Archive for September, 2012

Infographic: Cost Saving Opportunities in the U.S. Healthcare System

September 21st, 2012 by Melanie Matthews

While the U.S. healthcare system has made tremendous strides in managing and treating diseases that were fatal just a generation ago, there’s much work to be done within this system that is experiencing unsustainable cost increases and poor quality in comparison to many other countries.

The Institute of Medicine looks at how the healthcare industry compares to other industries in seven key areas, which could have a huge impact on the cost and quality of care in the United States.

What's Possible for the U.S. Healthcare System?

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10 Considerations When Preparing a Practice for the Embedded Case Manager

September 20th, 2012 by Cheryl Miller

Embedded case management

Practice-based case management is driving improvements in healthcare delivery and efficiency.

As practice-based case management continues to grow, resulting in more efficient and high quality care coordination of high-risk patients and chronically ill health plan members, one question looms large: how does a practice determine if it’s ready to take the leap?

We asked our case management experts for their opinions, and found that while there was no ‘one-size fits all’ method, many considerations were considered essential to a successful ECM practice.

  1. Find the right practice.

    Are your head physicians proponents of the medical home model? Because you don’t want to put efforts into a group that isn’t interested in embracing a new model of care. Says Irene Zolotorofe, administrative director of clinical operations at Bon Secours, “We began with the physicians who were absolutely willing to go ‘medical home,’ who were excited about this model of care. We like to go into a practice where they are motivated to do that type of transition with their patient population.”

  2. Involve all members of the practice in the selection process.

    Getting all members involved in selecting the case manager is key to sustaining a successful transition, says Diane Littlewood, RN, BSN, CDE, regional manager of case management for health services at Geisinger Health Plan. “We found great value incorporating and including the primary care doctor, the site and the team in the selection process. That case manager is embedded; she’s part of their team and that’s where she spends 100 percent of her time. It is key to each site’s success that the provider be involved with the selection. With this model, we’ve brought the provider at the medical home sites into the process and said, “Sit down with us, interview the candidates and help us with the final selection.’ “

  3. Assemble case manager hiring criteria.

    Although experience, education and training is important in this role, they should not be the main selection criteria, says Zolotorofe. “Is the case manager able to think quickly and critically given the newness and lack of infrastructure in place for this new program?” Other criteria for choosing a solid case manager included strong communication skills, people skills, patient engagement and activation skills, and negotiating and conflict resolution skills.

  4. Determine how much control your practice will have over your case manager’s work.

    Keeping everyone in the loop fosters an atmosphere of collaboration, says Littlewood. “As you roll out your model and educate providers and staff, you have to explain the case manager’s role and educate the site as to her duties.”

  5. Spend time building strong relationships among group members.

    Once the case manager is part of the team, it’s important that she sustains good relationships with all, says Dr. Randall Krakauer, Aetna’s Medicare medical director, during a recent HIN webinar: “You need to work out an arrangement in each case that works best for this particular medical or provider group. They’re all going to be somewhat difernt and it’s going to be up to your own management and your own embedded case managers to work out how best to work with this particular group, how best to support this group and how best to relate to this group. That relationship is absolutely key. The case manager and your staff must build a good supportive relationship. Your case manager has to feel to them like their case manager.”

  6. Allow case managers to build strong relationships with their patients, and provide tools to facilitate this.

    Geisinger Health Plan implemented a direct telephone line to embedded case managers for all patients, says Littlewood. “As simple and basic as it sounds, the ability for our case managers to have a direct line at the site for patients makes a difference. All the patient has to do is pick up a telephone, say hello and they will have a case manager on the phone. They’re not trying to navigate through the complex telephone lines as they call in to the clinic sites, which could be confusing for the patient. This is a direct access phone line. The case manager does the assessment and collects the information, and then the patient meets with the provider. This process takes out all of the middle people and we’re able to then handle acute issues much sooner. Since the nurse case manager is embedded in the site, she can walk right down the hallway and have a personal conversation with the provider about the person on the phone and their problem or issue. That leads to success with our communication.”

