Posts Tagged ‘HRAs’

Healthcare Business Week in Review: Telemedicine; Mail Order Pharmacies; HRAs; Home Healthcare

December 6th, 2013 by Cheryl Miller

Convenience, whether in the form of a telemedical consult, a mail order pharmacy, or even an HRA, is helping to improve patient care and quality.

According to a new Kaiser Permanente study, diabetic patients who received heart medications by mail were less likely to visit the emergency room than those who picked up prescriptions in person.

Among the reasons researchers suggested were that patients with disabilities or limited transportation were better able to take their meds when all they had to do was go to their mailbox.

In the same vein, children in rural areas are provided better care when telemedicine is available.

According to a new study from UC Davis Medical Center, rural physicians face distinct disadvantages when providing critical care for severely ill or injured pediatric patients. Lack of pediatric training, access to EMRs and 24-hour pharmacist coverage contribute to the problem. Telemedicine services with pediatric specialists resulted in far fewer dosage errors, among other things.

Despite the occurrence of face-to-face meetings, many patients’ health status and risks are overlooked because of the infrequent use of health risk assessments (HRAs), according to the AHRQ.

Problematic but treatable health behaviors like anxiety, alcohol use, depression and unhealthy eating are generally not explored in a primary care visit but can be detected with the use of a new evidence-based HRA. Designed for primary care physicians, nurses and other staff, patients provide the data.

A final ruling on home healthcare payments has been issued for 2014, and is designed to better align Medicare payments with home health agencies’ costs providing care, while lowering costs to taxpayers and the 3.5 million Medicare beneficiaries who receive services, according to the CMS. The final rule reduces the number of home-health quality measures reported by home health agencies (HHAs).

And lastly, don’t forget to take our online survey, Reducing Hospital Readmissions in 2013. 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 taking HIN’s fourth comprehensive Reducing Hospital Readmissions Benchmark Survey. Respond by January 3, 2014 and receive an e-summary of the results once they are compiled.

Healthcare Business Week in Review: Healthcare Reform, Medication Adherence, Readmission Rates

October 18th, 2013 by Cheryl Miller

Women are in charge when it comes to choosing their family’s healthcare coverage needs.

That’s the bottom line from a new survey from Cigna, which says that, regardless of where they live or who their insurer is, women are the CFOs and CMOs of their households.

Among their top concerns about healthcare coverage, in light of new reforms, are whether they can afford insurance, and care for their elderly parents. The extensive survey covers everything from how many women understand reform (1 in 10) to what steps they’re taking to manage costs (94 percent are using lower cost prescriptions).

A lack of family and social support is one of the seven chief barriers to medication adherence, says Thom Stambaugh, chief pharmacy officer and vice president of clinical programs and specialty pharmacy at CIGNA® Pharmacy Management. If a patient has no friends or family to discuss their health and required medications with, they are more likely to skip them, which is why it’s important to understand which barrier applies to a particular individual when trying to resolve medication compliance issues, and then find a solution around it.

Breast cancer screening, cervical cancer screening, and weight assessment and nutrition counseling for children were among the areas Kaiser Permanente received top marks in, according to the NCQA’s Quality Compass® data, which ranked the company number one in 13 out of 43 effectiveness of care measures. Out of nearly 500 commercial health plans in the nation, no other health plan received more than five No.1 rankings, according to Kaiser officials.

Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations (ACOs), according to a new RAND Corporation study.

Other factors associated with the formation of ACOs include a greater occurrence of payment risk sharing at hospitals, larger integrated hospital systems and primary care physicians practicing in large groups.

A region’s average household income, per capita Medicare spending, enrollment in Medicare Advantage Plans and physician density were not associated with formation of accountable care organizations.

Same-hospital readmission rates are an unreliable predictor for all-hospital readmissions rates, but that rate is what CMS penalizes hospitals for, according to research from the University of Michigan (U-M) Health System, presented at the 2013 Clinical Congress of the American College of Surgeons.

By tracking readmission rates solely within their own facility, instead of looking at rates at other hospitals, officials aren’t getting enough information to effectively target areas for quality improvement, researchers say.

And lastly, sophisticated analytics behind today’s health risk assessments or health risk appraisals (HRAs) provide employers, payors and providers an aggregate view of population health and the raw material for the development of prevention and lifestyle change programs. Tell us how your organization uses HRAs to improve population health in our online survey by October 15, 2013 and get a FREE executive summary of the compiled results.

Healthcare Business Week in Review: Affordable Care Act, Medical Apps, Cardiac Care Costs

October 4th, 2013 by Cheryl Miller


Technological problems hindered aspects of the October 1st rollout of the new health insurance exchanges — both at the state and federal level. According to New York Times reports, some aspects of the eagerly awaited exchanges in several states, including Oregon, Colorado, District of Columbia and Nevada, may not be fully operational for weeks and even months, with some officials referring to October as a “soft launch” period.

