Archive for November, 2013

Accountable Care in 2013: Can the ACO Maintain Its Momentum?

November 21st, 2013 by Patricia Donovan

The number of PHO-led ACOs nearly doubled from 2012 to 2013.

Like the hoopla surrounding the patient-centered medical home before it (a model recently pronounced ‘mainstream’ by one industry thought leader), the initial excitement accompanying the ACO has settled into more realistic levels, according to our third annual Accountable Care Organizations survey.

Physician-hospital collaborations and multi-specialty physician groups have emerged as front runners in accountable care organizations, largely because their organizational structures have the best “bones” for success in accountable care.

The number of ACOs continues to climb, with many more on the horizon, including the accountable care organizations survey respondents will roll out from January to June 2014. Once largely the domain of Medicare, the ACO model is popping up in commercial and even Medicaid territory. In fact, the Colorado Medicaid Accountable Care program just this month announced it had doubled its savings to $44 million in just one year.

And so the logical question to ask is: Can the ACO maintain its momentum? Steven Valentine, president, The Camden Group, and Catherine Sreckovich, managing director, healthcare, Navigant, who led HIN’s 2014 Healthcare Trends and Forecasts strategic planning session, believe it’s possible.

“Medicare will continue to expand, though perhaps in some different models,” notes Ms. Sreckovich. “For Medicaid, there is definitely an interest in moving forward with ACOs, and I believe the same thing with private plans. There are some state innovation grants out there now. For example, Ohio, Arkansas and a few other states are focused on single initiatives that cover all of the payors. Arkansas, for example, is trying to convince Medicare to join in its bundled payment initiative so that the payment bundles it creates will be the same for private health plans, Medicaid and Medicare.”

“Medicare will continue to grow, even though providers will seek to convert them to Medicare Advantage,” predicts Valentine. “And I do see opportunity with commercial ACO models; Blue Shield in California has had great success in reducing costs through commercial ACO activities in the state.”

The accountable care organization continues to hold promise, Valentine said, but despite the proliferation of ACOs, not all have delivered as expected. He advises ACOs to shore up infrastructure and focus more on medical management.

Infographic: Job Satisfaction for Nurses Helps Enhance Patient Outcomes

November 20th, 2013 by Jackie Lyons

When nurses enjoy their jobs and intend to stay in their positions long-term, patient outcomes improve, according to the American Nurses Association (ANA).

As a result, infection rate decreased by 87 percent in two years, according to a new infographic from ANA. The infographic shows additional ways patients benefit from having satisfied nurses, as well as other trends in the nursing profession.

Job Satisfaction for Nurses Helps Enhance Patient Outcomes

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You may also be interested in this related resource: Health Care System Transformation for Nursing and Health Care Leaders: Implementing a Culture of Caring.

Infographic: The Guide to the Future of Medicine

November 19th, 2013 by Jackie Lyons

Digital literacy is readily available to patients and meaningful use of social media is already in progress, while home diagnostic tools still need time to develop, according to a new infographic from Science Roll.

This infographic shows which stage of healthcare delivery and the practice of medicine is affected by emerging trends, whether the trends affect patients or healthcare professionals, and the practicability of trends and whether they are already available or not.

The Guide to the Future of Medicine

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You may also be interested in this related resource: Drug Benefit Trends and Strategies: 2013.

HealthFitness Refines Population Health via Engagement, Tools and Technology

November 19th, 2013 by Jessica Fornarotto

Integrated health coaching continues to move the needle on population health management with interventions that keep the healthy, healthy without compromising the clinical support needed for high-risk, high utilization individuals. Dr. Dennis Richling, chief medical and wellness officer for HealthFitness, and Kelly Merriman, vice president of service delivery for HealthFitness, believe coaching offers a great opportunity to change the health status of a population.

In HIN’s special report, Integrated Health Coaching: Reducing Risk and Empowering Change across the Health Continuum, these industry experts detail HealthFitness’ move toward integrated health coaching, including the rules of participant engagement, the role of technology, and the range of self-management tools provided for participants.

Question: What strategies reach the population and increase engagement in health and wellness coaching?

