HIN logo
From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

There are many points along the healthcare continuum to reduce rehospitalization risks for Medicare patients. In this week's issue, HealthFitness president and CEO Gregg Lehman describes five transitions where care breakdowns can occur and how to avoid them. Also profiled is a groundbreaking Baton Rouge pilot pairing a hospitalized patient with a health coach to prepare for post-discharge and getting great results...to the tune of an 80 percent reduction in unnecessary readmissions. As Aetna's national medical director for Medicare Dr. Randall Krakauer said during last week's conference on Aligning Reimbursement to Readmissions, "If we can cut even a minority of these avoidable readmissions, the savings and cost is considerable and the quality issues are even greater." Dr. Kraukauer describes Aetna's focus on the post-discharge period in its care transitions program for Medicare beneficiaries.

Our November survey on readmission reduction strategies is now closed, but if you'd like to receive a free summary of the results when they are compiled later this month, please e-mail me at pdonovan@hin.com. You'll learn how more than 100 healthcare companies are working to reduce avoidable readmissions.

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

>>Return to top

HIN podcasts: www.hin.com/podcasts/...
HIN blog: blog.hin.com
HIN videos: www.youtube.com/HealthSounds
New HIN products: store.hin.com

Contact HIN:
www.hin.com
(888) 446-3530
(732) 528-4468
Fax: (732) 292-3073
Email: info@hin.com

This week's featured download: Care Transitions Across Sites — Closing Gaps in Healthcare Settings

Care Transitions Across Sites — Closing Gaps in Healthcare Settings

Featured download










For advertising and sponsorship opportunities in the Healthcare Business Weekly Update, contact our Sales & Marketing Coordinator: Deirdre McGuinness, dmcguinness@hin.com

>>Return to top

December 7, 2009
Vol. XI, No. 46

Sponsored by:
Risk Adjustment in the Medical Home — Building an Effective Reimbursement Strategy

This week's industry news:

  1. How to Avoid the Top 5 Care Transition Breakdowns
  2. Reducing Readmission Risk for the Elderly
  3. Inpatient Transitions Coaching Reduces Readmissions by 80 Percent
  4. Reducing Hospital Readmissions Toolkit
  5. Healthcare Business White Paper: Living Quality Improvement Every Day
  6. Effectiveness of Mental Health Parity Law Linked to Patient Education
  7. Trends in Integration of Behavioral and Physical Health
  8. MedPAC Looks to Reform Medicare Hospice Payment System
  9. hospice letter
  10. Hospital Price Transparency Laws in California Fall Short
  11. Toward Transparency in Healthcare
  12. HealthSounds Podcast: Nurse-Case Manager Collaboration Reduces Avoidable Readmissions
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.

Join our Community: Twitter Facebook LinkeIn


Take the monthly e-survey:
Healthcare Case Management

You'll be emailed a synopsis of the survey results.


This week's industry news

1.) How to Avoid the Top 5 Care Transition Breakdowns

Gregg O. Lehman, Ph.D., president and chief executive officer of Health Fitness Corporation and former president and CEO of INSPIRIS, Inc., maps out when and how care transition breakdowns can occur for the Medicare population.

When do breakdowns in care transitions occur? First, breakdowns when moving from a primary care physician (PCP) to a specialty physician are common — often, information is not well documented. And because itís common for the Medicare population to be cognitively impaired, it can be difficult for them to effectively communicate their symptoms to the physician.

Get the full story.

>>Return to this week's industry news


2.) Reducing Readmission Risk for the Elderly through Care Transition Coaching

Reducing Readmission Risk for Elderly This resource presents new models of care coordination for the elderly, including an Oxford Health Plan care transition coach program modeled on research from Eric Coleman, M.D., at the University of Colorado. This resource also reports on Inspiris's care team approach to managing care transitions for the frail elderly — adults 65 and older who comprise 40 percent of elderly hospitalizations and who are particularly vulnerable during transitions from one care site to another.

Learn more about this resource.

>>Return to this week's industry news


3.) Inpatient Transitions Coaching Reduces Readmissions by 80 Percent

A pilot program that provides transitions coaching to patients hospitalized for heart attack, CHF or pneumonia has reduced unnecessary rehospitalizations at five Baton Rouge hospitals by 80 percent, according to early feedback from the program. The CMS-funded pilot targets patients 65 years and older, then pairs these older patients with a health coach.

Get the full story.

>>Return to this week's industry news


4.) Reducing Hospital Readmissions Toolkit

Reducing Hospital Readmissions Toolkit This toolkit is a comprehensive four-volume set that illustrates innovative strategies to reduce unnecessary hospital readmissions.

Learn more about this resource.

