HIN logo
From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Last year at this time we watched with disbelief as Hurricane Sandy pummeled our East coastline. Schools closed, power shut down, and Halloween was officially postponed until early November when it was considered safe for children to trick or treat.

Our own town is still recovering from the storm; scarred, vacant houses share the same block as rehabbed homes on stilt-like platforms; trailers double for once elegant restaurants and broken docks and abandoned boats patiently ride the crests of ocean waves.

It was a rocky year for healthcare as well, from an early surge in Medicare ACOs, to the embattled introduction of ACA-mandated health insurance exchanges during a government shutdown.

But many things remained the same; childhood obesity rates continued to climb, as did public health efforts to control it, including counseling and nutritional guidance, according to a new trends report from NCQA. Poverty continued to plague many Americans, particularly dual eligibles, but companies like WellCare did their best to help them by closing social gaps with health-oriented community connections looking to "give back," as its vice president of advocacy and community-based programs executive director Pamme Taylor demonstrates in this week's featured book excerpt.

Organizations like HealthEast and Mercy utilized clinical analytics technologies from Optum to better understand and manage treatment for patients with chronic conditions, and advance performance for its newly formed accountable care organization (ACO).

And doctors' policies toward accepting new Medicaid patients in the wake of expanded coverage will most likely stay the same, according to a study from Virginia Commonwealth University, Richmond. The decade-plus study found that physicians might be more likely to stop accepting those patients who remain uninsured, however, as our story details.

And lastly, self-management continues to result in better patient outcomes, according to researchers from the Boston Medical Center. Patient activation, or having the knowledge, skills, and confidence needed to manage one's health, leads to better health following hospital discharge, and lower readmission rates. Screening for patient activation could not only help hospitals identify patients at risk for readmission, but also inform the development of tailored, cost-effective intervention plans.

How did your healthcare organization fare in 2013? And what plans do you have the future? Tell us by completing our ninth annual survey on Healthcare Trends for 2014 and you’ll receive a free executive summary of the results. One respondent will win a training DVD of the "2014 Healthcare Trends and Forecasts" webinar recorded on October 30, 2013.

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:

Care Transitions in 2013 — Interventions Surge in Response to Payor Scrutiny; Home-Grown Approaches Trump Traditional Models

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

October 28, 2013
Vol. XV, No. 40

Sponsored by:
Healthcare Trends & Forecasts in 2014 — A Strategic Planning Session


This week's industry news:

  1. Clinical Analytics Deliver Patient, Population Health Insights
  2. 2013 Healthcare Benchmarks: Accountable Care Organizations
  3. Doctors Likely to Accept New Medicaid Patients as Coverage Expands
  4. Telephonic Case Management Protocols to Engage Vulnerable Populations
  5. Healthcare Business White Paper: Medication Adherence in 2013
  6. Study: Patient Activation Linked to Lower Readmissions
  7. New Table: 5 Reasons Bundled Payments Are Member-Friendly
  8. Avoiding the Readmissions Penalty Zone
  9. 5 Trends in Healthcare Include Antibiotic Overuse, Childhood Obesity Strategies: NCQA
  10. 38 Disease Management Metrics
  11. How WellCare Closed 4 Socially Based Care Gaps
  12. Community Care Connections for Dual Eligibles
  13. Infographic: 6 Frightening Truths About Stress
  14. Healthcare Trends in 2014: Expect Surge in Commercial ACOs to Continue
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:
Healthcare Trends for 2014

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

Interested in all open surveys? Review them here.


This week's industry news

1.) Clinical Analytics Deliver Patient, Population Health Insights

Advanced clinical analytics technologies from Optum are supporting population health management and accountable care strategies at Mercy and HealthEast Care System, according to the United Health Group.

Get the full story.

>>Return to this week's industry news


2.) 2013 Healthcare Benchmarks: Accountable Care Organizations

2013 Healthcare Benchmarks: Accountable Care Organizations This resource documents the numerous ways in which accountable care is transforming healthcare delivery, particularly in the area of care coordination, where the ACO model has had the greatest impact for this year’s respondents.


Learn more about this resource.

>>Return to this week's industry news


3.) Doctors Likely to Accept New Medicaid Patients as Coverage Expands

Doctors are likely to accept new Medicaid patients as coverage expands, but they may not accept patients who remain uninsured, according to a study from Virginia Commonwealth University, Richmond.