  7. Ensure you have the proper IT tools on hand for an effective program.

    Is there a minimum IT requirement for practices to participate in a practice-based case program, such as a patient registry or EMR? Explains Dr. Krakauer: We do have participating practices that don’t have EMR’s. An EMR will facilitate the process and will make collaborative care management and the work of the participating physicians easier. I don’t think it’s a requirement that there be an EHR. Going forward, as we start getting into more and more information exchanges and more and more reporting requirements promulgated by others, for sizeable groups doing this type of work, increasingly an EHR will be important.

  8. Make sure that your practice has enough eligible patients and the right case mix.

    It’s essential to consider both patient population and eligibility in the beginning, says Charlene Schlude, director of case management at CDPHP. “First, we consider the case mix in a practice. We use a predictive modeling tool that allows us to see the chronic nature of the patients in the practice. We like to see what products they have: is there a higher ratio of Medicare and Medicaid or even chronically ill commercial members in the practice? We use some reporting to do that. Another key element is an EMR in the practice because we want to be efficient and have information at the nurses’ fingertips to make this a valuable experience. We want them to have enough information to interact with the patients in a practice in a way that is going to impact that cost and quality.”

  9. Establish how the case manager will be reimbursed.

    Having a mutually agreed upon reimbursement plan is key to the program’s success, explains Dr. Krakauer. “Normally Aetna will provide this resource; we will provide our own trained experienced case manager who is capable of doing everything. Under certain circumstances, when the medical group already has case managers that are doing a good job, and knows how to do it, some assistance in this regard might be in order. But case management is a specialty in its own right. It’s not something you just hire a nurse to do — have her read a manual and put her at the desk or on the telephone. That’s kind of a prescription for it not to work.”

  10. Determine how you will judge the program’s effectiveness.

    Says Dr. Krakauer: “If I were to pick one single characteristic that’s positive of a good result, I would say it’s the level of commitment of the participating physicians to the concept, to the collaboration and to the idea that doing better will get good results, as opposed to those told to do it as a part of their job or those doing it just to receive an incentive payment.”

Guest Post: Healthcare Management Enters 21st Century via EMR, Point of Care Technology

September 17th, 2012 by Cheryl Jacque

In today’s post, guest blogger Cheryl Jacque tackles the pros and cons of implementing electronic medical records (EMRs) and point-of-care technology and whether or not they can improve efficiency of patient care without increasing costs to patients. A recent Healthcare Intelligence Network post about the most effective ACO tools and policies supports Cheryl’s claim that despite high initial costs, EMRs and point-of-care technology benefit patients and healthcare providers alike.

The recently upheld Affordable Care Act has been the subject of contentious political debate for the past few years in the United States, and for good reason. By 2019, the annual cost of healthcare is expected to balloon to almost $4.7 billion, or 20.9 percent of Gross Domestic Product (GDP). Though the United States spends more on healthcare than nearly any other industrialized nation, the quality of care often suffers for many, and millions remain uninsured. However, as healthcare management adjusts to a rapidly changing world, many health professionals are not looking to government for improved care and reduced costs, but to technology. Recent advancements like EMRs and point-of-care technologies could expedite care and dramatically decrease costs, perhaps having a more dramatic effect on healthcare than any legislation ever could.

For most Americans, medical data is not confined to one place. General physician check-ups, emergency room visits, even dentistry and orthodontic records are all kept at their respective facility data storage rooms. While hard copies of data will still be kept, EMRs store all of a patient’s medical data in a digital cloud, allowing medical professionals to immediately access and acquire important data from multiple sources and build a more complete and accurate portrait of an individual’s health. “(EMRs help) doctors assess the patient’s status and see exactly how the patient is performing,” said C. Martin Harris, chairman of the Cleveland Clinic Foundation’s technology division, in a 2011 U.S. News and World Report article. “And this information is available in real time.” Having medical records available to multiple specialists can also substantially limit the number of errors on records, and the chance of someone catching a mistake is increased substantially.

While EMR technology offers some clear benefits, opponents point to implementation costs of about $20,000 per physician, initially, nearly 100 percent more than most facilities anticipate, according to a 2011 report by Accenture, and lead to an IT operating cost increase of 80 percent. However, the report suggests that more effective EMR implementation can be achieved by designating a chief medical informatics officer to serve as a bridge between the healthcare IT organization and the hospital’s clinical and business operations.

