Two key areas hospitals are planning major tech investments in the immediate future

Posted on March 28, 2018 by henrykotula • Posted in Uncategorized • Tagged ACA, American Family Care, Care Coordination, CareNow Urgent Care, Chronic Disease Management, Concentra, Data Analysis, Data Integration, FastMed Urgent Care, GoHealth Urgent Care, Health System, High Risk Patients, Hospital, Major Investments, MedExpress, NextCare Holdings, Population Health, Population Health Management, Population Health Technologies, Strategy, Urgent Care Centers • Leave a comment

http://www.healthcarefinancenews.com/news/two-key-areas-hospitals-are-planning-major-tech-investments-immediate-future?mkt_tok=eyJpIjoiTkRsaU5HTTJNVEV5WldaaSIsInQiOiJFSTVVaHdzRmdQTGVCSXZORmhReEkrbVVWNjZOdzhlOWRuRUwxeUVXNktOa2FyNVpQWkc1dXk5SGNTQjc0YndcL3BuUTkrV2xkWEVLd01qWnd2UGNrWTBFTFFzRWxWaGM3bVFOclwvYjNlbXBPSjA2d1prU0tyMmNpQ0Qwdlg4TGhUIn0%3D

Providers are ramping up to focus on urgent care centers and population health initiatives.

Hospitals are gearing up to spend more on population health and urgent care centers in the coming years, according to new research from two different firms.

The market for population health technologies is expected to reach $69 billion by 2025 while the urgent care center space is forecasted to grow by roughly $8 billion in 2018 to $25.93 billion by 2023.

The global population health management market was worth $118.5 million in 2016 and is slated to grow at a CAGR of roughly 16 percent from 2017 to 2025, with the rise in demand for innovative technologies and adoption of healthcare IT tools fueling the growth, Transparency Market Research said in a new report.

In terms of end-users, it’s the healthcare provider segment of the market that is expected to account for the largest share of the global market thanks to rising use of PHM tools. Insurers, pharma and “others” follow in terms of segments.

The benefits of PHM tools like data integration, data analysis, care coordination, and lowering care costs have driven an increase in their adoption, especially in the case of chronic diseases like diabetes and cardiovascular diseases which require identifying high-risk patients and disease management measures.

“This is one of the factors projected to drive the global population health management market during the forecast period,” the report authors wrote. “Developed healthcare IT infrastructure and increase in healthcare IT spending are the other factors anticipated to propel the global market during the forecast period.”

Geographically, North America and Europe are expected to dominate the market thanks to the Affordable Care Act and a rise in healthcare IT spending, owing largely to providers.

“Well-established healthcare infrastructure and strong support from public and private sectors in terms of reimbursement are attributed to the largest market share of North America,” the firm said. “A rise in awareness about population health and government initiatives such as the Affordable Care Act are anticipated to drive the market during the forecast period.”

Urgent Care Centers, meanwhile, will represent a $26 billion market by 2023, and in this year will reach just over $20 billion, ReportsnReports projected. Health systems and corporations with a stake in the healthcare industry know the model is flourishing thanks to affordable pricing, shorter wait times, an increasing elderly population, and the market is seeing more investment activity as well as strategic development partnerships between urgent care providers and hospitals. Corporate-owned urgent care centers, however, are expected to occupy the largest share of this market in 2018.

Concentra, MedExpress, American Family Care, NextCare Holdings, and FastMed Urgent Care are already major market players with CareNow Urgent Care, GoHealth Urgent Care starting to gain more of a presence as well in the United States.

Health systems looking to diversify their portfolios might do well to look at both urgent care centers and population health programs when considering how to expand their footprints. With a reputation for faster service and better pricing, both things that the rising millennial population smile at, they could be a beacon for both primary and specialty care for younger consumers as opposed to traditional practices. Additionally, with the high-deductible health plans, reasonably priced care will be especially attractive to patients who will bear a greater portion of the financial responsibility related to their care.

As these facilities grow in popularity, including them could boost not only your reputation but also your bottom line.

The uninsured are overusing emergency rooms — and other health-care myths

Posted on January 2, 2018 by henrykotula • Posted in Uncategorized • Tagged Chronic Care Management, Emergency Room Use, Health Policy, Health System, High Risk Patients, Hospital, Medicaid, Uninsured • Leave a comment

https://www.washingtonpost.com/news/wonk/wp/2017/12/27/the-uninsured-are-overusing-emergency-rooms-and-other-health-care-myths/?utm_term=.98d00c3511a6

In the search for ways to bring down American health-care spending, there are certain ideas that are close to dogma. Chief among them: If you provide health insurance to people, they will stop overusing the emergency room.

“A lot of people just didn’t bother getting health insurance at all. And when they got sick, they’d have to go to the emergency room,” President Obama said in a 2016 speech. “But the emergency room is the most expensive place to get care. And because you weren’t insured, the hospital would have to give you the care free, and they would have to then make up for those costs by charging everybody else more money.”

