Healthcare Intelligence Network

Looking to jump-start patient outreach in the medical home? The appointment calendar is a great place to start, recommends Barbara Wall, a healthcare consultant who advises organizations on adoption of the patient-centered model of care. She describes the simple steps that medical home staff can follow to turn the appointment calendar into a patient teaching, recall and outreach tool. A featured presenter during HIN's Medical Home Open House webinar series, Wall explained the essential process changes that improve patient outreach and keep the patient at the center of the medical home during the August 5, 2009 webinar, Patient Engagement and Education in the Medical Home: Perspectives from Several Pilots.

The accountable care organization (ACO) --- a network of primary care physicians, one or more hospitals, and subspecialists that provide patient-centered care --- is receiving increasing attention as healthcare reform unfolds. Not only do ACOs complement the medical home model, but they are inextricably linked, says Dr. Craig Samitt, M.B.A., president and CEO of Dean Health System. Dr. Samitt discusses how ACOs complement the medical home model, the pros and cons of mandatory and voluntary ACOs and creating reimbursement strategies for ACOs. Dr. Samitt shared how Dean Health System uses its best practices to create an ACO that provides a high-value patient-centered care experience during the July 29, 2009 webinar, Meet the Medical Home Neighbor: Accountable Care Organizations, part of the Medical Home Open House webinar series.

Increasingly, uninsured patients are seeking chronic care via the ER, where they are stabilized, possibly admitted and eventually discharged. However, this cycle is not conducive to managing chronic diseases, and, in the end, will result in high costs and poor quality of care for these individuals, says Dr. Ricardo Guggenheim, vice president of care management services at McKesson Health Solutions. Dr. Guggenheim discusses what areas stand to see improvements as a result of managed uncompensated care, why it is essential to invest in managing uninsured care costs and future plans for McKesson's Care Advisor program. Dr. Guggenheim, along with Robin Barca, senior vice president and chief operating officer for Baptist Health, described how, with a small up-front investment, Baptist was able to manage its health system costs more effectively and provide care for chronic diseases in more appropriate settings during the July 16, 2009 webinar, Reducing Uncompensated Care Costs for the Chronically Ill Through a Medical Home Approach: A Health System Case Study.

Baptist's Health's referral of patients to its family medicine residency program has given residents a greater understanding of the fiscal impact of the uninsured on the healthcare system, and the benefits don't end there. Robin Barca discusses the residents' experience with the medical home model, details of patient contracts and just how much of Baptist's uncompensated care falls into charity care. Barca, along with Dr. Ricardo Guggenheim, vice president of care management services at McKesson Health Solutions, described how, with a small up-front investment, Baptist was able to manage its health system costs more effectively and provide care for chronic diseases in more appropriate settings during the July 16, 2009 webinar, Reducing Uncompensated Care Costs for the Chronically Ill Through a Medical Home Approach: A Health System Case Study.

There are several ways a healthcare organization can bring clinical credibility to the medical home contract negotiating table, explains Dr. Barbara Walters, senior medical director for Dartmouth-Hitchcock Medical Center. She describes the ways in which the medical home contracting process differs from the standard payor contracting experience and highlights some typical performance guarantees to include in a medical home contract. In a July 8, 2009 webinar, Medical Home Contracting: Building a Solid Framework, Dr. Walters shared how to effectively prepare, negotiate and contract with payors for the medical home model of care to better prepare organizations for a seat at the negotiating table. The 45-minute session is part of HIN's continuing Medical Home Open House webinar series.

A move backward in readiness to change should not be perceived as a failure on the client's part but rather as an opportunity to readjust behavior goals, observes Kate Larsen, president of Winning LifeStyles, Inc., an ICF-certified professional coach and a WellCoaches(R) faculty member and mentor coach. There's value in reminding clients that health coaching is a journey and in checking coaching egos at the door to improve listening skills and allow clients to own their behavior change goals, notes the author of "Progress, Not Perfection." Larsen and Claudine Reilly, wellness manager at CVS Caremark, a Certified Intrinsic Coach, and a Certified Health Education Specialist, provided different scenarios that coaches might encounter with patients and examples of how coaches can and should respond to assist clients in achieving the health behavior change they need during the July 15, 2009 webinar, Finding Success in Health Behavior Change, a 45-Minute Interactive Roundtable.

Early and costly proposals for healthcare reform are creating clouds of uncertainty on the healthcare horizon, providing scant relief for organizations stymied by the economy, patient safety issues and internal budget restraints, observes Paul Keckley, Ph.D, executive director of the Deloitte Center for Health Solutions. As he prepares a mid-year review of financial and legislative trends shaping the healthcare industry, Keckley anticipates a slow and bumpy road to EHR adoption and defines the three key elements of the platform for a new generation of care-giving and care consumption at a community level. Keckley examined how the industry is faring in 2009, including the impact of stimulus funding on the industry, the potential and expected shape for reform and other industry trends during the June 25, 2009 webinar, Healthcare Trends in 2009: A Mid-Year Financial and Legislative Update.