While EMRs may eventually streamline and connect all of healthcare, information technology at the point of care has provided the most immediate benefit to patients and pharmaceutical companies. Improved payor data sets have rapidly increased the availability of real-world data in healthcare. Both patients and pharmaceutical regulators are anxiously awaiting the impact of this data, with a hope that costs can be driven down substantially while patient safety is protected. Pharmaceutical companies expect the data to aid in characterizing diseases and patient populations, targeting products and services and developing new products and therapies. According to a 2002 literature review on point of care barcode technology by Bridge Medical, at a hospital utilizing point of care, pharmaceutical packages embedded with computer chips were able to eliminate errors and improve efficiency substantially, protecting patient health while leading to annual savings.

While many of these technologies are still in a nascent stage, the potential for increased efficiency and patient safety is readily apparent. The ability for doctors to view a patient’s detailed history, including blood tests, hospital stays and x-rays could prove invaluable, and even life-saving. Once the high initial costs are absorbed, the enhanced ability for patients to communicate with their doctors and medical professionals to communicate with each other could lead to an era of more efficient and accurate medical care than ever before.

Cheryl Jacque is a writer and researcher for The Health Administration Project, an online resource providing valuable and up-to-date information about the health administration field, including education and recent policy changes.

Significant Potential for ACOs to Improve Care, Lower Costs for Dual Eligibles

September 17th, 2012 by Cheryl Miller

Three cost-saving programs make headlines this week; the first, a new study by Dartmouth researchers showing that ACOs can slow the cost of treating dual eligibles. The results from a similar payment reform model, Medicare’s Physician Group Practice Demonstration (PGPD), showed that the PGPD trimmed the cost of serving this part of the population $532 annually (after adjustment for inflation), almost five times more than the $114 per beneficiary savings generated in the general Medicare population primarily by reducing acute care hospitalizations and readmissions.

In another cost-saving exercise, using data from nearly 250,000 U.S. physicians serving commercially insured patients nationwide, a new report from UnitedHealth Group’s Center for Health Reform & Modernization shows that high-quality medical care can be about 14 percent more affordable on average, with significant local variations. The report examines care quality and medical costs for episodes of care and emphasizes four strategies to accelerate care provider payment reform to improve patient care.

More than $34 million in healthcare costs was saved with a nationwide patient safety project aimed at reducing the rate of central line-associated bloodstream infections (CLABSIs) in ICUs. The project, funded and reported by the AHRQ, used a customizable toolkit program called the Comprehensive Unit-based Safety Program (CUSP) to help doctors, nurses, and other members of the clinical team understand how to identify safety problems. Overall, it reduced CLABSIs in ICUs by 40 percent, prevented more than 2,000 CLABSIs, and saved more than 500 lives.

Contrary to these cost-savings measures, the federal Pre-Existing Condition Insurance Plan, the high-risk health insurance pool established by the ACA, is succeeding as a transition program but failing as a long-term solution given the cost of running it, according to a new Commonwealth Fund report. Currently, the plan provides coverage options for people with pre-existing health conditions until they are eligible to purchase insurance through the new state exchanges in 2014, with much of their costs subsidized. But the program’s high costs and low enrollment numbers make it untenable for the long term. One reason: the federal high risk pool often attracts the sickest whose premiums are capped at certain levels, and their premiums fall short of paying for their treatment.

And lastly, don’t forget to take our Population Health Management in 2012 survey. Improvement of population health is a tenet of the Institute for Healthcare Improvement’s Triple Aim, along with enhancing the patient experience and curbing per capita health costs. Describe your organization’s efforts in population health management by September 30 and you will be e-mailed a free executive summary of survey results once it is compiled. Your responses will be kept strictly confidential.

Read all of these stories in their entirety in this week’s Healthcare Business Weekly Update.

Meet Healthcare Case Management Manager Teresa Treiger: Helping Clients Bridge Gaps To Self-Advocacy, Self-Management

September 14th, 2012 by Cheryl Miller

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

Teresa M. Treiger, RN-BC, MA, CHCQM-CM, CCM, Founder of Ascent Care Management, LLC

HIN: Tell us a little about yourself and your credentials.