The idea that uninsured people are clogging emergency rooms looks more and more like a myth, according to a recent study published in Health Affairs. Uninsured adults used the emergency room at very similar rates to people with insurance — and much less than people on Medicaid. Providing insurance to people can have many benefits, but driving down emergency room utilization doesn’t appear to be one of them.

“It would be nice if giving people insurance did get them so healthy and so much access to other care that they didn’t need to go to the emergency department, but that does not seem to be the case,” said Katherine Baicker, dean of the University of Chicago’s Harris School of Public Policy. “It seems clear to me that expanding insurance, in and of itself, does not contain spending. It increases spending, by giving people who had very limited access to care the ability to get their health-care needs met.”

Another Health Affairs study poked a hole in a different health-care mantra: that the key to cutting spending is to coordinate care for high-risk patients with chronic diseases, to keep them out of the hospital.

The study examined accountable care organizations, groups of hospitals and doctors that work together to improve health care and reduce costs. There were savings overall, but they weren’t mostly from reductions in spending on high-risk patients. The researchers measured some modest increases in hospitalizations for avoidable procedures, one of the categories of care that would be expected to be affected by efforts to help high-risk patients stay well.

These studies both chip away at ideas that stem from the overarching belief that improving the quality of health care will also save money.

“It turns out, when you do the math, it’s just very tough to save money when you’re doing things to improve quality. It’s very hard to save a dollar when you spend a dollar,” said J. Michael McWilliams, a professor of health-care policy at Harvard Medical School. “Why has this become such a widespread notion — that we can sort of coordinate our way out of the cost problem? One reason is that it’s a much easier conversation to have: We can all subscribe to this notion of prevention saves money and care coordination saves money — and we don’t have to talk about regulating prices, or breaking up monopolies.”

By now, it shouldn’t be a surprise that getting health coverage doesn’t drive down emergency room usage. A provocative study four years ago found that expanding Medicaid in Oregon had caused emergency room visits to increase. A follow-up study last year found the surge in ER visits wasn’t temporary at least two years out.

The study did find one possible reason the myth hasn’t died. Uninsured people used other kinds of care — such as visits to a doctor or other hospital departments — far less than insured people. That could contribute to the perception that they’re using the emergency room more, since they are so rarely seen in other care settings.

There are reasonable arguments for providing health coverage to uninsured people and helping chronically sick people better manage their diseases. But policymakers often return to the idea that such interventions will improve quality and costs, in one swoop — even as the evidence points to another conclusion.

“Just because something sounds true doesn’t mean that it is,” Baicker and Amitabh Chandra of the Harvard Kennedy School of Government wrote in a recent article in the New England Journal of Medicine calling for the use of more evidence in health policy. “And magical thinking won’t improve our health care system.”

Asking the Right Questions: Why Healthcare Predictive Analytics Often Don’t Predict Anything Meaningful at All.

Posted on January 30, 2017 by henrykotula • Posted in Uncategorized • Tagged Health System, Healthcare Analytics, High Risk Patients, Hospital, Leadership, Predictive Analytics, Problem Reframing • Leave a comment

https://www.linkedin.com/pulse/asking-right-questions-why-healthcare-predictive-dont-cousins-phd?trk=v-feed&lipi=urn%3Ali%3Apage%3Ad_flagship3_feed%3BgC0bModjFFl7I4auAFAWBQ%3D%3D

Healthcare organizations collectively waste billions of dollars every year by focusing on the wrong problem to solve. This isn’t unique to healthcare, of course. A recent, must-read article in Harvard Business Review, “Are You Solving the Right Problems” by Thomas Wedell explains how organizations that are good at problem solving often focus on the wrong ones to solve. It’s often human nature.

Healthcare analytics offers a particularly good example. Today, health plans, hospital systems, post-acute care companies and other provider organizations are keenly focused on identifying those patients who are at highest risk of adverse events, such as readmissions and post op complications. They then invest precious resources trying to reduce that risk through home visits, additional pre-op or post-operative care, and so on.

Yet, despite the apparent logic, according to our research, 50% or more of patients identified as high risk cannot be impacted by the interventions provided to reduce that risk.

Yet, despite the apparent logic, according to our research, 50% or more of patients identified as high risk cannot be impacted by the interventions provided to reduce that risk.

On the face of it, this seems like a logical approach to improving care and reducing costs. Yet, despite the apparent logic, according to our research, 50% or more of patients identified as high risk cannot be impacted by the interventions provided to reduce that risk. In some cases, they can’t be impacted at all. Our research is consistent with that conducted by others, including a randomized controlled study of telephone care management and study on nurse-led home-based intervention. In short, a lot of the money spent trying to avoid adverse events is wasted.

https://hbr.org/2017/01/are-you-solving-the-right-problems

Hospitals work to ensure high-risk patients are ready for surgeries

Posted on September 28, 2016 by henrykotula • Posted in Uncategorized • Tagged Elective Procedures, Health System, High Risk Patients, Hospital, Hospital Infection Rates, Infection Control, Surgical Outcomes, Value Based Health Care • Leave a comment

http://www.fiercehealthcare.com/healthcare/hospitals-work-to-ensure-high-risk-patients-are-ready-for-surgeries?mkt_tok=eyJpIjoiTVdZNE9UbGtZemxtTXpBMCIsInQiOiJVS01rMXhPNVNhS1c0V2JKaE53TSthTHg0dWFnaXVtcUtXeEZlK0VqQTk3SFBNTG01aEJpVVN0aFhqRDZ5cmFGYitGUmtrZHV0K0JGMHBcL2twN2RBeUpSSk5MaW5vS0NcL25JQTk3T2FFTUhrPSJ9&mrkid=959610&utm_medium=nl&utm_source=internal

As healthcare becomes increasingly value-based, surgical outcomes are more important than ever, leading many providers to assess patients’ fitness for elective procedures.

