Archive for June, 2010

Reversing the Quality Trend: Why Aren’t We Better?

June 28th, 2010 by Patricia Donovan

Three years after the last Commonwealth Fund international health system comparison, the news hasn’t changed much. Even with one more country — the Netherlands — added to the mix, the U.S. healthcare system still ranks last in six key performance areas. A featured story in this week’s Healthcare Business Weekly Update, the report highlights glaring inefficiencies in a system that spent nearly twice as much per capita — $7,290 — on healthcare in 2007 as did the first-ranked Netherlands healthcare system.

This year, the U.S. once again placed last when it comes to providing safe care, and next to last on coordinated care. Happily, there are some movements on the horizon to reverse these trends. This week we profile Kaiser’s Safe Transitions program that is reducing medication-related adverse events in the payor’s skilled nursing facility population.

You’ll also read about a NJ-based collaborative of 50 healthcare organizations doing its part to improve system efficiency by reducing hospitalizations and readmissions among patients with heart failure. The CDC estimates that heart failure will cost the United States $39.2 billion in 2010 — in healthcare services, medications, and lost productivity.

Kaiser Targets Preventable ED Visits

June 28th, 2010 by Melanie Matthews

Over the course of the last 18 months, Kaiser Permanente in Colorado has taken a very hard look at its ED utilization across its population, according to Sara Gray, senior manager of emergency services at Kaiser Foundation Health Plan of Colorado.

Kaiser found that avoidable and unnecessary emergency department visits accounted for upwards of 20 percent of its approximately 72,000 ED visits per year, which is not an insignificant amount of time and energy and resources being spent on things that may be better treated in other locations, she added.

Additionally like many health plans, Kaiser was experiencing sharply rising costs for ED visits, both as a health plan, as well as for its members in terms of what their cost share is. And finally, Kaiser has a subset of its population who excessively uses the emergency department.

Gray shared with participants in last week’s webinar Reducing Unnecessary Emergency Room Visits: Strategies To Discourage Inappropriate Use and Reduce Preventable Visits, the steps that Kaiser is taking to mitigate unnecessary and preventable emergency room visits, including a look at how a data review can identify potential areas to address, strategies to get members to appropriate care, the top 15 ICD-9 codes to target and how narcotic contracts can decrease the number of visits by chemical dependency patients.  Hear more details on Kaiser’s program in an online interview with Gray at:

Sobering Substance Abuse Data

June 21st, 2010 by Patricia Donovan

There was some sobering news on substance abuse last week that is straining hospital emergency departments and substance abuse treatment facilities.

Visits to hospital emergency departments involving nonmedical use of prescription narcotic pain relievers more than doubled, rising 111 percent, between 2004 and 2008, according to a SAMHSA/CDC report released last week. Kaiser Foundation Health Plan of Colorado has some innovative strategies for dealing with chemical dependency patients who show up in their emergency department, as you’ll read in this week’s issue of Healthcare Business Weekly Update. Kaiser’s Sara Gray, senior manager of emergency services, shared a dozen strategies to reduce preventable ER visits during a webinar earlier this month.

Also, the proportion of substance abuse treatment admissions involving older Americans (aged 50 and older) nearly doubled from 1992 to 2008. Get the details on this SAMHSA study — including the startling increases in cocaine and heroin abuse by this age group — in this week’s issue.

Top 3 Tactics for Obesity and Weight Management

June 21st, 2010 by Melanie Matthews

Weight management programs, nutrition counseling and exercise classes are the most commonly used strategies in obesity and weight management programs, according to a new white paper published by the Healthcare Intelligence Network.

The white paper analyzes responses from 131 healthcare organizations on the programs and strategies used to prevent and reduce obesity and related conditions and costs, highlighting how programs are financed, how individuals are identified for program participation and program results. Download a free copy at:

Remote Monitoring + Case Management = Better Care

June 14th, 2010 by Patricia Donovan

Remote monitoring of some Aetna Medicare members with CHF combined with enhanced case management has meant more timely attention to health alerts, resolution of medication errors and increased engagement of the member, physician and nurse case manager, according to early results of a study featured in this week’s issue of Healthcare Business Weekly Update.

We’ve already seen how the application of telemononitoring or case management alone can impact this population, so we imagine the combined intervention is hard to beat. According to a HIN benchmark study on the use of telehealth, more than half of survey respondents are using remote monitoring, with more than four-fifths focusing this effort on patients with CHF. In a 2010 study of healthcare case management trends, more than 80 percent of respondents employ case managers, of which more than half are primarily focused on CHF patients.

Download these complimentary study results.

Hospital Discharge is Care Transition Getting the Most Attention

June 7th, 2010 by Patricia Donovan

In our recently completed survey on managing care transitions across sites, nearly 80 percent of responding healthcare organizations said the hospital discharge is the care transition getting the most attention. This week’s Healthcare Business Weekly Update features a podcast from Sara Gray, senior manager of emergency services at Kaiser Foundation Health Plan of Colorado, who suggests two simple tasks to complete at discharge to keep recently discharged patients from returning to the hospital via the ER.

During the webinar, Sara shares Kaiser’s three-pronged approach to reducing avoidable ER visits.