Entries in Thayer, Claire (106)


Provider Networks Referral Leakage

By Claire Thayer, April 16, 2015

Containing patient referrals within a provider network is easier said than done, even with electronic health records.  According to Joel French, CEO of SCI Solutions, "more than 25 percent of orders and referrals from employed providers leak out of network."  Chief Financial Officers across the country cite referral leakage as a top concern. According to a recent survey, 51% of CFOs list reducing network leakage as the most successful methods for generating future revenue growth. 

MCOL’s infoGraphoid for this week takes a look at some of the root causes of referral leakage as well as identifies seven ways to contain the leakage:

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.


New Interactive Tool to Monitor U.S. Health Care Spending

By Claire Thayer, April 8, 2015

A week or so ago, The Peterson Center on Healthcare and the Kaiser Family Foundation unveiled a cool new interactive tool for public access to measure quality and cost components of the country's health care system on their new site, The Peterson-Kaiser Health System Tracker.  “This interactive tool provides up-to-date information on U.S. health spending by federal and local governments, private companies, and individuals. It was developed by analysts at the Kaiser Family Foundation using data from the National Health Expenditure Account and will be updated annually with each data release.”  Using the Health Spending Explorer interactive tool, data can be tracked as far back as 1960, with most recent data as of 2013 (which will be updated annually).  Search by single year, compare two years, or customized you own parameters.  Here are a couple of examples, comparing all types of services and hospital spending by health insurance and out-of-pocket costs in 1993 and twenty years later in 2013.

In addition to the option to use the interactive feature to create your own reports, the “Chart Collections” section has a bunch of charts and supporting slide decks to choose from:

Drilling down to the question of “How do health expenditures vary across the population?” here are a couple of related supporting slides available for download:

In addition to the interactive tool and chart collections, The Peterson-Kaiser Health System Tracker site provides access to their Insight Briefs and regular blogs.


Medical Identity Theft Impact on Health Care

By Claire Thayer, March 12, 2015

According to findings from The Fifth Annual Study on Medical Identity Theft, published by the Medical Identity Fraud Alliance, the number of patients affected by medical identity theft increased nearly 22 percent in the last year, an increase of close to half a million since 2013. Many of us by now have heard about the massive Anthem breach, affecting up to 80 million people and considered to be the largest security breach involving a major health organization. Anthem notes that "the information accessed may have included names, dates of birth, Social Security numbers, health care ID numbers, home addresses, email addresses, employment information, including income data."  However, while, yes, the breach at Anthem was massive, they’re far from alone! 

Since 2009, 109 health-plan related security breaches have been reported to the Department of Health & Human Services Office for Civil Rights.  Breaches affecting 500 or more individuals is public information and accessible directly via the aptly named Breach Portal, where you can search by covered entity, state, type of entity (i.e., health plan, healthcare provider, etc), individuals affected, breach submission date, type of breach (theft, hacking/IT, improper disposal, etc., location of breached information).

MCOL's infoGraphoid this week highlights health plan related security breaches since 2009 and how patients found out that their medical identity was exposed:

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.


Medicare Obesity Counseling – it’s Free!

By Claire Thayer, March 5, 2015

The Center for Disease Control and Prevention shows alarming obesity trend rates among the elderly population within the United States.  Thirty-six percent of men aged 65-74 are considered obese, along with slightly over 44% of women in this same age bracket, as highlighted on the CDC’s FastStats for Older Persons’ Health web page:

These findings continue to trend upward from the data previously available from the National Center for Health Statistics that found more than one-third of older adults aged 65 and over were obese in 2007–2010. 

Consider that over the next thirty years, the number of U.S. older adults is expected to more than double, rising from 40.2 million to 88.5 million. Primary care providers are critically important in helping to reverse these trends. The Kaiser Family Foundation reminds us in an article published this week, Few Seniors Benefiting From Medicare Obesity Counseling, that the Affordable Care Act included a new Medicare benefit offering face-to-face weight-loss counseling in primary care doctors’ offices. Doctors are paid to provide the service, which is free to obese patients, with no co-pay.  Surprisingly, as reported in USA Today, a mere 1% of Medicare's 50 million beneficiaries have used the free counseling benefit.


Predictable savings when health plan members are engaged in preventative care

By Claire Thayer, February 12, 2015

There are many approaches to patient care intervention, in terms of managing chronic disease. Several years ago an important study, that is still widely referenced, finds that some of the most successful patient care intervention approaches include those that are customized for each individual patient, allow for intensive time commitment in terms of time multi-disciplinary teams spent face-to-face with patient, and use of technology that is highly interactive with patients.  These approaches to engaging patients in preventative care, along with the payoff in financial savings and health outcomes is the focus of MCOL's infoGraphoid this week:

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here