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Industry News
The Department of Health and Human Services estimates that 1 million Americans will sign up for coverage through state and federal exchanges during the current open enrollment. About 900,000 to 1.5 million people currently covered by plans they bought outside the exchange may switch to HIX plans, according to HHS predictions. Overall, HHS aims to have about 10 million people enrolled and paying for coverage by the end of 2016--half of the Congressional Budget Office prediction. Many potential enrollees are worried about the cost of coverage, according to HHS. (Kaiser Health News)
Nearly a third of the co-op plans created under the Affordable Care Act will be out of business at the end of 2015, The Washington Post reports. The most recent development: Friday's announcement that plans in Oregon and Colorado are folding. In just the past week, four co-ops, as the nonprofit plans are known, have decided or been ordered to shut down. Overall, eight of the 23 co-ops in existence a year ago will be unavailable to consumers during this enrollment period. (The Washington Post)
Many employees aren't participating in any workplace wellness programs. A survey of 1,669 employees by Towers Watson and the National Business Group on Health finds that half of workers did not participate in any wellness activity or program despite a variety of offerings; they aren't even taking advantage of incentives. "Employees are leaving a huge amount of money on the table," says Shelly Wolff, New York-based senior health management consultant at Towers Watson. "It tells us that people can't be paid to change their health behaviors." (Benefits Pro)
Innovation & Transformation 
As health care continues to transition to value-based payment models, insurers and hospital groups increasingly want drug and device manufacturers to link their prices to results, Bloomberg reports. Humana and Premier, among others, are already involved in such pay-for-performance negotiations. But it can get tricky: "What metric are you going to select to measure performance? That can be challenging to select and agree on," says Genia Long, a senior adviser at Analysis Group, which consults with drug and device makers. (Bloomberg)
Startups look at ways to address behavioral health integration
Mental health has always been separate from the rest of health care, making access and reimbursement more challenging--and making it harder to address chronic conditions. Some companies--including SilverCloud, Prevail Health, Lyra Health and Big White Wall, see technology as a way to bridge that divide, MedCity News reports. In particular, behavioral health startups are providing a way to address the challenge of improving care for Medicare-Medicaid dual eligibles. Barriers exist, however, including concerns about HIPAA violations and the perceived vulnerability of digital records. (MedCity News)
Patients who use a nurse practitioner for primary care are less likely to have potentially avoidable hospital admissions, according to research published in Medical Care. Researchers also found that the impact of nurse practitioner care was stronger in nonmetropolitan areas; that's important, says Dr. Yong-Fang Kuo, the study's lead author and professor at the University of Texas Medical Branch. Physicians in rural areas may have a larger patient load, limiting their ability to spend sufficient time with each patient, or follow-up with them in a timely manner. Prior studies have shown that nurse practitioners spend more time with their patients, give patients more information and follow up more frequently than physicians do. (Medical Care; announcement)
Consumers & Providers
In a new Health Affairs Blog post, Drs. David Krueger and John Toussaint, both of ThedaCare in Wisconsin, call for a new approach to Medicare ACOs: a global, risk-adjusted payment model. CMS would pay ACOs a per-member, per-year fee adjusted for risk and geography. The approach would take into consideration patient mobility, support patient choice and reward patient engagement. It also takes into consideration high-cost/high-risk patients: "We recommend rewarding the successful management of high-cost patients through an upside-only type mechanism." (Health Affairs Blog)
Study: Medication adherence improves when patients see notes
When patients have access to their physician notes through an online portal, rates of medication adherence tend to go up, according to a study in Journal of Medical Internet Research. Researchers examined the medication adherence rate of adult patients at Geisinger Health System who were taking at least one antihypertensive or antihyperlipidemic. Patients were invited and reminded to read their primary care physicians' notes through the web portal; control patients had access to the web portal but not the notes. (Becker's Hospital Review; Journal of Medical Internet Research)
Doctors continue to debate the worth of a time-honored tradition of health care--the annual physical examination. Some want the once-a-year physical abandoned, based on a growing body of research that these exams don't reduce your overall risk of disease or death. But yearly checkups help build the relationship between doctor and patient, leaving both better prepared when illness does strike, other doctors respond. The debate plays out in dueling editorials in the Oct. 15 issue of the New England Journal of Medicine. (HealthDay News)
ACP issues position paper on retail clinics
Retail health clinics found inside pharmacies and other stores should be used as backups to people's regular doctors, according to a position paper from the American College of Physicians. Other elements of the ACP position: Retail health clinics should have a system in place to refer patients to primary care physicians if patients don't have one, and retail health clinics are primarily responsible for communicating information about a visit to a patient's primary care doctor. The ACP also says there isn't enough evidence to support the use of retail health clinics for managing chronic diseases like diabetes, and recommends against using the clinics for that purpose. (Reuters; Annals of Internal Medicine)

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New & Noted   
Supplements and ED visits: Roughly 23,000 emergency department visits each year are associated with "all-natural" dietary supplements, according to research published in the New England Journal of Medicine; children under 5 make up 21.6 percent of the visits. (Reuters; NEJM)
Smartphone thermometer: Vicks SmartTemp wireless smartphone thermometer is the first Bluetooth enabled thermometer from a major brand; a companion app is available for Android or Apple devices. (HIT Consultant)
Define data blocking: In a letter to the Office of the National Coordinator for Health IT, the HIMSS Electronic Health Record Association has asked the agency to clarify its definition of information blocking. (iHealthBeatletter)
Cyberattacks over the next five years will cost U.S. health systems $305 billion in cumulative lifetime revenue, according to a new report from Accenture. The firm estimates that one in 13 patients--roughly 25 million people--will have personal information, such as social security or financial records, stolen from medical technology systems over the next five years. (announcement and chart) 
MarketVoices...quotes worth reading
"These findings support previous research suggesting that nurse practitioners provide the same quality of clinical care as physicians." Dr. Yong-Fang Kuo, professor at the University of Texas Medical Branch at Galveston, lead author of a study in Medical Care, quoted in a UTMB announcement 
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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, October 21, 2015