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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

Hammered by increasing healthcare costs and their impact on a company’s bottom line, many employers are investing in and seeing results from wellness programs to reduce these costs. Take Florida Hospital’s Lifestyle Incentives for Employees (L.I.F.E.) program, which has been credited with reducing its healthcare costs by $28.24 per member per month over a period of three years in a time frame when most organizations reported healthcare costs increases. Prior to implementing the program, Florida Hospital’s health benefits costs were increasing 11 to 15 percent each year. Beyond the costs savings, the L.I.F.E. program also helped the employees of Florida Hospital adopt healthy behaviors, which will continue to pay-off the employees and Florida Hospital.

The L.I.F.E. program is just one of the case studies profiled in our new report, due out this week, Obesity & Weight Management Benchmarks and Case Studies, which profiles four weight management programs and provides comparative data from over 300 respondents on program components.

Your colleague in the business of healthcare,
Patricia Donovan
Editor, Healthcare Business Weekly Update

Please send comments, questions and replies to pdonovan@hin.com.

Associate Editor:
Jessica Papay, jpapay@hin.com

Publisher:
Melanie Matthews, mmatthews@hin.com

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Wellness and Health Promotion — Programs and Promotions Used by Health Plans and Employers

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April 20, 2009
Vol. XI, No. 15

Sponsored by:
The Strategic Ongoing Role of Disease Management in the Healthcare Continuum: Achieving the ROI

This week's industry news:

  1. AMA Files Physician Class Action Lawsuit Against WellPoint
  2. Healthcare Reimbursement Monitor
  3. Florida Hospital Offers Employees Obesity Programs
  4. Obesity & Weight Management Benchmarks and Case Studies
  5. Featured Healthcare Business White Paper: Healthcare Trends in 2009 — Economy Threat to Delivery of Care
  6. Two-Thirds of PCPs Cannot Get Mental Health Services for Patients
  7. The Clinician's Guide to Managed Behavioral Care
  8. Medicare Pilot Program to Improve Quality as Patients Move Across Care Settings
  9. Coordinating Care Transitions for the Elderly and Dually Eligible: Fostering Self-Management and Reducing Readmissions
  10. $2.3 Billion in Recovery Act Funds Available to Help Care for Children, Prevent Disease
  11. Grant Funding for Children's Health Services
  12. Featured HealthSounds Podcast: Physician Engagement — Creating Trust and Alignment Between Management and Physicians
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.) AMA Files Physician Class Action Lawsuit Against WellPoint

The American Medical Association (AMA) said it is among several medical societies that filed a class action lawsuit against WellPoint Inc. The lawsuit, filed in Los Angeles federal court, alleges that WellPoint colluded with others to underpay physicians for out-of-network medical services, resulting in patients paying an excessive portion of the medical bill.

Get the full story.

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2.) Healthcare Reimbursement Monitor

Healthcare Reimbursement Monitor The Healthcare Reimbursement Monitor is a monthly newsletter that gives you the full breadth of coverage of news and information that relates to how your organization gets paid. You'll get detailed updates on Medicaid and Medicare budget and reimbursement issues, reimbursement news for hospital operations executives as well as top financial management and more. Plus, you'll get the collective thinking of some of the nation's leading healthcare reimbursement specialists and consulting firms; what they are suggesting, strategies, actions you can take, news of survey results, special studies and reports.

Learn more about this resource.

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3.) Florida Hospital Offers Employees Obesity Programs

According to Bob Kamieneski, Ed.D, B.S., M.ED., an administrative director for Florida Hospital Zephyrhills, and Ethan Bird, M.P.H., B.S., community educator for Florida Hospital Zephyrhills, Florida Hospital Zephyrhills offers their employees programs to support behavior changes encouraged by their Lifestyle Incentives For Employees (L.I.F.E.) Program — “Fit To Be Trim!” modeled after NBC’s Biggest Loser, and a fitness challenge.

Get the full story.

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4.) Obesity & Weight Management Benchmarks and Case Studies

Obesity & Weight Management Benchmarks This special report 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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5.) Featured Healthcare Business White Paper: Healthcare Trends in 2009 — Economy Threat to Delivery of Care

When healthcare looks back upon 2008, it will no doubt remember a year that was all about the money sky-high fuel costs, a faltering economy and physician reimbursement worries. This summary of responses to HIN’s healthcare trends 2009 e-survey, conducted in the weeks leading to the election of Barack Obama as the country’s 44th president, captures the concerns of 169 healthcare organizations trying to run their businesses in the midst of a full-blown recession. This white paper also documents 53 of the most successful program ideas in 2008.

Download this complimentary white paper.

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6.) Two-Thirds of PCPs Cannot Get Mental Health Services for Patients

About two-thirds of U.S. PCPs reported in 2004-2005 that they couldn't get outpatient mental health services for their patients — a rate that was at least twice as high as for other services, according to a national study funded by the Commonwealth Fund published as a Web Exclusive in the journal Health Affairs.

Get the full story.

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7.) The Clinician's Guide to Managed Behavioral Care

Clinician’s Guide to Managed Behavioral Care The Clinician’s Guide to Managed Behavioral Care addresses how clinicians can develop and market professional services attuned to the needs of managed care systems, how to best manage the utilization review process, how to re-shape an office practice or hospital-based program to become more "managed care friendly" and how to best advocate for patients and clients.

Learn more about this resource.

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8.) Medicare Pilot Program to Improve Quality as Patients Move Across Care Settings

CMS has announced the 14 communities around the nation that have been chosen for the Agency’s Care Transitions Project, seeking to eliminate unnecessary hospital readmissions.

Get the full story.

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9.) Coordinating Care Transitions for the Elderly and Dually Eligible: Fostering Self-Management and Reducing Readmissions

Coordinating Care Transitions for the Elderly Throughout this 65-page report, respected thought leaders share their unique approaches to care transition management that positively impact cost and engage the patient in their care decisions.

Learn more about this resource.

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10.) $2.3 Billion in Recovery Act Funds Available to Help Care for Children, Prevent Disease

The Obama administration will make $2.3 billion available for crucial health and human services programs that help to provide care for children and prevent disease. States will receive $2 billion in recovery act funding to support child care for working families. The administration also plans to make $300 million in vaccines and grants available to ensure more underserved Americans receive the vaccines they need.

Get the full story.

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11.) Grant Funding for Children's Health Services

Grant Funding for Children's Health Services Grant Funding for Children's Health Services includes funding for programs that address current major concerns in children's health including childhood obesity, physical activity, nutrition in low-income families, pediatric HIV/AIDS and eating disorders. It is organized in sections that include nutrition, fitness and wellness, improving access to care, profiles of foundations funding children's health and more.

Learn more about this resource.

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12.) Featured HealthSounds Podcast: Physician Engagement — Creating Trust and Alignment Between Management and Physicians

Nathan Kaufman Hospitals should take advantage of the typically competitive nature of physicians to encourage collaboration, says Nathan Kaufman, managing director of Kaufman Strategic Advisors. Kaufman notes that "quality dialogue" between hospitals and physicians is key to engagement. In this podcast, he also discusses how a physician champion can drive success and explains physicians' reluctance to adding technology to their systems of care.

Listen to this podcast.

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