Click to access PDF%20AlmanacRegMktBriefOrange2016.pdf
Orange County: Changing Market Fuels New Models of Provider Collaboration
http://www.chcf.org/publications/2016/06/regional-market-orange
Tag Archives: Value Based Health Care
California Health Care Foundation – Regional Markets Issue Brief (June 2016)
Click to access PDF%20AlmanacRegMktBriefSanDiego16.pdf
SAN DIEGO: MAJOR PROVIDERS PURSUE COUNTYWIDE NETWORKS and NEW PATIENT CARE MODELS
http://www.chcf.org/publications/2016/07/regional-market-san-diego
California Health Care Foundation – Regional Markets Issue Brief (January 2016)
Click to access PDF%20AlmanacRegMktBriefSanFran16.pdf
SAN FRANCISCO BAY AREA: MAJOR PLAYERS DRIVE REGIONAL NETWORK DEVELOPMENT
http://www.chcf.org/publications/2016/01/regional-market-san-francisco
California Health Care Foundation – Regional Markets Issue Brief (September 2016)
Click to access PDF%20AlmanacRegMktBriefLosAngeles2016.pdf
LOS ANGELES: THRIVING OR SURVIVING IN A FRAGMENTED MARKET
http://www.chcf.org/publications/2016/09/regional-market-los-angeles
Hospitals work to ensure high-risk patients are ready for surgeries
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.
High-Need, High-Cost Patients: Who Are They and How Do They Use Health Care?
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
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.”
Cost Control Efforts Working ‘So Far’ in MA
Health policy veteran Stuart Altman, PhD, is hopeful, but not optimistic, about healthcare delivery reforms and thinks hospitals will be forced to bring costs down because patients won’t tolerate any more cost shifting.
Each year, we put together a cost trend report that outlines what forces are at play in the state in terms of raising spending and we have hearings every October. We are trying to play an interesting role which is not be regulatory, but really to be in the face of the healthcare system in terms of saying, “Hey be careful. Don’t go the extra mile on in spending or pricing.”
We want to do it in a way that doesn’t destroy or even hurt the health system. In any attempt to do that, some of the forces within the health industry scream.
But, for the most part, the hospitals have been supportive of our efforts. If we were to squeeze too hard, they would react more negatively. Everyone is engaged in a very interesting balancing act. We are trying getting the system to work more efficiently… and they are trying to control costs without destroying themselves. So far it’s working.
Geisinger to add 1,500 new jobs
Following a decade of unprecedented growth, Geisinger Health System has launched a nationwide recruitment effort to increase its workforce 5 percent, by hiring more than 1,500 physicians, advanced practitioners, nurses and support staff.
And that recruiting “will certainly continue to include many positions in the central Pennsylvania region, where Geisinger was founded and has its corporate headquarters,” according to an early evening statement released by Geisinger.
“Caring for more than 3 million patients every year takes a team,” said Julene Campion, vice president of talent management at Geisinger, in a prepared statement. “Every day, our 30,000 employees strive to improve that care. This responsibility has motivated Geisinger to push the boundaries of geography and healthcare innovation, grow its medical specialty and subspecialty offerings, and recruit the best and the brightest for more than 1,500 critical healthcare positions to better care for our patients in the communities we serve.”
Geisinger is seeking candidates for all levels of employment, including administration, clerical, environmental services, food services, laboratory services, information technology, marketing, occupational therapy, pharmacy and research.
In the past year, Geisinger President and CEO Dr. David Feinberg has also instituted a $10 minimum wage across the health system.
Value-based Care is Ripping Into Health System Profits
HENRY KOTULA 