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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

Last week CMS launched its new Center for Medicare and Medicaid Innovation, a by-product of healthcare reform. You can read about the center's four key targets in this week's issue, along with the United States' continued dismal ratings in healthcare accessibility, coverage and efficiency compared to the rest of the world. Of note is the finding that while two-thirds of Dutch, New Zealand and British patients say it's easy to get after-hours care without going to the ER, two-thirds of U.S. patients (and those in France and Canada as well) said it was difficult.

Also last week, we spoke to Advocate Physician Partners senior medical director Dr. Mark Shields in preparation for an upcoming webinar on framing an ACO through clinical integration of independent physicians. Three of Advocate Physician Partners' 41 performance measures are related to tobacco cessation and prevention efforts, said Dr. Shields. "Smoking cessation is one of the 'hot' interventions to improve health and reduce cost," he said. "It also has given us the ability to be successful at the bargaining table with managed care organizations."

Are you focused on smoking cessation and prevention, or do you want to learn what others are doing in this field? Take this month's survey and receive an executive summary of the results.

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 22, 2010
Vol. XII, No. 43

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

This week's industry news:

  1. Top 2 Drivers of Healthcare Investment for 2011
  2. Healthcare Trends & Forecasts in 2011
  3. Wide Variation in Private Insurer Payment Rates Evidence of Hospital Market Power
  4. Essential Guide to Accountable Care Organizations
  5. Healthcare Business White Paper: 2010 Telehealth Benchmarks
  6. 45.1 Million U.S. Adults Experienced Mental Illness in Past Year
  7. New Chart: Top Coordinators of Care Transitions
  8. 2010 Healthcare Benchmarks Yearbook
  9. CMS Introduces New Center for Medicare, Medicaid Innovation
  10. Medical Home Desktop Learning
  11. U.S. Lags in Healthcare Access, Patient Experience
  12. The Impact of Health Reform on Providers, Insurers and Employers
  13. HealthSounds Podcast: Redesigning the Physician Practice
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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This week's industry news

1.) Top 2 Drivers of Healthcare Investment for 2011

William Shea, partner in health industry consulting for Cognizant Business Consulting, discusses his predictions of the impact of reform and compliance initiatives for 2011.

Get the full story.

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2.) Healthcare Trends & Forecasts in 2011: Performance Expectations for the Healthcare Industry

Healthcare Trends & Forecasts 2011 Feeling the squeeze from softening service demands, growing competition, reimbursement cuts and increased regulatory oversight, the healthcare industry is ripe for financial relief. Will the coming year offer any respite from lingering economic and social malaise? In this resource, two key thought leaders tackle these questions and more as they look ahead to healthcare reform 2.0 — implementation and rollout.

Learn more about this resource.

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3.) Wide Variation in Private Insurer Payment Rates Evidence of Hospital Market Power

Wide variation in private insurer payment rates to hospitals across and within local markets suggests that some hospitals have significant market power to negotiate higher-than-competitive prices, according to a study by the Center for Studying Health System Change (HSC) commissioned by Catalyst for Payment Reform.

Get the full story.

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4.) 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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5.) Healthcare Business White Paper: 2010 Telehealth Benchmarks

This white paper captures the nuts and bolts of telehealth services offered by 111 healthcare organizations who responded to HIN's September 2010 Telehealth and Telemedicine survey, including top technologies, targeted populations and prevalence of remote monitoring.

Download this complimentary white paper.

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6.) 45.1 Million U.S. Adults Experienced Mental Illness in Past Year

According to new results from a national survey conducted by SAMHSA, 19.9 percent of American adults in the U.S. (45.1 million) have experienced mental illness over the past year.

Get the full story.

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7.) New Chart: Top Coordinators of Care Transitions

Top Coordinators of Care Transitions

Tighter management of transitions in care can help to close care gaps and reduce rehospitalizations, ER visits and medication errors. We wanted to see which staff members have chief responsibility for the management of care transitions.

Click here to view the chart.

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8.) 2010 Healthcare Benchmarks Yearbook: Metrics, Measurements and Innovations

2010 Healthcare Benchmarks Yearbook This resource is a comprehensive collection of benchmarks in key areas of healthcare activity and growth: the patient-centered medical home (PCMH), reducing readmissions, health coaching, patient outreach, financial incentives and telehealth to foster behavior change and reverse healthcare spend.

Learn more about this resource.

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9.) CMS Introduces New Center for Medicare, Medicaid Innovation

CMS’s new Center for Medicare and Medicaid Innovation (Innovation Center) will examine new ways of delivering healthcare and paying healthcare providers that can save money for Medicare and Medicaid while improving the quality of care.

Get the full story.

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10.) Medical Home Desktop Learning

Medical Home Desktop Learning This resource consists of patient-centered medical home training products and research that will help bring your staff up to speed on how this model of care is organized, delivered and funded. This four-CD set includes three 45-minute video and PowerPoint® tutorials by leading medical home experts, 11 patient-centered medical home case studies and 10 in-depth interviews with leading medical home experts on crucial medical home topics.

Learn more about this resource.

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11.) U.S. Lags in Healthcare Access, Patient Experience

A new 11-country survey from The Commonwealth Fund finds that adults in the United States are far more likely than those in 10 other industrialized nations to go without healthcare because of costs, have trouble paying medical bills, encounter high medical bills even when insured, and have disputes with their insurers or discover insurance wouldn’t pay as they expected.

Get the full story.

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12.) The Impact of Health Reform on Providers, Insurers and Employers

The Impact of Health Reform In this resource, insiders close to HHS and in leadership positions at health plans, provider organizations and PBMs identify the strategic impact of the reform law across all sectors of the industry, and the business implications and compliance issues raised by new rules covering dozens of topics — from dependent coverage expansions and high-risk pools to bans on pre-existing condition exclusions and annual and lifetime limits. This comprehensive report outlines the likely impact of health reform on coverage, benefit designs, medical costs, providers and pharmacy benefits.

Learn more about this resource.

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13.) HealthSounds Podcast: Redesigning the Physician Practice for Improved Efficiency and Increased Revenue

Redesigning the Physician Practice In the face of healthcare reform and new models of care delivery such as the patient-centered medical home, primary care physicians don't have to fly solo anymore, advises Dr. David Eitrheim, a family physician with the Mayo Clinic Health System in Wisconsin. Dr. Eitrheim describes how his practice's team-based approach has changed the nature of the patient visit as well as the nurses' workload, and provides the secret to a productive patient visit.

Listen to this podcast.

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