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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

Although the 2010 Winter Olympics concluded more than a week ago, several athletes are still making headlines. A figure skater, a skeleton racer and a snowboarder will appear in a series of videos from first lady Michelle Obama's Let's Move initiative to solve childhood obesity within a generation.

Also out of Canada this week is a new tool to predict a patient's probability of readmission to the hospital within 30 days. A featured story this week describes how an individual's LACE score (devised from length of stay, acuity, comorbidity and ER utilization) can indicate their risk of readmission or death. That's a gold medal strategy that healthcare organizations can use to reduce costly avoidable hospitalizations, as is a related initiative out of Maryland to identify reasons for potentially preventable readmissions. This week's issue provides more details.

Back on U.S. soil, there's a lot of work going on in medical homes around the country to improve care coordination and delivery. Take our fourth annual Patient-Centered Medical Home survey and see how your efforts stack up against those of your peers. Respond by March 31 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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March 8, 2010
Vol. XII, No. 9

Sponsored by:
Embedded Case Managers — Navigating Care Transitions, Gaps in Care and Patient Compliance

This week's industry news:

  1. Top Reasons for Potentially Preventable Readmissions
  2. Reducing Readmissions
  3. 4 Factors That Predict Probability of Readmission or Death
  4. Discharge Planning Primer
  5. Healthcare Business White Paper: Reducing Hospital Readmissions
  6. Few Employers Predicted to Drop Mental Health Benefits Despite Parity Regulations
  7. Model Medical Homes
  8. Retiring Americans Face $260,000 in Healthcare Costs
  9. Understanding Reimbursement for Skilled Nursing Facilities
  10. HHS Teams Up with Olympic Athletes to Fight Childhood Obesity
  11. Obesity & Weight Management Benchmarks
  12. HealthSounds Podcast: Achieving Medication and Care Plan Adherence Through an Integrated Care Team
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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Take the monthly e-survey:
Medical Homes in 2010

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


This week's industry news

1.) Top Reasons for Potentially Preventable Readmissions

Dianne Feeney, associate director of quality initiatives for the Maryland Health Services Cost Review Commission (HSCRC), discusses the top 15 reasons for potentially preventable readmissions as well as the related costs for these readmissions.

Get the full story.

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2.) Reducing Readmissions: Interventions, Incentives and Infrastructure

Reducing Readmissions This resource presents case studies from three healthcare organizations whose efforts have significantly reduced avoidable hospital readmissions in high-risk populations and include the alignment of financial incentives to readmission rates.

Learn more about this resource.

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3.) 4 Factors That Predict Probability of Readmission or Death

Canadian researchers have developed a simple tool to predict the probability that a patient discharged from hospital to the community will die or be unexpectedly readmitted within 30 days. The study could help identify patients who may benefit from closer monitoring and care, so that serious health problems can be prevented.

Get the full story.

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4.) Discharge Planning Primer: Community Collaborations to Decrease Hospital Readmissions Risk

Discharge Planning Primer In this resource, two industry experts describe the coordinated approaches central to their hospital discharge processes and the impact their programs have had on patients' outcomes and satisfaction, hospital readmission rates and healthcare costs.

Learn more about this resource.

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5.) Healthcare Business White Paper: Reducing Hospital Readmissions

With public and private payors sharpening their focus on and realigning reimbursement with hospital readmission rates, particularly among Medicare patients with heart attack, heart failure and pneumonia, more healthcare organizations are taking a hard look at readmission rates and launching programs to reduce these rates. This white paper summarizes the responses of 107 healthcare organizations to HIN's November 2009 Reducing Hospital Readmissions e-survey, which set out to identify the rudiments of readmission reduction efforts in the healthcare industry, from target populations and conditions to responsibilities, roles and ROI.

Download this complimentary white paper.

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6.) Few Employers Predicted to Drop Mental Health Benefits Despite Parity Regulations

Healthcare experts from Hewitt Associates believe that, despite the extra administrative and cost burden on U.S. employers, few companies will eliminate their existing mental health and substance abuse benefits as a result of new federal mental health parity regulations. Instead, most organizations will choose to modify their plans to comply with the new rules.

Get the full story.

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7.) Model Medical Homes: Benchmarks and Case Studies in Patient-Centered Care

Model Medical Homes This resource is a landmark publication that documents the healthcare industry's adoption of the patient-centered medical home (PCMH) model of care, and includes highlights from programs working to integrate mental health into the medical home model. This exclusive 65-page report contains case studies on medical home adoption by Geisinger Health Plan, MetCare, Reardon Consulting, the HealthQuilt Quality Health Record and Hagen Wall Consulting.

Learn more about this resource.

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8.) Retiring Americans Face $260,000 in Healthcare Costs

Healthcare costs for retiring Americans, including nursing home care, average $260,000 and can exceed $500,000, according to new research conducted by the Center for Retirement Research (CRR) at Boston College and underwritten by Prudential Financial.

Get the full story.

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9.) Understanding Reimbursement for Skilled Nursing Facilities

Understanding Reimbursement for Skilled Nursing Facilities This resource is a step-by-step guide to coverage, conditions of participation, skilled nursing facility (SNF) prospective payment system and swing bed hospitals. Contents include: Medicare coverage criteria; SNF PPS resident classification system; SNF PPS per diem federal rates; SNF consolidated billing requirements and Part B payments; medical review of SNF services; and more.

Learn more about this resource.

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10.) HHS Teams Up with Olympic Athletes to Fight Childhood Obesity

More than a dozen Olympic athletes are helping the HHS to combat the challenge of childhood obesity by providing the American public with tips to maintain a healthy lifestyle. Childhood obesity and excess weight threatens the healthy future of one third of American children.

Get the full story.

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11.) Obesity & Weight Management Benchmarks and Case Studies

Obesity & Weight Management Benchmarks This resource provides actionable information on current obesity and weight management programs for adults, children and adolescents from more than 300 organizations. Whether your organization will focus on obesity and weight management in the near future or retool an existing program, it will benefit from a review of metrics and measurements to evaluate and plan your program and compare performance and utilization data.

Learn more about this resource.

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12.) HealthSounds Podcast: Achieving Medication and Care Plan Adherence Through an Integrated Care Team

Achieving Medication and Care Plan Adherence While neither colocation of team members nor an electronic health record is a prerequisite for a successful integrated care team, explains Dr. Jan Berger, chief medical officer of Silverlink Communications Inc., there are four essential factors that contribute to the confidence and comfort levels of both patients and team members.

Listen to this podcast.

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