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Industry News
Analysis from the Urban Institute finds that nationally, the average second-lowest silver plan premium on an Obamacare exchange is 10 percent lower than the average employer-sponsored premium. The researchers made adjustments for actuarial value, or the percent of costs covered by the insurer, as well as utilization and age distribution. Researchers found variation across states and metro areas, but more than 75 percent of states and more than 80 percent of metropolitan areas had lower marketplace than employer premiums. (Morning Consult; analysis)

Family physicians should "firmly defend healthcare as a fundamental human right," Douglas Henley, MD, executive VP and CEO, American Academy of Family Physicians, told the AAFP Congress of Delegates earlier this month. He also expressed concerns about the lack of off-hours access and the "rapid rise in the number of referrals out of primary care to subspecialists." He lauded the fact that just over 45 percent of AAFP members now work in a patient-centered medical home, up 10 percentage points from last year. (Medpage Today
A Justice Department filing highlights growing tensions between Anthem and Cigna, The Wall Street Journal reports. Cigna's lawyers reported "further deterioration" in the relationship between the two companies, according to the filing. "Governance disputes between defendants have escalated, and the firms are now accusing each other of breaching the merger agreement." Both companies declined to comment. (The Wall Street Journal)
Innovation & Transformation  
With the move to value-based care, insurers are increasingly partnering with providers--not just health systems, but also primary care, the initial touch point for many patients. Fierce Healthcare profiles one organization doing this: UnitedHealth subsidiary Harken Health. "[P]eople deserve to be cared for," Krista Nelson, VP and co-founder, says. By offering "a very different relationship-based primary care experience, we can actually help support people in that care and in that care journey." (FierceHealthcare)

CMS' voluntary Bundled Payments for Care Improvement initiative has yielded mixed but promising results, according to a new report from CMS. "There have been modest reductions in Medicare episode payments for select clinical episode groups with isolated instances of quality declines and fewer instances of increased quality." The report analyzed 15 clinical episode groups; it found 11 had potential to save Medicare money. (Kaiser Health News; report)
FH Health Insurance 101 is a series of guides and videos that use "plain speak" to explain health insurance. It's a free resource offered by FAIR Health, an independent not-for-profit with a mission "to bring transparency to healthcare costs and health insurance information through comprehensive data products and consumer resources." The organization recently launched an app to help consumers in Connecticut and the surrounding area compare reimbursements for medical procedures. (FAIR Health; Internet Health Management)
Consumers & Providers
Dominick Bailey, a clinical pharmacist specializing in geriatric care, spends most of his time ensuring his patients are given the right medications in the right dosage and that that they understand how to take them. He's one of several clinicians, experts and patients Kaiser Health News highlights in a feature on "America's other drug problem"--polypharmacy among the elderly. For example, a study of VA hospitals showed 44 percent of elderly patients were discharged with at least one unnecessary drug. (Kaiser Health News)
The doctor may think the medication is important, but that won't necessarily influence patients. Researchers found no correlation between physician-assessed drug importance and patient-reported drug adherence; they reported their findings in the Annals of Family Medicine. Additionally, they observed only weak agreement among patients and physicians in their assessments of drug adherence and drug importance. "This discordance between patient adherence and physicians' assessment of drug importance may be due to a lack of patient-centered communication," they write, suggesting discussions between patients and physicians may make a difference. (Annals of Family Medicine; Physician's Briefing)
Despite ongoing attention to the issue, patient-identification errors persist. Most--perhaps all--are preventable, according to new research from ECRI Institute. Most (72.3 percent) occurred during patient encounters; another 12.6 percent occurred during the intake process. Most patient-identification mistakes are caught before care is provided, but when they aren't the results can be devastating. About 9 percent of the events led to temporary or permanent harm or death. Among the possible factors: increasing patient volume, frequent handoffs and increasing interoperability and data sharing among IT systems. (ECRI)
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New & Noted   
Virtual care in the heartland: Residents of Springfield, Ill., and its environs now have two options for virtual medical care through AnytimeCare from HSHS Medical Group and the Memorial MD SmartVisit app from Memorial Health System. (The State Journal-Register)

Consolidation continues: Physicians are continuing to move from smaller to larger group practices, according to research published in Health Affairs. Primary care physicians have made this change at a much faster pace than have specialists. (Health Affairs)

An app for HIX: Maryland health exchange officials have launched Enroll MHC, an app developed to help people enroll via phones and tablets. It will be loaded with 2017 plans before open enrollment begins Nov. 1, officials said. The move is a response to the high rate of people using mobile devices to visit the state's online marketplace for health insurance. (The Baltimore Sun)
A new briefing from The Alliance for Health Reform, High-Need, High-Cost Patients: Challenges & Promising Models, explores who these patients are and their importance to health system transformation. It also looks at the current data and identifies elements of successful interventions. (resources and video)
MarketVoices...quotes worth reading
"Although many healthcare workers doubt they will actually make a mistake in identifying their patients, ECRI Institute PSO and our partner PSOs have collected thousands of reports that show this isn't the case. We've seen that anyone on the patient's healthcare team can make an identification error, including physicians, nurses, lab technicians, pharmacists, and transporters." -- William M. Marella, MBA, MMI, ECRI Institute executive director of PSO Operations and Analytics, in an ECRI Institute announcement

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Wednesday, September 28, 2016