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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

Healthcare costs for various segments continue to increase. In fact, according to recently released figures from S&P Indices, commercial insurance and Medicare programs increased by nearly 6 percent for the 12 months ending August 2011. While commercial insurance rates rose for four months in a row, Medicare costs actually declined from their all time high rate of 8 percent in 2009.

Costs for long-term care also rose; according to MetLife, rates for those requiring care in nursing homes, assisted living facilities, and adult day services rose from four to 5 percent; with nursing home rates doubling those of assisted living. The survey, collated from 2,003 nursing homes, 1,492 assisted-living facilities, 1,644 home-care agencies and 1,341 adult-day services in all 50 states and Washington, D.C., presents a breakdown of rates according to region, gender and age.

The trend of embedding case managers in primary care continues. Aetna is embedding case managers in six Emory primary care practice facilities. The new patient-centered medical home program will provide care for both Aetna Medicare members and Emory’s employees and family members. Key goals of the collaboration are improved patient care, increased follow-up visits, and better quality and efficiency.

And CMS has launched a new initiative designed to help federally qualified health centers transform into advanced primary care practices. Five-hundred participants have been selected from 44 states around the country and will receive a portion of the $42 million allocated for the program. FQHCs will be assessed on their efforts to improve patient care and delivery.

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 31, 2011
Vol. XIII, No. 40

Sponsored by:
Healthcare Trends in 2012 — A Strategic Industry Forecast

This week's industry news:

  1. Aetna Embedded Case Managers and Emory Healthcare Physicians Collaborate on Medical Home Program
  2. The Medical Home Case Manager
  3. U.S. Healthcare Costs Continue to Climb for Fourth Month in a Row
  4. Prescription for Profitability
  5. Healthcare Business White Paper: 2011 Benchmarks in the Patient-Centered Medical Home
  6. New FQHC Advanced Primary Care Practice Demonstration to Improve Care for Medicare Beneficiaries
  7. New Chart: Who's Responsible for Reducing Readmissions?
  8. Healthcare Trends in 2012: A Strategic Industry Forecast
  9. Follow-Up Dialogues Key to Reducing Heart Failure Readmissions
  10. Reducing Readmissions
  11. Long-Term Care Costs Continue to Increase; Nursing Home Rates Double Assisted Living Costs
  12. Nursing Home Administration, Sixth Edition
  13. ACO Final Rule Accompanied by Advance Payments for Care Coordination Tools
  14. HealthSounds Podcast: The Patient Experience — How to Keep the Healthcare Customer Satisfied
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This week's industry news

1.) Aetna Embedded Case Managers and Emory Healthcare Physicians Collaborate on Medical Home Program

Aetna and Emory Healthcare are collaborating on a patient-centered medical home program that will provide care for both Aetna Medicare members and Emory's employees and family members.

Get the full story.

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2.) 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, skillset, processes and benefits of the Geisinger Health Plan case managers embedded within the payor's medical home practices.

Learn more about this resource.

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3.) U.S. Healthcare Costs Continue to Climb for Fourth Month in a Row

Healthcare services covered by commercial insurance and Medicare programs continued to climb for the fourth month in a row, culminating in a 5.73 percent increase over the 12 months ending August 2011, according to the S&P Healthcare Economic Indices.

Get the full story.

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4.) Prescription for Profitability: 50 Ideas to Stimulate Healthcare Savings

Prescription for Profitability This 35-page resource delivers cutting-edge advice on key programs funded for pilots, demos and incentives in healthcare reform, the patient-centered medical home, health coaching, care transitions, hospital readmissions, medication management and innovative payment models like the accountable care organization (ACO).

Learn more about this resource.

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5.) Healthcare Business White Paper: 2011 Benchmarks in the Patient-Centered Medical Home

From its fifth annual patient-centered medical home (PCMH) e-survey administered in March 2011, the Healthcare Intelligence Network gained insight from 115 organizations into the populations that would benefit from this model of care, components of a medical home, PCMH interest in the accountable care organization (ACO) model and the effects of the PCMH on utilization and cost.

Download this complimentary white paper.

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6.) New FQHC Advanced Primary Care Practice Demonstration to Improve Care for Medicare Beneficiaries

CMS has launched a new program designed to study the process and challenges involved in transforming community health centers into advanced primary care practices.

Get the full story.

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7.) New Chart: Who's Responsible for Reducing Readmissions?

Who's Responsible for Reducing Readmissions? When healthcare organizations cut even a minority of avoidable readmissions, the cost savings can be considerable and the quality impact even greater. We wanted to see who is responsible for tasks related to reducing hospital readmissions.

Click here to view the chart.

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8.) Healthcare Trends in 2012: A Strategic Industry Forecast

Healthcare Trends in 2012 With unprecedented economic conditions continuing to impact the industry, new healthcare payment and delivery options available for healthcare providers and the ongoing implementation of the Patient Protection and Affordable Care Act, healthcare organizations have much to monitor in the year ahead. This 45-minute webinar will provide a first look analysis at the key trends and opportunities for healthcare organizations in the coming year.

Learn more about this resource.

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9.) Follow-Up Dialogues Key to Reducing Heart Failure Readmissions

“Teach-back strategies,” or dialogues with patients post-discharge to ensure that they understand their healthcare concerns and can manage them effectively moving forward are just one of the ways Priority Health has successfully reduced readmission rates, explains Mary Cooley, RN, BSN, MS, CCM, manager of case and disease management at Priority Health.

Get the full story.

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10.) Reducing Readmissions: Interventions, Incentives and Infrastructure

Reducing Readmissions This 50-page report presents case studies from three healthcare organizations whose efforts have significantly reduced avoidable hospital readmissions in high-risk populations and include the alignment of financial incentives to readmission rates.

Learn more about this resource.

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11.) Long-Term Care Costs Continue to Increase; Nursing Home Rates Double Assisted Living Costs

Costs continue to rise for those requiring long-term care in the United States, according to the newly released 2011 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs.

Get the full story.

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12.) Nursing Home Administration, Sixth Edition

Nursing Home Administration, Sixth Edition This guide serves as a roadmap for studying and understanding all the various requirements: management, human resources, finance and business, industry laws and regulations, and patient care. It demonstrates how all components fit together to form the coordinated activity set required of a successful nursing home administrator.

Learn more about this resource.

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13.) ACO Final Rule Accompanied by Advance Payments for Care Coordination Tools

The anxiously awaited final rule on accountable care organizations (ACOs) for Medicare beneficiaries is finally out. Based on the more than 1300 comments CMS received on its proposed ACO ruling first released in March, this new rule will make it easier to establish ACOs by providing organizations with additional funding for support tools, such as new staff or information technology systems.

Read this blog post.

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14.) HealthSounds Podcast: The Patient Experience — How to Keep the Healthcare Customer Satisfied

Melanie Matthews Spiritual support, in-room WIFI access, improved housekeeping and valet parking are just a few of the perks hospitals have added to boost patient satisfaction ratings. In this month's healthcare benchmarks podcast, Melanie Matthews from the Healthcare Intelligence Network describes how 146 healthcare organizations rank their own efforts to improve patient satisfaction. She also shares key metrics from the 2011 survey on Improving Patient Satisfaction and Experience, including the most important aspect of the care delivery experience and preferred formats for patient surveys.

Patient satisfaction is an important driver of core measurement scores. Dr. Steven Berkowitz, president of SMB Consulting, shares his formula for achieving 100 percent performance on core measures and describes an incentive program for drivers of the quality measures.

Listen to this podcast.

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