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November 2010 Volume I, No. 11

Dear Healthcare Intelligence Network Client, HIN Managing Editor Patricia Donovan

This issue looks at two award-winning readmission reduction efforts: Thomson Reuters' top 50 cardiac hospitals ( a more elite list than its 100 top hospitals of the past) that are reducing readmissions and length of stay in this population, and the first health system in the nation certified as Level II transition coaches by the creator of the care transition model.

On the subject of coaching, this issue also charts the top health coaching IT tools and delivers the latest benchmarks and benefits of health coaching programs.

Your colleague in the business of healthcare,
Patricia Donovan
Editor, ReadmissionsRx

This week's ReadmissionsRx news:

Table of Contents

  1. Top 50 Cardiac Hospitals
  2. HealthSounds Podcast: ACO & Clinical Integration
  3. Q&A: 'Leaning' Healthcare
  4. New Chart: IT Coaching Tools
  5. Trends & Studies: Health Coaching in 2010
  6. Readmissions Roundup: Care Transition Coaching
  7. Vital Signs: Tobacco Cessation and Prevention

Read last month's ReadmissionsRx

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Top 50 Cardiac Hospitals Trim Readmissions, Length of Stay

Hallmarks of Thomson Reuters' top 50 cardiac hospitals include having fewer cardiac patients readmitted to the hospital in the 30 days following discharge, shorter hospital visits and lower costs, according to its newly released annual study identifying the top U.S. hospitals for inpatient cardiovascular services.

The 12th annual study, which for the first time singled out 50 hospitals rather than its traditional 100 winners, examined the performance of 1,022 hospitals by analyzing outcomes for patients with heart failure and heart attacks and for those who received coronary bypass surgery and percutaneous coronary interventions such as angioplasties.

The study shows that 96 percent of cardiovascular inpatients at these top hospitals survive and approximately 93 percent remain complication-free, indicative of improved cardiovascular care across-the-board over the past decade. Other factors in the 50 top hospitals' performance include:

  • Better risk-adjusted survival rates (33 percent fewer deaths than non-winning hospitals for bypass surgery).
  • Lower complications indices (21 percent lower for heart failure complications).
The study evaluated general and applicable specialty, short-term, acute care, non-federal U.S. hospitals treating a broad spectrum of cardiology patients.

Thomson Reuters researchers analyzed 2008 and 2009 Medicare Provider Analysis and Review (MedPAR) data, Medicare cost reports, and CMS Hospital Compare data. They scored hospitals in key performance areas: risk-adjusted mortality, risk-adjusted complications, core measures (a group of measures that assess process of care), percentage of coronary bypass patients with internal mammary artery use, 30-day mortality rates, 30-day readmission rates, severity-adjusted average length of stay, and wage- and severity-adjusted average cost.

To view the complete list of hospitals, please visit:

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HealthSounds Podcast: Framing an ACO Through Clinical Integration

The clinical integration of healthcare providers facilitates the coordination of services required for shared accountability and reward. Dr. Mark Shields, senior medical director with Advocate Physician Partners, describes the logistics of training 3,400 providers on clinical integration, the importance of the physician peer group in this effort, and the business case for the devotion of three of Advocate's 41 performance measures to smoking cessation and prevention.

To listen to this complimentary HIN podcast, please visit:

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Where to Start to 'Lean' Healthcare

Each month, a healthcare thought leader provides more insight on the challenges of reducing hospital readmissions. This week's expert is Steven Valentine, president of The Camden Group.

Question: Creation of a lean organization and cost reduction strategies are critical for the healthcare industry in 2011. What areas provide opportunities for health plans and providers to reduce costs?

Response: Number one is still length of stay; use of the hospitals and case management has really been the early focus. Bundled payments allow you to do all that, plus you would look at the actual resources during the stay, implantable devices and so on. But if you talk to any of these large medical groups who really look at accountable care, the true savings come from looking at frequency. They see a reduction in frequency, which is the number of procedures or number of admissions, as where they seek to start the whole effort to reduce down spend. Many hospitals today are readdressing all their vendor agreements and reexamining many of their business lines to say, “This hasn’t made money, it's not going to make money and it’s probably time to let this go.” They try to find a different means of providing this service, usually through an outside vendor or third party.

For more healthcare trends for 2011, please visit:

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New Chart: Top Health IT Coaching Tools

With so much technology available to support wellness and health promotion, we wanted to see which IT tools are framing organizations' health coaching programs.

Click here to view the chart.

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There are other free email newsletters available from HIN!

HealthCoach Huddle a monthly e-newsletter, brings you the most up-to-date news on health coaching, from coaching strategies to interviews and quotables from the industry's leading health coaches.

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2010 Health Coaching Benchmarks

This white paper captures the ways in which 161 organizations are implementing health coaching in 2010 — including the top three areas targeted by health coaching — as well as the financial and clinical outcomes that result from this health improvement strategy. These benchmarks are based on organizations' responses to the Healthcare Intelligence Network August 2010 e-survey on health coaching.

To download this complimentary white paper, please visit:

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Post-Discharge Coaching Reduces Readmissions, In-Home Medication Errors

HealthEast Care System's care navigation strategy, which has reduced hospital readmission rates and successfully identified medication discrepancies in the home following discharge, has received one of two Medica "Raising the Bar: Rewarding Innovation in Health Care Reform" awards.

Craig Svendsen, MD, HealthEast chief medical quality officer, noted that care navigation has been successfully implemented through several improvements in connecting navigators and providers across the continuum of care. One notable improvement is HealthEast's transition coaches, who partner with patients to provide post-discharge follow-up coaching, including the key components of:

  • Physician follow-up within seven days of discharge;
  • Understanding warning signs and symptoms;
  • Medication reconciliation;
  • Use of a personal health record.
HealthEast is the first system in the nation to have been certified as Level II transition coaches by Eric Coleman (the creator of the transitions coach model) and the first in the Twin Cities to use this model, delivering patient-centered care that is safe, timely, effective, equitable and efficient.

Sixteen entries from healthcare systems and individual hospitals and clinics were reviewed by a Medica committee, and HealthEast's Care Navigation Strategy was deemed to be ahead of the curve in undertaking clinical reform, making unique changes to improve quality outcomes, increasing patient satisfaction and decreasing the cost of healthcare with proven results.

HealthEast received $25,000 to continue expansion of care navigation; this is the third award that the strategy has won in the past year.

To learn more, please visit:

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Survey of the Month: Tobacco Cessation and Prevention

Cigarette smoking continues to be the leading cause of preventable morbidity and mortality in the United States, reports the U.S. Department of Health and Human Services. CDC data indicates that cigarette-smoking related healthcare expenditures in 2008 in the United States totaled nearly $96 million, and that the employer bears a cost of $3,391 per smoking employee per year, including $1,760 in lost productivity and $1,623 in excess medical expenditures. Learn what more than 60 organizations are doing in the areas of tobacco cessation and prevention. Complete HIN's Survey of the Month on tobacco cessation and prevention by November 30 and receive a free executive summary of the compiled results.

To take the survey, please visit:

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