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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

Analysts are asking how huge Republican victories in last week's midterm elections will impact healthcare reform.

"Minimal change, maybe some delays in funding," contributed Steven Valentine, president of the The Camden Group, in a follow-up to a recent webinar on healthcare trends for 2011.

"We have to remember, Medicare was putting a lot of these initiatives through ahead of Obama. We would have seen some of the bundled payments, new risk and payment methodologies and the Medicare reductions coming forward anyway."

Valentine noted that Obama can still veto whatever changes the new Republican-heavy House of Representatives serves up. Any tweaks to the healthcare reform bill must be approved by both houses, and the President still has a Democratic majority in the Senate (albeit one that is somewhat reduced).

While federal monies are still available, five states that act fast can take advantage of HHS 'Early Innovator' grants to fund development of IT systems for state health insurance exchanges. The application process is featured in this week's issue. Also this week, learn how an IT-infused toolkit is preventing up to 90 falls per year by older adults in short-stay hospitals.

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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This week's featured download: Medical Homes in 2010 — Awareness, Adoption, Tools and Outcomes

Medical Homes in 2010 — Awareness, Adoption, Tools and Outcomes

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November 8, 2010
Vol. XII, No. 41

Sponsored by:
How To Create an ACO Framework Through Clinical Integration with Independent Physicians

This week's industry news:

  1. Medical Home Pilot Uses a Three-Tiered Reimbursement Methodology
  2. Guide to Medical Home Reimbursement
  3. Prevention Toolkit Significantly Reduces Rate of Falls in Hospitals
  4. 27 Interventions to Reduce Avoidable ER Use
  5. Healthcare Business White Paper: Healthcare Industry Response to Uninsured
  6. Defense Department Unveils Smart Phone Mental Health Application
  7. New Chart: Who's Eligible to Take An HRA?
  8. The Next Generation of Health Coaching
  9. Comfort, Not Life Expectancy, Should Guide Hospice Admissions for Dementia Patients
  10. Guide to Patient-Centered Case Management
  11. HHS Early Innovator Grants to Fund Development of IT Systems for State Exchanges
  12. 2010 Healthcare Benchmarks: Telehealth and Telemedicine
  13. HealthSounds Podcast: Health Plan Rate Setting
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.) Medical Home Pilot Uses a Three-Tiered Reimbursement Methodology

Julie Schilz, co-chair of the Center for Multi-Stakeholder Demonstrations and Improving Performance in Practice (IPIP) manager for Health TeamWorks, formerly known as the Colorado Clinical Guidelines Collaborative (CCGC), discusses CCGCís reimbursement components for their medical home pilot.

Get the full story.

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2.) Guide to Medical Home Reimbursement

Guide to Medical Home Reimbursement This resource delivers comprehensive analyses of emerging payment models for patient-centered care from early adopters that are working overtime to put a fair price on care coordination tasks and adequately reward providers for medical home adoption. More than 70 illustrations; Q&A chapter answers 75 questions on medical home reimbursement.

Learn more about this resource.

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3.) Prevention Toolkit Significantly Reduces Rate of Falls in Hospitals

Use of a fall prevention toolkit, which included a fall risk assessment, patient-specific prevention plan, an educational handout and a poster for over the patientís hospital bed, reduced the number of older patients with falls in hospitals, according to a study in a November issue of JAMA.

Get the full story.

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4.) 27 Interventions to Reduce Avoidable ER Use

27 Interventions to Reduce Avoidable ER Use This 45-page resource describes 27 separate initiatives launched by Kaiser and WellPoint around the country that are effectively reducing avoidable emergency department use and redirecting patients to more cost-effective care venues.

Learn more about this resource.

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5.) Healthcare Business White Paper: Healthcare Industry Response to Uninsured — Organizations Take Steps to Counter Financial Impact

With the number of uninsured Americans having reached an all-time high as of 2005, at a record-breaking 15.9 percent (46.6 million), the entire healthcare industry is feeling the impact. It is a problem caught in an unending cycle: because of the expense of insurance, many employers are reluctant to provide health benefits to their employees, or if they do the premiums are often too steep for employees to afford. This in turn leads to higher healthcare costs as hospitals and federal assistance programs are increasingly called upon to cover the costs of patients who are simply unable to pay for their healthcare.

Download this complimentary white paper.

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6.) Defense Department Unveils Smart Phone Mental Health Application

The U.S. Department of Defense (DOD) has unveiled a free smart phone mobile application that will help service members, veterans and family members track their emotional health. The T2 MoodTracker application lets users monitor emotional experiences associated with common deployment-related behavioral health issues such as post-traumatic stress, brain injury, life stress, depression and anxiety.

Get the full story.

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7.) New Chart: Who's Eligible to Take An HRA?

Who's Eligible to Take An HRA?

Aggregate data from health risk assessments (HRAs) guides healthcare organizations in the development and delivery of health promotion and disease management interventions. We wanted to see who is eligible to take an HRA.

Click here to view the chart.

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8.) The Next Generation of Health Coaching: Multi-Platform Models for Sustained Behavior Change

Next Generation of Health Coaching To optimize program success and ROI, health coaching will need to be powered by multi-channel outreach — land lines, Web, e-mail, cell phones and even PDAs — and reinforced by tightly interwoven communication and incentive programs. In this 43-page special report, health coaching veterans set the stage for Health Coaching 3.0 and describe the skills, technology and training that will be required to equip health coaches for this eventuality.

Learn more about this resource.

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9.) Comfort, Not Life Expectancy, Should Guide Hospice Admissions for Dementia Patients

The system for hospice admissions for patients with advanced dementia should be guided by patient and family preference for comfort, not estimated life expectancy, says a new study by the Institute for Aging Research at Hebrew SeniorLife, an affiliate of Harvard Medical School.

Get the full story.

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10.) Guide to Patient-Centered Case Management

Guide to Patient-Centered Case Management This 110-page guide presents best practices in identifying, stratifying and monitoring individuals for case management and documents the returns generated by targeted case management interventions in place at Geisinger Health System and other organizations. The Q&A chapter answers more than 50 questions on patient-centered case management.

Learn more about this resource.

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11.) HHS Early Innovator Grants to Fund Development of IT Systems for State Exchanges

Competitive funding opportunities are now available for states to design and implement the information technology (IT) infrastructure needed to operate health insurance exchanges.

Get the full story.

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12.) 2010 Healthcare Benchmarks: Telehealth and Telemedicine

Telehealth and Telemedicine This 20-page resource provides actionable information from 139 healthcare organizations on their utilization of telehealth and telemedicine. This resource documents trends and metrics on current and planned initiatives in the use of telehealth and telemedicine, provides lessons from early adopters and identifies emerging applications of these technologies.

Learn more about this resource.

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13.) HealthSounds Podcast: Health Plan Rate Setting — Balancing Premium Increases Against Regulatory Oversight

John Steele Steve Young In an atmosphere of increased state and federal oversight of health plan rates, healthcare organizations need a sound strategy for determining premium rate increases that meet regulatory approval. HealthScape Advisors managing directors Steve Young and John Steele describe the challenges of setting rates in this environment and the essential experience that can best prepare health plans for dealing with commercial plans.

Listen to this podcast.

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