Archive for September, 2007

Healthcare Trends and Forecasts in 2008

September 27th, 2007 by Melanie Matthews

Coping with provider disbelief is a huge challenge for health plans and hospitals alike, but Dr. Peter Kongstvedt, a partner in the health and managed care consulting services division of Accenture, says including the provider in the process is most important. Click here to listen to Dr. Kongstvedt’s comments.

Dr. Kongstvedt comments on how to effectively use new media in today’s healthcare arena, as well as what many healthcare organizations are calling the biggest road block pay for performance initiatives during an October 10, 2007 audio conference Healthcare Trends and Forecasts in 2008.

Disease Management Update

September 27th, 2007 by Melanie Matthews

This week’s Disease Management Update looks at Alzheimer’s disease and Parkinson’s disease and certain factors that can trigger or suppress these illnesses. Don’t forget to read our blog entry about the Medicare Advantage Special Needs Plan for Alzheimer’s disease and chronic dementia patients as well as some stats from the National Institute of Mental Health.

System Should Cover Mind and Body

September 24th, 2007 by Melanie Matthews

In this week’s news…

According to the National Institute of Mental Health (NIMH), an estimated 26.2 percent of Americans ages 18 and older ­- about one in four adults ­- suffers from a diagnosable mental disorder in a given year. The NIMH Web site also reports that the burden of mental illness on health and productivity in the United States accounts for over 15 percent of the total burden of disease — more than the disease burden caused by all cancers. That’s why a bill recently passed by the U.S. Senate requiring health insurers to provide equal amounts of coverage for mental and physical illnesses should help ease the burdens on both sufferers of mental disorders and the economies to which they contribute.

Also chronicled in this week’s Healthcare Business Weekly Update is a first-ever Medicare Advantage Special Needs Plan for Alzheimer’s disease and chronic dementia patients, to be launched by Evercare in Arizona. The coverage, benefits and services are intended to meet the specific needs of this population.

The debilitating effects of mental and dementia-related illnesses cause many sufferers to fall through healthcare system cracks. If your organization has found a way to locate and engage hard-to-reach cleints and members, please share your strategies by responding to HIN’s monthly e-survey. You’ll receive a free e-summary of the results.

The Importance of the Brown Bag Medication Review

September 20th, 2007 by Melanie Matthews

Polypharmacy problems discussed in the New York Times—why so many discharge planners are focusing on medication reconciliation to improve care transitions for the elderly.

Doctor-Patient Communication is Key in Asthma Management

September 20th, 2007 by Melanie Matthews

Asthma is a serious condition. It affects upwards of 30 million people in the United States and over 300 million people worldwide — which makes it extremely important for primary care physicians (PCP) to discuss this chronic disease with their patients who have it. However, the contrary seems to be true, as most people with asthma who take medication rarely discuss the condition or medication side effects with their doctors, according the Global Asthma Physician and Patient survey (GAPP).

Doctor-patient communication is a crucial factor in asthma management. What are some things you can do differently with your patients to ensure the best outcomes when dealing with this chronic disease?

1. Develop an asthma action plan with your patient. According to national guidelines for asthma management, PCPs must write and discuss treatment plans with their asthma patients. Such action plans encourage open communication between doctors and patients.

2. Discuss the condition and the asthma action plan with your patients. Keep their action plan timely by encouraging patients to tell you when and how their condition is changing. Encourage your asthma patients to visit at least once every six months. As a PCP, it is critical that you have the most recent up-to-date information on your patient’s asthma. Encourage patients to keep an asthma symptoms diary as well.

3. Identify what triggers your patients’ asthma the most. Help them to limit their exposure to the worst one and to control triggers in the home.

4. Encourage asthma patients to become familiar with first aid procedures for managing asthma-related emergencies.

5. Promote healthy eating habits and exercise in your asthma patients. According to a recent study, children who are obese at the time of puberty are three times more likely than their peers to suffer from asthma in their teens. Further, some studies say obese adults are three times more likely to develop asthma than thinner adults.

A “Perfect” Case of Nurse Empowerment

September 17th, 2007 by Melanie Matthews

In this week’s Healthcare Business Weekly Update, a recent survey of nurses cautions that hospitals will be shy 340,000 RNs by 2020 if management and employee orientations don’t improve. Today’s 70 percent turnover in nursing can’t be good for continuity and quality of patient care — or a hospital’s quality ratings. When seeking to better patient outcomes and satisfaction, don’t underestimate the power of a satisfied and motivated workforce.

Case in point: Lenore Blank and Michele “Mickey” Gilbert — two nurse practitioners at Hackensack University Medical Center (HUMC) who coordinate HUMC’s award-winning heart failure team. A model in continuity of care and nurse empowerment, the team has earned a berth on the Pursuing Perfection healthcare quality initiative from the Institute of Healthcare Improvement. Read about the power of their initiative in this week’s Worth Repeating.

If you’re inspired to hear more, click here to listen to an audio interview with Lenore Blank.

Baby Boomers are Linked In: Opportunity for DM and Wellness Programs?

September 13th, 2007 by Melanie Matthews

The New York Times reports that baby boomers are using social networking sites more often. Is this an opportunity for healthcare organizations to be-“friend” this population? Or at least be flies on the “walls” of these healthcare consumers?

Does a social networking site pose an opportunity for health coaching and in-home monitoring?

September 13th, 2007 by Melanie Matthews

Pay for Performance Programs and “Provider Disbelief”

September 12th, 2007 by Melanie Matthews

In last Tuesday’s New York Times, infectious disease physician Manoj Jain M.D. explains four reasons for physician reluctance to endorse or participate in a pay for performance program. The medical director for Medicare’s quality improvement organizations in Tennessee and Georgia says doctors are loyal to fee-for-service systems.

His comments echo what we’re hearing from the industry. During a June 2007 non-scientific e-survey on pay for performance (PFP) in healthcare, fewer than half of the 157 respondents said their organizations participate today. An oft-cited roadblock to implementation is provider/stakeholder buy-in. One respondent blamed the reticence on “provider disbelief.”

A creative approach from one respondent: Run the numbers and show providers how much money they’ve lost by not submitting timely data and not getting members and patients in for recommended screenings.

Unintended Consequences of Pay for Performance

September 10th, 2007 by Melanie Matthews

Unintended consequences. According to Wikipedia, the free online encyclopedia and everyone’s new favorite news source, these are “situations where an action results in an outcome that is not (or not only) what is intended.” In discussing the unintended consequences of public reporting and pay for performance (PFP) in healthcare this week, Dr. Dale Bratzler said incentives that stimulate and accelerate quality improvement often result in direct or indirect harm to patients. If attention shifts to incentive-based conditions, he warned, some providers might turn away high-risk patients or treat payment-based rather than life-threatening cases first. This week, we report on Cardinal Health’s new reporting method for PFP that relies on clinical rather than administrative data, a step toward enriching reported data and reporting transparency.

More unintended consequences: Relying on public data to track Medicaid clients that may not keep pace with this transient population means some clients miss out on much-needed care. So sometimes unorthodox resources — like delivery records from a pizza service — can be the key to locating elusive clients. This worked for one health plan that surmised (correctly) that transient clients often order takeout meals. To share your strategies and find out how your colleagues track down and engage hard-to-reach clients, take this month’s online survey .

Respond by September 30 and we’ll email you a free summary of the results so you can get these types of innovative strategies for tracking down hard-to-reach members and patients.