From the editor
Dear Healthcare Intelligence Network Client,
Contrary to popular opinion, young adults between the ages of 19 and 26 do not think they’re immortal and do think they need health insurance. In fact, according to a study
from The Commonwealth Fund, if members of this population don’t have health insurance, it’s because they can’t afford it.
Nearly half of the 15 million young adults enrolled in a parent’s health plan last year most likely would not have been eligible for coverage without the health reform law’s
dependent coverage provision.
The survey also found that only 27 percent of young adults were aware of the state health insurance marketplaces launching October 1. The demographic that would benefit most
from these marketplaces are those without coverage and those from low- or middle-income households, or, those least likely to be aware of them.
But these young adults, and all other adults, can seek out help through a coterie of navigators funded by the HHS. The agency has granted $67 million to 105 applicants in
federally run and state partnership marketplaces, for navigators trained to help Americans who need assistance in shopping for and enrolling in plans in the health insurance
marketplaces beginning this fall.
Navigators are trained to provide unbiased information in a culturally competent manner to consumers about health insurance, the new HIEs, qualified health plans, and public
programs including Medicaid and the Children’s Health Insurance Program (CHIP). Funding was available to eligible private and public groups and the self-employed who met certain
standards to promote effectiveness, diversity, and program integrity, HHS officials say.
If all the health reform changes have made Americans’ blood pressure soar, there is help: a large scale study from Kaiser Permanente found that single pill combinations and
consistent follow-ups with hypertension patients helped improve the rate of blood pressure control by nearly twice as much. Through one of the largest community-based
hypertension programs in the nation, Kaiser Permanente Northern California nearly doubled the rate of blood pressure control among adult members with diagnosed hypertension
between 2001 and 2009, helping to reduce the risk of stroke and heart attack for patients.
And speaking of soaring, accountable care organizations are flooding the healthcare landscape; with the number of public and private ACOs nearing 500, participants and
pundits alike are looking more closely at the model's structure, challenges and benefits.
How is your organization participating in ACOs? Take HIN's third annual survey on
ACOs by September 6, 2013 and receive 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].
Associate Editor: Jessica Fornarotto, [email protected]
Publisher: Melanie Matthews, [email protected]
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August 26, 2013
Vol. XV, No. 32
Sponsored by:
Medicare Pioneer ACO Year One Lessons from a Top-Performer
This week's industry news:
- Young Adults Value Health Insurance But Can’t Afford It
- Healthcare Trends & Forecasts in 2013
- Navigators Guide Consumers through Health Insurance Marketplace
- Health Insurance Exchanges
- Healthcare Business White Paper: Mobile Health in 2013
- Blood Pressure Control Rates Nearly Double with Kaiser Permanente Program
- New Chart: Where are Case Managers Embedded?
- Guide to Improving Medication Adherence
- Patient-Clinician Communication Critical During Transitional Care: Study
- Guide to Care Transition Management
- 6 Best Practices for Physician Pay-for-Performance Programs
- Guide to Value-Based Reimbursement
- Infographic: Home Health Patients Versus All Medicare Beneficiaries
- Health Coaching’s Value in Accountable Care and Medical Homes
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.
Missed the last issue? Read it here.
Join our Online Communities:
Take our monthly e-survey:
Accountable Care Organizations in 2013
You'll be emailed a synopsis of the survey results.
Interested in all open surveys?
Review them here.
This week's industry news
1.) Young Adults Value Health Insurance But Can’t Afford It
Nearly half of the 15 million young adults enrolled in a parent’s health plan last year most likely would not have been eligible for coverage without the health reform law’s
dependent coverage provision, according to a new Commonwealth Fund survey.
Get the full story.
>>Return to this week's industry news
2.) Healthcare Trends & Forecasts in 2013: Performance Expectations for the Healthcare Industry
This resource provides sector-specific guidance for the next 12 months from three key thought leaders in HIN’s ninth annual industry forecast.
Learn more about this resource.
>>Return to this week's industry news
3.) Navigators Guide Consumers through Health Insurance Marketplace
Designed to help consumers navigate the health insurance marketplaces (HIEs), the HHS has granted $67 million in awards to 105 applicants in federally run and state
partnership marketplaces.
