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Industry News

Report: Employee share of insurance costs continues to grow
Growth in premiums and deductibles for employer-sponsored coverage slowed in 31 states and the District of Columbia from 2010-2013, but the average employee share of those costs continued to rise faster than income, according to a new Commonwealth Fund report. Average premiums amounted to 20 percent or more of median income in all but 13 states and the District of Columbia in 2013, up from two states in 2003. Average per-person deductibles exceeded $1,000 in all but three states and the District of Columbia in 2013, up from no states in 2003. (AHA News Now; Commonwealth Fund)



Hospitals, urgent care centers partner to increase access

Despite--or perhaps because of--the increased presence of retail clinics and urgent care centers, hospitals and health systems are viewing these would-be competitors as partners--usually. "With few areas of direct competition in core services, hospitals and health systems have largely embraced peaceful co-existence with retail clinics, but urgent care centers have been more daunting," according to HealthLeaders Media. The article explores the competitive challenges to health systems and hospitals that remain, as well as the opportunities to establish mutually beneficial relationships. (HealthLeaders Media)


Hawaii, Colorado and Minnesota exchanges under scrutiny

Three state-run exchanges are facing scrutiny, and in some cases, threats, to their viability, FierceHealthPayer reports. In Colorado, Republican lawmakers introduced legislation to repeal the law that created the state HIX. State senators are working on a measure to require a more thorough audit of Connect for Health Colorado. Minnesota lawmakers have undergone a bipartisan effort to reform MNsure, including making it a state-level department. Many state exchanges face financial uncertainty, including Hawaii. A recent state report found the site won't be financially viable until 2022. Exchange staff also spent 8,000 work hours this summer fixing technical glitches. (FierceHealthPayer)

Innovation & transformation

Cardiologist bullish on mobile health

Personal technology--think smartphone--could make health care cheaper, faster, better and safer, according to Dr. Eric Topol, former head of cardiology at the Cleveland Clinic and now director of the Scripps Translations Science Institute; he's the author of The Patient Will See You Now. "The hospital is an edifice we don't need except for intensive care units and the operating room," he argues. With the right technology and applications, everything else "can be done more safely, more conveniently, more economically in the patient's bedroom." (NPR

Practices implementing PCMH strategies

Research published in Health Affairs finds a significant increase in the implementation of patient-centered medical home processes--much of it attributable to increased implementation of EHR-related processes. Additionally, practices with external incentives--e.g., pay-for-performance and public reporting data--use more of the processes than those without such incentives. Researchers found much room for improvement, "most notably, the use of nurse care managers, registries, and patient reminders and improving patient access. It is particularly sobering to note that even among large practices, fewer than half of the recommended processes are being used, on average. Among small practices, the share is less than 30 percent." (Medscape Medical News; Health Affairs)



Retailers intend to take headache out of health care

Consumer demand for convenient care, aligned with expectations of other service industries and a shortage of physicians, has fueled retail clinics. Retail clinics staffed by nurse practitioners and physician assistants have increased more than sevenfold since 2007. CVS, Walgreens, Walmart and other vendors seek to improve access and increase foot traffic. Nearly half the patients visiting CVS, Walgreens and Walmart clinics reported they have no regular primary care provider. Moreover, retail clinics offer services at clearly marked prices, often lower than physicians' offices and hospitals, The Huffington Post reports. (The Huffington Post)

Consumers & Providers

AAFP paper calls for integration of primary care, public health

"Integration of Primary Care and Public Health," an American Academy of Family Physicians position paper, urges family doctors to cultivate an awareness of the environment their patients face outside the hospital or physician's office and forge partnerships with public health organizations. "[F]or successful broad system change, family medicine ... must co-align with the public health sector--two fields with a common interest, yet functioning independently for the last century," it adds. (AAFP News)


SNFs gear up for "doc fix" debate

Skilled nursing facilities don't want to be left out of deliberations about the next fix to the sustainable growth rate. According to The Hill, the industry has launched an aggressive campaign to avoid cuts and offer policy proposals ahead of Congress's debate over the next fix. The American Health Care Association, which represents nursing homes, assisted living facilities and other subacute care providers, is blanketing Washington with advertisements. "As the doc fix fight heats up again this year, skilled nursing and rehab providers stand ready to help Congress find a permanent solution," said AHCA President Mark Parkinson. (The Hill

Physicians push back against MU

Recent survey results published in BMC Medical Informatics and Decision Making indicate physicians are among the least willing to alter their work behavior for Meaningful Use; they are also less likely than staff to believe their department will effectively solve MU problems. Specialty care providers are more likely than their primary care counterparts to believe MU will detract from other patient care activities. (HealthData Management; results)
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New & Noted   

Calif. HIX rejects UnitedHealth: Covered California rejected UnitedHealth's bid to sell plans on the state exchange in 2016. Insurers can't enter the insurance exchange as they please and "undercut" rivals who have been involved since the beginning, says Peter Lee, executive director of Covered California. (LA Times)


FDA on wellness vs medical devices: The FDA has issued proposed guidance on determining when a wellness device promoting health management crosses into the territory of medical devices. Response to the guidance has been mixed. (HealthDataManagement; guidance)


Explaining H.R. 30

H.R. 30 would redefine a full work week under the Affordable Care Act as 40 hours. In a four-minute video, Melanie Zanona explains the bill and its implications. (C-SPAN) 

MarketVoices...quotes worth reading


 "We have what I term as a new age of consumerism. They're making choices based on convenience and economics." -- Dr. Patrick Carroll, the chief medical officer for Walgreens Healthcare Clinics and a primary care physician, in The Huffington Post 

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Editorial Team
Roxanna Guilford-Blake
Sandy Mau




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Wednesday, Jan. 21, 2014





























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The Familiar Physician