Reading this on a mobile device? Try our optimized mobile version here: http://r.smartbrief.com/resp/rUnshMrCDliIAdWadh

September 17, 2009     Spotlight  Quality, performance measurement take center stage in health care reform A key element of health care reform is to improve the quality of care to drive better outcomes at lower costs. "One of the main goals of health care reform is to make care more affordable, while improving quality," said Dan Dunn, senior vice president, Ingenix. "To make that happen, there needs to be a standard methodology for measuring current performance against stated goals, and making improvements based on that data." According to Dunn, health care improvement efforts must balance three factors -- quality, access and affordability -- each dependent on measurement. "Almost every aspect that you hear about health care reform will require measurement, whether it is used to identify improvement opportunities, to devise incentives or to track how well providers share vital information about their patients," he said. Click here to continue reading this article online. Learn more about measurement standards for surgical treatment Ingenix now presents an updated Procedure Episode Group (PEG) methodology that addresses uncommon, but important, circumstances related to surgical events. PEG 7.5 enables the quality and cost of care provided by surgical specialists to be measured as accurately as that provided by primary care practitioners and medical specialists. This analysis is essential for pay-for-performance, network tiering and other initiatives that demand valid and robust approaches to measuring value in health care. View the white paper.     Employers  Wellness program saves company $4.80 for every dollar invested Quest Diagnostics offers its employees -- as well as their spouses or domestic partners -- a voluntary wellness program called Healthy Quest, which helps individuals lose weight, get fit, quit smoking and more. "We determined that for about every dollar that we invest behind Healthy Quest, there's a savings of about $4.80," said a company official. CNN (9/1) Companies see importance of helping employees' spouses stay healthy Companies such as Syngenta have realized the importance of involving not only their workers but also workers' spouses in their health and wellness programs. Syngenta noticed that the costs of spouses' medical claims were actually higher than those of employees, so the company took measures to draw spouses into its preventive health screening program. The Wall Street Journal (8/31) Domestic medical tourism is a new way for employers to cut health costs Domestic medical tourism, which gives U.S. employers the option of sending their workers who need medical attention to closer locations than traditional medical tourism, which involves international travel, offers much cheaper care than local facilities -- without the lengthy travel. Business Insurance (8/24) Turnover down, productivity up due to company's employee health insurance program A restaurant chain called Burgerville has successfully used its innovative, comprehensive employee health insurance program to encourage workers to increase productivity and sales. Employees are so satisfied with their health insurance program that the company has also seen a drop in turnover. The Wall Street Journal (8/31) Raley's gives workers free flu shots to keep them healthy, reassure customers The almost 15,000 employees of grocery chain Raley's can get free flu vaccinations through their employer. "We've encouraged every employee to participate in flu shot clinics at no cost to them so [customers] can trust our employees are supplied with resources and services to keep themselves and those around them healthy," said a company official. Supermarket News (9/1) Solutions: For Employers |  Health & Productivity Optimization |  Decision Support |  Health Benefits Consulting   Hospitals  Patient safety would benefit from approach borrowed from other high-risk industries The Joint Commission has issued an alert to health care leaders saying they should borrow "zero-defect" approaches from other industries, including aviation and nuclear energy, to stop medical errors from happening. Modern Healthcare (free registration) (8/27) Cincinnati Children's Hospital uses efficiency measures to dramatically increase revenue Cincinnati Children's Hospital has been working with efficiency expert Eugene Litvak to streamline patient flow. The results include increased capacity, more hospital income and more predictable schedules for doctors and nurses. The Boston Globe (8/30) Relatives can follow surgery updates through Twitter While an Iowa woman recently underwent surgery, her children were able to follow news of the procedure through Twitter posts from hospital staff. Her relatives could read the updates from the hospital waiting room or even from their offices. "It's real-time information instead of sitting and not knowing in the waiting room," said one of the patient's sons. MSNBC/The Associated Press (9/1) Easing pediatric surgery patients into hospital surroundings helps reduce fear A surgery nurse at Children's Memorial Hospital gives pediatric patients 3 to 10 years old, as well as their families, tours of the surgical floor before their procedures to help familiarize them and calm their fears. "We give them masks and bandages to play with. It's all an attempt to reduce the fear of the unknown," said the nurse. Chicago Tribune (8/26) Fall risk is evaluated for each hospital patient to keep injuries down Since the top cause of injuries among hospital patients is falling, one hospital