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Former Senate Majority Leader Bill Frist, MD, has called on Congress to save AHRQ. "Today the demand for evidence-based healthcare delivery improvements is greater than ever. The Agency for Healthcare Research and Quality is under attack," he writes. The result would be "devastating." Frist offers a history of the organization and its beneficial impact on health care, and recounts his role in saving it while he was in office. "While AHRQ research rarely makes front-page headlines, it has had a meaningful impact on the care you and your family receive." (Forbes)
Those responsible for overseeing $600 million in contracts to build Healthcare.gov were inadequately trained, kept sloppy records and failed to identify delays and problems that led to cost overruns, according to an Office of Inspector General audit. Moreover, CMS failures contributed to the website's early problems. Bloomberg points out that leaders of both agencies overseeing healthcare.gov--CMS and the Department of Health and Human Services--have moved on, but says it's unclear if anyone else has been held accountable or if contracts are being handled better today. (Bloomberg; OIG audit)

Repealing the Affordable Care Act's individual mandate would save about $300 billion over the next decade, but it would increase the nation's uninsured rate back to 2013 levels--about 43 million, according to new Congressional Budget Office estimates. Moreover, repealing the mandate would increase the price of premiums in the individual market by 20 percent. (The Hill)

Innovation & Transformation 
Poverty is an insidious problem that can impair patient health, according to a recent policy paper from the American Academy of Family Physicians. It addresses how family physicians can mitigate the impact. "Such an approach requires a culturally proficient medical home and a well-resourced medical neighborhood that supplies readily accessible solutions. When these solutions are incorporated seamlessly into everyday practice workflows, family physicians and care teams can be true to the AAFP's vision by achieving positive change for individuals, families, and communities and improving population health." (AAFP News; position paper) 
Pennsylvania-based Consultants in Medical Oncology & Hematology (CMOH) became the first oncology practice to win NCQA recognition as a Level 3 patient-centered medical home. The practice followed PCMH principles and "developed data systems tracking performance and developed technology support to enable the care team to execute at this level." It increased patient access and "improved patient navigation, coordination, and communication, and we reduced patients' avoidable complications and unnecessary utilization of services," including emergency room trips and hospital admissions. (Health Business Daily--registration required; P&T Community) 
Consumers & Providers
Primary-care physicians have seen an increased, but not overwhelming, demand for services under the Affordable Care Act, according to research by the Kaiser Family Foundation and the Commonwealth Fund. Forty-four percent said the total number of patients they see had increased since January 2014; 59 percent reported an increase in the number who were newly insured or covered by Medicaid. Another interesting finding: Many providers are unaware of aspects of the ACA. For example, when asked whether their state has expanded Medicaid, only 59 percent of physicians answered correctly. (Wall Street Journal; report)

Census finds significant drop in the number of uninsured
The number of people without health insurance dropped last year by 8.8 million, to a total of 33 million, according to Census Bureau data. It found increases in both private and government coverage. From 2013 to 2014, it said, the overall rate of insurance coverage increased for all racial groups and for Hispanics. Much of the change was attributable to the Affordable Care Act, officials said. (The New York Times) 

Readmission penalties are punishing hospitals for the types of patients they see, according to research published in JAMA Internal Medicine. Hospitals with high readmission rates tend to see patients who are less educated, more disabled and more likely to suffer from depression, none of which are considered when calculating penalties. Researchers estimate about half the difference in readmission rates can be explained by patient population characteristics. That means some hospitals could be getting penalized more, simply for seeing vulnerable populations. (Vox; JAMA Internal Medicine 
A new Primary Care Learning Network forecast brief explores comprehensive medication management (CMM). CMM has the potential to solve a problem that's killing millions and costing billions while addressing the shortage of primary care providers. Successfully integrating these services into primary care has been shown to improve patient access, outcomes and satisfaction/engagement while lowering overall costs and improving provider/team efficiency and access. An elegant solution: Advancing comprehensive medication management for better care, better health, lower costs features Terry McInnis, MD, MPH, CPE, FACOEM, president of Blue Thorn, Inc. and Katherine Capps, president of Health2 Resources. (issue brief)    
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New & Noted   
Cancer cost/benefit tool coming soon: The National Comprehensive Cancer Network is launching a tool to offer patients and clinicians a clearer picture of the relative value of medication options. It will use an algorithm to compare the costs and benefits of cancer treatments based on price, effectiveness, safety, quality and consistency of clinical data. (Reuters) 
Population health launch: Partners HealthCare--Massachusetts' largest health care system--recently announced a $30 million population health management initiative designed to help other organizations improve patient care. The Center for Population Health, based at Massachusetts General Hospital, will train administrative teams in population health and care-management best practices. (Health Data Management)
Telemedicine grows: The rate of telemedicine adoption among health care providers increased between 2014 and 2015, with 57.7 percent of providers adopting such tools this year, up from 54.5 percent in 2014, according to a new HIMSS Analytics study. (HIMSS Analytics; FierceHealthIT
Too often, clinicians don't have information on the relative cost of health care services or facilities. The Network for Regional Healthcare Improvement recently completed an 18-month pilot to produce total cost-of-care and resource-use data in five regions. In a Patient-Centered Primary Care webinar, Elizabeth Mitchell, NRHI president and CEO, discusses the results and the organization's work in this area. (PCPCC)
MarketVoices...quotes worth reading
"We have heard too many times that our health care system is broken. Knowing that is the case, it would be irresponsible to end the agency that has a strong record of producing evidence-based research that leads to meaningful reform."  -- Bill Frist, in Forbes, encouraging Congress to continue funding the Agency for Healthcare Research and Quality
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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, September 23, 2015



Colorado RCCO video: Making a Medical Neighborhood Happen