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From the editor

Dear Healthcare Intelligence Network Client,

HIN Content Editor Cheryl Miller

CMS has proposed delaying the start of Stage 3 of the meaningful use program for the Medicare and Medicaid EHR Incentive Programs, while the Office of the National Coordinator for Health Information Technology (ONC) has proposed adjustments to its certification process, according to a December 6th post on the HHS blog site Health IT Buzz.

Under CMS' revised meaningful use timeline, the start of Stage 2 has not been changed, but it has been extended through 2016; and the start of Stage 3 has been postponed, and will begin in 2017 for healthcare providers who have completed at least two years in Stage 2 of the program.

Whether this delay sways hospital executives looking at implementing an ACO remains to be seen. EHR utilization is among the reasons nearly half of the hospital executives recently surveyed have no plans to implement the care model in the near future, according to a new survey from Purdue Healthcare Advisors. The respondents, who were categorized according to their progress with meaningful use implementation, voiced concern about the technology, particularly its interoperability with other providers, and staff readiness and training. More details on this comprehensive survey inside.

Interoperability of sorts is at the core of a qualitative study by the Center for Studying Health System Change (HSC), which focused on the effects of California's reference pricing initiative to guide consumers to hospitals that provide routine hip and knee replacements below a certain price threshold. Researchers found that the cost of these surgeries ranged from as little as $15,000 to as much as $110,000.

While the initiative was effective in setting a threshold for hospital facility payments for both procedures and designating certain hospitals that met certain quality standards, whether it contributed to overall healthcare savings was debated in the study.

But sometimes the high cost is well worth it, as in the area of telehealth and telemedicine services, according to our latest market research data.

Despite the significant financial costs of remote monitoring technologies, adopters report impressive gains in medication adherence and care of remote and rural patients, as well as a decrease in health complications. Active users of telehealth and telemedicine also experience fewer hospitalizations, hospital readmissions, ER visits and bed days.

And speaking of technology, nearly 365,000 Americans selected plans in the Health Insurance Marketplace (HIM) in October and November, and enrollment in November was more than four times greater than October's reported federal enrollment number, according to HHS Secretary Kathleen Sebelius.

The numbers reflect the technical improvements to HealthCare.gov, which has been unreliable since its launch in October. The open enrollment period is six months long and continues to March 31, 2014.

And lastly, don't forget to take our current e-survey, Reducing Hospital Readmissions in 2013. Describe how your organization is working to reduce hospital readmissions by taking HIN's fourth comprehensive Reducing Hospital Readmissions Benchmark Survey. Respond by January 3, 2014 and receive an e-summary of the results once they are compiled.

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 Fornarotto
Associate Editor:
Jessica Fornarotto, jfornarotto@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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December 16, 2013
Vol. XV, No. 47

Sponsored by:
Home Visits — Assessing Complex Patients Post-Discharge To Reduce Readmissions


This week's industry news:

  1. CMS Proposes Adjusting Meaningful Use Timeline
  2. A Best Practice Roadmap to ICD-10 Readiness
  3. 3 Reasons Hospitals are Reluctant to Implement ACOs
  4. Guide to Accountable Care Organizations
  5. Healthcare Business White Paper: Case Management in 2013
  6. Setting Price Caps on Surgeries Doesn't Always Generate Healthcare Savings: Study
  7. New Chart: Top Incentives for HRA Completion
  8. Aligning Value-Based Reimbursement with Physician Practice Transformation
  9. 4 Times More Americans Enrolled in Health Insurance Marketplaces in November Than October
  10. Health Insurance Exchanges
  11. Despite Financial Hurdles, Telemedicine Services Well Worth Cost
  12. 2013 Healthcare Benchmarks: Telehealth & Telemedicine
  13. Infographic: Executive Perspective on the Healthcare IT Landscape
  14. Using a Home Visit Assessment to Improve Care Transitions Post-Discharge
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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Reducing Hospital Readmissions in 2013

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This week's industry news

1.) CMS Proposes Adjusting Meaningful Use Timeline

CMS has proposed delaying the start of Stage 3 of the meaningful use program for the Medicare and Medicaid EHR Incentive Programs, while the Office of the National Coordinator for Health Information Technology (ONC) has proposed adjustments to its certification process, according to a December 6th post on the HHS blog site Health IT Buzz.

Get the full story.

>>Return to this week's industry news


2.) A Best Practice Roadmap to ICD-10 Readiness

A Best Practice Roadmap to ICD-10 Readiness This resource documents the process BCBSM has established to resolve discrepancies between ICD-9 and ICD-10 codes, a milestone that has allowed the payor to complete its version of the General Equivalence Mappings (GEMs) — referred to as the Blue GEM Encyclopedia.


Learn more about this resource.

>>Return to this week's industry news


3.) 3 Reasons Hospitals are Reluctant to Implement ACOs

Financial concerns, quality issues and the interoperability of electronic health records (EHRs) are among the reasons nearly half of the hospital executives recently surveyed by Purdue Healthcare Advisors have no plans to implement an accountable care organization (ACO) in the near future.

