Archive for November, 2013

Infographic: Predicted Benefits for Physicians

November 29th, 2013 by Jackie Lyons

In spite of the initial issues with the implementation of the Affordable Care Act (ACA), there are predicted benefits for physicians and U.S. citizens alike.

The ACA will lead to estimated savings of about $190 billion in the federal budget during the next 10 years, which will lower the healthcare deficit to 174 percent, according to a new infographic from Medical Billing Star. This infographic also shows ACA statistical data, new insurance payors, predicted coverage and more.

Obamacare – A Precursor for Financially Sound Healthcare Practice

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You may also be interested in this related resource: Healthcare Trends & Forecasts in 2014: Performance Expectations for the Healthcare Industry .

Healthcare Business Week in Review: Oncology PCMH; Medication Management; Seniors on FB

November 29th, 2013 by Cheryl Miller

As families gathered this week to celebrate Thanksgivikkuh, (which won’t happen again for 77,000 years!) we offered several stories that demonstrate the strength of partnerships.

To begin, a first-of-its-kind patient-centered medical home (PCMH) model for oncology from Aetna and Consultants in Medical Oncology and Hematology, PC (CMOH).

The collaboration combines evidence-based decision support in cancer care with enhanced personalized services and realigned payment structure and is designed to increase treatment coordination and improve quality outcomes and costs for cancer patients. Researchers found that more than half of all new cancer patients are 65 or older, and most have one or more health conditions in addition to cancer. Given their frequency of contact with patients, oncologists are well positioned to help their patients coordinate care for multiple conditions.

Physician-led, team-based models of care are the future of healthcare, according to the AMA, which has issued a set of recommendations for implementing these models, including a report for the development of payment mechanisms that promote satisfaction and sustainability of team-based models in various practice settings. Among the recommendations: establishing payment distribution models that foster physician-led team based care, and reimbursing those physicians who lead these teams accordingly.

High-risk heart failure patients receiving nursing interventions were four times as likely to take their medication, but their hospital readmission rates were not impacted, according to a new study at Duke Medicine.

Patients who were tutored about managing their symptoms, taking their pills on schedule, and developing an action plan for addressing their symptoms were more likely to take their prescribed medications. They were encouraged to use doctors’ offices and clinics rather than the emergency department.

But when the researchers looked at the hospital readmission rate, they found that readmissions were not significantly different between the two groups. Medication management is just one of many issues facing patients most at risk for their conditions to worsen, researchers found, and redesigning care to confront the issues that are keeping the vulnerable from regaining their health has to be addressed.

Developing a communication hub, virtually and in person, is critical to a successful care coordination plan for dual eligibles, says Timothy C. Schwab, MD, FACP, former chief medical officer of SCAN Health Plan. It ensures that all members of the immediate and long-term support team are in sync with each other.

Seniors want to stay connected. According to a new Accenture survey, more than half of seniors 65 years and older are seeking digital options for managing their health services remotely. In fact, researchers found that at least three-fourths of Medicare recipients access the Internet at least once a day for e-mail (91 percent) or to conduct online searches (73 percent) and a third access social media sites, such as Facebook, at least once a week.

And lastly, a way for you to communicate with us: participate in our fourth comprehensive online survey, Reducing Hospital Readmissions Benchmark Survey, and we will send you a free e-summary of the results once they are compiled.

Infographic: Giving Thanks for Caregivers

November 28th, 2013 by Jackie Lyons

As the baby boomer population continues to age, the need for long-term care continues to increase.

Sixty-five million family caregivers in the United States provide care for chronically ill, disabled, or aged family or friends, according to a new infographic from ACSIA, Long Term Care Inc. This infographic presents the duties, effects and financial aspects of care giving, along with statistics and facts regarding caregiver education and health.

Top 15 Enlightening Facts about Caregivers

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You may also be interested in this related resource: Guide to Care Transition Management.

Infographic: Lung Cancer

November 27th, 2013 by Jackie Lyons

Lung cancer accounts for 14 percent of all cancer diagnoses, according to a new infographic from TopMastersInHealthcare.com.

The incidence in men has been declining over the past two decades, and the rate in women has just begun to decrease, as shown in the infographic. This infographic also details a timeline of lung cancer, causes, risk factors, experimental treatments, cancer facts versus myths and more.

Lung Cancer

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

You may also be interested in this related resource: 2011 Benchmarks in Tobacco Cessation and Prevention.

Infographic: Leaks in the Healthcare Claim Process

November 26th, 2013 by Jackie Lyons

In healthcare’s post-reform volume-to-value world, payor reimbursement strategies are tipping in favor of providers who can deliver clinical and financial goods.

