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From the editor Dear Healthcare Intelligence Network Client,
Emergency physicians are increasingly picking up the slack left by difficult or unsuccessful transitions of care, says a new study from the Perelman School of Medicine at the University of Pennsylvania, but these visits, often within 30 days of hospital discharge, are not being counted as hospital readmissions unless they are admitted as inpatients. In fact, as many as one in four patients discharged from the hospital end up right back there as emergency patients. Failure to measure these visits is leading to faulty hospital utilization and care transition assessments, and needs to be addressed, say researchers. Details inside. Transforming healthcare payments from a fee-for-service (FFS) system to one that rewards quality and value also needs to be addressed, and is one of five recommendations aimed at improving healthcare quality while lowering costs nationwide. The recommendations, from five national healthcare organizations and nationally prominent advocates for employers, insurers, consumers, healthcare providers and others, is the result of a yearlong discussion funded by the Robert Wood Johnson Foundation. Among the recommendations: providing a tiered reimbursement strategy that links payment directly to effectiveness, and encouraging consumers to select high-performing providers. Another strategy for reducing healthcare costs: taking an innovative approach to classifying patient populations, so that health systems can more effectively prevent “triple fail” events — or outcomes that fail to advance population health, reduce healthcare costs and improve patient experiences and satisfaction, according to a recent Walgreen's study published in Health Affairs. Researchers examine how classifying (or ‘stratifying’) patients according to individual risk and expected response to an intervention can further the “Triple Aim.” The Triple Aim framework, created by the Institute for Healthcare Improvement (IHI), asks that health systems evaluate performance by simultaneously pursuing three dimensions: improved patient experience of care (including quality and satisfaction), improving population health and reducing per capita cost of healthcare. Identifying the main drivers of cost in a Physician Hospital Organization (PHO) population, and then the biggest cost consumers, are key toward managing that population, says Greg Mertz, MBA, FACMPE, director of consulting operations, Healthcare Strategy Group, in our upcoming book, Essential Guide to Physician-Hospital Organizations: 7 Key Elements for PHO Success, which describes describes the seven critical areas of PHO development. And lastly, despite the rising popularity of mobile health, and smartphone apps for monitoring everything from blood sugar to heart rhythms, the practice of health coaching remains a critical tool in population health management, helping to boost self-management of disease and reduce risk and associated cost across the health continuum, according to the latest e-survey from the Healthcare Intelligence Network (HIN). The telephone remains the chief modality for health coaching delivery, according to our infographic: "Health Coaching's Call to Manage Weight and Chronic Disease." Weight and chronic disease management remain the top two areas addressed by coaching, but in terms of populations, those considered 'well' are just as likely to receive coaching today as those with chronic diseases. 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
Contact HIN:
This week's featured download: Medication Adherence in 2013 — Closer Look at Compliance During Care Transitions
Medication Adherence in 2013 — Closer Look at Compliance
During Care Transitions
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April 15, 2013
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This week's industry news
1.) 1 in 4 Patients Back in ER Within 30 Days of Hospital Discharge
2.) 2012 Healthcare Benchmarks: Reducing Avoidable ER Visits
3.) 5 Recommendations for Improving Healthcare Quality While Lowering Costs
4.) Guide to Physician Performance-Based Reimbursement: Payoffs from Incentives, Data Sharing and Clinical Integration
5.) Healthcare Business White Paper: Health Coaching in 2013 — Weight, Chronic Disease Top Targets in Telephonic Field
6.) New Stratified Approach Toward Achieving Triple Aim for ACOs: Study
7.) New Chart: Top Health Professionals Responsible for Improving MA
Click here to view the chart.
8.) Guide to Accountable Care Organizations
9.) Health Coaching Conversation Happens Largely by Telephone: HINfographic Health coaching is a critical tool in population health management, helping to boost self-management of disease and reduce risk and associated cost across the health continuum, according to the latest e-survey from the Healthcare Intelligence Network (HIN). Get the full story. >>Return to this week's industry news
10.) 2013 Healthcare Benchmarks: Health Coaching
11.) Analyzing the PHO Population for Cost-Effectiveness
12.) Essential Guide to Physician-Hospital Organizations: 7 Key Elements for PHO Success
13.) Infographic: Ohio Hospitals Rank Facebook As Their Most Important Social Media Channel
14.) Improving CMS Star Quality Ratings
Thank you for your readership! Please urge your colleagues to subscribe by forwarding this email or visiting http://www.hin.com/freenews2.html or by calling (888) 446-3530 or visiting the 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 resource is designed to meet business and planning needs of hospitals, health plans, physician practices and others by providing critical benchmarks that show how the industry is working to reduce avoidable
hospital ED visits. This second annual collection of data points on this aspect of ER utilization management presents year-over-year trends and suggests how to engage the primary care physician, urgent care centers
and patient education tools in these efforts.
This resource explores newly minted reimbursement formulas at two health plans and two independent practice associations (IPAs), providing payor and provider perspectives on the formula development process;
clinical, quality and efficiency measures in use; physician incentive payments and program outcomes.
In its fourth Health Coaching e-survey conducted in January 2013, HIN captured the ways in which healthcare organizations implement health coaching as well as the financial and clinical outcomes that result from this
health improvement strategy. HIN found that 75 percent of respondents have a health coaching program in place, a slight increase of 5 percent over 2010, the last year the survey was conducted. This HINtelligence
Report provides data highlights on health coaching program components, the most successful tools and workflows in health coaching, results, reimbursement and ROI; and more.
According to the more than 100 healthcare companies who responded to HIN's latest medication adherence (MA) e-survey, nearly 51 percent say that nurses have primary responsibility for improving MA in their
population. We wanted to see which other healthcare professionals are considered responsible for improving MA.
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 guidelines for physician-led ACOs.
This resource presents actionable new data on overall health coaching activity, with the latest metrics on the prevalence of health coaching, program components, delivery methods, preferred behavior change models,
coaching case loads, ROI, future programs and much, much more.
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.
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).