Archive for August, 2010

Survey Identifies Top 3 Uses for HRA Data

August 30th, 2010 by Jessica Fornarotto

Aggregate data from health risk assessments (HRAs) provide a roadmap for healthcare organizations to deliver health promotion and disease management interventions to targeted individuals — with the goal of improving clinical and financial outcomes.

In its HRA e-survey administered in June 2010, the Healthcare Intelligence Network captured trends in the use of HRAs, from format and target audiences to incentive use and impact. Through responses provided by 116 healthcare organizations, the survey results reveal that the top three ways companies use HRA data are to identify health risks, develop programs aimed at high-risk indicators and deliver follow-up interventions for those at risk.

Figure 1: Top Uses for Aggregate HRA Data

Figure 1: Top Uses for Aggregate HRA Data

Survey Highlights

  • More than 67 percent of responding organizations use HRAs to assess health risk factors in their populations.

  • HRA completion is voluntary, according to 84.8 percent of respondents.
  • The biggest barriers to launching an HRA program are staffing and cost, according to 66.7 percent of responding organizations.
  • Many organizations said HRAs work best when integrated with wellness and disease management programs.
  • Several responding organizations said self-reporting data for HRAs is not often accurate. However, approximately 94 percent of respondents use self-reported data inputs for HRAs.

More Companies Offer Carrots for HRA Completion

August 30th, 2010 by Patricia Donovan

As open enrollment season nears, many companies are still planning major changes to employee coverage — from eliminating insurance for retirees to reducing premiums for employees who take a health risk assessment (HRA). Our own research on HRA use found that 56 percent of organizations offer incentives for HRA completion, with cash incentives of up to $100 offered by 63 percent and reduced premiums by 44 percent.

We share more employer insurance trends and more of our research on the top uses of HRA aggregate data by 116 healthcare organizations in this week's Healthcare Business Weekly Update. You can also download a free e-summary of the June 2010 HRA Survey results.

Project Hospital: Mock Patient Room Showcases Effect of Room Design on Patient Safety

August 23rd, 2010 by Patricia Donovan

Adverse drug events can not only extend the hospital stays of elderly adults, but also place them at risk for serious complications and even death. In separate stories in this week's Healthcare Business Weekly Update, two hospitals approach this problem from very different perspectives. First, a New Jersey hospital has constructed a mock hospital room to study the effect of room design on patient safety and care delivery. See what they learned about judicious placement of health IT in the hospital room.

And in Boston, a tweak by hospital researchers to physicians' CPOE systems also reduced medication-related dangers for older patients.

Also this week, we present the latest benchmarks in reducing avoidable ER visits, gleaned from respondents to our July 2010 e-survey.

Estimating the Financial Impact of MLR Compliance on Insurers

August 19th, 2010 by Patricia Donovan

Starting in January, payors will have to spend 80 to 85 percent of collected premiums on medical services and quality improvements. While the HHS awaits the NAIC's final recommendations on the final medical loss ratio (MLR) formula, a featured story in this week's Healthcare Business Weekly Update estimates the financial impact of MLR compliance on insurers.

According to HealthScape Advisors Managing Director John Steele, advance planning can soften the financial blow. During a recent webinar on preparing for January's MLR compliance regulations, Steele had this advice for payors:

Get together a team to look at some of the immediate compliance requirements on quality improvement, allocation methodologies, aggregation by the segment, as well as that preliminary financial impact and some preferred approaches. It may not be all accounting-related. It could be looking at your product portfolio or some of your cost management. Look at all of those areas and try to do a longer term forecast that would then flow into overall strategy development — look at where you’re going to go, not only from the accounting side but also opportunities to diversify products. Look at total cost management.

Also this week, learn how continuing diabetes education for Medicare and commercial populations is paying off for certain insurers. You can also join the more than 110 healthcare companies that have weighed in on the benefits of health coaching. Take our third annual Health Coaching survey by August 31 and get a free e-summary of the results next month.

Care Transition Programs on Rise in 2010

August 19th, 2010 by Jessica Fornarotto

A new study on care transition management has found that 85 percent of respondents have launched programs for older adults with complex acute or chronic conditions to close care gaps, avoid unnecessary hospitalizations, readmissions and ER visits, reduce medication errors and raise the bar on care quality.

In its second annual Managing Care Transitions Across Sites e-survey, conducted in May 2010, the Healthcare Intelligence Network documented programs and activities by 87 healthcare organizations to coordinate key care transitions. The survey results reveal slight increases from 2009 to 2010 in both the number of programs to manage transitions in care and the number of organizations conducting home visits in 2010 to improve care transitions.

