Health Plan Readmission Strategies: Contracting and Care Management Approaches

By Claire Thayer, March 14, 2012

MCOL’s Healthcare Web Summit announces Health Plan Readmission Strategies: Contracting and Care Management Approaches, scheduled for Wednesday, May 9th, 2012 at 1PM Eastern.  Health plan readmissions management encompasses a variety of approaches that often incorporate new provider payment structures, data tracking, education and engagement. Some initiatives are designed for specific care delivery settings, while others are system-wide programs. Please join Drs. Joe Gifford and Robert Herr from Regence, and Dr. Brian Wolf from BCBSRI as they provide a Medical Director's perspective on aspects of their organization's current approaches to drive accountability by reducing unnecessary readmissions.

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Reducing Readmissions: Collateral Effects

By Claire Thayer, March 13, 2012

MCOL’s Healthcare Web Summit announces Reducing Readmissions: Collateral Effects, scheduled for Thursday, March 29th, 2012 at 1PM Eastern and co-sponsored by Payers & Providers.  Changes to the Medicare program will financially penalize hospitals whose patients are readmitted within 30 days of their discharge. The readmission penalty affects other providers as well, including physicians and hospitalists in particular. Join Warren Hosseinion, M.D., the chief executive officer of the hospitalist firm Apollo Medical Holdings and Daniel C. Cusator, M.D., vice president of The Camden Group, as they discuss upcoming changes in the finance of hospital readmissions, and how the effects will ripple far and wide.

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The Microinsurance Opportunity - Understanding the market and its implications

By Claire Thayer, March 12, 2012

MCOL’s Healthcare Web Summit announces The Microinsurance Opportunity - Understanding the market and its implications, scheduled for Thursday, April 19th, 2012 at 1PM Eastern.  Microinsurance has emerged over the last decade on a global scale. First seen as a poverty alleviation strategy, it was embraced by donors and NGOs as a compliment to the burgeoning micro credit field. More recently commercial insurers and reinsurers have been more significantly involved.  Join Michael McCord, President of the MicroInsurance Centre and Rick Koven, an independent consultant working with the Centre, as they provide an understanding of the market and its implications for the emerging microinsurance opportunity.

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The Current Facts on Alzheimer's

By Clive Riddle, March 8, 2012

The Alzheimer's Association this week released their 2012 Alzheimer's Disease Facts and Figures, with the full report available from their web site.

Harry Johns, President and CEO of the Alzheimer's Association, tells us "Alzheimer's is already a crisis and it's growing worse with every year. While lives affected and care costs soar, the cost of doing nothing is far greater than acting now. Alzheimer's is a tremendous cost driver for families and for Medicare and Medicaid. This crisis simply cannot be allowed to reach its maximum scale because it will overwhelm an already overburdened system."

Johns goes on to say "this disease must be addressed on parallel tracks: supporting research to find treatments that cure, delay or prevent the disease, and offering assistance and support to the more than 5 million Americans now living with Alzheimer's and their more than 15 million caregivers. This is what the National Alzheimer's Plan is all about. Caring for people with Alzheimer's and other dementias costs America $200 billion in just one year. By committing just one percent of that cost, $2 billion, to research it could begin to put the nation on a path to effective treatments and, ultimately, a cure. Given the human and economic costs of this epidemic, the potential returns on this one percent solution are extremely high."

Here's a selection from the boatload of information provided in their 72 page report on Alzheimer's and other dementias:

  • $140 billion will be paid by Medicare and Medicaid in 2012 for care and treatment
  • Total costs by payer for 2012 will be $200 billion, broken down as follows: Medicare $104.5B; Medicaid $33.5B; Out-of-pocket payments $33.8B; Other $26.2B
  • Medicare payments for an older person with Alzheimer's and other dementias are nearly three times higher and Medicaid payments 19 times higher than for seniors without Alzheimer's and other dementias.
  • A senior with Alzheimer's and diabetes costs Medicare 81 percent more than a senior with diabetes but no Alzheimer's.
  • An older individual with cancer and Alzheimer's costs Medicare 53 percent more than a beneficiary with cancer and no Alzheimer's.
  • An estimated 800,000 individuals have Alzheimer's and live alone, and up to half of these individuals do not have an identifiable caregiver.
  • The 15.2 million friends and family members of the 5.4 million individuals with Alzheimer's and other dementias provide 17.4 billion hours of unpaid care valued at more than $210 billion.
  • 200,000 of the Alzheimer's population are under age 65 with “younger-onset Alzheimer's”
  • 45% of seniors over age 85 have Alzheimer's
  • 16 percent of women age 71 and older have Alzheimer’s disease or other dementias compared with 11% of men
  • Someone develops the disease every 68 seconds
  • Alzheimer's is the sixth-leading cause of death in the country and the only cause of death among the top 10 in the United States that cannot be prevented, cured or even slowed.
  • Based on final mortality data from 2000-2008, death rates have declined for most major diseases – heart disease (-13 percent), breast cancer (-3 percent), prostate cancer (-8 percent), stroke (-20 percent) and HIV/AIDS (-29) − while deaths from Alzheimer's disease have risen 66 percent during the same period.
  • Alzheimer's accounts for somewhere between 60-80% of all dementia cases

Pioneer ACOs: Quantifying Risks & Identifying Opportunities

By Claire Thayer, March 5, 2012

MCOL’s Healthcare Web Summit announces Pioneer ACOs: Quantifying Risks & Identifying Opportunities, scheduled for Wednesday, May 23, 2012 at 1PM Eastern.  This session discusses the elements of risk associated with Pioneer ACOs as well as potential strategies for controlling costs and identifying opportunities for savings. Organizations not participating in the Pioneer ACO program but either wishing to monitor Pioneer ACO issues and activities, or wishing to adapt applicable risk and cost control strategies discussed to other populations, can also benefit from this session.

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