Geisinger takes ‘radical’ approach to improve population health

http://www.fiercehealthcare.com/population-health/geisinger-launches-new-population-health-initiative

Geisinger Health System faciliity

Geisinger Health System will unveil a new “radical” population health initiative this week that aims to transform the health of an entire community.

“When it comes to the social determinants of health, we know there are many more causes impacting the health of a population than access to quality medical care,” said Geisinger CEO David Feinberg, M.D., in an announcement. “We want to transform healthcare at its core by focusing on preventive care, behavioral health and economic growth.”

The Danville, Pennsylvania-based system’s new program, called Springboard Health, will kick off in Scranton, Pennsylvania, and targets both patients’ chronic conditions and the community’s overall socioeconomic health, Geisinger said.

The organization will partner with several local stakeholders to implement the program, which features broad goals. The program’s website says it will test several approaches to tackle large-scale socioeconomic issues like hunger and housing insecurity. Potential projects that make it through testing will also be cost-effective, sustainable and designed so that they can be replicated in other regions, according to the website.

“We are going to introduce innovative programs and foster robust community collaborations and back it all up with data to make sure Scranton is the healthiest place to be in the country,” Feinberg said in the announcement. “Once we successfully implement Springboard Healthy Scranton, we’ll take the program on the road to communities with similar socioeconomic health challenges.”

The program’s first project (PDF), titled Fresh Food Pharmacy, aims to provide more healthy eating options to people in the Scranton area. Chronic conditions like diabetes are a significant driver of healthcare costs, research has shown, so the program will identify patients at risk for the disease and enroll them in the project.

The project will ensure that participants have access to at least 10 healthy meals per week and will connect them with local farmers and farmers’ markets to provide them with fresh options they may have had no access to otherwise. Geisinger is already eyeing other Pennsylvania communities for the project.

 

Vermont Tests The Waters On GOP Health Care Overhaul

http://www.healthleadersmedia.com/health-plans/vermont-tests-waters-gop-health-care-overhaul?spMailingID=10548476&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1120254532&spReportId=MTEyMDI1NDUzMgS2#

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A statewide experiment aims to test new payment systems, prevent unnecessary treatments, and constrain overall growth in the cost.

Tiny — and very blue — Vermont could be at the leading edge of the health reforms envisioned by the Trump administration and a Republican Congress.

The Green Mountain State, population around 626,000, got a broad waiver last October from the federal government to redesign how its health care is delivered and paid for. The statewide experiment aims to test new payment systems, prevent unnecessary treatments, constrain overall growth in the cost of services and drugs, and address public health problems such as opioid abuse.

The six-year initiative — an outgrowth of a failed attempt by Vermont a few years ago to adopt a single-payer plan for all residents — could eventually encompass almost all of its 16 hospitals, 1,933 doctors and 70 percent of its population, including workers insured through their jobs and people covered under Medicare and Medicaid.

The Obama administration approved the experiment, but it fits the Republican mold for one way the Affordable Care Act could be replaced or significantly modified. The Trump administration and lawmakers in Congress have signaled that they want to allow states more flexibility to test ways to do what Vermont is doing — possibly even in the short-term before Republicans come to an agreement about the future of the ACA.

8 key strategies for improving a hospital’s margins

http://www.beckershospitalreview.com/hospital-management-administration/8-key-strategies-for-improving-a-hospital-s-margins.html

Cash HospitalCash Hospital

As healthcare shifts toward value-based care, hospitals are looking for new ways to improve quality without unnecessarily increasing the cost of care.

“We think less about cost cutting and more about margin improvement,” says Allen Miller, CEO of COPE Health Solutions. “Folks are going to be more successful taking a strategic approach and focusing on improving margins by taking risks and building the type of infrastructure that will support value based contracts through which they take financial risk instead of the traditional cost-cutting approach.”

Here are some key strategies for financial success:

Biomarkers: Top challenges and opportunities in managed care

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/biomarkers-top-challenges-and-opportunities-managed-care?cfcache=true&ampGUID=A13E56ED-9529-4BD1-98E9-318F5373C18F&rememberme=1&ts=13102016

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High-Need, High-Cost Patients: Who Are They and How Do They Use Health Care?

http://www.commonwealthfund.org/publications/issue-briefs/2016/aug/high-need-high-cost-patients-meps1

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Issue: Finding ways to improve outcomes and reduce spending for patients with complex and costly care needs requires an understanding of their unique needs and characteristics.

