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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

The CMS continues to reward innovation in healthcare; the latest initiative, the New Health Care Innovation Challenge, plans to award up to $1 billion in grant money to organizations that come up with creative ways to deliver healthcare, improve care and lower costs. The agency will take notice of projects that can be up and running within six months and that can hire, train and deploy workers rapidly. Funded by the PPACA, it's a push for both creative healthcare solutions and increased healthcare job opportunities in as short amount of time as possible, contrary to the Innovation Advisors initiative launched in October, which seeks healthcare solutions over a year long, labor intensive period. All segments of the healthcare industry are encouraged to apply for the Innovation Challenge; December 19th is the cut off date for LOIs.

A quick, innovative, effective solution is also needed to alter the latest statistics on diabetes furnished by the IDF on World Diabetes Day (November 14th): studies show that one adult in 10 will have diabetes by 2030. Far too many are already afflicted with the preventable disease, including 78,000 children suffering with type 1; this despite the fact that the greatest number of diabetics fall within 40 to 59 years of age. The IDF is hoping that continued international awareness of this problem will help; and the agency is in the midst of a five-year campaign to promote diabetes education and prevention programs. Ironically, the CMS cited one health system that worked with community partners to decrease the risk of diabetes with nutrition programs as inspiration for its Healthcare Challenge initiative. Food for thought.

Another area of concern is the number of seniors receiving the wrong medication during their home healthcare visits. The Journal of General Medicine recently published a study stating that nearly 40 percent of patients 65 and over are prescribed potentially inappropriate medications (PIMs) at rates three times higher that patients who visit a medical office. Some of the blame can be placed on our fragmented healthcare system, researchers said: home health-based patients see multiple physicians who don't communicate with each other, resulting in the wrong medication. Perhaps most troubling about this study is that the majority of these patients are taking 11 medications on average, and nearly half of them are taking at least one PIM, researchers say.

And lastly, one quick fix that should boost care access for patients: a new clinical affiliation between CVS Minute Clinics and Emory Healthcare. The stand alone clinics are open seven days a week in select areas throughout metropolitan Atlanta and have nurse practitioners on hand to administer wellness and preventive services and tend to common family illnesses. Patients who need care not provided at the clinics will be referred to Emory Healthcare. Both CVS and Emory hope to streamline the process with the use of EMR systems.

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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November 28, 2011
Vol. XIII, No. 44

Sponsored by:
Demonstrating the Value of the Embedded Case Manager for the Medicare Population

This week's industry news:

  1. CMS to Award Up to $1 Billion for New Health Care Innovation Challenge Projects
  2. Benchmarks in Health & Wellness Incentives, 2011 Edition
  3. 1 Adult in 10 Will Have Diabetes by 2030
  4. 2011 Benchmarks in Obesity and Weight Management
  5. Healthcare Business White Paper: 2011 Benchmarks in Health & Wellness Incentives
  6. Emory Healthcare-MinuteClinic Clinical Affiliation to Expand Care Access
  7. New Chart: What's the ROI from Obesity Management Programs?
  8. The Emerging Role of Nurse Practitioners in Expanding Access, Enhancing Revenue
  9. Almost Half of Seniors Receiving Home Healthcare Taking the Wrong Medication
  10. Guide to Improving Medication Adherence
  11. Transforming Payment Reform for Enhanced Primary Care Models
  12. Case Study in Physician Practice and Payment Transformation
  13. Clinical Integration Update: APP Embeds Case Managers in Select Practices
  14. HealthSounds Podcast: Leveraging Population Health Management To Meet ACO Efficiency Metrics
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.) CMS to Award Up to $1 Billion for New Health Care Innovation Challenge Projects

CMS will award up to $1 billion in grants to innovative projects that implement creative ways to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and CHIP, particularly those with the highest healthcare needs.

Get the full story.

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2.) Benchmarks in Health & Wellness Incentives, 2011 Edition: Data to Drive Health Promotion, Compliance and ROI

Benchmarks in Health & Wellness Incentives, 2011 Edition This guide provides actionable information from 156 healthcare organizations on the use of incentives to promote health behavior change. This essential resource has been compiled from an analysis of responses to HIN's third annual survey on the use of health & wellness incentives, administered in March 2011.

