Archive for June, 2012

7-Step National Action Plan Promotes Prevention, Wellness: HHS

June 18th, 2012 by Cheryl Miller

Plans to make Americans healthier continue, with a new national action plan from the HHS.

Seventeen federal departments and agencies are currently on board to enact a seven step national plan, including initiatives to clean up the air and water, renovate or create safe outdoor spaces for physical activity, make healthier foods more accessible, and assure violence-free environments. This is part of a comprehensive effort to tackle such issues as obesity, tobacco use, health disparities and chronic disease.

One federal initiative that has helped to keep young adults healthy was the ACA’s ruling that youths could stay on their parents’ health plans until they are 26. According to a new study from the Commonwealth Fund, millions of young adults stayed on or joined their parents’ health plans in 2011 who wouldn’t have been eligible prior to ACA passage. However, nearly 40 percent of young adults aged 19 to 29 went without health insurance at some time in 2011 primarily because their parents did not have healthcare coverage, and affordability of healthcare remains a crucial issue for young adults.

Keeping older adults comfortable, while at the same time minimizing their hospitalization and healthcare costs, is behind a new study from UCSF and published in Health Affairs. The study finds that creating specialized hospital units for elderly people with acute medical illness could reduce national healthcare costs by as much $6 billion a year. Researchers suggest that minor changes in current healthcare models can yield significant results. Leaving patients in their hospital beds, for example, or constantly interrupting them in the middle of the night for disruptive evaluations, often lead to longer recovery time and longer hospital stays. Creating interdisciplinary teams that specialize in the care of older patients, and that tend to elderly patients daily, can do much to minimize their discomfort and shorten their stays.

And one healthcare model that will likely stand the test of time, and a potential Supreme Court challenge, is the ACO. According to our latest market research, ACO activity has doubled in the last 12 months. Also in our white paper: data on how many ACOs participate in the CMS Shared Savings Program, and which kinds of ACOs were the most common.

HIN Guidelines for Guest Bloggers

June 15th, 2012 by Melanie Matthews

Passionate about healthcare? The Healthcare Intelligence Network blog is happy to consider guest posts from bloggers who are looking for a new outlet to publish original content for the healthcare industry. Our blog is well established (since 2004) with a community that includes healthcare executives and industry thought leaders.

If you are thinking of writing a guest post for us, here are some guidelines to keep in mind:

Topics: Any topic found under the “Category” heading on the left side of the HIN bookstore home page. Other topical healthcare business news and trends will be considered on a case-by-case basis.

Length: 500-1,000 words

Format: Microsoft Word (.doc) only

Style: Well-written and carefully edited informational and/or editorial content: news, trends, data and ideas to help healthcare executives improve healthcare delivery and quality, population health outcomes and health spend. No blatantly self-promotional or sales/marketing posts, please, and no product promotion. Include a 3- to 4-sentence biography about yourself and/or your organization. Original posts only.

Links: You can include a link to your business site in your biography. We like internal linking, too, so feel free to link to one or two relevant posts from this blog.

References: Please do not include footnotes in your submission. Rather, hotlink any sources referenced in the article.

Images: You may submit for consideration (as attachment) a single image with your post, 640px maximum width. Be sure your image file names are descriptive. Insert Comments in your Word document where you want the image displayed. In addition, you can attach a head shot or logo, no larger than 100px x 150px.

Questions or Submissions: Email pdonovan@hin.com to discuss your idea or submit a post for consideration.

Publication Policy: We reserve the right to accept, edit, not publish posts and schedule publication at our discretion. All content published on our blog becomes the intellectual property of the Healthcare Intelligence Network. If your article is accepted, you consent to the full article, extracts, samples or examples appearing in other Healthcare Intelligence Network products and/or services. We will give you full credit as author. You may republish extracts – for example, on your own site – but the article in its entirety cannot appear elsewhere.

