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From the editor

Dear Healthcare Intelligence Network Client,

HIN Managing Editor Patricia Donovan

A new study from Geisinger Health System indicates that the patient-centered approach can be as effective in a hospital setting as it is in the primary care office. In a featured story this week, Geisinger reports that its Continuum of Care model — timely, coordinated, risk-stratified care of hospitalized patients — could save nearly 100,000 hospitalized patient lives each year as well as significant healthcare dollars. Earlier this month, Geisinger reported that its ProvenHealth Navigator, its self-developed medical home model, is capable of reducing admissions by 18 percent and readmissions by 36 percent for its Medicare Advantage members.

Risk stratification factors heavily into Kaiser's handling of high and ultra-high ED users, as you'll read in another of this week's stories. And in the first of our new monthly podcasts on healthcare market metrics, HIN's Melanie Matthews delivers the just-published results on reducing avoidable emergency room use.

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: Reducing Impact of Uninsured & Underinsured — Taking a Toll on the Healthcare Industry

Reducing Impact of Uninsured & Underinsured — Taking a Toll on the Healthcare Industry

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September 27, 2010
Vol. XII, No. 35

Sponsored by:
The Colorado Accountable Care Collaborative — Practical Lessons from an ACO

This week's industry news:

  1. Using Narcotics Contracts to Manage ED High Utilizers
  2. 27 Interventions to Reduce Avoidable ER Use
  3. Geisinger Study Shows Hospital Workflow Redesign, Patient-Centered Care Saves Lives, Money
  4. The Medical Home Case Manager
  5. Healthcare Business White Paper: Benchmarks in Obesity and Weight Management
  6. Teens Who Have Infrequent Family Dinners Likelier to Use Drugs
  7. New Chart: Case Manager Monthly Caseloads
  8. Guide to Health Coaching
  9. Growth in Long-Term Care Costs Slowed During Economic Downturn
  10. Managed Medicare and Medicaid Factbook
  11. Medicare Beneficiaries in Donut Hole to See 50 Percent Discount on Brand Name Drugs in 2011
  12. Healthcare Trends in 2011
  13. HealthSounds Podcast: How to Reduce Avoidable ER Visits
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.) Using Narcotics Contracts to Manage ED High Utilizers

Sara Tracy, senior manager of emergency services at Kaiser Foundation Health Plan of Colorado, describes a formula for identifying high utilizers of the ED.

Get the full story.

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2.) 27 Interventions to Reduce Avoidable ER Use

27 Interventions to Reduce Avoidable ER Use This 45-page resource describes 27 separate initiatives launched by Kaiser and WellPoint in eight states around the country that are effectively reducing avoidable emergency department use and redirecting patients to more cost-effective care venues. This resource details provider- and patient-focused interventions that target the high numbers of avoidable visits, high and ultra-high utilizers and the five key sub-populations noted for frequent ER use: asthma patients, those recently discharged from the hospital, non-network patients, nursing home and assisted living residents and dual-eligibles (Medicare and Medicaid).

Learn more about this resource.

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3.) Geisinger Study Shows Hospital Workflow Redesign, Patient-Centered Care Saves Lives, Money

Timely, acuity-stratified care delivered by the coordinated efforts of a team of healthcare professionals has the potential to nationally save nearly 100,000 hospitalized patient lives a year and save significant healthcare dollars, according to a large prospective study by Geisinger.

Get the full story.

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4.) The Medical Home Case Manager: Profiting from Patient-Centered Care Coordination

The Medical Home Case Manager This resource provides an inside look at the selection, training, skill set, processes and benefits of the Geisinger Health Plan case managers embedded within the payor's medical home practices.

Learn more about this resource.

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5.) Healthcare Business White Paper: 2010 Benchmarks in Obesity and Weight Management

This white paper captures the top strategies organizations are implementing to prevent and reduce obesity and related conditions and costs, based on responses from 131 healthcare organizations to the April 2010 Healthcare Intelligence Network Obesity and Weight Management e-survey.

Download this complimentary white paper.

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6.) Teens Who Have Infrequent Family Dinners Likelier to Use Drugs in Future

Compared to teens who have frequent family dinners (five to seven per week) those who have infrequent family dinners (fewer than three per week) are more than twice as likely to say that they expect to try drugs in the future, according to a new report from The National Center on Addiction and Substance Abuse (CASA) at Columbia University.

Get the full story.

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7.) New Chart: Case Manager Monthly Caseloads

Case Manager Monthly Caseloads

Healthcare case managers are playing a larger role in the coordination of all phases of patient care — from management of the chronically ill in primary care to monitoring hospitalized patients from pre-admission through post-discharge to overseeing care of residents in long-term care facilities. We wanted to identify the average monthly case load of a case manager.

Click here to view the chart.

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8.) Guide to Health Coaching

Guide to Health Coaching This resource defines the role of the health coach in population health management, tactics to motivate individuals to adopt healthier lifestyles, and health coaching at the Mayo Clinic, including use of health IT and incentives to encourage repeat and long-term participation.

Learn more about this resource.

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9.) Growth in Long-Term Care Costs Slowed During Economic Downturn

The 2008-2009 recession led to smaller cost increases at many long-term care facilities and forced some to close altogether, according to a study by Prudential Financial Inc.

Get the full story.

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10.) Managed Medicare and Medicaid Factbook: 2010

Managed Medicare and Medicaid Factbook As the economic downturn leads to more low-income enrollees and the political climate threatens to significantly alter how managed Medicare and Medicaid work, you need up-to-date enrollment data to help you assess the competitive landscape and develop strategic plans. This resource has current and historical statistics so you can easily make plan-by-plan or state-by-state comparisons to suit your analytical needs.

Learn more about this resource.

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11.) Medicare Beneficiaries in Donut Hole to See 50 Percent Discount on Brand Name Drugs in 2011

The nationís pharmaceutical manufacturers will provide 50 percent discounts on the cost of covered brand-name prescription drugs for beneficiaries in the Medicare Part D coverage gap, or donut hole, starting in 2011, according to HHS, CMS and Vice President Joe Biden.

Get the full story.

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12.) Healthcare Trends in 2011: A Strategic Industry Forecast

Healthcare Trends in 2011 This annual, must-attend webinar event provides a first look analysis of the trends and opportunities for healthcare organizations in the coming year. Now in its seventh year of providing healthcare executives with a look ahead to help shape strategic plans, this year's 60-minute program will cover: How healthcare organizations can prepare for the health reform changes required in 2011; the short and long-term reform ramifications for the coming year; what healthcare opportunities exist; the critical healthcare industry developments to monitor; and much more.

Learn more about this resource.

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13.) HealthSounds Podcast: Healthcare Performance Metrics — How to Reduce Avoidable ER Visits

Reduce Avoidable ER Visits In a new monthly podcast, Healthcare Intelligence Network executive VP and COO Melanie Matthews shares the latest market research on key healthcare topics. This month's metrics are derived from HIN's July 2010 survey on Reducing Avoidable ER Visits, with commentary from Dr. Barsam Kasravi, managing medical director for state-sponsored programs for WellPoint and Sara Tracy, senior manager of emergency services at Kaiser Foundation Health Plan of Colorado.

Listen to this podcast.

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