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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

There's a significant gap between preventive services older Americans should receive and Medicare coverage for those services, UCLA researchers say in a featured story this week. Researchers recommend tighter coordination between assessing risk in these patients and providing appropriate services to reduce or manage that risk. That's exactly the approach by Grand Valley Health Plan medical home physicians, whose use of health risk assessments (HRAs) are among Grand Valley best practices to help patients better manage their health. There are more best practices from Grand Valley in this issue.

Accountable care organizations (ACOs) have the potential to improve care coordination by making providers clinically and fiscally accountable for the care they provide to ACO members. Still in the dark about the ACO integrated healthcare delivery model? This week we invite you to follow us on a new Twitter feed to monitor ACO news and trends and also to assess your ACO readiness quotient by taking our new survey on Accountable Care Organizations. Respond by February 11 and you'll be e-mailed a summary of the survey 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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This week's featured download: 2010 Benchmarks in Managing Care Transitions Across Sites

2010 Benchmarks in Managing Care Transitions Across Sites

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January 31, 2011
Vol. XIII, No. 5

Sponsored by:
Evaluating Health and Wellness Incentive Programs for Behavior Change

This week's industry news:

  1. 3 Ways Medical Home Physicians Can Help Patients Manage Care
  2. Medical Home Improvement Guide Vol. III
  3. High Survival Rate for Patients Who Seek Care at Designated Stroke Centers
  4. An Evidence-Based Approach to Neurologic Emergencies
  5. Healthcare Business White Paper: 2010 Performance Benchmarks in Tobacco Cessation
  6. Smoking, Obesity Shortening Lifespans in U.S. Compared to Other Countries
  7. New Chart: Top 5 Case Manager Work Locations
  8. Health Coaching for Behavior Change
  9. Severely Injured Elderly Patients May Not Receive Same Care as Younger Patients
  10. Reducing Readmission Risk for the Elderly
  11. Health Reform Law Can Help Align Medicare with Preventive Care Recommendations
  12. The AIS Guide to Medicare Compliance Risks & Strategies
  13. HealthSounds Podcast: Recruiting Physician Practices for Medical Home Pilot
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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Healthcare Case Management in 2011

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This week's industry news

1.) 3 Ways Medical Home Physicians Can Help Patients Manage Care

Dr. James Kerby, vice president of medical affairs at Grand Valley Health Plan, suggests three ways that physicians and/or practices can assist their patients in managing their health and wellness.

Get the full story.

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2.) Medical Home Improvement Guide Vol. III: Even More FAQs on Patient-Centered Care

Medical Home Improvement Guide Vol. III This 35-page resource picks up where Volumes I and II leave off, providing insight on emerging reimbursement models like the accountable care organization (ACO) and bundled or episodic payments. It also delves more deeply into the PCMH’s care coordination responsibilities for its elderly patients with complex chronic illnesses — including the management of care transitions, medication reconciliation and reducing the possibility of readmission to the hospital. Responses are provided by such medical home heavy hitters as Group Health Cooperative, Geisinger Health Plan, Baptist Health System, Aetna Medicare and many others.

Learn more about this resource.

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3.) High Survival Rate for Patients Who Seek Care at Designated Stroke Centers

Hospitals with designated stroke centers are associated with up to 20 percent higher survival rate for patients with ischemic stroke and significantly greater use of acute stroke therapy, according to a study in the Journal of the American Medical Association, which compares treatment and outcomes in stroke care between hospitals in New York State.

Get the full story.

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4.) An Evidence-Based Approach to Neurologic Emergencies

Neurologic Emergencies The articles presented in this resource include topics that are frequent complaints in any ED, including stroke, acute headaches and seizures. With potential etiologies ranging from minor illness to serious, life threatening central nervous system disorders, these neurologic emergencies not only present diagnostic dilemmas, but also lend themselves to a variety of management options. The reviews in this resource allow individuals to make informed decisions based on their knowledge of the body of literature that supports guidelines for neurologic emergencies. The ultimate goal of this publication is to provide a focused, evidence-based perspective on the most challenging topics in emergency medicine.

Learn more about this resource.

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5.) Healthcare Business White Paper: 2010 Performance Benchmarks in Tobacco Cessation

This white paper summarizes results of the Healthcare Intelligence Network’s second annual Tobacco Cessaton & Prevention e-survey conducted in November 2010, revealing the efforts of 84 healthcare organizations to curb these trends, including program availability, program components and reimbursement trends.

Download this complimentary white paper.

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6.) Smoking, Obesity Shortening Lifespans in U.S. Compared to Other Countries

The nation’s history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations, and evidence suggests that current obesity levels also play a substantial part, says a new report from the National Research Council.

Get the full story.

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7.) New Chart: Top 5 Case Manager Work Locations

Case Manager Work Locations Case managers' influence has expanded beyond the health plan office to primary care offices, hospital halls, long-term care facilities, and provider or home health visits. We wanted to see how many healthcare organizations are embedding case managers at care sites and which care sites merit the most case manager effort.

Click here to view the chart.

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8.) Health Coaching for Behavior Change: Motivational Interviewing Methods and Practice

Health Coaching for Behavior Change Borrowing from integrative medicine, this resource presents motivational interviewing skills and how they can be used to invite and elicit behavior change and impact health coaching outcomes.

Learn more about this resource.

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9.) Severely Injured Elderly Patients May Not Receive Same Care as Younger Patients

Trauma centers that excel in the care of severely injured young patients do not necessarily provide the same quality of care to the elderly, according to a recent study by researchers using the American College of Surgeons (ACS) National Trauma Databank (NTDB).

Get the full story.

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10.) 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.

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11.) Health Reform Law Can Help Align Medicare with Preventive Care Recommendations

A significant gap exists between government recommendations on preventive health services older Americans should receive and Medicare coverage for those services, a new UCLA-led study has found. But researchers say the new healthcare reform law should be able to help close this gap.

Get the full story.

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12.) The AIS Guide to Medicare Compliance Risks & Strategies: For Hospitals, Physician Groups and Other Providers

The AIS Guide to Medicare This resource helps you stay current on the big-dollar topics of greatest concern to healthcare compliance professionals and anyone responsible for running a Medicare program. Containing both overview and analysis — along with field-tested tools — this resource can help you avoid problems before they occur. Its nine information-filled chapters cover everything from coding, billing, documentation and reimbursement, to Recovery Audit Contractors, OIG audits and much more.

Learn more about this resource.

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13.) HealthSounds Podcast: Recruiting Physician Practices for a Medical Home Pilot

Recruiting Physician Practices As more payors test the patient-centered medical home model of care, what are the pros and cons of participation for physician practices? Dr. Marjie Harbrecht, medical and executive director of Health TeamWorks, describes the financial middle ground that is likely to satisfy payors and providers who sign on for medical home pilots and offers some additional selection criteria her organization (formerly the Colorado Clinical Guidelines Collaborative) may use in the future.

Listen to this podcast.

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