Archive for February, 2014

Infographic: New Mobile Health Technology in 2024

February 28th, 2014 by Jackie Lyons

Technology is evolving at a fast pace, and healthcare is evolving with it. In 2024, mobile health (mHealth) technology will include contact lenses that monitor symptoms of diabetes, socks that track movement and monitor weight, and much more, according to a new infographic from BUPA.

This infographic looks at nine mHealth technologies that will monitor patients and aid in health management by 2024.

You may also be interested in this related resource: Integrating Mobile Health Remote Patient Monitoring with Telephonic Care Management for Improved Care Coordination Results. Want to know more about mHealth? During a March 19th webinar at 1:30 p.m. Eastern, Gail Miller, vice president of telephonic clinical operations in Humana’s care management organization, Humana Cares/SeniorBridge, will share details of Humana’s telephonic care management program and how these remote monitoring pilots will enhance their care coordination efforts.


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6 Strategies Help Stem Hospital Readmissions, Streamline Processes and Care Transitions

February 27th, 2014 by Cheryl Miller

Development of post-acute partnerships with home health, skilled nursing facilities (SNFs) and hospice is emerging as a key strategy to stem hospital readmissions, according to new market data from the fourth annual Healthcare Intelligence Network (HIN) Reducing Hospital Readmissions Survey.

More than half of survey respondents participate in post-acute partnerships, with home health collaborations the most common (79 percent). These partnerships serve to streamline processes and care transitions, educate and align staff, and implement changes of value to patients, respondents say.

Looking at more conventional approaches, medication reconciliation and telephonic monitoring of patients post-discharge emerged as frontrunner strategies to curb readmissions. Moreover, the 2013 survey revealed significant upticks in the use of each tactic over 2012 levels: medication reconciliation is now conducted by 73 percent of respondents, versus 54 percent in 2012, while the use of telephonic monitoring jumped from 48 to 71 percent over the same 12-month period.

In other new data, almost half of respondents — 47 percent — aim programs at individuals already assessed at high risk for readmission as well as traditional Medicare (53 percent), Medicaid (28 percent) and high utilizer (23 percent).

Other key findings include the following:

  • Two-thirds of respondents to HIN’s December 2013 Readmissions e-survey have a program to reduce readmissions.
  • In a new metric from the 2013 survey, more than half — 52 percent — aim readmission reduction efforts at individuals with diabetes.
  • Case management is the most successful approach to curbing rehospitalizations, say 27 percent. The case manager retains chief responsibility for reducing readmissions, say 34 percent of respondents.
  • Heart failure remains the top condition targeted by programs, although a fifth already track readmissions for hip and knee replacements, a metric the Centers for Medicare and Medicaid Services (CMS) will examine more closely in 2015.

Excerpted from 2014 Healthcare Benchmarks: Reducing Hospital Readmissions.

Hospitals More Likely to Offer Nutrition Health Coaching, Group Sessions

February 26th, 2014 by Jessica Fornarotto

Health coaching is a critical tool in population health management, helping to boost self-management of disease and reduce risk and associated cost across the health continuum. In its fourth Health Coaching e-survey, conducted in 2013, the Healthcare Intelligence Network captured the ways in which healthcare organizations implement health coaching as well as the financial and clinical outcomes that result from this health improvement strategy.

Drilling down to the hospital/health system perspective, this survey analyzed this sector’s health coaching program components, delivery methods, and more.

Health coaching programs by hospitals and health systems are more inclined to address weight management, tobacco cessation and nutrition than coaching programs overall, survey results reveal. For example, 87 percent of responding hospitals offer nutrition-related coaching, versus 70 percent overall.

Conversely, this sector, which comprised 27 percent of survey respondents, is only a third as likely to address falls prevention (7 percent versus 19 percent overall) and much less likely to address medication adherence (33 percent versus 51 percent overall).

When Coaching is Provided

Coaching delivery methods differed for this sector as well. While no respondent in this sector reported the use of a smartphone app, responding hospitals/health systems were three times as likely as health coaching or disease management respondents to conduct group coaching sessions (53 percent of hospitals versus 14 percent of health coaching or disease management organizations), and significantly more likely to conduct face-to-face coaching (73 percent versus 59 percent overall).

Hospitals/health systems are only half as likely to mandate participation in coaching (7 percent versus 12 percent overall), yet are more likely to incent program participation (60 percent of hospitals/health systems versus 50 percent overall).

Excerpted from: 2013 Healthcare Benchmarks: Health Coaching

Infographic: 7 Reasons to Engage With Patients Before Their Appointments

February 26th, 2014 by Jackie Lyons

The need to engage patients by preparing them before their appointments is rapidly growing. Positives include efficiency and increased patient satisfaction due to less manual data entry and shorter patient wait times among other benefits, according to a new infographic from Leading Reach.