Teresa Treiger: My given name is Teresa, but most people know me as Teri. I am a registered nurse although my educational background also includes degrees in healthcare administration and business. I have over 30 years of cumulative experience in the healthcare industry with more than 20 of those devoted to care coordination and care management. I am certified in case management by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP,) the Commission for Case Manager Certification (CCMC,) and the American Nurses Association (ANA.) I am also certified as a chronic care professional by the Health Sciences Institute (HSI.)

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

As so many of us did, I started off with bedside nursing on a general medical-surgical floor before moving to neurosurgery, orthopedics, respiratory intensive care, and urgent/emergent care. When it was time for a change of pace, I shifted to the business side of healthcare for a couple reasons:

  • I did not believe that the business of healthcare was enough of a concern for the people who worked within the sector. It was far too easy to not consider the financial implications of care when all I had to do was take a sticker off of a piece of equipment and place it on a patient’s supply charge sheet. I’ll expand on that more in a bit, and
  • I did not feel as though I was making an impact on the bigger picture of healthcare; bedside nursing was and is a wonderful experience but I knew I needed to make a different kind of impact. Subsequently, I worked in case management in a variety of settings – managed care, acute hospital, rehabilitation and long term care settings eventually focusing on care coordination program design/implementation and education.

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

This is an interesting question because my defining moment was not necessarily what got me into case management but rather what validated the choice I made as being perfect.

I was at a crossroads, having just undergone a corporate restructuring which left me unemployed. I attended a Case Management Society of New England (CMSNE) chapter conference on leadership and it literally changed the trajectory of my career path, but not because it was case management-focused. It validated that the business of healthcare delivery was in dire need of a focus point. With all due respect to clinician providers, their job is not to coordinate how the care is delivered – and they aren’t all that good at it. By and large, they are great at diagnosing and providing the blueprint of an individual’s care, but how that all gets accomplished — not so much.

In brief, describe your organization.

I am a case management consultant and have my own company, Ascent Care Management, LLC. I work with individuals who desire their own case manager, but the bulk of my business is focused on business clients who want to revamp their case management departments in one way or another. Frequently, I help organizations through process flow redesign, documentation, case management IT projects, and accreditation preparation. I also enjoy public speaking on a variety of healthcare and care management topics.

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

  • Don’t ever lose sight of the fact that behind every number is a patient.
  • Treat others with the courtesy and respect with which you hope to be treated.
  • How you are perceived as a case manager will be a reflection on every other person who refers to themselves as a case manager, so I make it a good experience for the client.

What is the single most successful thing that your organization is doing now?

I have a case management boot camp that has been well received. Often what I have found is that individuals transition into case management because of the work hours or other reason rather than actually wanting to make case management a professional adventure. Training is so vastly different from one organization to another that there is really very little actual training aside from the information system and day to day work flow process. The boot camp focuses on the actual steps of the case management process through interaction and exercises to help individuals to have a better framework for working with clients toward measurable and achievable goals. The way I see it, the case manager should be considered to be a bridge to self-advocacy and self-management of their own healthcare rather than a crutch.

Do you see a trend or path that you have to lock onto for 2012? 2013?

I see a few things…

  • Many PPACA provisions kick in during 2012 to 13. Knowing what is coming up for implementation will help case managers ramp up for what they need to understand.
  • Many health systems are implementing their own brand of case management and unfortunately it simply requires a change in an individual’s job title rather than an evaluation of skill sets and provision of training and development opportunities in order for that person to be successful. These types of programs are going to be running aground and a need for knowledgeable case management consultants will bloom as the C-suite opts to address these less-than-successful programs.
  • The home care sector needs for case management are going to blossom as transition of care programs begin to engage more services to avoid readmissions.

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

Having an impact.

Some days it might be a very small thing, but to the individual I have worked with, whether mentoring a newer case manager or working with a client, it is something of great importance. I like that what I do is a positive contribution rather than a negative detraction. It is too easy to whine about this or that. Then I look around at the challenges others are facing and realize how fortunate I am to be able to help improve the lives of others. That is a gift.