>>Return to this week's industry news


5.) Healthcare Business White Paper: Bellin Health — Living Quality Improvement Every Day

In the past, Bellin Healthís measurement control system had over 250 system-level quality indicators. Many of these indicators were also reported at the department-level and on varying schedules (monthly, quarterly, annually, etc.). It was also clear to the Quality Resources team that the demand for quality and safety information from both accreditation and certification agencies, as well as the general public, would continue to grow. In this white paper, you'll discover how Bellin revamped their measurement control system with one that provided reports that were timely, directed to the right audience, readily available and delivered in a format that was accessible to a variety of users.

Download this complimentary white paper.

>>Return to this week's industry news


6.) Effectiveness of Mental Health Parity Law Linked to Patient Education

A new article published in the journal Psychiatric Services examines experiences with implementing Californiaís mental health parity law, and discusses implications for the implementation of the federal Mental Health Parity and Addiction Equity Act of 2008. This act is designed to ensure that insurance plans offer mental health coverage as part of the overall health benefit packages and to eliminate disparities between the coverage for mental health and more traditional physical health conditions.

Get the full story.

>>Return to this week's industry news


7.) Trends in Integration of Behavioral and Physical Health

Trends in Integration of Behavioral and Physical Health This industry snapshot of depression management efforts by 260 healthcare organizations is enhanced by an update on evidence-based approaches to integration of primary care and behavioral health from Laura Galbreath, director of policy and advocacy for the National Council for Community Behavioral Healthcare (NCCBH) and Liz Reardon, president of Reardon Consulting and former managed care director for Vermont Medicaid.

Learn more about this resource.

>>Return to this week's industry news


8.) MedPAC Looks to Reform Medicare Hospice Payment System

The Medicare Payment Advisory Commission (MedPAC) has reaffirmed its earlier recommendation to reform the Medicare hospice payment system. As of now, Medicare makes a flat daily payment for most hospice care. However, MedPAC finds that this payment system does not align well with the provision of care at the end-of-life.

Get the full story.

>>Return to this week's industry news

9.) hospice letter

hospice letter An essential tool for hospice managers, this resource stays on top of the most current challenges facing hospice executives, including legislative scrutiny, the short average length of stay, Medicare and Medicaid reform, discussions about physician-assisted suicide, managed care and integration. Each month, you'll get the latest management intelligence regarding financing strategies, marketing success stories, solutions to staffing and management challenges, funding opportunities and legislative alerts, and updates about federal agencies, such as the Office of Inspector General and CMS.

Learn more about this resource.

>>Return to this week's industry news


10.) Hospital Price Transparency Laws in California Fall Short

Uninsured patients in California are unable to successfully obtain information about the cost of medical care at hospitals despite recent state legislation intended to improve price transparency, according to a new study. To make it easier for patients to shop for care and to prevent price gouging of the uninsured, more than 30 states have enacted price transparency legislation.

Get the full story.

>>Return to this week's industry news


11.) Toward Transparency in Healthcare: Competing for Quality and Consumers

Toward Transparency in Healthcare In this special report, experts discuss the challenges of incorporating public reporting as part of an integrated strategy, collaborating with providers, and developing objective metrics and reliable data. This report also includes details on furthering the transparency agenda with healthcare report cards, responding to data validity and reliability issues, evaluating internal vs. external reporting mechanisms, communicating quality and performance data to employees, patients and members; and building a quality-based specialty provider network.

Learn more about this resource.

>>Return to this week's industry news


12.) HealthSounds Podcast: Nurse-Case Manager Collaboration Reduces Avoidable Readmissions

Nurse-Case Manager Collaboration Reduces Avoidable Readmissions Case managers and advanced practice nurses in Aetna's Transitional Care pilot have also successfully partnered to reduce readmissions. Dr. Randall Krakauer, national medical director, Medicare at Aetna, describes the key focus and the complementary roles that reduced 90-day readmissions by 25 percent. Dr. Krakauer also weighs in on the pros and cons of bundled payments, and why incentives alone will not significantly impact avoidable readmissions.

Listen to this podcast.

>>Return to this week's industry news


Thank you for your readership! Please urge your colleagues to subscribe by forwarding this email or visiting http://www.hin.com/freenews2.html or by calling (888) 446-3530 or visiting the HIN Web site.

While we encourage you to forward this email to your colleagues, these articles may not be redistributed in any other publication, reproduced for publication in any form, distributed on an intranet or network or by e-mail distribution or distributed for commercial purposes without the expressed written permission of the Healthcare Intelligence Network.


Copyright 1997-2009 Healthcare Intelligence Network. All rights reserved.
Healthcare Intelligence Network
Gateway to Healthcare Business Information on the Internet
1913 Atlantic Ave., Suite 201, Manasquan, N.J. 08736