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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

With so much reform-era emphasis on bending the spend curve, we sometimes forget that the simplest interventions are often the most effective. For example, follow-up phone calls to select patients is a low-cost tactic getting significant results in a variety of healthcare settings.

In a featured story this week, U-M researchers report that patients suffering from depression who received follow-up calls from a primary office's care manager were more likely a year and a half later to have symptoms in remission and be more productive at work. And post-visit phone calls to ER high flyers, ER patients presenting with low-acuity complaints and patients recently discharged from the hospital are helping to reduce avoidable ER visits, according to results from July's Reducing Avoidable ER Use survey. Download survey results here.

"Perhaps the most underutilized technology in modern medicine is the telephone," noted Group Health Cooperative VP of Primary Care Services Michael Erikson during a recent webinar on staffing and roles of the medical home care team. He should know. Group Health's successful medical home pilot, which relied heavily on telephone outreach, reduced ER visits by 29 percent and in-person visits by 6 percent, according to results published last year in the American Journal of Managed Care.

Your colleague in the business of healthcare,
Patricia Donovan
Editor, Healthcare Business Weekly Update

Please send comments, questions and replies to pdonovan@hin.com.

HIN Associate Editor Jessica Papay
Associate Editor:
Jessica Papay, jpapay@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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November 1, 2010
Vol. XII, No. 40

Sponsored by:
Embedded Case Managers in the Emergency Department

This week's industry news:

  1. Majority of Healthcare Leaders Favor ACOs to Current FFS System
  2. Essential Guide to Accountable Care Organizations
  3. Risk Profiles Help Break Cycle of High-Cost, Unplanned Utilization
  4. Guide to Health Risk Assessment and Stratification
  5. Healthcare Business White Paper: Medical Home Disruptive Innovation
  6. Follow-ups Prove Powerful Tool for Depression Treatment in Primary Care
  7. New Chart: Top Financial Incentives for Health & Wellness
  8. 2010 Benchmarks in Healthcare Case Management
  9. Heavy Smoking Doubles Alzheimer’s Disease, Dementia Risk
  10. Health Coaching Benchmarks, 2010 Edition
  11. $335 Million Available to Boost Access to Primary, Preventive Healthcare
  12. Principles of a Patient-Centered Practice
  13. HealthSounds Podcast: Case Management Intervention in EDs
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.) Majority of Healthcare Leaders Favor ACOs to Current FFS System

In a new survey from the Commonwealth Fund, almost all healthcare opinion leaders agree that the country must move away from the current fee-for-service payment system. However, there were diverse opinions about the best payment approaches to replace it.

Get the full story.

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2.) Essential Guide to Accountable Care Organizations: Challenges, Risks and Opportunities of the ACO Model

Essential Guide to Accountable Care Organizations This resource answers key questions surrounding ACOs so that hospitals, PHOs, IPAs and other physician organizations, networks or group practices can weigh the merits now of creating an ACO and complete the necessary groundwork before CMS's ACO operation date of January 2012.

Learn more about this resource.

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3.) Risk Profiles Help Break Cycle of High-Cost, Unplanned Utilization

Predictive modeling can help healthcare organizations break the cycle of unplanned utilization, explains Rebecca Ramsay, senior manager of care support and clinical programs at CareOregon.

Get the full story.

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4.) Guide to Health Risk Assessment and Stratification

Guide to Health Risk Assessment In this guide, 13 industry thought leaders describe the processes of health risk assessment (HRA) and stratification as well as applications and benefits of health assessment in the workplace and various healthcare settings. This 140-page guide also examines the HRA's impact on cost, utilization and patient health status. Q&A chapter answers more than 60 questions on HRAs.

Learn more about this resource.

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5.) Healthcare Business White Paper: The Medical Home Disruptive Innovation for a New Primary Care Model

This white paper examines medical home models, their savings potential, and the implications for policymakers and key industry stakeholders. This paper also offers compelling arguments in favor of medical home adoption.

Download this complimentary white paper.

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6.) Follow-ups Prove Powerful Tool for Depression Treatment in Primary Care

A new study by University of Michigan (U-M) Health System researchers points to an encouraging strategy for improving and sustaining mental health results in chronically depressed patients by providing small amounts of flexible, targeted follow-up care — without overburdening busy doctors’ offices.

Get the full story.

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7.) New Chart: Top Financial Incentives for Health & Wellness

Top Financial Incentives

Financial and benefits-based incentives are used to promote participation in health and wellness programs. We wanted to see which financial incentives are offered most often.

Click here to view the chart.

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8.) 2010 Benchmarks in Healthcare Case Management: Responsibilities, Results & ROI

2010 Benchmarks in Healthcare Case Management This resource provides actionable information from 187 healthcare organizations on the placement and responsibilities of case managers and the impact case management has on healthcare utilization, cost and compliance.

Learn more about this resource.

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9.) Heavy Smoking Doubles Alzheimer’s Disease, Dementia Risk

Heavy smoking in midlife is associated with a 157 percent increased risk of developing Alzheimer’s disease and a 172 percent increased risk of developing vascular dementia, according to a Kaiser Permanente study.

Get the full story.

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10.) Health Coaching Benchmarks, 2010 Edition: Operations and Performance Data for Optimal Program ROI and Participant Health Status

Health Coaching Benchmarks, 2010 Edition This resource analyzes responses of 212 healthcare organizations to HIN's second annual 2009 Survey on Health and Wellness Coaching. An all-new follow-up to the best-selling “2009 Health Coaching Benchmarks,” the 2010 edition is packed with actionable new data on health coaching activity, with the latest metrics on the prevalence of health coaching, favored delivery methods, targeted populations and lifestyle conditions, preferred behavior change models, coaching case loads and much more.

Learn more about this resource.

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11.) $335 Million Available to Boost Access to Primary, Preventive Healthcare

HHS has made available $335 million for existing community health centers across the country which will, according to HRSA Administrator Mary Wakefield, Ph.D. R.N., "allow existing health centers to improve and expand vital primary healthcare services, and continue to meet the increased demand for services."

Get the full story.

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12.) Principles of a Patient-Centered Practice: Medical Home Guidelines for Staffing, Recognition and Evidence-Based Care

Principles of a Patient-Centered Practice This resource delivers essential lessons in a practice-wide redesign from organizations that have already completed the transformation to a medical home — including two of the top 10 commercial health plans for 2009-2010 as ranked by the National Committee for Quality Assurance (NCQA) and the US News Media Group and a Level III NCQA-recognized medical home.

Learn more about this resource.

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13.) HealthSounds Podcast: Key Targets for Case Management Intervention in EDs

Toni Cesta Organizations should advocate for a case manager in the emergency room, says Toni Cesta, senior vice president of operational efficiency and capacity management at Lutheran Medical Center. Making the business case for an ED-embedded case manager, Cesta shares key targets for case management intervention in the ED and describes how the ER case manager is positioned to improve patients' transitions in care.

Listen to this podcast.

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