Disclaimer for Guest Blog Posts: The following disclaimer will be added to each published guest post:

The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

New Market Data: ACOs Can Survive a Supreme Court Challenge

June 15th, 2012 by Patricia Donovan

The accountable care organization, the number of which has doubled in the last year, is here to stay, no matter how the nation’s highest court rules on healthcare reform legislation.

So say two-thirds of respondents to the second annual survey on ACO activity conducted by the Healthcare Intelligence Network.

The nation’s highest court is expected to release its opinion on the Patient Protection and Affordable Care Act (PPACA) before the end of this month. But the majority of healthcare organizations responding to the ACO survey said the accountable care model is robust enough to survive a Supreme Court challenge.

Almost a third of this year’s respondents — 31 percent — participate in an ACO, up from 14 percent in 2011. 200 healthcare companies completed the second annual survey, which also tracked trends in ACO size, administration, lead time, and early results.

“These results make it clear that the healthcare industry is prepared to go forth with accountable care, whether or not the U.S. Supreme Court upholds PPACA,” notes Melanie Matthews, HIN executive vice president and chief operating officer. “Even though many ACOs are still in their infancy, the accountable care model is already driving improvements in care coordination and a decline in hospital readmissions for patients cared for by an accountable care organization.”

Other data highlights from the survey include the following:

  • Just over half of responding ACOs participate in the CMS Shared Savings program, an ACO for Medicare beneficiaries.
  • Physician-led ACOs are the most common, with a quarter of 2012 respondents reporting physician administration of their ACO. In contrast, the number of ACOs with a hospital at the helm has dropped dramatically, from 32 percent in 2011 to around 5 percent.
  • The typical ACO is smaller in 2012, as the number of active ACOs with 100 to 500 physicians dropped almost 50 percent in the last 12 months. One-third of current ACOs have between 1 and 100 physicians participating.
  • Staff management and buy-in is the greatest challenge organizations must overcome during ACO creation, say 21 percent of respondents.
  • Organizations have become more efficient in ACO creation: 41 percent say it took less than a year to launch the ACO, up from 25 percent in 2011.

Download a complimentary executive summary of ACO survey results.

Meet Healthcare Case Manager Sonia Morrison: Respect and Kindness Key to End of Life Care

June 15th, 2012 by Cheryl Miller

This month we provide an inside look at a healthcare case manager, the choices she made on the road to success, and the challenges ahead.

Sonia Morrison, RN, CM, BSN, RN case manager at Salinas Valley Memorial Healthcare System (SVMHCS), Nurse Assessment Consultant and Educator for veterans at Visiting Angels of Santa Cruz

HIN:Tell us a little about yourself.

I am certified as a nurse case manager in oncology, and have worked in oncology for 21 years. I also worked in hospice for 11 years, was a certified nursing assistant (CNA) for three years, and a licensed vocational nurse (LVN) for one year.

What was your first job out of college and how did you get into case management?

I was in a junior college career ladder program, so I worked nights as a CNA in med-surg acute care and then in a licensed vocational nursing (LVN) registry, mostly in ob/gyn, prior to graduation. My first job was as an RN in the oncology med-surg unit at Salinas Valley Memorial Hospital (now Health Care System) or the SVMHCS, and I am still there.

Has there been a defining moment in your career? Perhaps when you knew you were on the right road?

I thought I wanted to be a midwife when I started my nursing education, however, I did not like assisting births in the hospital with strangers. In my last year of working toward my associate degree in nursing (ADN), I met an amazing oncology instructor. At the same time, my best friend was dying of cancer, thus I became an oncology case manager.

More recently, I taught a CNA program for several years. In mid 2011 I attended a life directions seminar and was able to harness all of my passions and focus them around caregiving.

In brief, describe your organization.

SVMHCS is an acute care hospital with an average census of 166.

What are two or three important concepts or rules that you follow in case management?