However, most practice are leaving up to 30 percent of potential revenue on the table due to insufficient internal resources, processes and technology, according to a new infographic from CareCloud. This infographic shows exactly where physicians are losing money, specifically during the pre- and post-visits, and the visit itself.

Leaks in the Claim Process

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You may also be interested in this related resource: Guide to Value-Based Reimbursement: Profiting from Payment Bundling, PHO Shared Savings, and Pay for Performance.

Meet Geriatric Care Manager Trish Colucci: ‘Jersey Girl’ Finds Passion Helping Others

November 26th, 2013 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.


Trish Colucci, RN, Certified Geriatric Care Manager, Certified Gerontological Nurse, Certified Case Manager, current president of the New Jersey chapter of NAPGCM, Owner of Peace of Mind Care Management Services, LLC

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

(Trish Colucci) I have been a N.J. state Registered Nurse (RN) since 1985 and have additional certifications in gerontological nursing, case management, and life care planning. Currently, I am the president of the N.J. chapter of the National Association of Professional Geriatric Care Managers (NAPGCM). Prior to that I served two years as treasurer and two years as vice president.

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

When I graduated, I started working as a floor nurse at a local hospital. Although I always saw myself in pediatrics, there were no positions available at the time, so instead I accepted a position on the orthopedic floor. It was serendipitous! In that unit, I developed a love for working with elderly folks. I was later offered a shift in career to insurance case management, at the time when that field of nursing was brand new. In that position, I developed valuable organizational skills and clinical knowledge that helped me coordinate care for our catastrophically ill or injured claimants and to ensure that they received the best medical care possible.

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

Years later, I gave birth to my son who has Down Syndrome, and who had a lot of special medical needs. I was able to utilize my case management skills (which were now second nature) to coordinate a team of top-notch doctors who addressed Michael’s multitude of medical problems and worked together, with my management. It was after that that I noticed friends coming to me to ask advice for coordinating care for their own loved ones. It helped me realize how valuable my case management skills were and how they could be helpful to others trying to navigate the confusing worlds of medical care and insurance.

In brief, describe your organization.

Peace of Mind Care Management Services, LLC is a care management firm that assists families, guardians and caregivers with the management of their loved one’s personal and medical care. We specialize in crisis management, often finding families confused and overwhelmed by their responsibilities in an arena with which they are not familiar. As care managers, we assess the situation and create a specialized plan of care that addresses the needs of the client within the available budget. We offer support, resources and guidance so that families feel more comfortable and informed in making important decisions for the care of their loved one.

Serving as president of the New Jersey chapter of the NAPGCM has opened my eyes to opportunities for care managers on both the local and national levels. Although the field of geriatric care management has been around for over 25 years, it is not well known by the general public. Our chapter’s main focus over the past year has been on developing a solid, working public relations committee, and to make, “geriatric care management” a household word and the first point of contact for families who need help with their loved one.

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

  • The most important concept in care management is a trusting relationship. Our clients need to know that as care managers we provide honest, caring advice that is in their (or their loved one’s) best interests. We are not financially connected to any resource we may offer to a family, and this keeps our advice objective and trustworthy. We refer to resources we would use for our own family members and this provides an extra level of trust with our clients.
  • Compassion is another important concept. At Peace of Mind, each client is as precious as the next, coming to us with his or her own history and special needs. We reach out to our clients and their caregivers with compassion and empathy, developing an understanding about where they’re coming from so we can tailor our guidance in a way that makes them the most comfortable.

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

What I derive the most satisfaction from is the look on the face of a client or caregiver we’ve helped. Seeing on their faces the signs of relief…of tensions easing…because they got the help they needed to care for their loved one, provides me, as the care manager, the signs that I’ve done a good job for the family. Even in situations where clients are in the process of dying, knowing that I have coordinated their care such that they will leave this world feeling comfortable and loved, makes me feel good about the work I do.

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

What I love about being a geriatric care manager is the diversity of duties, however that’s one of the things that makes this job such a challenge! Each day brings forth some new challenge, and my schedule can change hour-to-hour. It helps to be flexible! I am fortunate to have a strong, warm and wonderful care management team made up of nurses and social workers. When we are faced with tight situations, we reach out to one another for assistance and support. Whether it’s a race against time to get medical equipment in the home before a client comes home from the hospital, or a family member who needs extra hand-holding and reassurance on a particular day, or an unexpected emergency with a client that needs immediate attention, we are ready to act.

Where did you grow up?

I grew up in Denville, N.J. and am the eldest of three girls. I am a “Jersey Girl” through and through. My dad was a police officer and my mom was a bank teller. Sounds like the makings of a good Bruce Springsteen song, doesn’t it?

