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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

Medicare is moving into the Medical Home model in a big way. Last week the federally administered health insurance system for persons 65 and older got the green light to participate in state multi-payor patient-centered medical home (PCMH) initiatives. Medicare is also set to launch its own three-year PCMH demo that will pay eligible physicians a monthly care management fee for medical home services for high-need patients — those with prolonged or chronic illnesses that require regular medical monitoring, advising or treatment.

This is good news on all fronts. With the management of chronic conditions in older adults taxing healthcare resources, Medicare should be participating in multi-payor PCMH collaborations. In 2008, Medicare's annual costs were 3.2 percent of the GDP. According to the CMS Chronic Condition Data Warehouse, 50 percent of Medicare FFS beneficiaries were receiving care for one or more chronic conditions in 2005. The medical home is built to manage the complexity of care and multiple medical providers required by multi-morbid patients.

With evidence mounting that the medical home produces better care at no added cost, it makes sense for Medicare to adopt the patient-centered team approach for its beneficiaries. Participating physicians are likely to see results well before the pilot's end, especially among baby boomer patients that embrace disease management e-health tools wired into the medical home.

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 21, 2009
Vol. XI, No. 35

Sponsored by:
Adopting and Implementing Evidence-Based Guidelines in the Medical Home

This week's industry news:

  1. Engaging Physicians in Telemedicine 'Curbside Consults'
  2. Model Medical Homes
  3. New Study of Best in Value™ Hospitals Highlights Savings
  4. Discharge Planning Primer
  5. Healthcare Business White Paper: Healthcare Trends Mid-2009
  6. 8.3 Million U.S. Adults Had Serious Thoughts of Suicide in Past Year
  7. Coaching in the Healthcare Continuum
  8. Improving Compliance for Hospice Patients in Nursing Homes
  9. Reducing Readmission Risk for the Elderly
  10. Medicare Gets OK to Participate in Multi-Payor Medical Home Programs
  11. Medical Home Reimbursement Models
  12. HealthSounds Podcast: Applying Evidence-Based Guidelines in the Medical Home
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This week's industry news

1.) Engaging Physicians in Telemedicine ‘Curbside Consults’

Kim Dunn, M.D., Ph.D., director of the HealthQuilt Project, assistant professor at the University of Texas School of Health Information Sciences and founder and CEO of Your Doctor Program, L.P., explains how to engage physicians in telemedicine to provide quality care.

The medical doctors who will participate in the HealthQuilt Quality Health Record (QHR) pilot will look at the protocol and customize it to their practice, which takes about two minutes per protocol, explains Dr. Dunn. That training, provided by the Your Doctor Program, L.P., overcomes the traditional provider barrier of, "I practice differently," which often prevents physicians from participating in quality initiatives.

Get the full story.

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2.) 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 model of care. This exclusive 65-page report analyzes the responses of more than 220 healthcare organizations to HIN's 2009 Industry Survey on the Patient-Centered Medical Home Model and 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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3.) New Study of Best in Value™ Hospitals Highlights Potential Savings of $600B Over 10 Years

Many hospitals in every state are providing exceptional value in an increasingly demanding environment, according to a study by Data Advantage, a healthcare information company. After ranking hospitals by an independent analysis of each hospital’s quality, affordability, efficiency and patient satisfaction performance, the 2009-2010 Hospital Value Index™ found that out of the more than 4,500 hospitals that were analyzed, 747 were identified as providing the Best in Value™ care.

Get the full story.

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

Discharge Planning Primer Coordinated planning of a patient's care following a hospital or nursing home stay can greatly affect health outcomes, likelihood of readmission and/or ER visits, as well as cost to patients, providers and insurers. A discharge management plan that integrates community resources and programs can further ease the transition from hospital to home and improve continuity of care. 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: Healthcare Trends Mid-2009 — A Six-Month Adjustment

Some healthcare organizations have seized the economic downturn as an opportunity to test new programs and services. In a new white paper from HIN, learn some of the surprising programs emerging in a leaner business environment, why the first half of 2009 was better than the previous six months for almost half of 65 responding organizations, the top three issues impacting the industry mid-year and much more.

Download this complimentary white paper.

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6.) 8.3 Million U.S. Adults Had Serious Thoughts of Suicide in Past Year

Nearly 8.3 million adults (age 18 and older) in the U.S. (3.7 percent) had serious thoughts of committing suicide in the past year, according to the first national scientific survey of its size on this public health problem. The SAMHSA study also shows that 2.3 million adult Americans made a suicide plan in the past year and that 1.1 million adults — 0.5 percent of all adult Americans — had actually attempted suicide in the past year.

Get the full story.

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7.) Coaching in the Healthcare Continuum: Models, Methods, Measurements and Motivation, Second Edition

Coaching in the Healthcare Continuum This resource is based on two conferences on the role of health coaching in disease management and population health management, as well as a 2008 update from two Mayo Clinic thought leaders on the shift in focus of Mayo's health coaching initiatives, its increasing integration of Web 2.0 technologies and innovative use of incentives to encourage repeat and long-term participation. This report also includes a bonus interview with Mayo clinical health psychologist Dr. Kristin Vickers Douglas on the merits of motivational interviewing in health coaching, including its value in the coaching of individuals with multiple health risks or chronic illness.

Learn more about this resource.

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8.) Improving Compliance for Hospice Patients in Nursing Homes

In a review of the hospice benefit for residents of nursing facilities, HHS found that 82 percent of the 470 claims that were part of the study did not meet at least one Medicare coverage requirement for hospice services. For hospices with this compliance issue, the HHS’ Office of the Inspector General (OIG) recommends increased hospice provider education, tools fostering better compliance and strengthened monitoring of practices, such as medical review and additional surveys.

Get the full story.

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9.) Reducing Readmission Risk for the Elderly through Care Transition Coaching

Reducing Readmission Risk for Elderly With the healthcare industry focused on reducing the high numbers of Medicare patients readmitted to the hospital within 30 days of discharge, landmark studies of transitions in older adults at high risk for readmission upon discharge by Eric Coleman, M.D., at the University of Colorado are transforming care management approaches across the country. This resource presents new models of care coordination for the elderly, including an Oxford Health Plan care transition coach program modeled on Dr. Coleman's research. This book 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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10.) Medicare Gets OK to Participate in Multi-Payor Medical Home Programs

HHS has given Medicare the go-ahead to join Medicaid and private insurers in state-based efforts to improve the way healthcare is delivered. These efforts include models that improve care for patients, give primary care providers better information about their patients and achieve greater value for the health dollars spent.

Get the full story.

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11.) Medical Home Reimbursement Models: Funding Patient-Centered Care with Multi-Stakeholder Collaborations

Medical Home Reimbursement Models This resource presents three ongoing medical home pilots built on a variety of reimbursement models. It provides an opportunity to evaluate three PCMH financial models and benefit from the experiences of multi-stakeholder collaborations.

Learn more about this resource.

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12.) HealthSounds Podcast: Applying Evidence-Based Guidelines in the Medical Home

Evidence-Based Guidelines in Medical Home Despite the challenges, cost and uncertain return of EHRs, practices should move quickly to adopt this tool, recommends Dr. Richard J. Baron, president and CEO of Greenhouse Internists, where the EHR is the backbone that supports the implementation of evidence-based practices.

Listen to this podcast.

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