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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

"Your blood pressure, pulse, temperature are all normal, but your exercise level is low. Let’s talk about this further."

This might be a potential new line of discussion in the doctor’s office, if exercise habits join the fray of typical vital statistics now taken in routine outpatient medical visits. A new initiative created by Kaiser Permanente systematically records patients’ exercise data into their EHRs, giving clinicians the opportunity to counsel them during these routine visits if it turns out they are not meeting national guidelines for physical activity. Designed to maximize findings showing the correlation between regular exercise and better health, the tool also has the potential to provide information about the relationship between exercise and healthcare utilization, cost and chronic disease, researchers say.

Helping patients overcome their objections to taking medication could vastly improve their adherence levels, says a new report from the University of Missouri. Studies show that nearly half of all patients taking medications for chronic conditions do not follow their prescribed medication regimens because of fears of long-term effects and dependency, among other concerns. But failure to use medications as directed increases patients’ risk for side effects, hospitalizations, reduced quality of life and shortened lifespans, the report states.

The study focused on older patients with high blood pressure, a condition that affects nearly 70 million adults in the United States and can lead to heart disease and stroke. It found that patients rejected medication in favor of other methods that had been proven successful in treating high blood pressure, like walking or cutting down on salt. Physicians need to be more proactive in helping patients amend their behaviors.

Those dealing with the advanced ill can help them to better manage their situations with education and emotional support, says Dr. Joseph Agostini, senior medical director of Aetna Medicare about Aetna’s Compassionate Care program. A lack of understanding about care options is one of the primary barriers when dealing with end-of-life patients; once options are in place, getting all parties to agree about a treatment plan is another.

Medicare beneficiaries' care and savings will improve significantly when new ACA-enacted Medicare policies are rolled out between now and 2014, according to a new Commonwealth Fund report. The new policies will reward four- and five-star plans and cut $12.7 billion in annual overpayments to private plans with three major changes, including rewards for quality and new benchmark rates. Detailed analysis of the changes can be found in our story.

And lastly, don’t forget to participate in our latest Healthcare Trends for 2013 survey. 2013 was a year in which the United States Supreme Court upheld the constitutionality of the ACA 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 by November 5, 2012, the day before election day. 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 22, 2012
Vol. XIV, No. 39

Sponsored by:
Readmission Penalties in 2013 — A Cross-Continuum Approach To Lessen the Financial Impact


This week's industry news:

  1. Walgreens Pharmacist-Based Discharge Services Help to Reduce Readmissions
  2. 27 Interventions to Reduce Avoidable ER Use
  3. New Study Finds Efforts to Embed Exercise in EHRs Improves Patient Care, Quality
  4. Patient Engagement in the Patient-Centered Medical Home
  5. Healthcare Business White Paper: ACOs in 2012
  6. 3 Changes to Medicare Advantage Plans Will Significantly Improve Patient Care, Healthcare Costs
  7. New Chart: How Long Does it Take to Create an ACO?
  8. CMS Star Quality Ratings
  9. Medication Beliefs Strongly Affect Individuals’ Management of Chronic Diseases
  10. 2011 Benchmarks in Improving Medication Adherence
  11. 3 Barriers to Care Management of Advanced Illness
  12. Case Management for Advanced Illness
  13. Infographic: Identity Theft and Healthcare Fraud Factor Into High Healthcare Cost Equation
  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.

Missed the last issue? Read it here.

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Take our monthly e-survey:
Healthcare Trends for 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.) Walgreens Pharmacist-Based Discharge Services Help to Reduce Readmissions

A new pharmacist-based transition of care program brings hospitals and health systems together with Walgreens in a coordinated care model designed to reduce readmission rates and overall healthcare costs, while improving patient health outcomes and medication adherence, according to Walgreens.

Get the full story.

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2.) 27 Interventions to Reduce Avoidable ER Use

27 Interventions to Reduce Avoidable ER Use This resource details 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. Five interventions target these sub-populations: asthma patients, those recently discharged from the hospital, non-network patients, nursing home and assisted living residents and dual-eligibles.

Learn more about this resource.

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3.) New Study Finds Efforts to Embed Exercise in EHRs Improves Patient Care, Quality

A new initiative to systematically record patients’ physical activity data into their EHRs along with other vital statistics can help improve patient care and quality, according to a Kaiser Permanente study published in the journal Medicine & Science in Sports & Exercise.

Get the full story.

>>Return to this week's industry news


4.) Patient Engagement in the Patient-Centered Medical Home: A Continuum Approach

Patient Engagement in the Patient-Centered Medical Home During this webinar, Jay Driggers, director of consumer engagement at Horizon BCBS, shared how Horizon approaches engagement, including: the impact of stand-alone pilots on consumer engagement, from iPhone apps to telemonitoring; and a best practice approach to driving awareness and education of the patient-centered medical home to build a connection between a patient and a practice, among other things.

Learn more about this resource.

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

ACOs 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.) 3 Changes to Medicare Advantage Plans Will Significantly Improve Patient Care, Healthcare Costs

Medicare beneficiaries’ care and savings will improve significantly when new ACA-enacted Medicare policies are rolled out between now and 2014, according to a new Commonwealth Fund report.

Get the full story.

>>Return to this week's industry news


7.) New Chart: How Long Does it Take to Create an ACO?

How Long Does it Take to Create an ACO? The typical ACO is smaller in 2012; the number of active ACOs with 100 to 500 physicians dropped almost 50 percent in the last 12 months. Twenty-seven percent of healthcare companies report ACOs of that size. We wanted to see how long it took healthcare companies to build an ACO.

Click here to view the chart.

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8.) CMS Star Quality Ratings: Shifting Strategies for Medicare Advantage and Part D Plans and Providers

CMS Star Quality Ratings This resource provides an in-depth look at the impact and implications of CMS’s star-ratings system so far, as well as how the star-rating program is likely to change in 2012 and subsequent years. Details on new measures under consideration by CMS are included, and much more.


Learn more about this resource.

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9.) Medication Beliefs Strongly Affect Individuals’ Management of Chronic Diseases

Nearly half of patients taking medications for chronic conditions do not follow their prescribed medication regimens because of prior beliefs about their necessity and long-term effects and dependency, according to a new report from the University of Missouri.

Get the full story.

>>Return to this week's industry news

10.) 2011 Benchmarks in Improving Medication Adherence

2011 Benchmarks in Improving Medication Adherence This resource provides actionable information from 162 healthcare organizations on their efforts to improve medication adherence and compliance in their populations, and documents the impact of these programs on adherence levels, medication costs and ER visits, among other areas of concern.


Learn more about this resource.

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11.) 3 Barriers to Care Management of Advanced Illness

Caring for those with advanced illness comes with its own set of unique barriers, says Dr. Joseph Agostini, senior medical director of Aetna Medicare, in describing the Aetna Compassionate Care program.

Get the full story.

>>Return to this week's industry news


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

Case Management for Advanced Illness This resource presents two advanced care leaders’ thoughts on the best practices and barriers that often arise with this population, the tools and resources that can contribute to their higher quality of care, and effective patient engagement techniques, among other things.


Learn more about this resource.

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13.) Infographic: Identity Theft and Healthcare Fraud Factor Into High Healthcare Cost Equation

Patient identification, patient fraud, and medical identity theft are having a negative impact on the healthcare industry, according to a new infographic by M2SYS.

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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