Survey Highlights:

  • Nearly 85 percent of respondents have adopted a care transition program this year, compared to 80.2 percent in 2009.

  • The amount of organizations conducting home visits increased from 56.5 percent in 2009 to 60.3 percent in 2010.
  • About 79 percent of responding organizations are focused on hospital-to-home transitions, while 49.2 percent address skilled nursing facility (SNF)-to-home, and 45.9 percent address ER-to-home.
  • According to 80.3 percent of respondents, hospital to home is the most critical care transition for their population.
  • Many respondents said post-transition contact with patients, such as home follow-up and post-discharge calls, is the most successful strategy to improve care transitions.
  • A nurse practitioner or certified home health agency nurse is most likely to conduct the home visit, according to 37.1 percent of respondents.
  • Almost 83 percent of respondents said medication review occurs during home visits. Only 22.9 percent are conducting physical therapy during home visits.

Tools to Trim Weighty Obesity Problem

August 12th, 2010 by Patricia Donovan

Obesity is now an even heavier burden on this country, according to new CDC data released last week. No state met the Healthy People 2010 obesity target of 15 percent, and in nine states, over 30 percent of adults are obese.

The CDC's recommendation?

Obesity should be addressed through a comprehensive approach across multiple settings and sectors that can change individual nutrition and physical activity behaviors and the environments and policies that affect these behaviors.

In the healthcare setting, at least, we've responded with more programs to prevent and manage obesity and rein in associated healthcare costs. In our 2008 survey on obesity and weight management programs, 64 percent of respondents had launched programs in this area. In this year's April survey, that number rose to 71 percent. Get this year's results here.

In response to this trend, this week's Chart of the Week looks at the top components of obesity and weight management programs, and a related story in this week's Healthcare Business Weekly Update offers a cautionary tale on evaluating hospitals for bariatric surgery — a popular weight loss procedure that is performed more than 180,000 times a year.

3 Reasons to Conduct Home Visits for Medically Complex Patients

August 11th, 2010 by Jessica Fornarotto

Jessica Simo, program manager with Durham Community Health Network for the Duke Division of Community Health, maps out three reasons why home health visits can reduce unnecessary utilization.

The Durham Community Health Network is a primary care case management program for Medicaid recipients who live in Durham County. We are responsible for over 22,000 covered lives in the Medicaid program and home visits were not necessarily something new for our program. Since the inception of the program in 1998, it is something that we have done to better address the needs of the Medicaid recipients and link them to their medical homes. However, home visits were vital to the pilot program and were done in a more structured way than our program had done previously. The Care Partners patients who were selected for the pilot received home visits at least once a week in the first phase of the pilot project. That is something we monitored vigorously in our weekly multidisciplinary meetings.

Why are home visits so important? Number one, it is very challenging to observe problems that individual patients may have with adhering to their medication regimens if you can’t see the medicines in the bottle in the patient’s home. You need to be available to count the medicines and ascertain definitively that they are not missing. Trying to do medication reconciliation over the phone is nowhere near as effective as being in a patient’s home.

Another reason home visits are more effective is that you can physically see what activities of daily living (ADL) or instrumental activities of daily living (IADL) deficits the patient may be experiencing in their natural environment. This is something you can’t directly observe within the confines of an exam room.

The engagement of family or their other support persons is also important. Home visits are an excellent way to see somebody in their natural environment, find out who the support people are for the patient, have a comfortable discussion in their home about an individual plan of care and get the people who can assist with that on board.

For all of the previous reasons, home visits were critical to the pilot. It’s especially important in a medically complex patient population where there are frequent transitions, whether those be from the acute care setting, from any ED visit or back into the home from an assisted living facility.

Social Networks That Are Good for Your Health

August 3rd, 2010 by Patricia Donovan

Social networks are good for your health — not the Facebook, Twitter, LinkedIn kind of networks, but the live connections we forge with friends, family, neighbors and colleagues, says a new Brigham Young University study featured in this week's Healthcare Business Weekly Update. A lack of live social bonds is tantamount to being an alcoholic or smoking 15 cigarettes a day, say the researchers.

Another area where connections are important is the hospital discharge. This issue also contains six tips for improving communication with patients during hospital discharge.

And finally, a health coach is a good person to have in your social network. Take our third annual Health Coaching survey by August 31 to find out how healthcare organizations are implementing health coaching and the financial and clinical outcomes that can result. Respondents will be e-mailed a free summary of the survey results next month.