  • The keys to successful utilization review and discharge planning and collaboration are communication, including written documentation and collaboration with the full team, including the patient, family, doctor, nursing staff and other providers.
  • Patients are assessed and educated within the first 24 to 48 hours of admissions.
  • Balanced self-care allows me to serve my team the best.
  • What is the single most successful thing that your organization is doing now?

    Expanding the role of case management to include p.m. shifts.

    Do you see a trend or path that you have to lock onto for 2012?

    Money talks and reimbursement has been the biggest challenge.

    What is the most satisfying thing about being a case manager?

    Treating patients and families with respect and kindness, especially at the end of life.

    What is the greatest challenge of case management, and how are you working to overcome this challenge?

    Finding services for obese or no pay source patients. SVMHCS case managers are working with management for creative sponsoring of needed services.

    What is the single most effective workflow, process, tool or form case managers are using today?

    Extended Care Information Network and executive health referrals.

    Where did you grow up?

    I was born in Los Angeles, CA, one of five girls and two surviving boys.

    What college did you attend? Is there a moment from that time that stands out?

    I attended Cabrillo Community College, Santa Cruz, CA for an advanced degree in nursing and a bachelor degree in public health nursing (PHN) at California State University at Dominguez Hills, CA. I enjoyed being of creative service in the community during my PHN clinicals; I used bilingual teaching tools to explain lab results, diet choices and I created new curriculum to introduce teens to human health by relating what they knew to horse health, disease, symptoms and interventions.

    Are you married? Do you have children?

    I have a husband of twelve years, a forty year old son and a six year old granddaughter.

    What is your favorite hobby and how did it develop in your life?

    The very first profession I fell in love with was a veterinarian, but my parents told me I was not smart enough to be a vet. So then I wanted to be a dancer, but my parents told me I couldn’t do that because if I broke my leg, I couldn’t support myself. So, now, I am a dancing nurse with six dogs!

    Is there a book you recently read or movie you saw that you would recommend?

    A book I wrote: The Heart of Caregiving, A Guide to Joyful Caring.

    Click here to learn how you can be featured in one of our Case Manager Profiles.

    Over 2600 U.S. Hospitals Graded on Patient Safety

    June 11th, 2012 by Cheryl Miller

    It’s the end of the school year, but not just students are getting graded on their performance.

    According to a new study from the non-profit Leapfrog Group, more than 2600 U.S. hospitals received grades on their patient safety performances, or how many errors, accidents, and infections patients acquired while in their care. Studies show that one in four Medicare patients leave a hospital with a potentially fatal issue they didn’t have prior to hospitalization, and more than 180,000 Americans die every year from hospital accidents, errors, and infections. This study, free to all, is intended as a public service. There were some anticipated results, including A’s for well-known hospitals including the Mayo Clinic, and some surprises, including A’s for hospitals not as well-known or well-located. Details inside.

    Primary care physicians that provide enhanced services for their Medicare patients also get high marks this week. In its continued efforts to bolster the primary care workforce, CMS has launched a new initiative that compensates PCPs that provide extended quality care to their patients. The Comprehensive Primary Care program rewards physician groups that offer enhanced hours and accessibility, and use EHRs among other services. Approximately 75 primary care practices will be selected to participate in the initiative in each designated market. Interested PCPs have until July 20th to submit applications.

    And Kaiser Permanente gets an A for providing us with a new medical term: video ethnography, or the anthropological use of videos to study specific human (patient) cultures. Designed as part of their quality improvement program, the process involves videotaping patients and caregivers as they are being interviewed, and observing how they interact with each other in a clinic, hospital or at home. The tool is proving particularly effective with vulnerable populations such as frail elders, patients nearing the end of life, and those with multiple chronic conditions, because it enables caregivers to “see nuances that otherwise might be missed, and discrepancies between what people say, what they do, and what they may think,” according to a lead researcher.

    And finally, don’t forget to chart your own progress in the patient-centered medical home model in our survey. Two years post-healthcare reform, we’re taking our sixth annual look at adoption and support of the PCMH. Describe your organization’s progress and outcomes in this area by June 15th and we will reward you with a free e-summary of the results. And remember, there are no wrong answers!

