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From the editor Dear Healthcare Intelligence Network Client,
It looks like good surgeons are, literally, a cut above the rest, at least according to a new study from Harvard School of Public Health. Quality surgical care is strongly linked to hospital readmission rates, a somewhat surprising new statistic given that much of policy focus has been on reducing readmissions after hospitalizations for medical conditions, such as heart failure and pneumonia. Readmissions for medical conditions are primarily driven by how sick the patients are and whether they live in poor or better-off communities; the link between hospital quality and readmissions is less clear. The study sought to find out if there was a relationship between readmission rates after surgery and the quality of surgical care in that hospital; more details inside. Poor healthcare quality does not discriminate. According to a new study from the Commonwealth Fund scorecard, access to affordable, quality healthcare varies greatly for low and high-income people based on where they live. The report finds that higher-income people living in states that lag far behind the top scoring states are often worse off than low-income people in states that rank at the very top of the scorecard. The scorecard provides the first state-by-state comparison of the healthcare experiences of the 39 percent of Americans with incomes less than 200 percent of the federal poverty level, and compares their experiences with higher income families. Lower-income families, particularly those on Medicaid, have grown increasingly more dependent on using the emergency room, despite widely held assumptions that uninsured patients are high ER utilizers, according to a study from the University of California, San Francisco. In order to investigate recent trends between insurance coverage and ED use, researchers analyzed California ED visits by adults aged 19 to 64 years old from 2005 to 2010, and found that the number of visits to California EDs by adults overall increased by 13.2 percent, with Medicaid beneficiaries leading the pack. This study has wide implications with upcoming ACA reforms; many uninsured people are expected to transition to Medicaid, and as a result, overall ED use may increase because Medicaid patients have higher rates of ED use. Physician-hospital organizations (PHOs) have taken the accountable care organization (ACO) reins from physicians over the last year, according to our 2013 market data. PHO leadership of ACOs almost doubled in the last 12 months; in 2012, one-quarter of ACOs were physician-led, a trend that replaced the hospital-administered ACOs that dominated in 2011. As ACOs continue to evolve, the composition of the care delivery model will shift as well, with hospice, long-term care and home health entering the fray. Lastly, don't forget to take our Health Risk Assessments in 2013 survey — 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 to develop 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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September 23, 2013
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This week's industry news
1.) Hospital Readmission Rates Linked with Quality of Surgical Care
2.) Avoiding the Readmissions Penalty Zone: Population Health Management for High-Risk Populations
3.) Affordable, Quality Healthcare Varies Due to Income, Geography
4.) Service Delivery for Vulnerable Populations, New Directions in Behavioral Health
5.) Healthcare Business White Paper: Dual Eligibles Care Management in 2013 — Case Management, Education Boost Compliance, Satisfaction
6.) ACO Leadership by Physician-Hospital Organizations Doubles
7.) New Chart: What's Required Training for the Care Transition Team?
Click here to view the chart.
8.) 2013 Healthcare Benchmarks: Accountable Care Organizations
9.) Adult Medicaid Beneficiaries in California Have Highest Increase in ED Visits: Study While uninsured patients are often thought of as high emergency department (ED) utilizers, insured patients, particularly those with Medicaid coverage, have come to rely more frequently on EDs, according to a study from the University of California, San Francisco. Get the full story. >>Return to this week's industry news
10.) Reducing Avoidable ER Visits by Medicaid Patients Through Quality-Based Interventions
11.) Disease-Specific Medical Homes Help Deliver Value-Based Healthcare
12.) 46 Healthcare Metrics to Boost Profitability: Charting 2013 Trends
13.) Infographic: A Short Look at Long-term Care for Seniors
14.) Managing Population Health with Integrated Registries and Effective Patient Touchpoints
Another is the vigorous use of registries — more than 50 in all, at last count — even for relatively rare diseases. Dr. Bellows defines the criteria for registry
creation, expands on the choice and availability of patient touchpoints and explains the evolution of other Web-based PHM tools in use by Kaiser Permanente.
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This resource delivers winning process improvements and interventions that can help organizations make measurable progress toward reducing readmissions in high-risk populations,
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This resource provides students and professionals in healthcare and service delivery with innovative programs and models to address the needs of vulnerable populations with such
health issues as substance abuse, mental illness, and poverty.
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of Dually Eligible by the Healthcare Intelligence Network. 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 population's unique medical, social and functional needs in a coordinated and cost-efficient manner. Download this HINtelligence report
for more data on dual eligibles as reported by 72 healthcare companies in HIN's 10 Questions on Care Coordination of Dual Eligibles Survey, including dual eligible care
coordination program components, results and ROI, and successful care coordination strategies for dual eligibles in respondents' own words.
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Managing Care Transitions. We wanted to see which other training is needed by care transition teams.
This resource documents the numerous ways in which accountable care is transforming healthcare delivery, particularly in the area of care coordination, where the ACO model has
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This webinar shares specifics from a collaborative effort among five regions of Ohio that targeted the key reasons for avoidable ER visits among Medicaid beneficiaries and
rolled out test interventions in a rapid cycle quality improvement approach.
This resource delivers charts and tables on 46 actionable metrics carefully curated from 2012 market research data by the Healthcare Intelligence Network.
A patient might expect a reminder about a missed colonoscopy during a primary care visit, but during a trip to the dermatologist? Providing health plan members with “consistent
and ubiquitous reminders” via multiple touchpoints in their healthcare journey is one of Kaiser Permanente’s key population health management strategies, reports Jim
Bellows, PhD, senior director of evaluation and analytics for Kaiser Permanente.