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This week's industry news

1.) CMS Announces Major Savings for Medicare Beneficiaries

Medicare beneficiaries are seeing significant out-of-pocket savings due to the Affordable Care Act (ACA), according to the Centers for Medicare and Medicare Services (CMS).

Get the full story.

2.) Managed Medicare and Medicaid Factbook: 2013

This resource presents all-new information on enrollment, benefit designs, company activity and trends for the Medicare Advantage, Medicare Part D and managed Medicaid programs.



Learn more about this resource.

3.) Pediatric Mental Health Diagnoses Jump 30 Percent in Last Four Years

Pediatricians are seeing an increase in behavioral health problems among children, including sharp increases in Attention Deficit Hypertension Disorder (ADHD), anxiety, depression, and eating disorders, according to a study from athenahealth, Inc.

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4.) Emergency Room Triage of the Mental Health Patient: Pilot Projects in Reducing ED Diversion

This resource describes how two emergency department veterans' backup plans are sometimes necessary to manage the flow of behavioral health patients in the emergency room.



Learn more about this resource.

5.) Healthcare Business White Paper: Dual Eligibles Care Management in 2013 - Case Management, Education Boost Compliance, Satisfaction

Education and engagement are key to managing the health of dual eligibles but also the most formidable challenges, say a third of respondents to a new survey on Care Management 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.

Download this complimentary white paper.

6.) Hospital Errors Third Leading Cause of Death in United States

Nearly 440,000 Americans are dying annually from preventable hospital errors, making them the third leading cause of death in the United States, according to a Fall 2013 update to The Leapfrog Group Hospital Safety Score report.

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7.) New Chart: Top 5 Challenges of Home Visits

Forget yesterday's house calls: doctor and dusty medical bag tending a swooning patient. Today's home visits provide a unique perspective on the patient experience while helping individuals meet everyday needs, avoid rehospitalization or an ER visit, and connect with community resources. We wanted to see what the top five challenges are for conducting home visits.

Click here to view the chart.

8.) Guide to Reducing Medicare Readmissions, Vol. II

This resource examines innovative interventions to reduce preventable admissions, rehospitalizations and ER visits by high-utilizing Medicare beneficiaries, by looking at four multidisciplinary collaborative interventions aimed at key factors fueling readmissions in this population.

Learn more about this resource.

10.) Formula for CMS Five-Star Quality Population Health Management

This resource examines star quality improvement strategies, including this "star czar's" successful care management efforts that have made it a leader in the five-star space.



Learn more about this resource.

11.) PHO 2.0: Opportunities Abound in Physician- Hospital Organization Model

With acquisition and consolidation rampant on the value-based healthcare landscape, it's time to take another look at the physician-hospital organization (PHO) model, suggest healthcare thought leaders Travis Ansel, manager of strategic services, Healthcare Strategy Group, and Greg Mertz, director of consulting operations, Healthcare Strategy Group.

Get the full story.

12.) Essential Guide to Physician-Hospital Organizations: 7 Key Elements for PHO Success

This resource describes the seven critical areas of PHO development, from defining the PHO mission to creating a data environment conducive to registry use, analytics and active patient management.



Learn more about this resource.

13.) Infographic: The Prescription Drug Price Tsunami - Are We Powerless?

Prescription drugs use are the source of a significant amount of healthcare costs. Over the last decade, the percentage of Americans using five or more prescription drugs increased by 70 percent, according to a new infographic from Healthcoverageally.com.

 Read this blog post.

14.) A Strategic, Best Practice Approach to Improve CMS Star Quality Ratings

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).
 

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