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

The biggest challenge is that of complacency. I wrote about this in a recent blog post and summed up with the following… “Health care is always changing… consumer expectations are on the rise… and case managers are being viewed by many as a critical factor of successful patient-centered care coordination. I believe that an overwhelming number of case managers are up to the challenge being placed before them. The essential element that we must remain mindful of is to never fall into the pit of thinking that we know it all or that do not need to consistently and continuously improve the quality of the service we bring to the health care team.”

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

This is a great question for which I do not know an answer exists. Because case managers work in so many different settings of care, a tool or process that is great in one setting may not work in the next. However, with that said, I think that technology has the greatest potential for being the most effective tool… but it depends on the case manager and his/her ability to use it effectively and efficiently.

Where did you grow up?

I was born in Boston, Massachusetts and lived there for the first few years before moving to Hawaii for three years. We returned to live just south of Boston for the rest of my childhood and adolescence.

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

I have an ongoing love of learning so my education has progressed through a number of institutions: Laboure College, Stonehill College, Boston University, University of Phoenix. Currently, I am considering a return to school to earn my Doctor of Nursing Practice degree.

Are you married? Do you have children?

Yes, I am married to Dave Treiger. We will celebrate our 10th anniversary in August 2013. I have two furry children, cats whose names are Tang and Skooch.

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

I enjoy photography. It was something I used to do with my Dad that started when I was in high school. I still have both of our old SLR cameras… but now I primarily use a digital Nikon SLR.

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

It’s a classic but it remains my favorite book of all times, A Tale of Two Cities by Charles Dickens. I can’t tell you how many times I have read it since high school. As for a movie, I hate to sound so down on them but the quality of movies that have been made in the past 5 to 10 years has been less than overwhelming. Nothing really stands out that I would risk recommending to a friend.

Any additional comments?

Case management has changed my life and afforded me opportunities to travel around the world to share my experiences and learn about how case management is done in other healthcare systems.

I think that the case managers of today (and tomorrow) have to find ways in which to be proud and passionate about what they do and the critical part that they play in the healthcare delivery system. Our opportunities are endless so if a job isn’t working out to your expectations, find another one. Don’t allow complacency and resignation to direct your career choices. Envision your goals and then make them happen.

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

Health and Wellness Incentives in 2012: Participants Have to Hit Clinical Marks

September 13th, 2012 by Patricia Donovan

health incentives

Incentives in 2012: Rewarding Risk Assessment, Lifestyle Change

Showing up isn’t enough any more to earn a cash- or benefit-based incentive for health improvement, say respondents to HIN’s fourth annual Health & Wellness Incentives survey. Instead, employers and health plans are rewarding measurable achievements in health behavior change &#151 weight loss, smoking cessation, BMI reduction or other lifestyle changes that reduce an individual’s risk of developing or exacerbating a chronic (and costly) illness.

“That’s the future of population health management,” concurs Patricia Curran, principal in Buck Consultants’ National Clinical Practice. “Companies have developed incentive programs, but they’ve found that awarding incentives just for participating is not necessarily achieving the outcomes they want. Just taking the health risk assessment and the biometric screenings isn’t getting the results.”

While completion of a health risk assessment (HRA) remains the most heavily incented health improvement activity for the fourth consecutive year, according to two-thirds of survey respondents, more companies are incentivizing the lifestyle behavior changes of weight loss (57 percent) and smoking cessation (51 percent) than 2011’s favored activities of preventive screenings and participation in on-site wellness.

This makes sense, says Ms. Curran. “They’re making participants toe the mark. They have to meet certain health goals, and they’re going to be measuring that effort. They’re going to incentivize individuals for meeting those goals going forward. It’s a new trend — making people more aware of the importance of these health goals. [Companies] really want to see people getting results, so they’re going to be targeting things like weight management, tobacco cessation, BMI.”

In other survey findings, the use of texting to communicate incentive program details doubled in the last year, from 7 to 14 percent. Social networks and health portals also gained favor for this purpose. At the same time, more are relying on the more traditional communication modalities of work site flyers and table cards, a trend that has risen steadily from 61 percent in 2009 to 68 percent in 2011 to 84 percent this year.