Get the full story.

>>Return to this week's industry news


4.) Guide to Accountable Care Organizations

Guide to Accountable Care Organizations This resource lays the groundwork for an ACO program, delivering a comprehensive set of 2012 ACO benchmarks from 200 companies; a framework for clinical integration, a key ACO prerequisite that puts participating providers on the same performance and payment page; and guidelines for physician-led ACOs.


Learn more about this resource.

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5.) Healthcare Business White Paper: Case Management in 2013 — Achieving Results with Cardiovascular Disease; Long-Term Care Next Frontier for Embedded Case Managers

Case Management in 2013 New market research from the Healthcare Intelligence Network found that 57 percent of healthcare companies will add case managers in the coming year (up from 27 percent in 2012). Download this HINtelligence report to learn more about case management trends for 2013 as told by 118 healthcare companies in HIN's fourth annual Healthcare Case Management Survey. This HINtelligence Report provides data highlights on case management program components, results, and ROI; as well as improvements and innovations from embedded case management.

Download this complimentary white paper.

>>Return to this week's industry news


6.) Setting Price Caps on Surgeries Doesn't Always Generate Healthcare Savings: Study

Despite successfully setting price caps on hip and knee replacements in California, reference pricing's potential to generate healthcare savings hasn't materialized, according to a qualitative study by the Center for Studying Health System Change (HSC) for the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR).

Get the full story.

>>Return to this week's industry news


7.) New Chart: Top Incentives for HRA Completion

New Chart: Top Incentives for HRA Completion Combined with other 'big data' analytics, aggregate results from health risk assessments or health risk appraisals (HRAs) become the building blocks of population health management programs designed to bend the healthcare cost curve. We wanted to see which incentives healthcare companies offer for HRA completion.

Click here to view the chart.

>>Return to this week's industry news


8.) Aligning Value-Based Reimbursement with Physician Practice Transformation

Aligning Value-Based Reimbursement with Physician Practice Transformation This webinar shares the key features of WellPoint's transformation initiative, including results from its pilot program that have led to a system-wide rollout.


Learn more about this resource.

>>Return to this week's industry news


9.) 4 Times More Americans Enrolled in Health Insurance Marketplaces in November Than October

Nearly 365,000 Americans selected plans in the Health Insurance Marketplace (HIM) in October and November, and enrollment in November was more than four times greater than October's reported federal enrollment number, according to HHS Secretary Kathleen Sebelius.

Get the full story.

>>Return to this week's industry news

10.) Health Insurance Exchanges: Product Design, Promotion and Positioning

Patient Engagement in the Patient-Centered Medical Home This resource features insights from key industry consultants, state regulators and health insurers on the primary issues that will affect product designs for state health insurance exchanges.



Learn more about this resource.

>>Return to this week's industry news


11.) Despite Financial Hurdles, Telemedicine Services Well Worth Cost

Despite the significant financial costs of telehealth and telemedicine services, where technologies such as videoconferencing for remote diagnostics are deployed, adopters report impressive gains in medication adherence and care of remote and rural patients, as well as a decrease in health complications, according to new market data from the Healthcare Intelligence Network's 2013 Telehealth and Telemedicine survey.

Get the full story.

>>Return to this week's industry news


12.) 2013 Healthcare Benchmarks: Telehealth & Telemedicine

2013 Healthcare Benchmarks: Telehealth & Telemedicine This resource provides actionable new information from more than 125 healthcare organizations on their utilization of telehealth & telemedicine, and documents trends and metrics on current and planned telehealth and telemedicine initiatives, including a year-over-year comparison of telehealth trends from 2009 to present.

Learn more about this resource.

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13.) Infographic: Executive Perspective on the Healthcare IT Landscape

The top healthcare IT priority of healthcare executives is implementing ICD-10, while the most significant barrier is a lack of staffing resources, according to a new infographic from Praetorian Guard. This infographic illustrates highlights of a web-based survey that garnered responses from professionals representing nearly 600 U.S. hospitals.

Read this blog post.

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14.) Using a Home Visit Assessment to Improve Care Transitions Post-Discharge

Samantha Valcourt Modifying a popular hospital admissions risk assessment tool for its own use helps Stanford Coordinated Care to prioritize home visits for its roster of high-risk patients, all of whom have complex chronic conditions, explains Samantha Valcourt, MS, RN, CNS, Stanford’s clinical nurse specialist. Stanford's HARMS-11, based on Iowa Healthcare Collaborative's HARMS-8 hospital risk screening tool, looks at individuals’ utilization, social support and medication issues, among other factors, to measure a patient's risk of readmission.

The resulting home visits, a critical component of Stanford's care transitions management program, help to uncover health challenges the complex chronic patient may still face, including four common medication adherence barriers Ms. Valcourt describes in this interview.

Listen to this podcast.

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