Goal: Examine demographics and health care spending and use of services among adults with high needs, defined as people who have three or more chronic diseases and a functional limitation in their ability to care for themselves or perform routine daily tasks.

Methods:Analysis of data from the 2009–2011 Medical Expenditure Panel Survey.

Key findings: High-need adults differed notably from adults with multiple chronic diseases but no functional limitations. They had annual health care expenditures that were nearly three times higher—and which were more likely to remain high over two years of observation—and out-of-pocket expenses that were more than a third higher, despite their lower incomes. On average, rates of hospital use for high-need adults were more than twice those for adults with multiple chronic conditions only; high-need adults also visited the doctor more frequently and used more home health care.

Conclusion: Wide variation in costs and use of services within the high-need group suggests that interventions should be targeted and tailored to those individuals most likely to benefit.

Tailoring Complex Care Management for High-Need, High-Cost Patients

http://www.commonwealthfund.org/publications/in-brief/2016/sep/tailoring-complex-care-high-need-high-cost?omnicid=EALERT1104498&mid=henrykotula@yahoo.com

High-need, high-cost (HNHC) patients account for a disproportionate share of health care spending, and the complex care they need can be fraught with quality and safety issues. Any effort to address quality and cost challenges must focus on improving care for this population. The Commonwealth Fund’s David Blumenthal, M.D., and Melinda Abrams highlighted six key opportunities in this JAMA “Viewpoint.”

Caring for High-Need, High-Cost Patients—An Urgent Priority

http://www.commonwealthfund.org/publications/in-brief/2016/jul/caring-high-need-high-cost-patients-urgent-priority?omnicid=EALERT1072635&mid=henrykotula@yahoo.com

Meaningful improvement in the health system will require improvement in care for those patients using it the most: people with multiple chronic conditions. Within this clinically diverse group are patients who remain stable for years with appropriate treatment, others who live with extreme functional limitations, and still others with persistent behavioral health challenges or related social needs, like housing or food, that exacerbate their conditions. Care for these high-need, high-cost patients is expensive: despite comprising just 5 percent of the U.S. population, they account for 50 percent of the nation’s annual health care spending.

How social factors are driving precision medicine

http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/how-social-factors-are-driving-precision-medicine?cfcache=true

Precision Medicine2

Mention precision medicine, and genomics quickly comes to the top of mind. While genomics and clinically oriented analysis are extremely valuable in implementing precision medicine as the next step in population health management, they are really only a small part of the big picture.

Increasingly, the value of environmental, social and lifestyle factors that live outside the medical system is also getting recognized in the effective implementation of personalized medicine in this country. The federal government’s Precision Medicine Initiative (PMI) that calls for $215 million in fiscal year 2016 to support research in this area focuses not just on genetics and biology, but also behavior and environment — “with the goal of developing more effective ways to prolong health and treat disease.”

Healthcare reform, value-based pay bolsters credit ratings, for now, experts say

http://www.healthcarefinancenews.com/news/healthcare-reforms-value-based-pay-bolsters-credit-ratings-now-experts-say

While reforms tied to the Affordable Care Act have most healthcare providers focusing on quality and efficiency, financial experts say the dramatic change in business model is driving improvement in credit ratings. But worries still persists about just how stable those changes are.

According to Martin Arrick, a managing director at Standard and Poor’s, said a number of factors are affecting ratings trends, although the outlook in general appears to improving. S&P had been negative on the healthcare sector a couple of years ago, mostly because of pressure on operating margins, but that outlook has since reverted back to stable.

“We still see pressure on operating margins, but there are two big things,” said Arrick. “One is that hospitals have done a good job containing costs and keeping their margins generally solid. Two is Medicaid expansion.”

Merge ahead: Healthcare deals adapting as industry evolves

http://www.healthcaredive.com/news/merge-ahead-healthcare-deals-adapting-as-industry-evolves/418868/

There’s little doubt healthcare consolidation will continue as demand increases and the population ages. However, it remains to be seen whether the potential cost savings trickles down to consumers.