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From the editor Dear Healthcare Intelligence Network Client,
Technological problems might hinder aspects of tomorrow's rollout of the new health insurance exchanges — both at the state and federal level. According to New York Times reports late yesterday, some aspects of the eagerly awaited exchanges in several states, including Oregon, Colorado, District of Columbia and Nevada, may not be fully operational for weeks and even months, with some officials referring to October as a "soft launch" period. Last week, the Obama administration acknowledged it will not be ready to accept online applications from small businesses when the program officially launches October 1st. Once fully operable, the exchanges, one-stop online shopping sites for consumers’ health insurance needs, will enable consumers to comparison shop for health benefits much like they do now for airline tickets or hotel rooms, and see if they qualify for tax credits. Plans are categorized according to levels of coverage and co-pays, and no one can be denied coverage because of preexisting conditions. There will be a six-month open enrollment period that runs through March 2014, and coverage should begin as early as January 1st. Smart phones can now diagnose abnormal heart rhythms, act as ultrasound devices, or function as the "central command" for a glucose meter used by a person with insulin-dependent diabetes. To ensure that patients' safety isn't compromised for the sake of technological innovation, the FDA is clamping down on those apps considered dangerous. The agency has cleared about 100 mobile medical applications over the past decade; about 40 of those were cleared in the past two years. The costs of patient care after heart attacks, continues to climb, according to a new study from the University of Michigan (U-M) Frankel Cardiovascular Center. Despite advancements in cardiac care and increases in less invasive procedures to treat symptoms, including more angioplasty instead of open heart surgery,hospital stays have decreased by just one day. Medicare spending to treat heart attack patients rose by 16.5 percent between 1998 and 2008, with the majority of costs incurred weeks after patients left the hospital. According to researchers from the NYU School of Medicine, elderly nursing home residents with advanced dementia who were enrolled in a Medicare managed care insurance plan were more likely to have do-not-hospitalize orders and less likely to be hospitalized for acute illness than those residents enrolled in traditional Medicare. The frail elderly received more nursing home-based primary care visits every 90 days, and more nursing home-based nurse practitioner visits in general. The extra individual attention precluded the need for more acute treatment, and resulted in less aggressive, more humane end-of-life care. And lastly, sophisticated analytics behind today's health risk assessments or health risk appraisals (HRAs) provide employers, payors and providers an aggregate view of population health and the raw material for the development of prevention and lifestyle change programs. Tell us how your organization uses HRAs to improve population health by October 15, 2013 and get a FREE executive summary of the compiled results. Your colleague in the business of healthcare,Cheryl Miller Editor, Healthcare Business Weekly Update Please send comments, questions and replies to [email protected].
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Accountable Care Organizations in 2013 — ACO Leadership Shifts to Physician-
Hospital Organizations
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September 30, 2013
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This week's industry news
1.) Managed Care Reduces Hospitalizations in Nursing Home Residents with Advanced Dementia
2.) Case Management for Advanced Illness: Best Practices in End-of-Life Care
3.) Significant Choice and Lower than Expected Premiums Available in New Health Insurance Marketplace
4.) Healthcare Trends & Forecasts in 2014: A Strategic Planning Session
5.) Healthcare Business White Paper: Medication Adherence in 2013 — Closer Look at Compliance During Care Transitions
6.) Medicare Spending on Heart Attack Patients Jumps 16 Percent in Last Decade
7.) New Chart: Top 5 Care Coordinators for Dually Eligible
Click here to view the chart.
8.) Guide to Reducing Medicare Readmissions, Vol. II
9.) Some Mobile Medical Apps to Face Closer FDA Scrutiny Designed to protect consumer safety while supporting innovation, the U.S. Food and Drug Administration (FDA) issued final guidance for developers of mobile medical applications, or apps. Get the full story. >>Return to this week's industry news
10.) 2013 Healthcare Benchmarks: Mobile Health
11.) 7 Barriers to Effective SNF-Hospital Care Transitions
12.) Accountable Care Strategies to Improve Hospital-SNF Care Transitions
13.) HINfographic: How an Integrated SNF Network Supports Accountable Care
14.) A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings
Thank you for your readership! Please urge your colleagues to subscribe by forwarding this email or visiting http://www.hin.com/freenews2.html or by calling (888) 446-3530 or visiting the HIN Web site. While we encourage you to forward this email to your colleagues, these articles may not be redistributed in any other publication, reproduced for publication in any form, distributed on an intranet or network or by e-mail distribution or distributed for commercial purposes without the expressed written permission of the Healthcare Intelligence Network. |
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This resource examines Aetna’s Compassionate Care program, a case management approach for this population. The payor’s initiative breaks down barriers commonly encountered in
this highly sensitive stage of the health continuum while positively impacting both healthcare utilization and spend.
This webinar will provide a roadmap to the key issues, challenges and opportunities for healthcare providers and payors in 2014, including the launch of health insurance
exchanges, cuts in the Medicare Advantage program and the challenge of meeting the care coordination needs of the dual eligible population.
In its third annual Medication Adherence e-survey conducted in January 2013, HIN captured emerging trends in efforts to improve medication adherence (MA) among more than 100
healthcare organizations. According to 75 percent of survey respondents, complex patients remain the most common targets of MA programs. This HINtelligence Report provides data
highlights on MA program components, the most successful tools for improving MA, and more.
Care coordination of the 9 million Americans eligible for both Medicare and Medicaid is a growing priority for the nation’s payors who wish to address this group’s unique
medical, social and functional needs in a coordinated and cost-efficient manner. We wanted to see which healthcare professionals are responsible for the care coordination of
dual eligibles.
This resource examines innovative interventions to reduce preventable admissions, rehospitalizations and ER visits by high-utilizing Medicare beneficiaries. This guide looks at
four multidisciplinary collaborative interventions aimed at key factors fueling readmissions in this population — and that support an accountable care vision.
This resource delivers a snapshot of mobile health (mHealth) trends, including current and planned mHealth initiatives, types and purpose of mHealth interventions, targeted
populations and health conditions, and challenges, impact and results from mHealth efforts.
This resource provides a look at a health system-SNF network that has curbed rehospitalizations and length of stay for participants. The hospital-to-SNF transition is one of the
top three care transitions addressed by healthcare organizations, behind hospital-to-home and hospital-to-SNF.
Low scores on patient outcomes measures within the CMS Star Quality ratings program — metrics CMS weights most heavily in its assignment of stars — can typically be
traced to poor provider and member engagement, notes Joseph Johnson, vice president of L.E.K. Consulting. Johnson suggests ways to enlist support from these two
stakeholder groups, and describes how MA plans should prepare for the possible display in 2014 of CAHPS care coordination ratings along with with its star scores (though the
care coordination ratings will not be factored into star ratings).