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

Infographic: A Majority of Eligible Adults Likely to Shop for Coverage in Health Insurance Marketplaces

November 25th, 2013 by Jackie Lyons

Open enrollment in a health plan that covers essential benefits and pre-existing conditions continues until March 31, 2014. But what do we know about experiences with the health insurance marketplaces thus far?

Seventeen percent of eligible adults went to their state’s marketplace in October to shop for a health plan, according to a new infographic from the Commonwealth Fund. The infographic also documents awareness of the marketplace, ages of those who shopped, enrollment percentages and those likely to shop for a plan in the near future.

A Majority of Eligible Adults Likely to Shop for Coverage in Health Insurance Marketplaces

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You may also be interested in this related resource: Health Insurance Exchanges: Product Design, Promotion and Positioning.

Infographic: Healthcare.gov is Fundamentally Flawed

November 22nd, 2013 by Jackie Lyons

The launch of the healthcare.gov website was plagued with large-scale problems, and some of the issues have yet to be fixed.

Only .38 percent of visitors- or 36,000 people – were able to complete enrollment on the healthcare.gov website, according to a new infographic from Healthcare-Administration-Degree.net. This infographic also outlines specific issues with the site, market efficiency, repercussions of centralizing health data and more.

Healthcare.gov is Fundamentally Flawed

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You may also be interested in this related resource: The Financial Professional’s Guide to Healthcare Reform.

Healthcare Business Week in Review: Healthcare Costs; Health Insurance Marketplaces, Diabetes Management

November 22nd, 2013 by Cheryl Miller

The United States spends more money on healthcare than other developed countries, and yet their outcomes are worse, according to a new study from Johns Hopkins.

But political infighting is preventing the country from achieving ways to deliver care more effectively and efficiently.

The study, published in JAMA, attempts to dispel several common misconceptions informing the current healthcare debate. Among them: that the aging of the population and the large numbers of tests and treatments being prescribed have been primarily responsible for escalating healthcare costs. Researchers assert that the prices of drugs, medical devices and hospital costs have driven up the costs of healthcare in this country over the last decade, and that it’s not the elderly that are ratcheting up healthcare costs, but those under 65 with chronic conditions.

What is needed to fix the system? An investment in primary care doctors, and a unified government, among other things.

Policymakers can start coming together on the latest news from the White House: insurers can extend current insurance plans that would otherwise be canceled into 2014, and Americans whose plans have been canceled can choose to re-enroll in the same kind of plan.

In the past few weeks, some Americans have been notified by their health insurance companies that plans they bought on the old individual insurance market were being cancelled, often because these plans no longer met the ACA’s requirement to cover basic benefits like prescription drugs or doctors’ visits. These people now have an additional year of coverage.

Some news that no one can debate: 106,185 Americans selected health plans in the first reporting period of open enrollment (October 1st through November 2nd) ; 975,407 customers made it through the process but have not yet selected a plan; and an additional 396,261 customers were determined eligible for Medicaid or the Children’s Health Insurance Program (CHIP). These results, from an issue brief from HHS, show that the level of interest is strong, and that enrollment should grow substantially throughout the next five months.

In other news: diabetic patients treated in the ED who were enrolled in a program sending daily automatic text messages improved their level of control over their diabetes and their medication adherence, according to a study from the Keck School of Medicine at the University of Southern California in Los Angeles.

The text messaging program, called TExT-MED, is low cost and widely available for those patients who have no other source of medical care.

Don’t forget to participate in our fourth comprehensive Reducing Hospital Readmissions Benchmark Survey. While great strides have been made in the reduction of 30-day all-cause hospital readmissions, CMS still docked reimbursement for more than 2,200 hospitals in 2013 for exceeding 30-day readmission rates for heart failure, pneumonia and myocardial infarction. In 2015, CMS penalties will extend to acute COPD and elective hip and knee replacements. Describe how your organization is working to reduce hospital readmissions by January 3, 2014 and receive an e-summary of the results once they are compiled.

Infographic: Pick Your Provider Before You Pick Your Plan

November 21st, 2013 by Jackie Lyons

As millions of Americans begin choosing a health plan under the Affordable Care Act (ACA), it is important to know how a patient’s health can be impacted by hospital selection.

If all hospitals performed similarly to the quality of 5-star hospitals from 2010 to 2012, 234,252 lives could potentially be saved, according to a new infographic from Healthgrades. The infographic shows the American attitude toward healthcare, percentage of Americans who gather information before making a care decision, examples from the 2014 Healthgrades American Hospital Quality Report, and the extent of healthcare spending.

Pick Your Provider Before You Pick Your Plan

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

You may also be interested in this related resource: The Patient-Centered Payoff: Driving Practice Growth Through Image, Culture, and Patient Experience.