Response: (Dr. Richling) One of the key strategies has been the use of an incentive that draws people toward the program. Incentives are fairly effective in getting people to do certain kinds of activities. If we provide an incentive for taking a health assessment, for instance, then we can engage them in a health advising session. We can take that external incentive and try to leverage it into an intrinsic motivation to go into our health coaching program. We see a better engagement rate when we offer an HRA, and when we provide screenings and advisement.

(Kelly Merriman) Engagement is also how long participants are choosing to engage with their coach. One of the main reasons we created our EMPOWERED Coaching program, or coaching across the continuum, is to more appropriately assign those individuals who have a chronic condition that is being well managed with somebody specially trained in lifestyle engagement techniques. Individuals working with our advanced practice coaches are much more likely to remain engaged with their coach because they’re focusing on those things that are most important to them.

Question: What is the role of technology in the various levels of health and lifestyle coaching?

Response: (Dr. Richling) We have developed a sophisticated algorithm that uses claims data and HRA data to decide which coach would be the best coach for the participant. The algorithm evaluates whether the individual has the appropriateness of care compared to chronic care guidelines, whether they are compliant to those guidelines, if they are having trouble with functions of daily living, and it also evaluates the risk for high cost in the future. These all go into identifying which professional coach would be the best fit for an individual. Technology continues to play a role after a person and coach are matched:

  • Assessment of risk is ongoing; HealthFitness’ data and technology platform can reassess a participant’s health status whenever new data becomes available.
  • Health coaches access a unique dashboard of participant-specific information via a proprietary HealthFitness technology platform. The technology populates a record with personal health risk factors, claims data, biometric screening results and previous contact with the coach and other program personnel, as well as complete activity and program information feeds.
  • The platform also displays a 360-degree interactive view of client-specific program options so the coach can reference participants to health management activities and programs from their employer, whether HealthFitness provides the services or not.

Question: What tools do you provide to your coaching participants to help them self-manage their conditions?

Response: (Kelly Merriman) We have a series of educational and self-management tools available for participants via their wellness Web site and/or the mail. For example, a coach can share documents and resources with a participant through a toolbox, which then integrates with the wellness portal. Additionally, participants are able to set up and track their focus area goals of interest. The coaching program has a mobile phone interface that allows users to track their progress remotely and stay in touch with their coach.

HINfographic: The Medical Home Neighborhood

November 18th, 2013 by Jackie Lyons

There are more than 6,037 PCMH sites in the United States, according to the NCQA. To further reduce fragmented care, many PCMHs are expanding to house the entire care continuum – a phenomenon known as the Medical Neighborhood.

Medical home neighbors include specialists along with primary care clinicians to better coordinate care, according to a new infographic from the Healthcare Intelligence Network. This HINfographic also includes successful tactics for medical home ‘neighbors,’ signs of a desirable medical neighborhood and medical home neighborhood advice and comments from actual healthcare organizations.

The Medical Home Neighborhood

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.

Information presented in this infographic was excerpted from: Medical Home Neighborhoods: Uplinking Specialists To Create Integrated Systems of Care. If you would like to learn more about medical home neighborhoods, this resource includes even more information, including how to help physicians understand the link between meaningful use, care coordination across the neighborhood, and detailed lessons learned in building medical neighborhoods.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Healthcare Business Week in Review: Patient Satisfaction; Health Insurance Marketplaces; Physician Shortage

November 15th, 2013 by Cheryl Miller

Familiarity does not breed contempt; instead, it leads to increased patient satisfaction scores, according to a new Vanderbilt study.

Realizing that nearly 90 percent of medical patients are unable to correctly name their treating physician following inpatient admission, researchers studied the effects of giving a randomized group of patients a simple biosketch card about their doctor. Patient satisfaction scores for the group receiving the card were 22 percent higher than those who did not receive the card. With Medicare reimbursements linked to HCAHPS patient satisfaction scores, this study has significant ramifications.

Some good news about the health insurance marketplaces: despite widespread difficulty accessing the online sites, public awareness has tripled since their October 1st launch, and a majority of those unable to access them will try again, according to a new Commonwealth Fund survey.