Last week, the Obama administration acknowledged it will not be ready to accept online applications from small businesses when the program officially launches October 1st.

Once fully operable, the exchanges, one-stop online shopping sites for consumers’ health insurance needs, will enable consumers to comparison shop for health benefits much like they do now for airline tickets or hotel rooms, and see if they qualify for tax credits. Plans are categorized according to levels of coverage and co-pays, and no one can be denied coverage because of preexisting conditions. There will be a six-month open enrollment period that runs through March 2014, and coverage should begin as early as January 1st.

Smart phones can now diagnose abnormal heart rhythms, act as ultrasound devices, or function as the “central command” for a glucose meter used by a person with insulin-dependent diabetes. To ensure that patients’ safety isn’t compromised for the sake of technological innovation, the FDA is clamping down on those apps considered dangerous. The agency has cleared about 100 mobile medical applications over the past decade; about 40 of those were cleared in the past two years.

The costs of patient care after heart attacks, continues to climb, according to a new study from the University of Michigan (U-M) Frankel Cardiovascular Center. Despite advancements in cardiac care and increases in less invasive procedures to treat symptoms, including more angioplasty instead of open heart surgery, hospital stays have decreased by just one day. Medicare spending to treat heart attack patients rose by 16.5 percent between 1998 and 2008, with the majority of costs incurred weeks after patients left the hospital.

According to researchers from the NYU School of Medicine, elderly nursing home residents with advanced dementia who were enrolled in a Medicare managed care insurance plan were more likely to have do-not-hospitalize orders and less likely to be hospitalized for acute illness than those residents enrolled in traditional Medicare. The frail elderly received more nursing home-based primary care visits every 90 days, and more nursing home-based nurse practitioner visits in general. The extra individual attention precluded the need for more acute treatment, and resulted in less aggressive, more humane end-of-life care.

And lastly, sophisticated analytics behind today’s health risk assessments or health risk appraisals (HRAs) provide employers, payors and providers an aggregate view of population health and the raw material for the development of prevention and lifestyle change programs. Tell us how your organization uses HRAs to improve population health on our Health Risks Assessments online survey by October 15, 2013 and get a FREE executive summary of the compiled results

Healthcare Business Week in Review: Hospital Readmissions, State-by-State Scorecard, PHOs, HRAs

September 27th, 2013 by Adam Ghosh

It looks like good surgeons are, literally, a cut above the rest, at least according to a new study from Harvard School of Public Health.

Quality surgical care is strongly linked to hospital readmission rates, a somewhat surprising new statistic given that much of policy focus has been on reducing readmissions after hospitalizations for medical conditions, such as heart failure and pneumonia.

Readmissions for medical conditions are primarily driven by how sick the patients are and whether they live in poor or better-off communities; the link between hospital quality and readmissions is less clear. The study sought to find out if there was a relationship between readmission rates after surgery and the quality of surgical care in that hospital; more details inside.

Poor healthcare quality does not discriminate. According to a new study from the Commonwealth Fund scorecard, access to affordable, quality healthcare varies greatly for low and high-income people based on where they live.

The report finds that higher-income people living in states that lag far behind the top scoring states are often worse off than low-income people in states that rank at the very top of the scorecard. The scorecard provides the first state-by-state comparison of the healthcare experiences of the 39 percent of Americans with incomes less than 200 percent of the federal poverty level, and compares their experiences with higher income families.

Lower-income families, particularly those on Medicaid, have grown increasingly more dependent on using the emergency room, despite widely held assumptions that uninsured patients are high ER utilizers, according to a study from the University of California, San Francisco. In order to investigate recent trends between insurance coverage and ED use, researchers analyzed California ED visits by adults aged 19 to 64 years old from 2005 to 2010, and found that the number of visits to California EDs by adults overall increased by 13.2 percent, with Medicaid beneficiaries leading the pack. This study has wide implications with upcoming ACA reforms; many uninsured people are expected to transition to Medicaid, and as a result, overall ED use may increase because Medicaid patients have higher rates of ED use.

Physician-hospital organizations (PHOs) have taken the accountable care organization (ACO) reins from physicians over the last year, according to our 2013 market data. PHO leadership of ACOs almost doubled in the last 12 months; in 2012, one-quarter of ACOs were

physician-led, a trend that replaced the hospital-administered ACOs that dominated in 2011.

As ACOs continue to evolve, the composition of the care delivery model will shift as well, with hospice, long-term care and home health entering the fray.

Lastly, don’t forget to take our Health Risk Assessments in 2013 survey – sophisticated analytics behind today’s health risk assessments or health risk appraisals (HRAs) provide employers, payors and providers an aggregate view of population health and the raw

material to develop prevention and lifestyle change programs. Tell us how your organization uses HRAs to improve population health by October 15, 2013 and get a FREE executive summary of the compiled results.