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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

This week we're talking about trends that could transform healthcare. In separate stories, learn why the doctor will see you now (at least in California) and maybe even in your car. Besides the details on these consumer-centric concepts, this issue also offers a blueprint for a successful accountable care organization (ACO). Loosely defined, ACOs are a set of providers associated with a defined population of patients that is accountable for the quality and cost of care delivered to that population.

According to healthcare consultant William DeMarco, "through technology, these small groups can link together and act, think and leverage themselves as a larger group, giving them a reward and also an asset value they didn’t have before. This also allows them to coordinate services virtually between the medical group and the hospital."

Still haven't taken our medication adherence survey? You'll miss out on strategies from the 100 healthcare organizations that already have. There's still one week left to take the survey and receive an e-summary of compiled 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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January 25, 2010
Vol. XII, No. 4

Sponsored by:
Assessing and Predicting Health Risk in the Elderly

This week's industry news:

  1. 5 Strategies for a Successful ACO
  2. Medical Home Case Studies
  3. Drive-In Triage: Could Cars Serve as Exam Rooms?
  4. Emergency Room Redirection Handbook
  5. Healthcare Business White Paper: Medical Net Systems EncounterSuite Creates Framework for PCMH
  6. Number of U.S. Adults In Treatment at Substance Abuse Facilities Remains Stable
  7. The Addiction Treatment Planner
  8. New Guidelines to Prevent Falls Among Elderly
  9. Assessing and Predicting Health Risk in the Elderly
  10. California First State to Shorten Wait Times for Doctor Appointments
  11. Healthcare Trends & Forecasts in 2010
  12. HealthSounds Podcast: Achieving NCQA's Patient-Centered Medical Home Recognition
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.) 5 Strategies for a Successful ACO

Dr. Craig Samitt, president and CEO of Dean Health System, lists five essential strategies that can lead to a successful ACO in the healthcare industry.

The first strategy for a successful accountable care organization (ACO) is effective recruiting. We all have a tendency to fill a spot just because a spot is available. When one of our doctors leaves, we replace them with anyone who has the technical skills.

Get the full story.

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2.) Medical Home Case Studies: Profiles in the Patient-Centered Approach

Medical Home Case Studies This resource profiles 11 experiences on the adoption, organization, delivery, funding and outcomes of the medical home model. This 100-page special report profiles the efforts of 11 healthcare organizations as they explore the benefits, opportunities and challenges of the patient-centered medical home model from the viewpoints of payor, hospital, physician, nurse practitioner, case manager and C-suite executive. Supplemented with key graphs and data, these case studies provide details on disease-specific medical home approaches, care management transition teams, medical homes for high-risk patients and much more.

Learn more about this resource.

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3.) Drive-In Triage: Could Cars Serve as Exam Rooms?

Your car can be an effective examination room — one that prevents the spread of infectious diseases from patient to patient and patient to caregiver, and reduces ED wait times. That’s the conclusion of a study that physicians at Stanford Hospital and Clinics conducted last fall to test a model drive-through EDs.

Get the full story.

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4.) Emergency Room Redirection Handbook

Emergency Room Redirection Handbook This two-volume set illustrates innovative strategies to reduce unnecessary emergency room visits. For Emergency Use Only: Curbing Unnecessary Emergency Room Use Through Education, Accountability and Physician Engagement details interventions for decreasing non-urgent ED use, mining data to target high-utilization, high-cost individuals, implementing an ED case management program, communicating proper ED use to targeted populations and much more. In Emergency Exits: Reducing Emergency Room Utilization by Retooling Care-Seeking and Care Access Options, three physicians share the specifics of their health plans' ER diversion initiatives.

Learn more about this resource.

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5.) Healthcare Business White Paper: How Medical Net Systems EncounterSuite Creates the Framework for the PCMH

The Patient-Centered Medical Home (PCMH) is a concept for the ideal medical practice of the future. The American Academy of Family Practice’s TransforMed program has reported that the technology to create the PCMH framework is not ready and is fragmented. New solutions must be identified. Medical Net Systems EncounterSuite, an online integrated Electronic Medical Record (EMR) and Personal Health Record (PHR), provides a unified turnkey software framework for the PCMH. This is accomplished through its integrated PHR/EMR, point of care wellness and disease management guidelines and best practices application, and three tracking modules, patient registries, Inbox (order tracking) and Tracking the Patient at Home module.

Download this complimentary white paper.

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6.) Number of U.S. Adults In Treatment at Substance Abuse Facilities Remains Stable

SAMHSA’s annual census of substance abuse treatment facilities shows that the total number of substance abuse treatment facilities remained relatively constant between 2004 and 2008 (13,454 to 13,688), while the number of people in treatment increased slightly (from 1,072,251 to 1,192,490).

Get the full story.

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7.) The Addiction Treatment Planner, 3rd Edition

The Addiction Treatment Planner This resource provides all the elements necessary to quickly and easily develop formal treatment plans that satisfy the demands of HMOs, managed care companies, third-party payors, and state and federal review agencies. This resource also includes chapters covering chronic pain, dangerousness/lethality, opioid dependence and self-care; is organized around 42 main presenting problems, including chemical and nonchemical addictions such as substance abuse, eating disorders, schizoid traits, and others; and its easy-to-use reference format helps locate treatment plan components by behavioral problem or DSM-IV-TR® diagnosis.

Learn more about this resource.

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8.) New Guidelines to Prevent Falls Among Elderly

New guidelines aimed at preventing serious and potentially deadly falls among older adults recommend that a home assessment and medication review be conducted as part of a multi-factorial fall risk assessment. Roughly a third of Americans 65 and older fall each year, and 10 to 20 percent of those who fall suffer moderate to severe injuries that limit their mobility and threaten their independence.

Get the full story.

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9.) Assessing and Predicting Health Risk in the Elderly

Assess and Predict Health Risk in Elderly To increase and maximize revenue, many health plans are focusing on the health risk assessment scores of the elderly population they serve, including Medicare members. Managing these risks can have a bottom line impact by reducing healthcare resource utilization through early identification and management of potentially high expense conditions. During this 45-minute webinar, you will learn what to assess in the elderly population, how to match interventions based on risk score and the impact of this type of initiative.

Learn more about this resource.

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10.) California First State to Shorten Wait Times for Doctor Appointments

With the development of new managed care rules, California has become the first state in the nation to shorten the time a patient has to wait to see a doctor, according to the California Department of Managed Health Care (DMHC). The “Timely Access” regulations will make a significant difference for approximately 21 million California health plan members by specifying that appointments must be scheduled within certain time frames.

Get the full story.

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11.) Healthcare Trends & Forecasts in 2010: Performance Expectations for the Healthcare Industry

Healthcare Trends & Forecasts in 2010 In HIN's annual industry forecast, two analysts predict the 2010 climate for physicians, hospitals and health plans, proposing strategies to close care and business gaps, likely areas for new products, and ways to rethink payment and benefit design to support changing healthcare delivery systems.

Learn more about this resource.

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12.) HealthSounds Podcast: Achieving NCQA's Patient-Centered Medical Home Recognition

NCQA's PCMH Recognition Grand Valley Health Plan's (GVHP) workgroup approach helps the staff model HMO to successfully disseminate workflow changes resulting from its NCQA medical home recognition process, explains Barbara Luskin, GVHP quality manager, and also created location champions in the process. Luskin describes how GVHP demonstrates compliance with the most challenging NCQA "must-pass" elements and shares GVHP's early returns in patient satisfaction ratings, quality of care and healthcare utilization.

Listen to this podcast.

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