“You have to leverage the right tools and techniques matched to those consumers or their preferences,” notes Jay Driggers, director of consumer engagement at Horizon Blue Cross Blue Shield. A key area of study for Driggers’s consumer engagement team is behavioral economics, which he refers to as “the carrots and the sticks, things that will motivate people to change their behavior or to do something.” Incentives fall into this category, he says.

The survey also identified a 2 percent increase in the awarding of incentives via contests and drawings, a practice reported by 57 percent of 2012 respondents. “In most cases, I think a lottery can be a cheaper option that will drive more participation than a one-to-one reward,” suggests Driggers, who recently outlined Horizon’s approach to consumer engagement in its patient-centered medical home initiative.

Other 2012 survey results:

  • The number of respondents reporting incentives program ROI of between 3:1 and 4:1 has doubled in the last 12 months, from 2.6 percent in 2011 to 5.3 percent this year. Program ROI of between 2:1 and 3:1 remained constant at 14 percent from 2011 to 2012.
  • The use of biometric screening to identify participants for incentive-based programs rose slightly in 2012 to 40 percent, up from 36 percent in 2011. Opt-in or self-registration remains the top identification tool, at 62 percent.
  • Group incentives lost some favor this year, in use by just 23 percent, versus 36 percent of 2011 respondents.
  • In new survey data this year, 20 percent extend eligibility for health and wellness incentives to domestic partners.

For more survey highlights, download the executive summary of Health & Wellness Incentives in 2012: Rewarding Risk Assessment, Lifestyle Changes. A detailed analysis of these metrics, including year-over-year trends, is provided in 2012 Healthcare Benchmarks: Health & Wellness Incentives.

Pharmacists Join CDC Team to Fight Rising Blood Pressure

September 12th, 2012 by Cheryl Miller

What with the economy, upcoming presidential elections, and several of our news stories this week, its no wonder Americans’ blood pressure is up. But it’s no excuse either, given that nearly one in three American adults has high blood pressure, and more than half don’t have it under control. It’s a major risk factor for heart disease and stroke, and the first and fourth leading causes of death in the United States, leading to nearly 1,000 deaths a day, and costing the United States almost $131 billion annually, CDC officials say.

To counter these alarming statistics, CDC has joined forces with pharmacists and is launching a care team initiative to help patients control their blood pressure. Customers at drugstores around the nation will receive informational materials, including wallet cards to track medication use and educational videos.

More news to raise blood pressure: nearly one third of America’s healthcare spending in 2009 – roughly $750 billion – was wasted on unnecessary services, excessive administrative costs, and fraud, among other problems, according to a report from the Institute of Medicine (IOM). Such inefficiencies are hindering progress and threatening the nation’s economic stability and global competitiveness, says the IOM. But there are ways to repair the system, as suggested in one report recommendation: mobile technologies and EHRs can help professionals to capture and share health data better. Others are detailed in our story.

And still more news to keep that pressure up: the United States performs worse than France, Germany, and the United Kingdom, according to a Commonwealth Fund–supported study published in Health Affairs. Between 1999 and 2006 to 2007, the overall potentially preventable death rate among men ages 0 to 74 dropped by only 18.5 percent in the United States, while the rate declined by nearly 37 percent in the United Kingdom. For women, the rate fell by 17.5 percent in the United States but by nearly 32 percent in the United Kingdom.

But there is some news to slow Americans’ pulse: results from a multi-year accountable care collaborative program between Aetna and NovaHealth, an IPA, show significant improvements in quality of care and lowered healthcare costs, Aetna reports.

Read all of these stories in their entirety in this week’s Healthcare Business Weekly Update.

Medicare Aims to Improve User Experience

September 7th, 2012 by Cheryl Miller

Medicare user

Two new initiatives designed to help Medicare beneficiaries better understand their benefits are now available.

CMS has redesigned its Medicare Web site,, in an attempt to simplify the language and home page layout and make the content more accessible and quicker to navigate for Medicare beneficiaries, families and caregivers.