According to the survey brief, more than half (58 percent) of those who are potentially eligible for coverage but who have not yet enrolled say they are likely to try to enroll or find out about financial help by March 31, 2014, the end of the open enrollment period. Seventeen percent of Americans who are potentially eligible for coverage have visited new health insurance marketplaces to buy coverage, via mail, Internet, phone, or in person. And nearly a third of adults who visited the marketplaces ranked their experiences as good or excellent. The extensive tracking survey is expected to come out again in December.

The expected glut of newly insured Americans seeking healthcare under the ACA could result in anticipated shortage of primary care physicians (PCPs) over the next decade, according to a new RAND Corporation study.

Expanding the role of nurse practitioners and physician assistants could help eliminate this. By using new models of healthcare that depend more on non-physicians, such as patient-centered medical homes (PCMHs) and nurse-managed health centers, more than 50 percent of the expected shortage predicted to hit the United States over the next decade could be eliminated.

One way to keep Americans healthy: offer them incentives. And while offering NASCAR® tickets for completing a health risk assessment (HRA) might not be successful for everyone, they were the right incentive for one trucking company surveyed by Buck Consultants’ National Clinical Practice, says principal Patricia Curran. Many companies offer employees incentives for wellness participation, but they need to look at their population and determine what would most motivate them. We detail more in this week’s featured book excerpt.

Need an incentive to finish our current online survey on Healthcare Trends in 2014? How about a training DVD of the “2014 Healthcare Trends and Forecasts” webinar recorded on October 30, 2013? One lucky respondent to our survey will win it, so please tell us about the last 12 months and how your organization is preparing for 2014 by completing HIN’s ninth annual survey by November 18, 2013.

Infographic: 17 States Hinder Consumers from Getting Help in Health Insurance Marketplaces

November 15th, 2013 by Jackie Lyons

The Affordable Care Act (ACA) will ideally make it easier and less expensive to obtain healthcare, yet there are still several barriers to care in the foreseeable future.

Seventeen states have passed laws restricting navigators and others trained to help consumers learn about and enroll in the ACA’s health insurance marketplaces, according to a new infographic from the Commonwealth Fund. This infographic identifies those states, as well as how specific states will be affected by these laws.

17 States Hinder Consumers From Getting Help in the Health Insurance Marketplaces

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

One-Minute Health Metrics Video: Mobile Health

November 14th, 2013 by Jackie Lyons

Used a smartphone app for health reasons lately? Chances are your patients and health plan members have, too. The use of mobile health (mHealth) technologies has transformed the exchange of healthcare data, with mobile apps monitoring everything from blood sugar to medication adherence, and text-based reminders urging smokers not to give into that craving.

In fact, some studies predict that mHealth technologies can save from $1.96 billion to $5.83 billion in healthcare costs by the year 2014. This One-Minute Metrics video summarizes mobile health practices of 150 healthcare organizations from HIN’s first mHealth e-survey conducted in March 2013.

Click here for other mobile health resources.

Infographic: Can EHRs Save the Private Practice?

November 14th, 2013 by Jackie Lyons

One study reported in JAMA Internal Medicine suggested a steady 2 percent per year decline of private practices — especially those with fewer than 10 providers. Can electronic health records (EHRs) help save these private practices?

More than 45 percent of physicians in private practices of less than five physicians do not have an EHR, according to a new infographic from Kareo. This infographic also includes data on the lack of EHR adoption, advantages of EHRs, effects on patient satisfaction, return on investment of EHRs and more.

Can EHRs Save the Private Practice?

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: Electronic Health Records: Transforming Your Medical Practice.

Infographic: Mobile + Apps = Healthcare Future

November 13th, 2013 by Jackie Lyons

Numbers show that mobile health (mHealth) apps are not only growing, but they will also play a large role in healthcare in the future.

More than 50 percent of patients downloaded health information from the Internet in 2012, according to a new infographic from IMS Institute for Healthcare Informatics. This infographic also includes the barriers to mHealth implementation, reasons for gaps in use, generational differences in use and four factors necessary to drive mHealth apps.

Mobile + Apps = Healthcare Future

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: 2013 Healthcare Benchmarks: Mobile Health.