Category Archives: Avoidable Hospitalization

Pioneer ACO Results Year 2: Inpatient Utilization Down; Medicare Saves More Than $384 Million

The Pioneer Accountable Care Organization (ACO) Model has generated over $384 million in savings to Medicare over its first two years — an average of approximately $300 per participating beneficiary per year — and significantly decreased inpatient care, while continuing … finish reading Pioneer ACO Results Year 2: Inpatient Utilization Down; Medicare Saves More Than $384 Million

Posted in Accountable Care Organizations, affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Care Coordination, Care Transitions, Disease Management, dual eligibles, Elderly Care, Improving Patient Care, Medicare | Tagged , , , , , | Leave a comment

Evidence-Based Care, Obesity Among 15 ‘Vital Signs’ for Monitoring Nation’s Health: IOM Report

Tracking 15 core measures, including evidence-based care and obesity, are crucial for assessing and monitoring the nation’s health, according to a new report from the Institute of Medicine (IOM). Progress in these vital signs—or core measures— should reduce the burden … finish reading Evidence-Based Care, Obesity Among 15 ‘Vital Signs’ for Monitoring Nation’s Health: IOM Report

Posted in affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Care Coordination, Disease Management, Elderly Care, electronic health records (EHRs) | Tagged , , , | Leave a comment

Senate’s Repeal of Medicare Sustainable Growth Rate Strengthens Move Toward Value-Based Physician Reimbursement

The U.S. Senate voted Tuesday, April 14th, to approve a bill that repeals the Medicare Physician Payment Reform Bill, otherwise known as the Sustainable Growth Rate (SGR), a mechanism used to calculate Medicare payments to physicians. The legislation also created … finish reading Senate’s Repeal of Medicare Sustainable Growth Rate Strengthens Move Toward Value-Based Physician Reimbursement

Posted in affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Improving Community Care, Improving Patient Care | Tagged , , | Leave a comment

EDs Seeing More Patients with Complex, Chronic Conditions, Mental Illness; Fewer Injuries

The rate of emergency department (ED) visits in California for non-injuries has risen while the rate of visits for injuries has dropped, according to a new study led by UC San Francisco that documents the increasing amount of care provided … finish reading EDs Seeing More Patients with Complex, Chronic Conditions, Mental Illness; Fewer Injuries

Posted in Alternative Healthcare Coverage, Avoidable Hospitalization, Behavioral Health, Disease Management, Emergency Room, Hospital Readmissions, Hospital Safety, Hospital Services, Reducing Healthcare Costs | Tagged , , , | Leave a comment

Mental Health Disorders Complicate Standards for Readmissions

Co-existing psychiatric illness should be considered in assessing hospital readmissions for three common medical conditions used by Medicare and Medicaid to penalize hospitals with “excessive” readmission rates: heart failure, acute myocardial infarction (AMI) and pneumonia, according to a new collaborative … finish reading Mental Health Disorders Complicate Standards for Readmissions

Posted in affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Behavioral Health, Cardiac Care, Care Coordination, Hospital Readmissions, Improving Community Care, Improving Patient Care, Reducing Healthcare Costs | Tagged , , , , , , | Leave a comment

Humana Accountable Care Snapshot: Reduced Readmissions Among Value-Based Results

Improving access to accountable care is one of four improvements Humana disclosed from ongoing programs to improve quality and reduce costs for Medicare beneficiaries, according to Humana. Humana disclosed results to date from initiatives to foster value-based reimbursement in the … finish reading Humana Accountable Care Snapshot: Reduced Readmissions Among Value-Based Results

Posted in Accountable Care Organizations, affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Bundled Payments, Care Coordination, Elderly Care, Healthcare Costs, Medicare | Tagged , , , , , | Leave a comment

Physicians Need Help with Details, Data Management in New Value-Based Payment Models: Study

As value-based healthcare payment models continue to surge, physician practices need help managing increasing amounts of data and responding to the diversity of programs and quality metrics from different payors, according to a new joint study by the RAND Corporation … finish reading Physicians Need Help with Details, Data Management in New Value-Based Payment Models: Study

Posted in affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Bundled Payments, Care Coordination, Clinical Integration | Tagged , , | Leave a comment

CMS 2015 Impact Assessment of Quality Measures: Healthcare’s Triple Aim Improved

Results from the 2015 National Impact Assessment of Quality Measures Report (2015 Impact Report) demonstrate progress in improving healthcare’s Triple Aim, and impacts populations beyond Medicare, according to the CMS. The report is a comprehensive assessment of quality measures used … finish reading CMS 2015 Impact Assessment of Quality Measures: Healthcare’s Triple Aim Improved

Posted in affordable care act, Avoidable Hospitalization, CMS Acute Care Episode, Disease Management, dual eligibles, Elderly Care, Healthcare Costs, Healthcare Utilization, Population Health Management | Leave a comment

Colorado Hospital Engagement Network Reduces Healthcare Costs by $15 Million, Avoidable Readmissions by 11 Percent

Colorado hospitals and health systems participating in a three-year quality improvement project led by the Colorado Hospital Association (CHA) prevented 2,800 patient harms, 1,250 of which were avoidable readmissions, for an estimated cost savings of $14.8 million, according to the … finish reading Colorado Hospital Engagement Network Reduces Healthcare Costs by $15 Million, Avoidable Readmissions by 11 Percent

Posted in affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Bundled Payments, Care Coordination, Clinical Integration, Disease Management, Hospital Readmissions, Hospital Safety, Hospital Services, Hospital Training, Improving Patient Care | Tagged , , , , | Leave a comment

Advanced Primary Care Initiatives Reduce Hospital Admissions, ED Visits: CMS

Preliminary findings from two advanced primary care initiatives from CMS show decreased hospital admissions and emergency department (ED) visits, CMS officials report. The two large-scale tests of advanced primary care—the Comprehensive Primary Care (CPC) initiative and the Multi-Payer Advanced Primary … finish reading Advanced Primary Care Initiatives Reduce Hospital Admissions, ED Visits: CMS

Posted in Accountable Care Organizations, affordable care act, Avoidable Hospitalization, Care Coordination, Case Managers, Healthcare Reform, Healthcare Spending, Physician Organizations, Population Health Management | Tagged , , , , | Leave a comment