pre-emptively combats the problem by evaluating all patients for fall risk. Those most at risk get yellow socks, blankets and signs in front of their rooms. "They should be being rounded on every half-hour versus every hour," said a nurse. WBUR-FM (Boston)/National Public Radio (8/25) Solutions: For Hospitals |  Health Care EDI |  Coding & Reimbursement |  Performance Analysis |  Operational Improvement   Payers  Electronic records lead to significant savings for payer Minnesota-based health insurer HealthPartners says its use of electronic medical records led to $430,000 in savings in the past year. "The benefits of being paperless include increased efficiency because [diagnostic] images can be available quickly at multiple locations and they cannot be lost," said an official from one of the company's hospitals. Minneapolis/St. Paul Business Journal (8/28) Interest is growing in sending members overseas for care A growing number of payers are tapping health care providers overseas, in locations such as Costa Rica and India, to provide more cost-effective treatment. Heart bypasses and knee-replacement surgery can be up to $40,000 cheaper overseas. Yahoo!/The Associated Press (8/23) Members are rewarded for adherence to drug regimens UnitedHealth is giving its members an incentive to be prompt about refilling their prescriptions for a number of medicines that require higher co-payments. The payer is giving these patients discounts in the form of $20 rebates to encourage them to better adhere to their medication regimens. The Wall Street Journal (8/28) Payers are already doing comparative effectiveness research Payers realize they don't need to wait for federal initiatives to tap the potential of comparative effectiveness research. "Most health plans and many others are extremely eager to find ways to use data and information of CER coupled with benefit designs that make those more effective treatments available at low costs," said an expert. Atlantic Information Services/Specialty Pharmacy News (8/28) More payers use bricks-and-mortar shops to sell their products Shopping malls are seeing more retail health insurance shops pop up among their other stores as insurers work to make purchasing health insurance a more personal experience. One buyer said it "seemed weird to go to a little store to buy insurance," but added, "I wanted a name, a business card, a person" to be able to call. The Wall Street Journal (9/1) Solutions: For Payers |  Care & Health Management |  Network & Credentialing |  Payment Integrity |  Consumer Tools |  Underwriting & Actuarial |  Health Care EDI |  Decision Support |  Claims Reimbursement   Pharma  Pharma companies pour billions into cancer drug development More than 850 drugs to treat cancer are in clinical studies and most large drug companies are working in the cancer arena. Two drivers are pushing companies in this direction: new potential targets for cancer treatments and the drugs' ability to command high prices. The New York Times (9/1) Researchers are closer to developing cancer vaccines Recent clinical trials have shown that researchers are closer to reaching the goal of creating cancer vaccines. "Understanding how the immune system works is going to play a significant role in our treatment of cancer going forward," said a member of the American Cancer Society. TIME (9/15) Drugmakers are fulfilling post-marketing study requirements, FDA says A new FDA report shows most pharmaceutical manufacturers are meeting their post-marketing study requirements. "The data indicate that makers of approved drugs and biologics ... are on track with their studies," said an FDA official. HealthImaging.com (9/7) Discovery could be significant to AIDS vaccine development Researchers say they have discovered antibodies that could help patients with HIV stop the virus from leading to severe AIDS. The discovery puts scientists closer to production of a vaccine. "This is opening up a whole new area of science," said the head of the International AIDS Vaccine Initiative. Los Angeles Times (9/4) Companies partner to develop drugs for "difficult" targets Two drug companies -- GlaxoSmithKline and BioLeap -- have agreed to collaborate on drug targets that require more than conventional approaches. Proprietary BioLeap algorithms will be used to test compounds that may potentially target proteins identified by GSK. American City Business Journals/Philadelphia (9/8) Solutions: For Pharma |  Therapeutically-Specialized Research |  Drug Safety |  Research Staffing |  Health Economics & Outcomes |  Clinical Data Services   Physicians  Physician survey finds pediatricians have highest job satisfaction Pediatricians have the most job satisfaction among doctors, a new survey by the Center for Studying Health System Change found, with 88% of pediatricians reporting that they were satisfied and 9% saying they were dissatisfied. The Wall Street Journal (9/3) Living in a nursing home gives medical students a new perspective A University of New England program sends some of its medical students who are focusing on geriatric medicine to live in a nursing home for 10 days to give them the residents' perspective and increase interest in the specialty. One student, Kristen Murphy, used a wheelchair during her stay and learned firsthand what it's like to get help with bathing, be lifted out of bed and fed pureed food. The New York Times (8/23) Survey details technology's importance to medical students A survey of more than 1,000 U.S. medical students found that nearly half use an iPhone or iPod Touch and almost 90% believe online medical information is credible. Most students' clinical