    Disney To Curb Sugar, Salt in Parks, Products

    June 8th, 2012 by Cheryl Miller

    What, no more super-sized popcorns and unlimited soda refills at Magic Kingdom?

    Maybe not, according to a statement just released by Disney. By 2015, the company will no longer advertise or promote a wide range of fast foods, sugared cereal, candy, drinks and other products considered unacceptable. As stated on their Web site,

    Under Disney’s new standards, all food and beverage products advertised, sponsored, or promoted on Disney Channel, Disney XD, Disney Junior, Radio Disney, and Disney-owned online destinations oriented to families with younger children will be required by 2015 to meet Disney’s nutrition guidelines. The nutrition guidelines are aligned to federal standards, promote fruit and vegetable consumption and call for limiting calories and reducing saturated fat, sodium, and sugar.

    This ban extends to Disney’s theme parks, as well, where an estimated 12 million children’s meals are served each year. Disney plans to reduce the amount of sodium in these meals by 25 percent, and to limit sugar in foods to no more than 2.5 grams per 100 calories.

    The nutrition guidelines align to the federal dietary guidelines for Americans, and address the following criteria:

  • Do they contribute to a nutritious diet? i.e. fruit, vegetables, whole grain, low fat dairy, or lean protein?
  • Do they encourage kid-appropriate portions? i.e. calorie criteria
  • Do they limit ‘nutrients to avoid’? i.e. sodium, sugar, saturated fat, trans fat
  • Disney is the latest company to join in the anti-obesity campaign we first reported on in May when the IOM released a list of real world recommendations to combat the obesity epidemic. Included was the need to:

    reduce unhealthy food and beverage options while substantially increasing access to healthier food and beverages at competitive prices. The overconsumption of sugar-sweetened beverages must be reduced; calories substantially slashed in meals served to children while the number of affordable, healthier menu options is boosted significantly.

    In the interests of full disclosure, I traveled to a theme park recently, and I was struck by the legions of food counters available. It seemed as though we couldn’t walk a few hundred feet before encountering another food stand. Foods ranging from turkey legs to pizza to salted pretzels competed with rides and attractions for consumers’ attention. I just couldn’t help but wonder…wasn’t riding Aerosmith’s Rockn’ rollercoaster enough of a rush, without compounding it with a mega-slushy?

    This isn’t to say that there wasn’t a fair representation of healthier foods, like fruits, salads and low fat milks in the parks, but they were usually sold at a higher price than their unhealthier alternatives.

    But these unhealthy alternatives probably will not merit the “Mickey Check” tool, an icon that will call out nutritious food and menu items sold in stores, online, and at restaurants and food venues at its theme parks and resorts effective the end of this year.

    This isn’t the first time Disney has initiated nutritional guidelines; in 2006, Disney pioneered new, well-balanced kids’ meals served at its parks and resorts, which automatically included nutritious sides and beverages such as carrots and low-fat milk, unless parents opted out. Disney is now enhancing its efforts by further reducing sodium in kids’ meals and introducing new well-balanced kids’ breakfast meals.

    In addition to its nutritional efforts, Disney will introduce fun public service announcements throughout its parks inspiring and encouraging kids and families to live healthier lifestyles through better eating habits and fun activities.

    Meet Health Coaching Director Cheryl Walker: Integrative Care, Motivational Interviewing Future Trends

    June 7th, 2012 by Cheryl Miller

    This month’s inside look at the director of the nation’s first master’s degree program for health and wellness coaching.

    Meet Cheryl Walker, ML, MCC, Academic Director for Tai Sophia Institute’s Master of Arts in Health and Wellness Coaching.

    HIN: Describe the Health and Wellness Coaching Program at Tai Sophia Institute.

