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From the editor Dear Healthcare Intelligence Network Client,
Women are in charge when it comes to choosing their family�s healthcare coverage needs. That�s the bottom line from a new survey from Cigna, which says that, regardless of where they live or who their insurer is, women are the CFOs and CMOs of their households. Among their top concerns about healthcare coverage, in light of new reforms, are whether they can afford insurance, and care for their elderly parents. The extensive survey covers everything from how many women understand reform (1 in 10) to what steps they�re taking to manage costs (94 percent are using lower cost prescriptions). A lack of family and social support is one of the seven chief barriers to medication adherence, says Thom Stambaugh, chief pharmacy officer and vice president of clinical programs and specialty pharmacy at CIGNA� Pharmacy Management. If a patient has no friends or family to discuss their health and required medications with, they are more likely to skip them, which is why it�s important to understand which barrier applies to a particular individual when trying to resolve medication compliance issues, and then find a solution around it. Breast cancer screening, cervical cancer screening, and weight assessment and nutrition counseling for children were among the areas Kaiser Permanente received top marks in, according to the NCQA�s Quality Compass® data, which ranked the company number one in 13 out of 43 effectiveness of care measures. Out of nearly 500 commercial health plans in the nation, no other health plan received more than five No.1 rankings, according to Kaiser officials. Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations (ACOs), according to a new RAND Corporation study. Other factors associated with the formation of ACOs include a greater occurrence of payment risk sharing at hospitals, larger integrated hospital systems and primary care physicians practicing in large groups. A region's average household income, per capita Medicare spending, enrollment in Medicare Advantage Plans and physician density were not associated with formation of accountable care organizations. Same-hospital readmission rates are an unreliable predictor for all-hospital readmissions rates, but that rate is what CMS penalizes hospitals for, according to research from the University of Michigan (U-M) Health System, presented at the 2013 Clinical Congress of the American College of Surgeons. By tracking readmission rates solely within their own facility, instead of looking at rates at other hospitals, officials aren't getting enough information to effectively target areas for quality improvement, researchers say. 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].
Publisher: HIN podcasts
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This week's featured download:
Dual Eligibles Care Management in 2013 — Case Management,
Education Boost Compliance, Satisfaction
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October 14, 2013
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This week's industry news
1.) Cigna Survey: Women Confident Now, Yet Worried about Future Health Concerns
2.) Healthcare Trends & Forecasts in 2014: A Strategic Planning Session
3.) NCQA Ranks Kaiser Permanente Number One in 13 of 43 Quality Measures
4.) Formula for CMS Five-Star Quality Population Health Management
5.) Healthcare Business White Paper: Telehealth in 2013 — Videoconferencing, Virtual Visits and Smartphones Power Population Health Management
6.) Consolidated Health Networks Lead to Greater Creation of ACOs
7.) New Chart: Top 5 Health Targets of Telehealth
Click here to view the chart.
8.) Guide to Accountable Care Organizations
9.) Same-Hospital Readmission Rate Unreliable Predictor for All-Hospital Readmission Rate Same-hospital readmission rates are an unreliable predictor for all-hospital readmissions rates, but that rate is what CMS penalizes hospitals for, according to research from the University of Michigan (U-M) Health System, presented at the 2013 Clinical Congress of the American College of Surgeons. Get the full story. >>Return to this week's industry news
10.) 2012 Healthcare Benchmarks: Reducing Hospital Readmissions
11.) 7 Barriers to Medication Adherence
12.) Guide to Improving Medication Adherence
13.) Infographic: The $18B Impact of Medicare Hospital Readmissions
14.) Features of WellPoint's Physician Practice Transformation Initiative
Smoothing the transformation rollout is the simultaneous participation of 500 WellPoint practices in CMS's Comprehensive Primary Care (CPC) program, whose goals dovetail with key PCMH principles — as though WellPoint had another partner in its transformation initiative, Schilz notes.
Just as important as practice support is transparency with health plan members, Schilz adds, especially when it comes to explaining the concept of the medical home neighborhood
— where care coordination is a collaboration between primary care and the specialist.
Thank you for your readership! Please urge your colleagues to subscribe by forwarding this email or visiting http://www.hin.com/">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 webinar will provide a roadmap to the key issues, challenges and opportunities for healthcare providers and payors in 2014. This 10th annual, must-attend event will
highlight the strategic importance of health insurance exchanges for health plans and providers even if they�re not participating in the initial enrollment period, among other
key issues
This resource examines star quality improvement strategies, including Kaiser Permanente's successful care management efforts that have made this "star czar" a leader in the
five-star space.
Healthcare is leaning on videoconferencing more than ever to monitor discharged patients, conduct remote consultations and facilitate communication, according to responses to
2013 Telehealth Survey by the Healthcare Intelligence Network. Respondents reported an increase in the use of videoconferencing — from 41 percent in 2010 to 59 percent in
2013. Download this HINtelligence report for more telehealth trends for 2013 as reported by 129 healthcare companies in HIN's third annual Telehealth Survey. Included in the
report are the greatest barriers or challenges to telehealth implementation, top funding to support telehealth efforts, telehealth use in clinical applications, and much more.
Congestive heart failure (CHF) is one of the top health conditions targeted by telehealth programs, according to about 53 percent of healthcare companies who responded to HIN's
third annual industry survey on telehealth and telemedicine. We wanted to see which other health conditions are targeted by telehealth programs.
This resource lays the groundwork for an ACO program, delivering a comprehensive set of 2012 ACO benchmarks from 200 companies, a framework for clinical integration, a key ACO
prerequisite that puts participating providers on the same performance and payment page, and more.
This resource identifies the key strategies, challenges, target populations and health conditions of 119 healthcare organizations to reduce avoidable rehospitalizations, and
provides critical benchmarks that show how the industry is working to reduce rehospitalizations, particularly for the CMS target conditions of heart failure, myocardial
infarction and pneumonia.
This resource analyzes trends in improving medication adherence at more than 160 healthcare companies, and takes an in-depth look at pioneering efforts by Kaiser Permanente
Colorado and CIGNA Pharmacy Management to improve medication compliance levels in their populations. Additionally, the past president of the Case Management Society of America
shares a case manager�s take on what�s needed to move individuals toward medication compliance.
In its quest to transform 70 to 80 percent of its physician practices to a patient-centered medical home (PCMH) over the next three years, WellPoint has adopted a "meet the
practices where they are" philosophy, reports Julie Schilz, director of care delivery transformation for WellPoint. Each practice is at a different place in the
transformation effort and requires specialized supports, she adds.