New NCQA Measure Helps Health Plans Reduce Preventable Hospital Readmissions

Thursday, December 6th, 2012
This post was written by Cheryl Miller

Studies show that up to 20 percent of Medicare patients discharged from the hospital will be readmitted within 30 days, disrupting the lives of patients and their families, and leading to increased morbidity and healthcare costs.

A new report from the NCQA provides a detailed look at a new measure designed to help purchasers and health plans reduce hospital readmissions, improve care and reduce costs. Improving discharge and transition procedures and chronic care management are some of the processes examined in the report, which can be found online.

Reductions in employee health risks lead to immediate cost savings, while the accumulation of additional health risks lead to significantly higher medical and pharmacy costs, according to a study from StayWell Health Management and Towers Watson.

In one of the first multi-employer studies to explore the timing of changes in healthcare costs related to increases or decreases in health risks, prevention is found to be key to reducing healthcare costs for all employees, and especially important for the chronically ill. This study is particularly timely given the number of employers who are evaluating their workplace health management programs.

Keeping healthy people healthy, empowering people to reduce modifiable lifestyle risks and addressing acute and chronic disease are some of the imperatives for total population health management, according to a new collaboration between Healthways and Mercy, the sixth largest Catholic healthcare system in the United States. Other strategies include managing financial risks associated with caring for populations, enhancing physician alignment with integrated and independent physicians. The effort will enable both health systems to bring combined capabilities to a larger network of regional employers and insurance companies.

Health coaching is also a critical tool in population health management, helping to boost self-management of disease and reduce risk and associated cost across the health continuum. Take our fourth annual survey to find out how healthcare organizations use health coaching as well as the financial and clinical outcomes that result. Complete the survey by December 21st and receive a free executive summary of the compiled results. Your responses will be kept strictly confidential.

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

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