    Cheryl Walker We are teaching what I like to call the “art and science of behavior change.” Our students begin the program gaining a basic understanding of what constitutes wellness. Next they learn about behavior change through study of the International Coach Federation coaching competencies. They also learn Motivational Interviewing, an evidence-based model for behavior change, and then complete a 21-hour practicum, where they actually work with clients.

    There are four key components that distinguish our program.

    First, we teach students the concept that the body is wise. We teach them how to listen to their own bodies, how to key in to their symptoms, and how to understand what is happening so that they can, in turn, teach their clients to do the same.

    Second, we teach our students to use nature as a model or a blueprint for health and wellness. When we observe nature we can see a natural rhythm, and if we follow that rhythm we can experience health and healing. For example, winter is a time for quiet and going within. People can ask themselves if this quiet, too, is something that they need, rather than being overly active. Or perhaps, they may need more time to play and be active, qualities experienced in summer. We teach our students how to assess these qualities in themselves so they can teach that to their clients.

    The third thing that we teach is that there is a biochemical reaction in the body that happens with the words that we speak. So, when we say things that have a more positive nature, we are actually enhancing health. When we speak words that are more negative, we can actually, if we tune in, feel our body shut down. We teach our students to have a high level of awareness of what they’re speaking, how they speak it, and how to begin to choose words that generate health.

    Finally, the other distinguishing piece to our coaching program, (and to all of our programs at Tai Sophia) is that we teach our students how to be a healing presence for others. Over the years people have consistently told us that when they walked into the office of a practitioner who graduated from Tai Sophia, they started to feel better right away. When we really looked at that experience and pulled it apart, we discovered that we really were teaching our students how to establish rapport with clients and how to have a compelling presence and demeanor that actually inspires change. So we began to purposefully teach healing presence as an integral part of our program.

    I also want to emphasize that all of our courses in our coaching program have been approved by the International Coach Federation (ICF), enabling our graduates to apply to become certified coaches through the ICF. Right now, ICF is the gold standard professional organization of coaches.

    What drove Tai Sophia Institute to create this program?

    We have always been on the cutting edge of innovative practices in health and wellness, so establishing a health and wellness coaching program seemed like a natural next step for us as well.

    On a national level, all of us are aware that we are facing an extremely large health crisis. It’s been widely reported that 70 percent of doctor visits are preventable and are directly related to behavior. Yet, in spite of having more information about how to stay healthy than ever before, we have more chronic illness. Studies show that although education is an important component, it’s not enough and coaching can be the lynchpin between education and actually helping people make sustainable changes. The Affordable Care Act named health and wellness coaching as a key component to a new healthcare model. As with all our programs at Tai Sophia, we continue to stay on the forefront of the best health and wellness practices.

    What led you into the field?

    I’ve been an educator all my professional life. Yet, while I know that education is a key component in helping people, I know that education is clearly not enough. I find myself philosophically aligned to the theory and practice of coaching. Coaching is based on positive psychology which focuses on what’s working in a person’s life, rather than what’s broken. Coaching works to build on a person’s successes, and on their values; it looks at whatever goals or challenges a person has within the context of his or her whole life and what she or he cares about. Coaching also taps into a person’s intrinsic motivation to change. My experience has been that there’s nothing more thrilling than to work with people and see them have their own epiphanies as to why they get stuck and then see them begin to make positive change.

    Who is the main demographic for your program and has it changed?

    The demographic for this program has remained pretty consistent. About a third to a half are already healthcare professionals looking to either develop a new skill set or transition to another way of practicing their profession. Others come from the field of human resources and the business world and have an interest in working in corporate wellness programs. And some people have had a long-time interest in wellness and helping other people.

    Has the field of health coaching changed in the last five years?

    I think the biggest change is that we’re seeing a shift from disease management to true coaching. In other words, the trend is towards putting the client at the center of care, recognizing that the client is the expert and that the role of the professional is to be a partner in the relationship. Another very significant change is the creation of the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC). Harvard, Duke, the University of Minnesota, Wellcoaches Corporation and some others have been involved in defining the field and developing professional standards, scope of practice and a certification process. We at Tai Sophia have also played a part by being on committees on this consortium.