Get the full story.

>>Return to this week's industry news


4.) Telephonic Case Management Protocols to Engage Vulnerable Populations

Telephonic Case Management Protocols to Engage Vulnerable Populations This resource describes a suite of tools to facilitate identification, interaction, surveys, follow-up action, resource matching, and member engagement and outreach for a behavioral health population that is also a template for case management and care coordination of any organization’s hard-to-reach or vulnerable members.

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.) Study: Patient Activation Linked to Lower Readmissions

Patient activation — or having the knowledge, skills, and confidence needed to manage one’s health — leads to better health following hospital discharge, and lower readmission rates, according to researchers from the Boston Medical Center.

Get the full story.

>>Return to this week's industry news


7.) New Table: 5 Reasons Bundled Payments Are Member-Friendly

New Table: 5 Reasons Bundled Payments Are Member-Friendly With 500 provider organizations participating in the Bundled Payments for Care Improvement initiative, believed to be the largest demonstration project ever run by CMS, both payer and provider interest in the adoption of payment bundling is at an all-time high. We wanted to see the reasons why one organization, TriZetto®, created member benefits specific to payment bundling.

Click here to view the table.

>>Return to this week's industry news


8.) Avoiding the Readmissions Penalty Zone: Population Health Management for High-Risk Populations

Avoiding the Readmissions Penalty Zone This resource delivers winning process improvements and interventions that can help organizations make measurable progress toward reducing readmissions in high-risk populations, including a look at a health system-SNF network that has curbed rehospitalizations and length of stay for participants.


Learn more about this resource.

>>Return to this week's industry news


9.) 5 Trends in Healthcare Include Antibiotic Overuse, Childhood Obesity Strategies: NCQA

Childhood obesity and overuse of antibiotics are among the five trends healthcare advocates are targeting, according to the State of Health Care Quality Report 2013 from the National Committee for Quality Assurance (NCQA).

Get the full story.

>>Return to this week's industry news

10.) 38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care

Pharmacists and Medication Adherence This resource dives deep into several years of market research to document the role and outcomes of disease management in 11 key areas, as well as the high-focus diseases and health conditions of such initiatives as obesity and weight management and diabetes management.

Learn more about this resource.

>>Return to this week's industry news


11.) How WellCare Closed 4 Socially Based Care Gaps

Imagine, if you will, a family of six living in a 1,100-square foot home in rural United States. Mom and Dad work two part-time jobs, their daughter is 19 and pregnant for the second time; her 10-year-old twin brothers have developmental issues, and their grandmother has diabetes and early onset dementia. Finding ways to help this family access healthcare, food and even transportation is one of WellCare’s primary goals, explains Pamme Lyons Taylor, vice president of advocacy and community-based programs.

Get the full story.

>>Return to this week's industry news


12.) Community Care Connections for Dual Eligibles: Closing Social Gaps to Improve Health Outcomes

Community Care Connections for Dual Eligibles This resource details the WellCare approach to duals' care coordination — a healthy mix of public health and social support in which a team of advocates works the front lines of the community, cataloging and pooling resources with a common goal — the reopening of a local food bank, for example.


Learn more about this resource.

>>Return to this week's industry news


13.) Infographic: 6 Frightening Truths About Stress

It is widely accepted that stress is a common experience, with almost eight out of 10 people regularly having physical symptoms. What you may not know is the cost to the healthcare system. There is a $300 billion annual cost of stress related to healthcare and missed work, according to a new infographic from HowToHandleStress.info. This infographic also identifies symptoms and effects of stress, as well as trends and potential causes.

Read this blog post.

>>Return to this week's industry news


14.) Healthcare Trends in 2014: Expect Surge in Commercial ACOs to Continue

Steven Valentine Despite the migration of some Pioneer ACOs to CMS’s Medicare Shared Savings Program (MSSP), expect the surge in commercial accountable care organizations to continue in 2014, predicts Steven Valentine, president, The Camden Group. In this audio interview, Valentine suggests improvements to patient handoffs, an area in which ACOs have disappointed, in Valentine’s view, as well as expectations for the other much-modeled care delivery platform, the patient-centered medical home (PCMH).

In both the ACO and the PCMH, Valentine anticipates specialists will be critical parts of the solution, especially when it comes to emerging payment models, quality and performance.

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