Posts Tagged ‘chronic disease’

Infographic: 30-Day Readmission Rates to U.S. Hospitals

July 17th, 2013 by Jackie Lyons

To avoid leaving reimbursement money on the table, healthcare organizations are working hard to reduce avoidable rehospitalizations. Still, certain populations have a significantly higher rate of 30-day readmissions.

Twenty-five percent of patients with congestive heart failure are readmitted to the hospital within 30 days of discharge, according to a new infographic from the Agency for Healthcare Research and Quality. This infographic also details the other top conditions, as well as Medicare and Medicaid populations, being readmitted to hospitals.

30-Day Readmission Rates to U.S. Hospitals

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You may also be interested in this related resource: Rethinking Readmissions: Patient-Centered Collaborations in Care Transition Management.

1 Out of 3 Patients Hospitalized for Heart Conditions, Pneumonia Readmitted Within 15 Days

February 1st, 2013 by Cheryl Miller

Almost 3 million Medicare patients hospitalized for heart failure (HF), heart attack, or pneumonia were readmitted to the hospital within 30 days, and almost two-thirds were readmitted within 15 days, according to a study from Columbia University Medical Center and published in JAMA.

Hospital readmissions are common and can be a marker of poor healthcare quality and efficiency. To lower readmission rates, CMS began publicly reporting 30-day risk-standardized readmission rates for these conditions after these measures were endorsed by the National Quality Forum.

CMS also began penalizing hospitals with high readmission rates; one way to avoid these readmissions penalties is by arming yourself with as much of your own readmissions data as possible, says Amy Boutwell, MD, MPP, president of Collaborative Healthcare Strategies, and co-founder of the IHI STAAR (State Action on Avoidable Rehospitalizations) initiative. Too many hospitals and healthcare organizations are relying on data from vendors and secondary information sources. Hiring a quality analyst run your discharge data can be very helpful. Ms. Boutwell elaborates on this and several other recommendations adapted from the IHI STAAR initiative.

Another way to avoid readmission penalities is to increase the use of telehealth solutions. Telehealth could reach as many as 1.8 million patients worldwide by 2017; studies show that an estimated 308,000 patients were remotely monitored by their healthcare provider for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, hypertension and mental health conditions worldwide in 2012. The majority of these patients were post-acute patients who had been hospitalized and discharged.

One area where high costs aren’t impacting professional decisions is in the use of expensive imaging tests. Despite evidence to the contrary, a new study from Johns Hopkins University School of Medicine shows that price transparency doesn’t influence the way physicians order imaging tests; instead, when it comes to expensive tests like MRIs, it seems that doctors have already decided they need to know the information regardless of their cost.

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

Infographic: The Dollars and Sense of Chronic Disease

October 5th, 2012 by Melanie Matthews

Nearly one in two Americans suffers from a chronic disease, defined as a noncommunicable disease (NCD) prolonged in duration, including cancer, heart disease, stroke, and diabetes, according to the Centers for Disease Control and Prevention. Chronic diseases are the number one cause of death in the United States.

The most common behaviors that lead to chronic disease and the economic toll of chronic diseases is explored in this Harvard School of Public Health infographic.
The Dollars and Sense of Chronic Disease

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Integrated Health Coaching: Spanning the Risk Continuum with Health Behavior Change Management

October 5th, 2012 by Cheryl Miller

Adam is 40 years old, married, and father to two children. He doesn’t smoke, but he’s overweight, with biometric risks that, if left untreated, could lead to chronic disease.

Sally is 52 years old, married, and mom to two busy teenage boys. She was diagnosed with diabetes five years ago and is diligent about her diet and medication regimen, but she doesn’t exercise and needs to lose 20 pounds.

Bob is 56 years old, suffered a myocardial infarction (MI), has been diagnosed with coronary artery disease (CAD), recently underwent cardiac rehabilitation, but isn’t sure he can stay on course.

All three patients require different levels of health coaching, says Dr. Dennis Richling, HealthFitness’ chief medical and wellness officer during a recent HIN webinar, Integrated Health Coaching: The Next Generation in Health, Behavior Change Management. And HealthFitness’ person-centric, integrated health coaching approach addresses participants’ needs across the health continuum — from those needing lifestyle and health behavior changes to those requiring help managing chronic, comorbid diseases, while delivering results via a reduction in healthcare utilization, improvements in clinical and HEDIS measures and a return on investment.

In addition, the program aligns with many of the key principles of post-ACA care delivery models like the patient-centered medical home (PCMH) and the accountable care organization (ACO), Dr. Richling continues.

He and Kelly Merriman, HealthFitness’ vice president of service delivery, shared key features of HealthFitness’ program, from how participants are assessed and assigned to coaches to the program’s impact.

First steps include assessing a patient’s health risk factors and using a predictive modeling algorithm to determine patients’ eligibility for coaching, and then matching them with the right one.

“We see our coaching solution as being population-based, so that it’s not a separate silo-type of solution, but a continuum. We did not want a situation where a lifestyle management coach and a nurse worked with an individual at the same time,” explains Dr. Richling.

Which means that Adam, with no chronic disease, but who is at risk and doesn’t know it, will be matched with a health coach. Sally, who is managing her chronic disease, has no other comorbid diseases, but has underlying lifestyle issues, will meet with an advanced practice coach. And Bob, who is not following his care plan, is seeing multiple doctors, and not adhering to medication as prescribed, will see a nurse coach.

Once patients and coaches are matched up, coaches must discern participant values during the coaching intervention, and utilize the art of ‘appreciative inquiry’ – an essential coaching skill that helps to define an individual’s ‘exceptionality.’

It’s a step away from the traditional method of disease management to one of active listening, Ms. Merriman says. “We’ve changed the traditional, clinical nurse coaching model by adding the element of positive engagement that really is what motivates people to change,” says Ms. Merriman. By using such tools as motivational interviewing, stages of change, positive psychology and appreciative inquiry, coaches are able to produce change, says Ms. Merriman. And risk is reduced when behaviors are changed.

Ways that technology supports these interactions include monitoring risk and changes in health status and providing information back to the coaches, via a dashboard they can interact with. Providing the patient with tailored educational material is another resource, and even handing the patient off to a more effective source of support, and maintaining strong interactions with primary care and specialist physicians, all lead to reduced risk and utimately reduced utilitization and healthcare costs.

“The keys to a successful population health management offering is effective tools that help align the individual with the right service at the right time,” says Dr. Richling. “That type of alignment is really leading to healthier lives in general within a population.”