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Industry News
Kaiser Permanente announced Friday it will acquire the Seattle-based Group Health Cooperative. This allows Kaiser to expand into an eighth market and add Group Health's more than 590,000 members. Kaiser Permanente's appetite for new markets is growing,
Modern Healthcare reports, noting that the company is also looking at Detroit. Kaiser currently operates in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington, D.C. (Modern Healthcare)
 

The Commonwealth Fund's 2015 International Health Policy Survey finds 24 percent of primary care doctors in the United States are concerned their practices are not well prepared to manage patients with multiple chronic illnesses. That goes up to 84 percent when it comes to managing patients with severe mental illness. The survey reveals all nations are struggling to coordinate care for the sickest and most complex patients, and stronger primary care is needed to care for their aging populations. (Commonwealth Fund)


The U.S. Supreme Court has upheld a Texas law that prevents veterinarians from giving advice to pet owners online and, according to FierceHealthIT, this could have implications for telemedicine. Dr. Ronald Hines, a vet in Texas, was fined by the Texas Board of Veterinary Medical Examiners after giving advice to pet owners online. Hines challenged that, saying it was a First Amendment right, but the Supreme Court disagreed. (FierceHealthIT)
Innovation & Transformation 
Until recently, "love-'em-and-leave-'em" characterized care transitions, writes Jennifer Thew, RN. "You take great care of patients while they're under your charge, but when they're discharged or transferred, your work is done." That's changing, due to an increased focus on outcomes; now, alliances between acute care and post-acute care providers are necessary to meet care standards. She looks at how Ascension Senior Living is accomplishing that. One way the organization is moving toward care that follows patients across the continuum is by phasing out the idea of the traditional discharge. (HealthLeaders Media)
 
For the first time in the Commonwealth Fund's state health care system scorecard's nine-year history, states have improved more than they have declined. While there is still wide variation, access to health care improved in every state and gains were made in health care quality and safety. In the overall rankings, Minnesota, Vermont, Hawaii and Massachusetts stayed at the top. The four lowest-ranking states were (again) Louisiana, Arkansas, Oklahoma and Mississippi. "These are the most substantial and widespread state improvements in access to care we've seen since we created the state scorecard series in 2007," said Commonwealth Fund President David Blumenthal, MD. "While there are still wide differences among states, and performance has worsened in some instances, policy changes like those in the Affordable Care Act, incentives to improve health care quality and safety, and provider-led efforts are beginning to bear fruit." (Commonwealth Fund)
 
Consumers & Providers
Many PPO plans are removing out-of-network cost limits, Kaiser Health News reports. This could have a serious impact on consumers: Many choose plans that provide some outside-network coverage. Traditionally, such plans paid a portion of the bill and set an annual cap on how much policyholders paid toward out-of-network care. Now, an increasing number of PPOs offered on the insurance exchanges have ceilings for out-of-network costs: Forty-five percent of new 2016 silver-level PPO plans provide no annual cap for policyholders' out-of-network costs. This means consumers face unlimited financial exposure, similar to the less costly HMOs. (Kaiser Health News)
 
Physician burnout increased by nearly 10 percentage points in three years, prompting concerns about physician health and patient safety, according to a new report from Mayo Clinic and the American Medical Association published in Mayo Clinic Proceedings. It finds there is too great a focus on self-help solutions, such as physician self-care or resilience training. Researchers argue that the overall work environment needs to change to reduce physician burnout. (Advisory Board Daily BriefingMayo Clinic Proceedings)
 
 
Hospital-acquired conditions such as adverse drug events, pressure ulcers and catheter-associated urinary tract infections declined sharply between 2010 and 2014. Data collected by the Agency for Healthcare Research and Quality shows HACs fell from 145 per 1,000 discharges in 2010 to 121 per 1,000 discharges in 2014. There were 2.1 million fewer hospital-acquired conditions; 87,000 lives were saved and health care costs reduced by nearly $20 billion. "Although the precise causes of the decline in patient harm are not fully understood, the increase in safety has occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events." (HealthLeaders MediaAHRQ)
 
 
The rate of avoidable complications affecting patients in hospitals leveled off in 2014 after three years of declines, according to a report by the Agency for Healthcare Research and Quality. The frequency of hospital complications last year was 17 percent lower than 2010's but the same as 2013's, indicating some patient safety improvements are sticking. But the lack of improvement raised concerns it's becoming harder for hospitals to further reduce in-patient harm. Hospitals have averted many types of injuries where clear preventive steps have been identified, but still struggle to avert complications with less clear-cut solutions. (Kaiser Health NewsAHRQ)
 
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New & Noted   
Allina boots junk food: Minneapolis-based Allina Health announced that, starting in 2016, it will no longer offer sugar-sweetened beverages or deep-fried foods in its cafeterias, vending machines and other food service areas. The changes are part of Allina's "Choose Healthy" initiative. (Pioneer Press)
 
 
End research ban, say docs: Congress should lift the current ban on CDC gun violence research, a coalition of physician groups urged last Wednesday, just hours before the San Bernardino shooting. (MedPage Today)

UnitedHealth CEO has regrets: It was a "bad decision" for the company to join two dozen state-based exchanges for 2015, UnitedHealth CEO Stephen Hemsley told investors. UnitedHealth jumped into two dozen state-based exchanges for 2015 after selling coverage on just four in 2014. (Associated Press)
Multi-media 
Humana recently released its 2014 Medicare Advantage data that analyzed the quality and outcomes of members treated by providers in value-based reimbursement models compared to those in standard MA settings. The findings indicate that providers deliver better quality, members experience healthier outcomes and Humana has lower costs as a result of value-based reimbursement. (Humana infographic)
 
MarketVoices...quotes worth reading
     
"It's imperative that we learn about the various levels of care and where we're transitioning patients and our residents. We can no longer discharge; it has to be a transition. It really is a true mindset change for all of us." -- Rita Vann, RN, chief clinical officer for Ascension Senior Living, quoted in HealthLeaders Media

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Wednesday, December 9, 2015