Get the full story.
>>Return to this week's industry news
4.) Health Insurance Exchanges: Product Design, Promotion and Positioning
This resource features insights from key industry consultants, state regulators and health insurers on the primary issues that will affect product designs for state health
insurance exchanges.
Learn more about this resource.
>>Return to this week's industry news
5.) Healthcare Business White Paper: Mobile Health in 2013 Diabetes, Heart Disease Top Targets for Technologies
The use of mobile health (mHealth) technologies has transformed the exchange of healthcare data, with mobile apps monitoring everything from blood sugar to medication adherence,
and text-based reminders urging smokers not to give into that craving. In its first mHealth e-survey conducted in March 2013, the Healthcare Intelligence Network (HIN) captured
current trends in emerging mHealth technologies. Nearly 150 healthcare organizations describe the technologies they use, the conditions and populations they target, and the
challenges and successes they've encountered along the way.
Download this complimentary white paper.
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6.) Blood Pressure Control Rates Nearly Double with Kaiser Permanente Program
Single pill combinations and consistent follow-ups with hypertension patients helped improve the rate of blood pressure control by nearly twice as much, according to a study at
Kaiser Permanente, as reported in the Journal of the American Medical Association (JAMA).
Get the full
story.
>>Return to this week's industry news
7.) New Chart: Where are Case Managers Embedded?
According to nearly 57 percent of healthcare companies, the primary care office is where their case managers are embedded. We wanted to see at which other care sites case
managers are embedded.
Click here to view the chart.
>>Return to this week's industry news
8.) Guide to Improving Medication Adherence
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.
Learn more about this resource.
>>Return to this week's industry news
9.) Patient-Clinician Communication Critical During Transitional Care: Study
One in five patients are ending up back in the hospital due to faulty communication between doctors and patients, according to two studies from Yale School of Medicine, and
published in the Journal of Hospital Medicine (JHM), and JAMA Internal Medicine (JAMA IM).
Get the full
story.
>>Return to this week's industry news
10.) Guide to Care Transition Management
This resource delivers a comprehensive set of 2013 transitional care management benchmarks from 86 companies as well as select metrics from related interventions influencing the
quality of care transitions: Medication Adherence, Reducing Readmissions, Case Management, Patient-Centered Medical Home and Health Coaching.
Learn more about this resource.
>>Return to this week's industry news
11.) 6 Best Practices for Physician Pay-for-Performance Programs
In order to ensure the success of a best practice project for pay-for-performance programs, there are several requirements, including finding a physician to champion and truly
lead it, and targeting as large a population as possible, explains Julie Hobson, RN, BSN, manager of provider engagement, performance and partnership at Highmark, Inc.
Get the full story.
>>Return to this week's industry news
12.) Guide to Value-Based Reimbursement: Profiting from Payment Bundling, PHO Shared Savings, and Pay for Performance
This resource explores emerging models of episode-based payments, physician-hospital organizations (PHOs) and physician bonus structures.
Learn more about this resource.
>>Return to this week's industry news
13.) Infographic: Home Health Patients Versus All Medicare Beneficiaries
In recent years, the home health benefit has been hit with spending cuts, which have the potential to directly impact the services offered to vulnerable Medicare recipients.
Seventy-eight percent of Medicare's Home Healthcare Patients are non dual-eligible patients and are not covered by Medigap insurance, according to a new infographic from the
Partnership for Quality Home Healthcare. This infographic explains the differences between Medicare home health beneficiaries and the average Medicare beneficiary, as well as
the most chronic conditions treated by home health.
Read this blog post.
>>Return to this week's industry news
14.) Health Coaching’s Value in Accountable Care and Medical Homes
Primary care and the patient-centered medical home offer a great opportunity for health coaches to become allies with patients in improvement of their health, notes William
Appelgate, executive director of the Iowa Chronic Care Consortium. Individuals with the highest health risks should be given priority, but those on the cusp of a serious
health event also merit coaching assistance, he says. For providers new to the coaching conversation, Appelgate shares three benefits of incorporating health coaches in the care
process including the upping of their ‘outcomes game.’
Listen to this podcast.
>>Return to this week's industry news
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