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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Six states have been awarded HHS grants to establish new health insurance exchanges, making a total of 49 states, the District of Columbia, and four territories that have received grants to begin planning their exchanges, and 34 states and the District of Columbia that have received grants to begin building their exchanges. States may apply for grants through the end of 2014 and may use funds through the initial start-up year, HHS officials say.

When patients use technologies, like smartphone apps, iPads, and sensors to share personal information with their physicians, their care and outcomes are enhanced, according to new research from the Robert Wood Johnson Foundation (RWJF). Patients from around the country recorded details about their daily lives and shared them with physicians who explored how they could be incorporated into clinical care. The results were promising; some of the health conditions that could be improved upon include Crohn’s disease, asthma, and even cognitive decline, among others.

Not so promising: rates of hospitalizations for nursing home patients. Nearly 50 percent of hospitalizations among nursing home residents receiving either Medicare SNF services or Medicaid nursing facility services could have been avoided, according to CMS, and total costs for these hospitalizations for 2011 were between $7 and $8 billion. Seven organizations in seven states are partnering with CMS in a new program to improve care and reduce hospitalization for 145 selected long-stay nursing facility residents. Care quality models will be tested, and funding will be provided to the organizations that provide enhanced on-site services and supports to nursing facility residents.

The benefits of PCMH’s continue to be documented; the latest study, fromHealthCore Inc., an independent subsidiary of WellPoint Inc., showed that physicians working in New York area-based PCMHs better managed their patients’ diseases, ordered fewer high-cost imaging tests, reduced ER visits and avoidable hospitalizations, and reduced costs of care for patients overall. The PCMHs were working to earn NCQA recognition during the study measurement period, which encompassed all of 2009. All PCMHs achieved recognition by 2010. More details inside.

Today is the last day to participate in our population health management (PHM) survey. Clinical and financial evidence increasingly supports a PHM approach that spans the risk continuum, targeting upstream contributors to poor health as well as chronic conditions to improve health systems and bend the cost curve. Improvement of population health is a tenet of the Institute for Healthcare Improvement's Triple Aim, along with enhancing the patient experience and curbing per capita health costs. Participants will be e-mailed a free executive summary of survey results once it is compiled. Your responses will be kept strictly confidential.

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 8, 2012
Vol. XIV, No. 37

Sponsored by:
Healthcare Trends & Forecasts in 2013 — A Strategic Planning Session


This week's industry news:

  1. HHS Continues to Reward States’ Efforts to Build Affordable Insurance Exchanges
  2. The Financial Professional’s Guide to Healthcare Reform
  3. New Personal Technologies Help Improve Patient Engagement, Healthcare Delivery and Outcomes
  4. 2011 Performance Benchmarks in Telehealth & Telemedicine
  5. Healthcare Business White Paper: Asthma Management in 2012
  6. Study Demonstrates Better Health Outcomes, Lower Costs in PCMH Practices
  7. New Chart: What's the ROI from Medication Adherence Programs?
  8. The Medical Home Case Manager
  9. New Program Aims to Decrease Avoidable Hospitalizations among Nursing Home Residents
  10. Retooling Care Transitions to Reduce Hospitalizations in Medicare Patients
  11. 2 Key Performance Improvement Tools for Clinical Integration
  12. Case Study in Clinical Integration
  13. Infographic: Rolling Out the Red Carpet to Improve Patient Satisfaction
  14. Integrated Health Coaching
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.) HHS Continues to Reward States’ Efforts to Build Affordable Insurance Exchanges

Six states have been awarded grants to establish new health insurance exchanges, so they will have the flexibility and resources needed to create new health insurance marketplaces, known as exchanges, for their residents, according to the HHS.

Get the full story.

>>Return to this week's industry news


2.) The Financial Professional’s Guide to Healthcare Reform

The Financial Professional’s Guide to Healthcare Reform This resource explains the healthcare law for individuals and businesses alike, what to expect from it and what actions they need to take to comply.




Learn more about this resource.

>>Return to this week's industry news


3.) New Personal Technologies Help Improve Patient Engagement, Healthcare Delivery and Outcomes

When patients use technologies, like smartphone apps, to share personal information with their physicians, their care and outcomes are enhanced, according to new research from the Robert Wood Johnson Foundation (RWJF.)

Get the full story.

>>Return to this week's industry news


4.) 2011 Performance Benchmarks in Telehealth & Telemedicine

2011 Performance Benchmarks in Telehealth & Telemedicine This resource provides metrics and measurements on devices utilized in telehealth, the top non-clinical and clinical applications for telehealth, and much more.