    Another trend that I think is very important is that health professional schools now are incorporating coaching into their curriculum. For example, I taught a health coaching course for two semesters to pharmacy students at the School of Pharmacy – Notre Dame of Maryland University. In addition, there have been nursing schools that have approached us about teaching health coaching to their students. It’s definitely an exciting trend that we see developing.

    What are the main trends in health coaching now, for example, telephonic or virtual within the PCP office or in private practice?

    It seems most coaching is done by phone. Most of our students and alumni are working telephonically, which is very efficient and effective. I’m sure there are people coaching virtually, as well, perhaps, through video cams. I’m not aware of that, but I suspect that’s probably being done. There is also a trend toward primary care physicians working with coaches. I am currently in conversation with a local doctor who is interested in that.

    How is social media and technology, I Phone apps for example, affecting health coach delivery?

    I know that there are coaches using social media for marketing their practices as well as for forming professional groups. There are also apps for tracking food and diet and exercise.

    What trend or path will the field be locking onto for 2012?

    I think the most important thing will be working towards a national certification.

    Where do you see the industry going beyond that in the next five years?

    Again, I think more doctors and other healthcare professionals like chiropractors, acupuncturists, dieticians and nutritionists will incorporate coaches as part of an integrative practice. I also believe there will be a continuation of coaching classes being incorporated into academic professional programs. We are the first school in the country to offer a master’s degree in health and wellness coaching, and I suspect that we’ll see more schools offering it as well.

    What do you see as the greatest challenge of health coaching and how is Tai Sophia’s program addressing this challenge?

    As with any new field, the main challenge is that it is relatively unknown and the public needs to be educated so they understand the benefits of coaching. Two ways we are meeting this challenge is to stay involved with NCCHWC and be aligned with the best practices in the field, and by developing strategic partners with innovators in healthcare. We are working with our local health department in a statewide demonstration project which is utilizing health coaches to provide community based healthcare. In addition, there’s a free community clinic in Washington D. C. that’s interested in providing internships for our students. We will continue to look for ways to work with progressive organizations and bring credibility to the field.

    What is the single most effective workflow process tool or form coaches are using today?

    In my opinion, Motivational Interviewing (MI) is the most effective model in behavior change. This process begins by assessing a person’s readiness to change. We can’t assume that everybody is actually ready to change. Motivational interviewing assesses where a person is on a spectrum, and helps them move up the spectrum. Coaches utilizing an MI approach are actively listening to what a person is saying and then reflecting back what they hear. This process helps a person see that they may have ambivalence to actually changing. The reason people have difficulty making behavior change is not because they are lazy or unmotivated. People have difficulty because there is some ambivalence to change of which they are unaware. Through questioning and listening you can reveal some level of ambivalence to change. And once that’s discovered, a person is freed up to start to move forward. MI also looks at how important change is to a person, and how confident they are that they can change. For instance, a person may say they want to stop smoking, and in fact it’s important to them because they may have developed some health issues, but they don’t yet have the confidence that they can change. So we work with them to increase their confidence level.

    New Market Data: Co-Located Case Managers Put Face on Population Health Management

    June 5th, 2012 by Patricia Donovan

    Add community clinics, home care and longterm care facilities to the list of work locations for embedded case managers, according to new market research by the Healthcare Intelligence Network.

    Despite challenges ranging from physician buy-in to recruitment and retention of case managers, the number of companies embedding or co-locating case managers within care sites continues to rise.

    Just over half of respondents to our third annual Healthcare Case Management e-survey said they embed case managers at the point of care; of those 2012 respondents, nearly 60 percent cited the primary care practice as the most likely work site for an on-site case manager.

