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Industry News
Health plans offered through public insurance exchanges must cover prescription drugs, but insurers create their own formularies, which can vary plan to plan. Consumers in these exchanges have trouble finding or understanding drug formularies on insurers' websites, says a study by the California HealthCare Foundation. The study suggests that health plan providers do more to educate consumers and enrollment counselors about formularies. (California Healthline)
A recent Business Insurance webinar, "Measuring the Value of Investment in Wellness," examined the ways employers measure the value of workplace wellness programs. The marketplace is moving from a return-on-investment methodology to a value-on-investment methodology, according to Dr. Ron Leopold of Willis North America. Willis survey data show 64 percent of companies are using value-on-investment methodology when assessing their wellness plans, compared with 28 percent that are looking at ROI. The value-on-investment method goes beyond financial results to include factors such as employee morale, productivity, absentee rates and safety. (Business Insurance--registration required)

The National Institutes of Health has awarded 12 grants to support research that incorporates DNA sequence information into EHRs, FierceEMR reports. The focus: Move genomics research closer to clinical application by identifying the potential medical effects of rare genomic variants in about 100 clinically relevant genes. This represents the third phase of the Electronic Medical Record and Genomics (eMERGE) program. Researchers will look at the best ways to provide DNA test results to physicians and patients, as well as ways doctors might use this information to improve clinical treatment and practice. (FierceEMR; NIH announcement)

Innovation & Transformation 
The millennial generation--specifically, via its online habits--is poised to change the way health care is provided. For example, Millennials use online ratings and their social networks for selecting a physician at greater rates than do the two previous generations, according to a survey by Nuance Communications. And Millennials are more likely to share their experiences with their peers via social media. "[C]ombining millennials' numbers, inclination to share, willingness to use the Internet for research with the growing transparency taking place in health care, and explosive change could be coming," H&HN Daily reports. (H&HN Daily; survey)
Many employers are already preparing for the "Cadillac tax." One of them, The Port of Portland, was anticipating a $1 million liability. Working with its benefits advisor, it cut that to $156,000. This year, it changed its PPO to a high-deductible plan with a health savings account, and it modified HMO copays. Both plan types include wellness incentives. After experiencing double-digit growth in health costs previously, costs dropped 13 percent after the changes took effect. The Port of Portland implemented the changes first with the administrative and police unions. It is now negotiating with other unions. (Portland Business Journal)
Mission Health in Asheville, N.C., decreased readmissions by more than 14 percent after making audio and video discharge instructions available to patients via mobile app, Managed Healthcare Executive reports. Piloted in a 33-bed general surgery unit in 2014, nurses used Good to Go to record instructions for 27 percent of patients in 2015; 11 percent accessed their instructions. The decision to use the app was driven in part by a Mission Health review of best practices: The Agency for Healthcare Research and Quality found that recorded discharge instructions can help reduce readmissions. (Managed Healthcare Executive)
Consumers & Providers
To improve patient satisfaction, most hospitals use the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to gauge patients' perspectives on care. But although it can offer insight into the patient experience, the survey tool isn't designed to provide the high-level details that hospitals need to link patient satisfaction with business performance, according to a new McKinsey & Company paper. In fact, most hospital systems don't have strong ways to fully measure and understand the patient experience. HCAHPS doesn't take into account many factors that affect patient satisfaction, such as the patient's experience during pre-admission testing and outpatient follow-up. (FierceHealthcare)

Study: Parents go to ED when they can't get a timely appointment
Parents were more likely to turn to an emergency department when they couldn't get a timely appointment for routine care, according to research published in Emergency Medicine Journal. Moreover, having a medical home did not reduce the likelihood that parents would take their child to an ED. Of the parents surveyed who took their child to the ED, about 70 percent said the visit could have been avoided if a primary care clinician had been available at the time. "Expanding access to primary care could lead to a reduction in avoidable ED visits by children," the researchers concluded. (Reuters Health via MedPage Today; Emergency Medicine Journal)

One in four Americans lives with multiple chronic illnesses, and responsibility for coordinating treatments often falls on the patients themselves, The Wall Street Journal reports. Dr. Victor Montori, professor of medicine at the Mayo Clinic, talks about the "work of being a patient." But doctors who prescribe medications should be responsible for taking into account the various illnesses, he says. And if clinicians don't understand potential drug interactions, they should seek pharmacists' advice. He also recommends patients not in an integrated health system find a "quarterback"--such as a primary care physician--to keep an eye on the big picture. (The Wall Street Journal)
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New & Noted   
Navigators may cut LOS: Use of patient navigators as inpatient care facilitators shortens hospital length of stay, according to a study published in the Journal of Hospital Medicine. (Physicians Briefing; Journal of Hospital Medicine)
Hush! The University of Michigan Health System in Ann Arbor is piloting the use of acoustic panels to muffle sounds in patient hallways. It's led to a three to four decibel reduction, similar to a fall in noise generated by a car slowing down from 80 mph to 60 mph, FierceHealthcare reports. (FierceHealthcare; BMJ Quality and Safety)
Direct primary care: USA Today recently featured Las Vegas-based Turntable Health, one of the growing number of membership-based primary care practices. Turntable has partnerships with health insurance companies offering low-cost options and charges a monthly fee to individuals without insurance. The idea emerged from a conversation between Tony Hsieh, CEO of Zappos.com, and Dr. Zubin Damania (aka ZDoggMD). (USA Today) 
NPR's Rachel Martin explores the new field of bibliotherapy, which dispenses a prescription of literature specifically tailored to a patient's unique circumstances. She interviews pioneering bibliotherapist Susan Elderkin. (NPR) 
MarketVoices...quotes worth reading
"Having a primary care provider is not the same as access to primary care. There is a difference between 'Come in right away, we'll take a look at the child now' and 'Our next opening is tomorrow at 8:00 pm.'" -- Dr. Alfred Sacchetti, quoted by Reuters Health

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Wednesday, September 9, 2015




Colorado RCCO video: Making a Medical Neighborhood Happen