Learn more about this resource.

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3.) 1 Adult in 10 Will Have Diabetes by 2030

Unless things change, one in 10 adults is expected to have diabetes by 2030, according to new figures from the International Diabetes Federation (IDF).

Get the full story.

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4.) 2011 Benchmarks in Obesity and Weight Management

2011 Benchmarks in Obesity and Weight Management This 25-page resource captures the efforts of more than 130 organizations in the prevention and reduction of obesity and related conditions and costs in their populations.



Learn more about this resource.

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5.) Healthcare Business White Paper: 2011 Benchmarks in Health & Wellness Incentives

Benefit-based incentives are proving most successful at effecting positive health behavior change, according to the third annual Health & Wellness Incentives e-survey conducted by the Healthcare Intelligence Network. This white paper summarizes responses from 156 healthcare organizations to the March 2011 survey.

Download this complimentary white paper.

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6.) Emory Healthcare-MinuteClinic Clinical Affiliation to Expand Care Access

A new clinical affiliation between MinuteClinic, the retail healthcare division of CVS Caremark, and Emory Healthcare will provide enhanced care access to communities throughout the Atlanta metropolitan area.

Get the full story.

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7.) New Chart: What's the ROI from Obesity Management Programs?

What's the ROI from Obesity Management Programs? Increasingly, healthcare organizations are aiming disease management programs at the 67 million obese and 85 million overweight Americans. We wanted to see what ROI is generated by obesity management programs.

Click here to view the chart.

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8.) The Emerging Role of Nurse Practitioners in Expanding Access, Enhancing Revenue

Emerging Role of Nurse Practitioners in Expanding Access, Enhancing Revenue This 45-minute webinar examines how nurse practitioners are being utilized in the physician practice, hospital and clinic settings to increase access to care and coordinate care for patients with chronic conditions.


Learn more about this resource.

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9.) Almost Half of Seniors Receiving Home Healthcare Taking the Wrong Medication

Older adults receiving home healthcare are taking at least one prescription that is unsafe or ineffective for someone their age, according to the Journal of General Medicine.

Get the full story.

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10.) Guide to Improving Medication Adherence

Guide to Improving Medication Adherence This guide analyzes trends in improving medication adherence at more than 160 healthcare companies, and takes an in-depth look at pioneering efforts by Kaiser Permanente Colorado and CIGNA Pharmacy Management to improve medication compliance levels in their populations.

Learn more about this resource.

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11.) Transforming Payment Reform for Enhanced Primary Care Models

Fee-For-Service (FFS), resource-based relative value scale (RBRVS) reimbursement has resulted in a “triage” model of primary care, explains Dr. Bruce Nash, CDPHP's senior vice president of medical affairs and chief medical officer.

Get the full story.

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12.) Case Study in Physician Practice and Payment Transformation: The CDPHP Experience

Case Study in Physician Practice and Payment Transformation CDPHP’s successful two-phase pilot reforms both the practice of primary care in its network and payment to its physicians. This guide chronicles the clinical and financial journeys of this network model health plan, sharing practical strategies and lessons learned from this two part-process.

Learn more about this resource.

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13.) Clinical Integration Update: APP Embeds Case Managers in Select Practices

In an expansion of its highly regarded clinical integration program, Advocate Physician Partners (APP) has embedded 60 outpatient case managers in select physician practices.

Read this blog post.

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14.) HealthSounds Podcast: Leveraging Population Health Management To Meet ACO Efficiency Metrics

Dr. Barbara Walters As one of 10 participants in the CMS Physician Group Practice Demonstration, Dartmouth-Hitchcock has developed a competency in population health management that is being deployed in current and planned ACO pilots. Dr. Barbara Walters, Dartmouth-Hitchcock’s senior medical director, describes how the CMS demo experience provided the building blocks for an ACO, the impact of its pilots on Medicare utilization and costs, and the critical elements in managing population health in an ACO.

Listen to this podcast.

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