Increasingly, providers make an effort to learn more about patients’ health before operations such as hip and knee replacements, according to The Wall Street Journal, looking for evidence of dangers of infection and other complications. Patients with chronic conditions or lifestyles that put them at higher risk may be directed to “pre-habilitation” programs to increase the odds that their procedures go off without a hitch. These initiatives can involve medical treatments or simply improved diet and exercise, according to the article.

This approach builds on strategies surgeons have employed for years, including advising patients to quit smoking or get in better shape ahead of a procedure, but the range of risks they focus on has broadened considerably to encompass everything from sleep disorders to mental illness, according to the article.

“In health care, we often bring patients into surgery without fully addressing their chronic medical conditions,” Solomon Aronson, M.D., executive vice chair in the anesthesiology department at Duke University School of Medicine in Durham, North Carolina, told the WSJ, and when patients are healthier pre-surgery, “we can significantly diminish the risk of complications.”

For example, Duke Health’s “Poet” (Peri-Operative Enhancement Team) program has focused its efforts on patients with anemia, malnourishment, poor tolerance for exercise, complex pain disorders and diabetes. The fixes the provider offers range from pre-operative iron infusions for anemic patients to a protein shake regimen for older, malnourished patients. In the cases of patients who need such fixes as weight loss or blood sugar control, the Duke team employs longer-term regimens as well.

Why A Single-Payer Healthcare System Is Inevitable

Posted on August 23, 2016 by henrykotula • Posted in Uncategorized • Tagged ACA, Competition, Health Insurance Industry, Health Policy, High Risk Patients, Market Consolidation, Market Power, Risk Aversion, Risk-based Contracts, Single Payer Health System, Structure of Private Markets for Health Insurance • Leave a comment

http://www.huffingtonpost.com/entry/why-a-single-payer-healthcare-system-is-inevitable_us_57bb38d0e4b0b51733a4e665?&utm_campaign=KHN%3A+Daily+Health+Policy+Report&utm_source=hs_email&utm_medium=email&utm_content=33278487&_hsenc=p2ANqtz–pFhM1yVmgKE5kBJSkJqgzGm6EX86cVbU_jxP8glbnNrQH2CY9ktk8qbzIisOdLEgV0JX5fgsxqoDwrFym5ZxmTnCJOw&_hsmi=33278487

The best argument for a single-payer health plan is the recent decision by giant health insurer Aetna to bail out next year from 11 of the 15 states where it sells Obamacare plans.Aetna’s decision follows similar moves by UnitedHealth Group, the nation’s largest health insurer, and by Humana, another one of the giants.

All claim they’re not making enough money because too many people with serious health problems are using the Obamacare exchanges, and not enough healthy people are signing up.

The problem isn’t Obamacare per se. It lies in the structure of private markets for health insurance – which creates powerful incentives to avoid sick people and attract healthy ones. Obamacare is just making this structural problem more obvious.

In a nutshell, the more sick people and the fewer healthy people a private for-profit insurer attracts, the less competitive that insurer becomes relative to other insurers that don’t attract as high a percentage of the sick but a higher percentage of the healthy.

Eventually, insurers that take in too many sick and too few healthy people are driven out of business.

If insurers had no idea who’d be sick and who’d be healthy when they sign up for insurance (and keep them insured at the same price even after they become sick), this wouldn’t be a problem. But they do know – and they’re developing more and more sophisticated ways of finding out.

Milestones On The Path To Population Health

Posted on April 11, 2016 by henrykotula • Posted in Uncategorized • Tagged ACO, Community Health Dashboard, Diabetes, High Risk Patients, Hypertension, Morbidity, Mortality, Population Health, Population Health Management, Quality of Life, Super Utilizers, Undiagnosed Chronic Conditions • Leave a comment

http://healthaffairs.org/blog/2016/04/11/milestones-on-the-path-to-population-health/

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HENRY KOTULA

A Healthcare Leadership Blog

Tag Archives: High Risk Patients

Two key areas hospitals are planning major tech investments in the immediate future

Providers are ramping up to focus on urgent care centers and population health initiatives.

The uninsured are overusing emergency rooms — and other health-care myths

Asking the Right Questions: Why Healthcare Predictive Analytics Often Don’t Predict Anything Meaningful at All.

Hospitals work to ensure high-risk patients are ready for surgeries

Why A Single-Payer Healthcare System Is Inevitable

Milestones On The Path To Population Health

Providers are ramping up to focus on urgent care centers and population health initiatives.

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