Users can now do the following directly from the home page:

  • Search for whether a specific test, item, or service is covered under original Medicare;
  • Get customized information based on a beneficiary’s specific situation;
  • Get quick links to replace a lost Medicare card, find a Medicare Advantage or prescription drug plan, and get help with healthcare costs.

And HHS has partnered with five major pharmacies to make educational materials on Medicare benefits more widely available, including information on newly available preventive services, and savings on prescription drug spending in the “donut hole” coverage gap.

Some examples of how the pharmacy partners, which include CVS Caremark, Walgreens, Thrifty White, Walmart, and Sam’s Club, will work together to increase awareness include the following:

  • CVS Caremark will distribute material to beneficiaries at its more than 7,300 CVS/pharmacy stores and 600 MinuteClinic locations, through brochures, register receipt messages and online;
  • Thrifty White pharmacy will provide information through its 85 locations throughout the midwest;
  • Walgreens will distribute information in nearly 8,000 pharmacies and over 350 Take Care Clinic locations, as well as use in-store announcements;
  • HHS will also work with Walmart and Sam’s Club to provide healthcare information to their shoppers online.

Other pharmacies or partners can find information on how to work with CMS to educate consumers about the benefits available to them, while interested users can visit the new Medicare benefits site.

11 Ways to Engage Consumers in Patient Portals

September 5th, 2012 by Patricia Donovan
patient portal

Patient portals increase engagement, support stage 2 meaningful use.

Patient portals are an ideal way to boost patient engagement, a metric getting lots of attention in stage 2 of the federal government’s incentive plan for meaningful use of EHRs. Stage 2, which will begin as early as 2014, increases health information exchange between providers and promotes patient engagement by giving patients secure online access to their health information.

Under the final rule issued last month, organizations vying for meaningful use incentives will not only have to demonstrate the availability of patient portals, but also the percentage of patients accessing health information via these channels.

There are plenty of portals already out there, but how can healthcare companies convince patients and health plan members to use the portal? Problems with portal awareness, functionality and health literacy can sink a portal project before it gets off the ground. In a Physicians Practice podcast, pediatrician Peter M. Kilbridge, a senior research director with The Advisory Board Company, suggests 11 ways to not only engage patients in portal use but also increase the likelihood they’ll return to the tool continually to manage their health:

  1. Make sure patients are aware of the portal. Staff should inform patients about the portal, and brochures and sign-in credentials should be readily available, recommends Dr. Kilbridge.
  2. Highlight functions patients care about, such as the ability to send secure messages or questions and schedule referrals.
  3. If patients aren’t scheduled to come in to the office for an appointment, send them an e-mail or snail mail announcement about the portal.
  4. When building a portal, it’s important that patients get there on the first try. Keep the instructions and path to the portal simple.
  5. Define the physician’s role in this process — the most important role, Dr. Kilbridge emphasizes. “Physicians have a greater ability than anyone else to influence. You must educate the physicians in proper portal use.” Even among physicians, the digital divide is great, he adds. “Show the physicians how the portal will help them — by reducing phone calls, by motivating patients to follow up on test results.” All of these benefits can improve overall clinical indicators for a practice.
  6. Encourage the healthy to use the portal. “Healthy patients will use the portal when it simplifies routine tasks, like making appointments.”
  7. Add health and wellness information, such as links to community activities such as walks or runs, that providers can point to during visits.
  8. For patients with chronic illness, offer logs for them to enter regular data, such as weight o A1C levels, and activate red flags when they reach warning levels.
  9. Pay attention to health literacy levels, making sure the information and tools available from the portal are easy to understand.
  10. Coordinate the portal with other means of patient access, such as a call center or nurse advice line. These groups can also refer patients to the portal for more information.
  11. Coordinate the portal with other communication modalities. “Some portals can be built to interact with texting,” notes Dr. Kilbridge, who estimates that about 85 percent of individuals are comfortable using texting.

What about the elderly? Will they use the portal? “There are always populations that won’t use it — minorities, elders, the less educated.”

But judging from the numbers of grandparents proudly sharing their grandchildren’s photos on social networks like Facebook, expecting them to tackle a patient portal may not be such a stretch.