This infographic provides the top seven reasons to engage with patients before their appointments and 10 examples of information that can be sent to patients before their appointment to ensure satisfaction.

You may also be interested in this related resource: Healthcare Innovation in Action: 19 Transformative Trends. Need more ways to increase patient satisfaction? This 40-page resource examines a set of pioneering efforts supporting the industry’s seismic shift from a volume-based culture to one rewarding value and patient-centeredness.


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Technology Reshaping Behavior Change Business

February 25th, 2014 by Patricia Donovan

Technology, particularly mobile health, is reshaping the delivery of health coaching, as revealed by these select metrics from the 2013 Health Coaching survey conducted by the Healthcare Intelligence Network.

The prevalence of health coaching has climbed steadily in the last five years—from 60 percent five years ago to 75 percent today. Incentives to participate in health coaching are more plentiful, too, although participants have to do more than just sign up. Today’s trend is to hold the reward until the health goal is attained.

Technology, particularly mobile health, is reshaping coaching delivery. Telephonic coaching is still the most common coaching modality, but not as common as it was in 2008, when 86 percent of respondents reported the use of telephonic coaching. This year, that figure is 75 percent. Meanwhile, the use of smartphone coaching apps has nearly tripled in the last 12 months, from 4 percent in 2012 to 12 percent this year. Text messaging is up more than 50 percent, too, with 14 percent of respondents incorporating texting in their coaching programs.

health coaching technology
The effect of all of this technology? It remains to be seen. What we do know is that face-to-face coaching interactions are waning, down from 70 percent in 2010 to 59 percent in 2013, as are group coaching visits, which are now conducted by only 28 percent of respondents, versus 40 percent last year.

One constant: motivational interviewing remains the behavior change tool of choice. However, this year’s survey identified a near doubling in use of the Patient Activation Measure® to evaluate participants’ progress, from 10 to 18 percent. Interest in positive psychology has dropped steadily in the last five years, from 48 percent in 2008 to 26 percent this year.

Excerpted from: 57 Population Health Management Metrics: Assessing Risk to Maximize Reimbursement

Which Value-Based Reimbursement Model Will Ultimately Align Physicians?

February 24th, 2014 by Patricia Donovan


Move over, ACO: a new payment model in town “has an excellent chance of coalescing value around a single model,” according to Greg Mertz, MBA, FACMPE, managing director of Physician Strategies Group, LLC.

It’s not yet law, but the federal Better Care, Lower Cost Act introduced last month circumvents the ACO’s attribution model, which Mertz describes as “loosey-goosey,” and targets the sickest and highest cost patients, who are also eligible for financial incentives if they play by the act’s health management rules. In Mertz’s eyes, the ACO has a limited life span.

Touching briefly on the proposed legislation, Mertz all but left the accountable care organization off his list of six value-based physician compensation models explored during Physician Alignment: Which Model Is Right for You? workshop sponsored by the Healthcare Intelligence Network — except as a footnote under Population Management, a model Mertz described as still evolving.

And while three-quarters of healthcare leaders agree that quality is driving the need for alignment around a preferred reimbursement model, the simple presence of physicians in a hospital does not translate to alignment.

Instead, the financial catnip of incentives will draw physicians to collaborative efforts, he said. Mertz moved workshop participants along a “collaborative continuum” of alignment from an environment of “mutual toleration”—the state of many two- to four-doctor practices today where planning can be challenging—to Population Management, a model he termed “the least defined, most questionable of the value models right now.”

In all, Mertz explored the following six models:

  • Process Improvement
  • Physician-Hospital Organization (PHO)
  • Shared Savings
  • Case Pricing/Bundled Payments
  • Co-Management
  • Population Management

Engaging physicians in process improvement efforts is a first step toward much larger things, Mertz noted. “If you can’t get doctors to collaborate over something like standard orders, surgical trays or discharge orders, you’re going to be hard-pressed to move up the continuum toward any other kind of value models.”

Shared savings, a term nearly synonymous with kickbacks until a few years ago, now aligns with the government’s goal of reducing costs, Mertz noted, although it can be complex to implement. High cost service lines like orthopedics are good contenders, he added.

Case pricing and bundled payment models have great potential, while population management requires large numbers of physicians and patients. Many questions still surround population management, including the idea model to employ (Medicare’s ACO or a commercial payor’s), the best quality metrics to measure, and the likely short- and long-term benefits.

To guide workshop participants, Mertz presented examples of a small rural hospital, a competitive community hospital, and a large health system, outlining the challenges, likely realities and possible reimbursement models for each.

Regardless of an organization’s size, to foster alignment, healthcare companies should focus on education, engagement and fostering good citizenship among physicians, Mertz said, defining this last concept as being an active participant in organizational efforts.

“Help [physicians] develop the skills and ability to interact with their peers. Just because they have an MD or a DO after their name, doesn’t mean they know how to do that.”

