Monthly Archives: January 2014

3 Barriers to Care Management of Advanced Illness

Among the barriers care managers face in treating those with advanced illness are determining a prognosis that’s amenable to the patient and caregivers, says Joseph V. Agostini, MD, senior medical director of Aetna Medicare. Part of the problem is that … finish reading 3 Barriers to Care Management of Advanced Illness

Posted in affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Care Coordination, Care Transitions, Case Managers | Tagged , , | Leave a comment

Savings from Medicare ACOs, Pioneer ACOs Exceed $380 Million: CMS

Initial financial results for a number of CMS healthcare reform delivery initiatives are positive, with savings from both the Medicare Accountable Care Organizations (ACOs) and Pioneer ACOs exceeding $380 million, according to the CMS. Interim reports on select Medicare ACO … finish reading Savings from Medicare ACOs, Pioneer ACOs Exceed $380 Million: CMS

Posted in Accountable Care Organizations, affordable care act, Bundled Payments, Healthcare Costs, Healthcare Reform | Tagged , , , | Leave a comment

3 Proposals Allowing People to Keep Health Insurance Won’t Threaten Marketplaces

Three plans allowing people to keep their individual health insurance policies even if they don’t meet the requirements of the federal Affordable Care Act (ACA) are unlikely to threaten new health insurance marketplaces, according to a new RAND Corporation study. … finish reading 3 Proposals Allowing People to Keep Health Insurance Won’t Threaten Marketplaces

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40 Percent of Health Plan’s Star Rating Attributed to Regional Variation

Nearly 40 percent of a health plan’s CMS Five-Star Quality rating can be explained by the quality of the providers in a given county or region, says Joseph Johnson, vice president of L.E.K. Consulting. Here he points out where those … finish reading 40 Percent of Health Plan’s Star Rating Attributed to Regional Variation

Posted in Healthcare Costs, Healthcare Utilization, Improving Patient Care | Tagged , , , | Leave a comment

Care Managers in Medical Homes Contribute to Improved Diabetes Outcomes

Patient-centered medical homes (PCMHs) are an effective way to help care for patients with chronic diseases such as diabetes, and placing care managers in them further improve patient outcomes for high-risk diabetes patients, according to a study conducted at Joslin … finish reading Care Managers in Medical Homes Contribute to Improved Diabetes Outcomes

Posted in Care Coordination, Case Managers, Case Managers and the Patient Experience, Diabetes, Disease Management, Embedded Case Manager | Tagged , , , | Leave a comment

HSAs Growing, Health Reimbursement Accounts Declining for First Time

While account-based health plans continue to expand, a shift in account types may suggest a change in how the accounts are funded, according to new research from the nonpartisan Employee Benefit Research Institute (EBRI). The latest data, from the 2013 … finish reading HSAs Growing, Health Reimbursement Accounts Declining for First Time

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New Hospital to Home Initiative Improves Strategies to Prevent Readmissions

Participation in a new hospital to home quality improvement initiative has helped to improve hospital readmission strategies, including tracking discharged patients and partnering with local hospitals, according to a study published in JAMA Internal Medicine. Researchers from the American College … finish reading New Hospital to Home Initiative Improves Strategies to Prevent Readmissions

Posted in Avoidable Hospitalization, electronic health records (EHRs), Hospital Readmissions, Reducing Healthcare Costs | Tagged , , , | Leave a comment

CMS, Maryland Work to Modernize State’s Healthcare System

CMS and the state of Maryland have launched a new initiative designed to modernize Maryland’s unique all-payor rate-setting system for hospital services aimed at improving patient health and reducing costs. It will replace Maryland’s 36-year-old Medicare waiver and allow the … finish reading CMS, Maryland Work to Modernize State’s Healthcare System

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States’ Restrictions on ACA Implementation Hinder Access to Coverage

Community health centers across the country are waging intensive efforts to find and enroll eligible and uninsured patients and community residents, but are hampered by states resistant to healthcare reform, according to the Geiger Gibson/RCHN Community Health Foundation Research Collaborative … finish reading States’ Restrictions on ACA Implementation Hinder Access to Coverage

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Identifying High Utilizers First Step in Reducing Readmissions

Businesses do it all the time — analyze their repeat customers, and market to them, says Susan Horton, DNP, APRN, CHFN, VP of peri-operative services at Central Maine Medical Center and executive director of the Central Maine Heart and Vascular … finish reading Identifying High Utilizers First Step in Reducing Readmissions

Posted in Emergency Room, Hospital Training, Improving Patient Care | Tagged , , | Leave a comment