Individuals with severe and persistent mental illnesses are likely to die 20 years earlier than people without such conditions, says Liz Reardon, president of Reardon Consulting and a member of the National Council for Community Behavioral Healthcare (NCCBH) Integration Consulting Team. Putting the right medical home services in place for adults with chronic mental illness can help to reduce this disparity, suggests Reardon, explaining why the earliest medical homes for children with complex health needs are great models for behavioral healthcare organizations. Reardon, along with Laura Galbreath, NCCBH Director of Policy and Advocacy, kicked off HIN's Medical Home Open House webinar series when they presented current developments in the patient-centered medical home model with evidence-based approaches to integration of primary care and behavioral health during the July 1, 2009 webinar, Under One Roof: Integrating Primary Care and Behavioral Health in the Medical Home.

American Health Holding relies on the Patient Activation Measure(TM) (PAM) to assess a patient's level of engagement in their own overall disease management (DM), but it does more than just that. PAM scores are also used to gauge the success of the DM program and its coaches. Director of DM and wellness services Diane Bellard discusses PAM --- who is using it, how to deal with a decrease in PAM levels, how it fits with a patient's readiness to change and PAM's role in an organization's overall quality improvement. Bellard, along with Dr. Judith Hibbard, professor of health policy at the University of Oregon and developer of the Patient Activation Measure(TM), shared the research behind the development of the PAM, its potential for improving a patient's healthcare self-efficacy and examples of its use in a DM setting during the June 18, 2009 webinar, Patient Activation Measure(TM): Assessing the Engaged Healthcare Consumer for Self-Efficacy.

There are many ways to administer the Patient Activation Measure(TM) (PAM) and many socioeconomic factors that influence its outcomes, explains Dr. Judith Hibbard, developer of the PAM and professor of health policy at the University of Oregon. Dr. Hibbard identifies the PAM scores that signal a behavior change and the value of adding patient activation assessment to a health improvement initiative. Dr. Hibbard, along with Diane Bellard, director of disease management and wellness services for American Health Holding, shared the research behind the development of the PAM, its potential for improving a patient's healthcare self-efficacy and examples of its use in a DM setting during the June 18, 2009 webinar, Patient Activation Measure(TM): Assessing the Engaged Healthcare Consumer for Self-Efficacy.

Health IT is extremely important in improving an organization's communication and prevention strategies, says Ewa Matuszewski, CEO of Medical Network One. In this podcast, Matuszewski also comments on how health IT supports the joint principles of the PCMH and describes how her health IT tool of choice can be a stepping stone to further implement IT within an organization. Matuszewski, along with Dr. James Crawford, senior vice president for laboratory services and chair of the department of pathology and laboratory medicine at North Shore-Long Island Jewish Health System, presented case studies on the use of health IT in the medical home and its impact on care access, quality and cost during a May 28, 2009 webinar, Wiring the Medical Home: Healthcare IT to Power a Patient-Centered Model.

Implementing an EHR into your organization is not the same as implementing a patient-centered medical home (PCMH) model of care, according to Dr. James Crawford, senior vice president for laboratory services and chair of the department of pathology and laboratory medicine at North Shore-Long Island Jewish Health System. To be a PCMH, the practice workflow has to change as well. In this podcast, Dr. Crawford discusses the key process change that has to accompany the adoption of health IT by a medical home as well as health IT's impacts on care coordination and findings from the PCPCC's survey of physician practices on their use of health IT in support of the medical home model. Dr. Crawford, along with Ewa Matuszewski, CEO, Medical Network One, presented case studies on the use of health IT in the medical home and its impact on care access, quality and cost during a May 28, 2009 webinar, Wiring the Medical Home: Healthcare IT to Power a Patient-Centered Model.

Health claims are still scrutinized during risk stratification, but today's analysts examine these data points through a slightly different lens, explains John Harris, chief wellness officer and senior vice president for Healthways. Harris explains why the focus has shifted from ICD-9 coding patterns to the financial trends evident in the claims, and what accelerating or decelerating costs reveal about an individual's health status. Harris, along with Dr. William Vennart, vice president of medical management and national medical director with CareAdvantage Inc., described how their organizations have approached health risk stratification, from how individuals are identified for stratification purposes to the effectiveness of risk stratification programs during the webinar, Reducing Acute and Chronic Care Costs Through an Effective Health Risk Stratification Model.

Predictive modeling and health risk stratification can help providers identify members for case management and disease management interventions, says Dr. William Vennart, vice president of medical management and national medical director with CareAdvantage Inc. These methods ensure that patients receive treatment for their chronic conditions early on and, in turn, reduce unnecessary utilization and lower acute and chronic care costs. Dr. Vennart, along with John Harris, chief wellness officer and senior vice president for Healthways, described how their organizations have approached health risk stratification, from how individuals are identified for stratification purposes to the effectiveness of risk stratification programs during the webinar, Reducing Acute and Chronic Care Costs Through an Effective Health Risk Stratification Model.

Nightly data mining has helped Vanderbilt University and Medical Center identify and make contact with high-risk high-volume patients, explains Dr. Dexter Shurney, which has vastly improved patient outcomes and closed care gaps. But the medical director of Vanderbilt's Employee Health and Care Plan would like to see even more data put in front of physicians at the point of care --- especially regarding certain patients with no claims history. Dr. Shurney describes these "bombs waiting to explode," as well as the impact of the patient-centered medical home (PCMH) model of care on disease management and why wellness and prevention services may be the best responses to individuals with comorbidities. Dr. Shurney, along with Dr. Ariel Linden, Dr.P.H., M.S., president of Linden Consulting Group, examined how disease management programs can continue to prove their worth and new developments in disease management that are netting results during The Strategic Ongoing Role of Disease Management in the Healthcare Continuum: Achieving the ROI.