    A new white paper on 2012 Trends in Embedded Case Management examines the responses of companies who embed case managers, providing a high-level look at work locations, program components, and the greatest challenges and benefits of this case management strategy. The analysis revealed that case management presence at primary care sites had quadrupled in just the last 12 months, from 14 percent in 2011 to 58 percent this year.

    Case managers remained integral parts of the hospital process in 2012, with 52 percent reporting the presence of case managers in hospitals. And this year’s respondents said they embed case managers within the community (14.6 percent), the community clinic (12.5 percent), home care (10.4 percent) and long-term care facilities (2.1 percent).

    Respondents say the benefits of embedding case managers include improved patient engagement and satisfaction, care continuity and transition management.

    Download a complimentary executive summary of 2012 Trends in Embedded Case Management.

    Consumer Reports Publishes First Patient Experience Ratings of Primary Care Practices

    June 4th, 2012 by Cheryl Miller

    Looking for advice on a lawn mower, vitamin supplement, or primary care physician?

    Then pick up a copy of Consumer Reports, because it’s now in the healthcare business. The consumer-friendly publisher of product ratings and reviews has released its first ever patient evaluation report of primary care practices. Developed jointly with the Massachusetts Health Quality Report, the report provides patient evaluations of nearly 500 practices in the Massachusetts area, including 329 adult practices and 158 pediatric practices on such topics as physician communication skills and accessibility. Patients also weigh in on whether they would recommend their physician to others.

    We don’t need Consumer Reports, or any publication, for that matter, to weigh in on the dangers of smoking. But there’s now new information on how costly it is to smoke prior to undergoing surgery. A report from the Journal of the American College of Surgeons shows that smoking increases post-operative complications and drives up healthcare costs. Research shows that approximately 30 percent of patients undergoing elective general surgery procedures smoke, increasing inpatient costs by as much as 4 percent. The good news: quitting four to six weeks prior to a procedure can improve post-operative outcomes and decrease complications in patients. More details in this issue.

    CMS is taking steps to reverse an alarming trend: the use of antipsychotic drugs on patients with dementia in nursing homes. Data shows that in 2010 more than 17 percent of nursing home patients had daily doses exceeding recommended levels. Beginning next month CMS, along with industry and advocacy partners, will launch a multi-tiered approach to the problem, including a training series for nursing homes and the publication of data on nursing home antipsychotic drug use.

    And lastly, for six years we’ve tracked the growth of continuous coordinated patient care at the heart of the patient-centered medical home (PCMH), which has been shown to lower costs while improving healthcare outcomes. The PCMH lays the foundation for the delivery of accountable care. Once again, we invite you to describe your organization’s progress and outcomes in the PCMH model by June 15, 2012 and you’ll receive a free e-summary of the results from this sixth annual review of the medical home model. All responses will be kept confidential. Thanks for participating!

    10 Ways to Strengthen Health Coaching-Physician Collaborations

    June 1st, 2012 by Cheryl Miller

    There’s a “confluence of influences bringing health coaching to the forefront” of healthcare delivery, observes Richard Botelho, MD, professor of family medicine at the University of Rochester Medical Center. Dr. Botelho suggests 10 ways to foster successful collaborations between health coaching or disease management organizations and the provider community that enhances health outcomes and the quality of care delivery.

    His suggestions include the following:

  • Establish a physician-patient-community advisory board about integrated health coaching.
  • Get provider-patient-community input about health coaching for program development.
  • Assess what practices need to promote and provide health coaching.
  • Create forums for the dialogue between providers and healthcare plans to improve performance of health coaching programs.
  • Provide payment to support out-of-visit health coaching.
  • Develop self-management support and health education materials that make work easier for providers and practices.
  • Tailor knowledge transfer strategies about integrated health coaching programs to practice sites.
  • Provide academic detailing to providers about health coaching programs.
  • Provide programs to support staff about workflow issues that support health coaching processes.
  • Provide data systems to track health coaching processes about outcomes.