Gregory Spencer Whether extracted from an EHR or compiled with a spreadsheet program, there's nothing magical about a registry, explains Dr. Gregory Spencer, chief medical officer for Crystal Run Healthcare. Dr. Spencer demystifies the registry, describes how to leverage registry data in multiple ways and underscores registries' growing value in emerging care delivery models like the accountable care organization.

Listen to this podcast.

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