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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

The hospital ER is the de facto primary care provider for 28 percent of Americans seeking acute care, according to a study published in this month's edition of Health Affairs. Patient-centered medical homes and accountable care organizations — reforms featured prominently in the Patient Protection and Affordable Care Act — are intended to eventually improve access to acute care. In the meantime, the healthcare industry is taking a three-pronged approach to reduce avoidable ER visits, according to new market research featured in this week's issue.

Case in point: Kaiser Permanente in Colorado took a very hard look at its ED utilization across its population and found that avoidable and preventable ED visits accounted for upward of 20 percent of its approximately 72,000 ED visits per year. In a recent webinar on redirecting patients to more cost-effective care settings, Sara Gray, senior manager of emergency services at Kaiser Foundation Health Plan of Colorado, shared more than two dozen population-specific strategies Kaiser is using to maximize the time, energy and resources expended by ER staff.

In response to our July 2010 e-survey, 90 healthcare companies told us how they are reducing avoidable ER use and the impact their efforts are having on emergency department utilization. Get a free summary of the results here.

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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September 13, 2010
Vol. XII, No. 33

Sponsored by:
Case Management: Identifying, Monitoring and Managing Target Populations

This week's industry news:

  1. 3 Strategies to Reduce Avoidable ER Use
  2. 2010 Performance Benchmarks in Reducing Avoidable ER Visits
  3. 2-Minute Surgical Checklist Improves Quality of Care, Reduces Costs
  4. Improving Physician Performance and Value-Based Reimbursement Levels
  5. Healthcare Business White Paper: 2010 Benchmarks in HRA Use
  6. Decline in U.S. Adult Smoking Rate Stalled
  7. New Chart: Points in Care for Patient Education
  8. Health Coaching for Behavior Change
  9. 3 Factors Affecting Older Admissions to Substance Abuse Treatment
  10. Reducing Readmission Risk for Elderly through Care Transition Coaching
  11. National Coalition Enrolls Uninsured Children in Healthcare
  12. The Colorado Accountable Care Collaborative
  13. HealthSounds Podcast: Coordinating a Virtual Medical Home in Your Community
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.) 3 Strategies to Reduce Avoidable ER Use

Patient education, promotion of urgent care or walk-in centers and medical home assignments are the top three programs companies use to prevent inappropriate use of the ER, according to a new survey conducted by the Healthcare Intelligence Network.

Get the full story.

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2.) 2010 Performance Benchmarks in Reducing Avoidable ER Visits

2010 Performance Benchmarks in Reducing Avoidable ER Visits How prevalent are programs to reduce avoidable ER use, and what kind of results do they net? Which populations and conditions are responsible for most preventable ER visits, and what are the most effective strategies for redirecting these patients to more cost-effective and appropriate healthcare settings? This resource addresses these concerns and others by providing actionable information from 90 healthcare organizations on their efforts to reduce inappropriate use of the ED. This 50-page resource documents trends and metrics from emergency departments across the country that are successfully managing ER utilization.

Learn more about this resource.

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3.) 2-Minute Surgical Checklist Improves Quality of Care, Reduces Costs

New research from Brigham and Women’s Hospital (BWH) finds that not only does use of a two-minute surgical checklist improve the quality of care by reducing surgical complications, but also may provide cost savings at the hospital level.

Get the full story.

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4.) Improving Physician Performance and Value-Based Reimbursement Levels Through Meaningful Data Sharing

Improving Physician Performance and Value-Based Reimbursement Levels Taconic IPA, through a community transformation program, is leveraging performance reporting data to engage physicians in quality improvement while increasing reimbursement rates for its physicians. During this webinar, industry experts described how the sharing of data across their organizations is improving physician performance and value-based reimbursement levels.

Learn more about this resource.

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5.) Healthcare Business White Paper: 2010 Benchmarks in HRA Use

This white paper captures trends in the use of aggregate data from health risk assessments (HRAs) by 116 healthcare organizations to design and deliver health promotion and disease management interventions to targeted individuals in response to the Healthcare Intelligence Network June 2010 Health Risk Assessments e-survey.

Download this complimentary white paper.

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6.) Decline in U.S. Adult Smoking Rate Stalled

Despite the known dangers of tobacco use, one in five American adults continues to smoke cigarettes, and four in 10 nonsmokers were exposed to cigarette smoke during 2007-2008, according to reports from the CDC.

Get the full story.

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7.) New Chart: Points in Care for Patient Education

Points in Care for Patient Education

Healthcare organizations are learning that an investment in patient and member education is money well spent. We wanted to find out at which points in care patient education is conducted.

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 Integrative medicine includes the best of conventional medicine but redefines health to include the person's body, mind, spirituality and community — with a special focus on the patient-practitioner bond. 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.) 3 Factors Affecting Older Admissions to Substance Abuse Treatment

Admissions for substance abuse treatment among those aged 50 and older have more than doubled, and their sociodemographic characteristics have significantly changed, between 1992 and 2008, according to a study by SAMHSA.

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.) National Coalition Enrolls Uninsured Children in Healthcare

The Connecting Kids to Coverage Challenge coalition will enroll 5 million children in Medicaid and CHIP within five years, according to HHS.

Get the full story.

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12.) The Colorado Accountable Care Collaborative: Practical Lessons from an ACO

Colorado Accountable Care Collaborative During this webinar, two industry experts will walk through the ACO development process in Colorado. From the practical challenges to the processes for addressing these challenges, the experts will cover: The system changes required before launching an ACO; developing performance measures and an incentives program for year one of the pilot and how these will differ in the expansion year; balancing between prescriptive and permissive in enlisting healthcare providers to be accountable to their outcomes; and much more.

Learn more about this resource.

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13.) HealthSounds Podcast: Coordinating a Virtual Medical Home in Your Community— Lessons from the Iowa Collaborative Provider Network

Sarah Dixon Gale Michelle Stephan To create a virtual medical home — also called a virtual healthcare home — primary care providers partner with community organizations to deliver a full continuum of healthcare services in a manner that is transparent to patients and health plan members. Sarah Dixon-Gale, lead contract manager for the Iowa/Nebraska Primary Care Association, explains how Iowa's virtual medical home program has improved access at Siouxland Community Health Center. Also in this podcast, Siouxland CEO Michelle Stephan describes a major challenge faced by the virtual medical home. Learn how this unique community partnership helps to position these organizations for federal Medicaid expansion in 2014.

Listen to this podcast.

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