Those efforts will pay dividends, he notes—including the kind that could eventually end up in physicians’ pockets.

Click here for an extended interview with Greg Mertz on the future of accountable care organizations.

Infographic: Top Physician Information Sources by Mobile Device

February 24th, 2014 by Jackie Lyons

As physician practices prepare for significant changes in 2014, many are looking to new technologies and information sources to drive efficiency and ensure quality of care.

Seventy-two percent of physicians use smart phones to access drug information such as dosage calculators, side effects and interactions, according to a new infographic from Wolters Kluwer Health. This infographic also shows smart phones versus tablets regarding frequency of usage and how they are being used, as well as other top physician information sources.

You may also be interested in this related resource: 2013 Healthcare Benchmarks: Mobile Health. Healthcare organizations need to be informed of new technologies and information sources. This 50-page resource details everything you need from mHealth trends, including current and planned mHealth initiatives, types and purpose of mHealth interventions, targeted populations and health conditions, to challenges, impact and results from mHealth efforts.


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Infographic: Differences Between ACO Patients and Non-ACO Patients

February 21st, 2014 by Jackie Lyons

The average total cost for a non-accountable care organization (ACO) patient is $470 more than the total cost of care for an ACO patient, according to a new infographic compiled by Health Affairs.

This infographic breaks down the two types of patients by race, Medicaid eligibility, income by geography, participating hospitals and more.

Differences Between ACO Patients and Non-ACO Patients

You may also be interested in this related resource: 2013 Healthcare Benchmarks: Accountable Care Organizations. This 65-page report documents the numerous ways in which accountable care is transforming healthcare delivery, particularly in the area of care coordination, where the ACO model has had the greatest impact for this year’s respondents.


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

3 Reasons Home Visits Critical During Care Transitions

February 20th, 2014 by Cheryl Miller

As far back as 2010, home visits were a vital component of the Durham Community Health Network (DCHN), a primary care case management program for Medicaid recipients who live in Durham County, NC, explains Jessica Simo, program manager with Durham Community Health Network (DCHN) for the Duke Division of Community Health. Conducted in three-month increments, and designed initially to better address Medicaid recipients’ needs and link them to their medical homes, the face-to-face visits helped establish a level of trust between case manager and patient, eventually leading patients to better outcomes, including improving medication reconciliation.

Why are home visits so important? Number one, it is very challenging to observe problems that individual patients may have with adhering to their medication regimens if providers can’t see the medicines in the bottle in the patient’s home. You need to be available to count the medicines and ascertain definitively that they are not missing. Trying to do medication reconciliation over the phone is nowhere near as effective as being in a patient’s home.

Another reason home visits are more effective is that you can physically see what activities of daily living (ADL) or instrumental activities of daily living (IADL) deficits the patient may be experiencing in their natural environment. This is something you can’t directly observe within the confines of an exam room.

The engagement of family or other support persons is also important. Home visits are an excellent way to see somebody in their natural environment, find out who the support people are for the patient, have a comfortable discussion in their home about an individual plan of care and get the people who can assist with that on board.

For all of the previous reasons, home visits were critical to the DCHN pilot. It’s especially important in a medically complex patient population where there are frequent transitions, whether they be from the acute care setting, from any emergency department (ED) visit or back into the home from an assisted living facility.

Excerpted from 2013 Healthcare Benchmarks: Home Visits.

9 Things to Know About Patient and Disease Registries

February 19th, 2014 by Jessica Fornarotto

In the environment of accountable and value-based healthcare, registries are a straightforward tool for creating realistic views of clinical practices, patient outcomes, safety and comparative effectiveness and for supporting evidence-based medicine development and decision-making.

The Healthcare Intelligence Network’s most recent analysis of registries and their impact on healthcare quality, efficiency and cost, reveals that the management of chronic disease is a key driver in the use of registries.

E-survey responses provided by 105 healthcare organizations also found that one-third of existing registries are a component of an electronic health record (EHR); the top reason for not having implemented a registry is because respondents already use an alternative, such as an EHR.

Other survey highlights include:

  • A disease- or condition-specific registry is the most popular type of registry, say 17 percent of respondents.
  • Diabetes is the condition most frequently targeted by respondents’ registries (78 percent), followed by CHF and asthma (both reported at 59 percent).
  • The most popular reason for using a registry is to measure quality and performance on key health outcomes, followed by disease management and the identification of high-risk patients.
  • Almost two-thirds of respondents who are not using registries at this time say they will launch a registry within the next 12 months.
  • A third of respondents include 20 percent or more of their population in registries.
  • Chart audits are the most common sources from which registries draw data, say half of respondents.
  • Engaging staff in registry use is the greatest challenge of implementing a patient registry, according to 29 percent of respondents.

Excerpted from: 38 Disease Management Metrics: Population Health Benchmarks to Drive Accountable Care