From the editor
Dear Healthcare Intelligence Network Client,
There is no place like home visits to address safety issues, and patient care concerns. Despite the explosion of mobile and telehealth technologies, there is no substitute for person-to-person contact - at least when it comes to populations at high risk of hospital admission or readmission, the results of the Healthcare Intelligence Network's inaugural Home Visits study indicate. Three-fourths of healthcare organizations visit some percentage of their patients or health plan members in their homes in order to keep patients safer and healthier and to keep readmissions and costly utilizers at bay.
But there is a time and place for telehealth technology, and new research in the journal Medical Care shows that diabetics who used an online patient portal to refill medications and schedule their appointments, among other tasks, increased their medication adherence and improved their cholesterol levels by 6 percent, compared to occasional users or non-users. Researchers say the current study provides new evidence that patient portals may help patients adhere to their medications and achieve improved health outcomes.
About one-quarter of Americans potentially eligible for health coverage visited insurance marketplaces by December, up from 17 percent in October, according to a new Commonwealth Fund survey. Forty percent of these visitors were young adults; three-quarters said they were in good health; and more than half said they are likely to try to enroll by the March 2014 deadline. The survey, conducted between December 11 and 29, 2013, is the second in a series aimed at tracking Americans' experiences with the marketplaces in the ACA's first open enrollment period. The first Commonwealth Fund survey, conducted in October, found that 17 percent of people potentially eligible for coverage had visited the marketplaces during the first month.
Despite increasing scrutiny on hospital pricing practices, some U.S. hospitals are charging more than 10 times their cost, or nearly $1200 for every $100 of their total costs, according to new data released by National Nurses United (NNU) and the Institute for Health and Socio- Economic Policy (IHSP).
The 100 most expensive hospitals listed charge 765 percent and higher, more than double the national average of 331 percent, the report says. Fourteen U.S. hospitals charge more than $1,000 for every $100 of their total costs (a charge to cost ratio of 1,000 percent) topped by Meadowlands Hospital Medical Center in Secaucus, NJ, which has a charge-to-cost ratio of 1,192 percent. California, with a statewide average of 451 percent charge to cost ratio, ranks third overall in the United States. The detailed report includes the most expensive hospitals, the top 10 for each state, and the 50 most expensive hospital systems.
Discussions about end-of-life care for adults are never easy; they are even more difficult when they concern children. The National Institute of Nursing Research (NINR) has launched a new campaign, Palliative Care: Conversations Matter, that is designed to help children and families navigate a serious illness, and better inform them of supportive resources. A component of the National Institutes of Health (NIH), it brings together parents and palliative care clinicians, scientists, and professionals, who give their input and expertise on what they feel is needed in the field. Don't miss the video which tells one mother's story about her daughter's bout with neuroblastoma and how palliative care helped them through it.
You can share your organization's work in palliative care in our current e-survey: 10 Questions on Palliative Care. With more organizations focusing on palliative care as a means to enhance the patient experience during advanced or terminal illness, many are strategizing new ways to assess and address patients' needs at this time, from consultations in the ED to face-to-face evaluations in outpatient clinics. Describe your organization's efforts in palliative care by February 7, 2014 and you will receive a free summary of survey results once it is compiled.
Our congratulations to one of our survey participants, Timothy Price, a market research analyst with Caresource, who was randomly selected as the winner of our training DVD from our 10th annual Healthcare Trends & Forecasts webinar.
This resource explores emerging models of episode-based payments, physician-hospital organizations and physician bonus structures. 
This resource is HIN's ninth annual industry forecast. It provides both a handle on what's keeping healthcare CEOs up at night and a dream prescription for sounder program management this year. 
The number of accountable care organizations led by a physician-hospital organization (PHO) nearly doubled over the last year, according to the third annual ACO survey conducted by the Healthcare Intelligence Network. As the ACO model finds its feet, administration has changed hands from hospitals in 2011 to physician-led in 2012 to PHOs in 2013 - a year when the number of public and private ACOs in the country swelled to almost 500. Almost one in three ACOs is PHO-led. Download this HINtelligence report for more data on ACO trends in 2013 as reported by 138 healthcare companies, including ACO program components, results and ROI, and the greatest successes achieved by accountable care organizations in respondents' own words. 
Sustained growth in emerging reimbursement models, including accountable care, bundled payments and shared savings, will continue to impact innovation within the healthcare industry in 2014 as providers and payors struggle to find more ways to reduce costs within their systems and better manage the care they provide. We wanted to see the impact of ACA's health insurance marketplaces on health plans in 2014.
This resource examines Aetna's Compassionate Care program, a case management approach for the advanced illness population, and breaks down barriers commonly encountered in this highly sensitive stage of the health continuum while positively impacting both healthcare utilization and spend. 
This resource provides actionable information from more than 100 healthcare organizations on efforts to improve medication adherence and compliance in their populations. 
This resource examines the latest trends in home visits for medical purposes, from the populations visited to top health tasks performed in the home to results and ROI from home interventions. 
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).