Learn more about this resource.

>>Return to this week's industry news


5.) Healthcare Business White Paper: Asthma Management in 2012 — Action Plans, Coaching Help Patients To Breathe Easier

Asthma Management in 2012 New market research from the Healthcare Intelligence Network has determined that asthma action plans and health coaching are key components of an effective asthma management program. Download this HINtelligence report to learn how 71 healthcare companies are helping individuals with asthma to manage their disease more effectively, reducing the likelihood of ER visits and hospitalizations by this population.

Download this complimentary white paper.

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6.) Study Demonstrates Better Health Outcomes, Lower Costs in PCMH Practices

Physicians working in New York area-based patient-centered medical homes (PCMHs) better managed their patients’ diseases, ordered fewer high-cost imaging tests, reduced ER visits and avoidable hospitalizations, and reduced costs of care for patients overall, according to a new study from HealthCore Inc., an independent subsidiary of WellPoint Inc.

Get the full story.

>>Return to this week's industry news


7.) New Chart: What's the ROI from Medication Adherence Programs?

What's the ROI from Medication Adherence Programs? Evidence continues to mount that heightened levels of medication adherence correlate to reduced hospitalizations and emergency room visits, especially among Medicare patients. We wanted to see what ROI has been generated by medication adherence programs.

Click here to view the table.

>>Return to this week's industry news


8.) The Medical Home Case Manager: Profiting from Patient-Centered Care Coordination

The Medical Home Case Manager This resource provides an inside look at the selection, training, skill set, processes and benefits of the Geisinger Health Plan case managers embedded within the payor’s medical home practices.



Learn more about this resource.

>>Return to this week's industry news


9.) New Program Aims to Decrease Avoidable Hospitalizations among Nursing Home Residents

Nearly 50 percent of hospitalizations among nursing home residents receiving either Medicare skilled nursing facility services or Medicaid nursing facility services could have been avoided, according to research reported by the CMS, and total costs for these hospitalizations for 2011 were between $7 and $8 billion.

Get the full story.

>>Return to this week's industry news

10.) Retooling Care Transitions to Reduce Hospitalizations in Medicare Patients

Retooling Care Transitions to Reduce Hospitalizations in Medicare Patients This resource delivers current trends in care transition programs as well as advice and guidance from industry thought leaders on key elements of care transition programs — from enhancements to the hospital discharge process to medication reconciliation ideas to better utilization of home visits during care transitions.


Learn more about this resource.

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11.) 2 Key Performance Improvement Tools for Clinical Integration

Clinical integration (CI) is considered essential to the framework of an accountable care organization (ACO) because of its ability to generate physician trust, commitment, and acceptance of performance monitoring to achieve goals.

Get the full story.

>>Return to this week's industry news


12.) Case Study in Clinical Integration: The Advocate Physician Partners Experience

Case Study in Clinical Integration In this resource, Mark Shields, MD, MBA, senior medical director for Advocate Physician Partners (APP) and vice president of medical management for Advocate Health Care, details the clinical integration (CI) program APP developed for its 3,800 physicians — from the structure of the CI group to funding, incentives, mechanisms and technology that support CI.

Learn more about this resource.

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13.) Infographic: Rolling Out the Red Carpet to Improve Patient Satisfaction

Valet parking, online booking, concierges, turn-down service, in-room Wifi, gourmet meals…the stuff of four star hotels, right? In this case, however, we're not talking about hospitality, we're talking healthcare, and about the lengths to which hospitals, physician practices and payors will go to enhance that elusive yet all-important metric known as the Patient Experience.

Read this blog post.

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14.) Integrated Health Coaching: The Next Generation in Health Behavior Change Management

Integrated Health Coaching: The Next Generation in Health Behavior Change Management Integrated Health Coaching: The Next Generation in Health Behavior Change Management Integrated health coaching's person-centric approach to health behaviors across the entire health risk continuum aligns with many of the key principles of post-ACA care delivery models like the patient-centered medical home and the accountable care organization (ACO), explains Dr. Dennis Richling, HealthFitness chief medical and wellness officer. Dr. Richling and HealthFitness Vice President of Service Delivery Kelly Merriman describe the population presenting the greatest opportunities for integrated health coaching, the key to discerning participant values during the coaching intervention, and the art of 'appreciative inquiry' — an essential coaching skill that helps to define an individual's 'exceptionality.'

Listen to this podcast.

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