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Industry News
Growth in outcomes-based employee wellness programs remains stagnant, according to a survey from Fidelity Investments and the National Business Group on Health. This reflects "waning enthusiasm" for outcomes-based programs, Employee Benefit News reports. Among the reasons: Legal challenges to such programs, difficult implementation processes, employee questions about use of data and concerns about hurting company culture. Another important reason could be that these programs are narrowly focused on physical health. (Employee Benefit News)
Changing reimbursement models and evolving legal guidelines are moving telemedicine into the mainstream, Managed Healthcare Executive reports. Anthem, Cigna, Aetna and UnitedHealthcare all provide some reimbursement for such visits, and Walgreens plans to roll out a smartphone app that allows consumers to consult virtually with physicians. Typically, private payers follow Medicare's lead, but in telemedicine the reverse is true. "Medicare is the last great holdout," says Jonathan Linkous, CEO of the American Telemedicine Association. "Fortunately, we're seeing private insurance companies, employers and states take the lead in telemedicine." (Managed Healthcare Executive)

Innovation & Transformation 
The CMS Innovation Center is awarding $685 million to 39 organizations under the Transforming Clinical Practice Initiative. The goal: Help clinicians achieve large-scale transformation. Twenty-nine group practices, regional health care systems, and regional extension centers and 10 national organizations and professional associations were selected. One of those 10, The American Board of Family Medicine, will use the money to help 25,000 family physicians move from a volume-based approach to a value-based approach, Modern Healthcare reports. Other grantees include the Patient Centered Primary Care Foundation, the Colorado Department of Health Care Policy & Financing, and the Network for Regional Healthcare Improvement. (Modern Healthcareannouncement)

The Veterans Administration reported it provided remote care to more than 690,000 veterans during FY 2014. Telemedicine offers an ideal way to provide ongoing communication and care coordination for caregivers of patients with traumatic brain injury, according to a case study from the Department of Veterans Affairs published in Telemedicine and e-Health. Among the elements that make it work: A caregiver is present with the patient, there's an emergency plan that includes information about the primary care physician and nearest hospital, and the patient has access to a secure and reliable Internet connection. (Telemedicine and e-Health; FierceHealthcare)
Diagnostic errors are likely to affect almost every American, and a new Institute of Medicine report calls for better use of health IT to help hospitals reduce them. But such reductions will be difficult, Kaiser Health News reports: There is no standard, required way to track such errors. It will require better medical teamwork, training and computer systems, the report says. "Some people go to their graves with a diagnostic error that is never detected," said Robert Berenson, an Urban Institute research fellow, and one of the committee members who wrote the report. "It's much more difficult to measure than a medication error." (IOM report; Kaiser Health News) 
Consumers & Providers
The nation is still expected to be short of nurses in coming years, although the seemingly chronic shortage of registered nurses is predicted to be far less serious down the road than previously forecast, according to research published in Medical Care.  It predicts a shortage of about 130,000 nurses in 2025, compared to earlier estimates of  500,000 to 800,000. One reason for the change: Foundations, corporations and other groups began encouraging enrollment in nursing programs, leading to an "unexpected surge" in RNs. (Hospitals & Health Networks; Medical Care)

Why are hospitals buying up practices? It depends on whom you ask, according to Kaiser Health News. Hospitals cite improved care coordination, lower costs and better patient experiences. Skeptics cite other reasons: to raise costs, gain pricing power and steer patient referrals. To get at the truth, researchers at Stanford University compared referral patterns between independent doctors and those working for hospitals. Ownership by a hospital "dramatically increases" odds a doctor will admit patients there instead of another, nearby hospital, they found. It also boosts chances that patients will go to higher-cost, lower-quality hospitals. (Kaiser Health News; National Bureau of Economic Research)

There are more than twice as many health apps today compared to 2013, but they are no more likely to connect to provider systems or to have more than one function, according to a new report from IMS Health. Researchers suggest one reason may be consumers opt for the most popular app--which might not be the most appropriate clinically. IMS found 90 percent of downloads were for just 12 percent of apps; 40 percent of apps had fewer than 5,000 downloads. (MobiHealthNews) 
Research published in Annals of Family Medicine has put a price tag on maintaining a PCMH: $105,000 a year per full-time clinician; most of this cost isn't reimbursable in a fee-for-service environment. PCMH advocates note truly accountable care may be what's needed to address implementation's financial barriers. But establishing ACOs many not be enough, Marci Nielsen, PhD, MPH, CEO of the Patient-Centered Primary Care Collaborative, tells HealthITAnalytics. "We need to change the way we pay for care delivery at the practice level as well. We're not doing it enough yet." (HealthITAnalytics; Annals of Family Medicine)
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New & Noted   
Focusing on bedside manner: Changing reimbursement and increasing patient expectations are driving changes in how physicians interact with patients. Some health systems are creating programs to infuse more compassion and understanding into the doctor-patient relationship. (Kaiser Health News)
Know your patient: In a recent issue of Medium, the Commonwealth Fund's Martha Hostetter and Sarah Klein explore how patient profiles that combine consumer data with clinical information can help providers who are increasingly accountable for improving health outcomes and reducing costs. (Medium)
ACP on telemedicine: Telemedicine can be beneficial, but it must be used correctly--and there are still hurdles to overcome, according to a position paper from the American College of Physicians. The paper includes 13 recommendations; some address the immediate use of telemedicine and others call for future action. (HealthLeaders Mediaposition paper)
Earlier this month, Julie Appleby of Kaiser Health News appeared on C-SPAN's Washington Journal to explain the "Cadillac tax" that goes into effect on high-value health insurance plans in 2018. (KHN)
MarketVoices...quotes worth reading
"The evidence is becoming clearer that physical health is not the main driver of productivity, performance and business outcomes. "-- LuAnn Heinen, vice president of the National Business Group on Health, quoted in Employee Benefit News
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Editorial Team
Roxanna Guilford-Blake
Sandy Mau




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Wednesday, September 30, 2015