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Industry News
In the fourth year of the Hospital Readmissions Reduction Program, 2,592 hospitals will face penalties to their Medicare reimbursements for a high number of 30-day readmissions. Becker's Infection Control & Clinical Quality lists 10 things to know about the penalties. For example, 18 fewer hospitals were penalized this year (2,592 vs. last year's 2,610). All but 209 punished this year were also punished last year. (Becker's Infection Control & Clinical Quality)
Health care spending has been growing at a historically low rate, but that will change, according to a CMS analysis published in Health Affairs. Growth is projected to average 5.8 percent for 2014-24, reflecting ACA's coverage expansions, faster economic growth and population aging. Rates in the use of medical goods and services, and medical prices, are expected to gradually increase. However, in part because of the impact of anticipated continued health-plan cost-sharing increases, only modest rate acceleration is expected. The health share of U.S. GDP is projected to rise from 17.4 percent in 2013 to 19.6 in 2024. (Health Affairs)

Research published in the Annals of Family Medicine found that, on average, primary care physicians at practices participating in an ACO received only 3.4 percent of their compensation based on performance on quality metrics, vs. 0.8 percent for PCPs working at non-ACO physician practices that were at substantial risks for primary care costs. PCPs in ACO practices also received 49 percent of their compensation from salary, about 46 percent based on productivity and 1.5 percent from other factors. By contrast, PCPs in non-ACO practices at substantial risk for primary care costs received about 67 percent of their compensation from salary and 32 percent from productivity. (Annals of Family Medicine)
Innovation & Transformation 
Keck Medicine of the University of Southern California is seeking to build an interdisciplinary workforce to treat the elderly that incorporates pharmacists, dentists, occupational therapists, physicians, social workers and others. USC won a $2.5 million federal grant to help build the USC-Los Angeles County Training Workforce in Interprofessional Geriatrics program over the next three years. That will include developing a routine primary care assessment of elderly patients, building new training programs for students to work in teams to treat seniors and opening a geriatrics primary care assessment clinic. (H&HN Daily; announcement)

Boeing recently entered into direct contracts with two health systems: Roper St. Francis Health Alliance in South Carolina and Missouri-based Mercy. Under the arrangements, which will be available to about 19,000 Boeing employees in 2016, the systems have agreed to hit certain cost, patient-satisfaction and quality targets. These are in addition to similar arrangements Boeing has with University of Washington Medicine and Providence Health & Services. Boeing is one of a few national employers that negotiate directly with hospitals and medical groups to provide employee health benefits or specific services, Modern Healthcare reports. Others include Intel, Lowe's and Wal-Mart. (Modern Healthcare
Consumers & Providers
The American Academy of Family Physicians' board of directors has adopted a nine-point list detailing how retail clinics should deliver care. It's what AAFP News calls the first step in a "tough love" approach that reflects a commitment to care continuity. The bottom line? Retail clinics have a place in the health care marketplace--when they meet the outlined criteria. Among the items on the AAFP list: Employ local physicians as supervising medical directors; seek to support the PCMH and patients' coordination of care; use EHRs; and help patients who don't have a primary care physician find one locally. (AAFP News)

A survey of more than 1,600 primary care physicians (PCPs) and other providers by the Kaiser Family Foundation and the Commonwealth Fund finds just 14 percent of PCPs believe ACOs are having a positive effect on care quality, including 30 percent of PCPs participating in ACOs. About 24 percent of all PCP respondents participating in ACOs said the organizations are having a negative effect on care quality, 20 percent said they are having no effect and 25 percent were unsure. In contrast, 33 percent of physicians and 40 percent of nurse practitioners and physician assistants said they believe medical homes are having a positive impact. (Commonwealth Fund / Kaiser Family Foundation; Advisory Board Daily Roundup)

Most (69 percent) physician leaders surveyed agree doctors should be held accountable for costs of care in addition to quality of care, according to a survey by the American Association for Physician Leadership (formerly, the American College of Physician Executives) and Navigant. Fifty-seven percent of respondents agree or strongly agree ACOs will become a permanent model for risk-sharing with payers. Sixty-three percent disagree or strongly disagree that "elimination of FFS (fee-for-service) incentives in favor of value-based payments will hurt the quality" of patient care. (announcement)
Patient safety is often at risk because of ineffective communication during the emergency department handoff process when patients are moved to inpatient units, according to research published in the Journal of Hospital Medicine. Researchers say the findings support the need for collaborative efforts to improve communication between physicians during that transition. The small study looked only at the 627-bed University of Nebraska Medical Center; researchers surveyed 94 admitting physicians from five inpatient medical services and 32 emergency medicine physicians. (FierceHealthcare; Journal of Hospital Medicine)
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New & Noted   
ACOs and insurers: ACOs increasingly are pairing with insurers to offer ACO-based insurance products that offer employers and consumers the advantages of a name-brand network--even if it's a narrow network--coupled with a lower price. (Value-Based Care News)
Iora and Humana: After successfully launching an Accountable Care arrangement and population health management partnership last fall, Humana and Iora Health have expanded the partnership by opening seven new primary care practices in four markets across Arizona, Colorado and Washington. The practices are designed exclusively for Humana's Medicare Advantage members. (Humana announcement)
CO-OPs can't repay loans: Most of the CO-OP plans established with loans under the Affordable Care Act are losing money and failing to meet enrollment targets, according to an HHS inspector general report. Member enrollment for 13 of the 23 CO-OPs that provided health insurance in 2014 was considerably lower than initial annual projections, and 21 of the 23 CO-OPs had incurred net losses as of Dec. 31, 2014. (National Law Review; report)
According to data from HIN's 2015 Healthcare Benchmarks: Care Transitions Management, hospital-to-home is the most important transition. This pie chart shows where other transitions fall in order of importance. (HIN Chart of the Week)
MarketVoices...quotes worth reading
"There's this huge sort of bolus of older people emerging--we refer to this in the field of geriatrics as the 'silver tsunami'--and we're ill-equipped to care for them."
 -- Dr. Bonnie Olsen, clinical professor of family medicine at USC, who is leading a team that's creating a USC-Los Angeles County Training Workforce in Interprofessional Geriatrics program, in
H&HN Daily

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Wednesday, August 12, 2015



































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