rotations gave them electronic medical record experience and 90% believe electronic records are important. Healthcare IT News (8/24) IOM: Doctors should protect themselves from flu by using respirators The Institute of Medicine issued a new report on how physicians and other health care workers can protect themselves when seeing patients who have H1N1. Using fit-tested respirators, hand washing and other measures are recommended. Reuters (9/3) Rhode Island loan-repayment program expected to draw primary care doctors Primary care doctors have a new financial incentive for practicing in Rhode Island: up to $20,000 per year for medical school loans for four years. "If we don't do something to start supporting primary care in Rhode Island, we are in for the long haul," said the head of Blue Cross & Blue Shield of Rhode Island. The Providence Journal (R.I.) (free registration) (8/27) Solutions: For Physicians  |  Health Care EDI |  Revenue Cycle Optimization |  Coding & Reimbursement |  Operational Improvement   Public Sector  House calls could be a part of U.S. health care reform U.S. lawmakers are considering making house calls a part of health care reform, and the experience of the Virginia Commonwealth University Medical Center supports the idea as a way to improve care and reduce costs. "This is one of the most promising ideas I have seen," said an AARP official. Los Angeles Times (8/25) Millions in grants aimed at helping Minnesota fight obesity, smoking Forty communities in Minnesota are receiving grants from the state totaling $47 million to be used on efforts against obesity and smoking. "We are the first state in the nation to start with a statewide investment in preventing future health problems," Minnesota's health commissioner said. Star Tribune (Minneapolis-St. Paul, Minn.) (8/26) People can send health-related e-cards through CDC The Centers for Disease Control and Prevention has a line of e-cards for people to e-mail to friends and family about health events or wellness tips. There are cards about colonoscopies, limiting salt intake, alcohol-free pregnancy and more. The Miami Herald/The Orange County Register (8/18) Minnesotans have new resource for comparing health care prices The governor of Minnesota announced an online price-shopping tool that gives people comparison information on prices for 85% of the state's primary care services. Information for the Web tool was collected from health insurers. Star Tribune (Minneapolis-St. Paul, Minn.) (8/26) Solutions: For Public Sector |  Claims Overpayment Prevention |  Care & Health Management |  Coding & Reimbursement   Workers' Compensation & Auto Liability  Insurance Institute for Highway Safety zeroes in on roof strength The Insurance Institute for Highway Safety said there will be more stringent roof-strength requirements for auto manufacturers that want their 2010 models to be awarded "top safety pick" status. "We want to reward manufacturers who are ahead of their competition when it comes to providing protection in rollover crashes," said the IIHS president. The Wall Street Journal (8/25) Cash for Clunkers program to benefit auto insurers, expert says The U.S. government's Cash for Clunkers program could benefit Progressive, Geico and other insurers, according to the head of the Insurance Information Institute. "When they buy that new vehicle, the insurance generally will cost more," he said. Bloomberg (8/27) Workers' compensation premiums to decrease in North Carolina next year The North Carolina Rate Bureau, representing workers' compensation insurers offering products in the state, has filed 9.6% lower insurance premiums for next year. Once approved, the new rates would take effect in April. American City Business Journals/Charlotte, N.C. (9/3) Research examines insurers' strategies for handling the recession New research shows insurers are optimistic about the end of the recession. Insurers are handling the recession primarily by streamlining processes and divesting themselves of assets. They are also outsourcing and considering launching new products. Insurance Networking News (8/25) Report looks at rating systems used by insurers A new report covers rating technologies available to and used by insurers. "The surprise was that rating is now being seen as more than a calculator -- it's beyond a rating system. It must be usable from the business users' standpoint. And it's becoming more obvious that carriers are asking, 'How much functionality do I have?' versus 'How do I get the right rate out?'" said a senior analyst with Celent, the company that released the report. Insurance Networking News (8/25) Solutions: For Workers Comp & Auto Liability |  Claims Cost Management |  Data Benchmarking & Pricing |  Health Care EDI   SmartQuote  There are two ways to pass a hurdle: leaping over or plowing through. ... There needs to be a monster truck option." --Jeph Jacques, creator of online comic strip "Questionable Content" Subscriber Tools       Web version |  Search past news |  Archive |  Privacy policy   About Ingenix Ingenix unites the brightest minds to transform organizations and improve health care through information and technology. We partner with more than 250,000 clients worldwide to solve the most important problems in health care. Learn more at ingenix.com.       Recent Ingenix Innovations Issues: Tuesday, September 01, 2009 Tuesday, August 25, 2009 Thursday, August 06, 2009 Tuesday, July 21, 2009 Tuesday, July 07, 2009     Lead Editor:  Elizabeth Collins       Distributed by: SmartBrief, Inc.®, 1100 H ST NW, Suite 1000, Washington, DC 20005     © 1999-2009 SmartBrief, Inc.® Legal Information