Monday
Apr242017

6 Ways to Improve Your Member Communications

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 By Claire Thayer, April 24, 2017

Change Healthcare doubled member engagement for a regional health plan after introducing engagement best practices with a marketing mix that included email, blog posts, social media, a direct mail campaign, presentations to key group leaders and on-site workshops.

This special edition of the MCOL Infographic, co-sponsored by Change Healthcare, identifies 6 effective ways for health plans to improve communications with members:

 (Click to Enlarge Image)

(Click to Enlarge Image)

 

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.

 

 
Friday
Apr212017

How Do You Build a Culture of Innovation at a Healthcare Organization?

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By Clive Riddle, April 21, 2017

 

Now that we’re thirty days in the Spring of 2017, nurturing seedlings with hopes of taking deeper root should be on the mind of every healthcare gardener. Along these lines, the current issue of Healthcare Innovation News asks their panel the question, “How Do You Build a Culture of Innovation Within Your Organization?” Here’s some excerpts from what these sowers of innovation seeds had to say:

 

David R. Strand, Chief Executive Officer of Life Cross Training, based in Chicago, says in part, “We often point to technology advances as “innovation” in healthcare. Yet, the next real innovation in healthcare will come from our investments in human capital—investments in the people we count on to deliver high-quality care and a great patient experience.  Addressing this problem requires comprehensive, innovative solutions focused in three distinct areas: (1) Improving the practice environment. Systematically identifying and eliminating hassles from technology to process to organizational design and identifying and accentuating those things that bring joy to clinical practice; (2) Aligning teams around common values and shared goals. Establishing guiding principles for interactions with one another and with patients and building cultures that support the well-being of both patients and clinicians; (3) Providing clinicians with evidence-based skills driving individual well-being. Ensuring that clinicians are better equipped to handle the intrinsic stress associated with their work and busy lives.

 

James Polfreman, CEO and President of Solis Mammography based in Addison, Texas echoes the theme that technology is not enough, sharing that  “In the field of women’s breast health, innovation is not only measured in terms of technology and clinical accuracy, but also in areas of patient service, convenience and care to ensure annual compliance and repeat business.” He advises that “to foster innovation, an environment must be actively cultivated to promote openness and collaboration in order to tap into the natural passion of employees. This type of environment benefits the entire team and translates into superior patient care Well-informed teams are vital. Communication of a crystal-clear vision and mission is fundamental……When new ideas are implemented, having clear processes in place from training to implementation is key…..Consistently challenging the status quo motivates initiative….. Finally, a culture of innovation is maintained through leadership by example, repetition and affirmation of a job well done. This influences how you attract, recruit, retain, train and reward teams.”

 

Joanna Engelke, Managing Director at Halloran Consulting Group in Boston counsels in part that “there are numerous best practices cited to support an innovative culture: (A) Enabling employees to spend 5% to 10% of their time on freethinking and creating “skunkworks” projects—those dedicated solely to radical innovation; (B) Creating office designs that encourage “bumping into each other” with lots of light, mobile whiteboards, huddle rooms, collaboration centers and games; (C) Investing in an internal, venture capital-like fund with all the trappings of pitches, business plans, proof of concept and funding milestones that are outside a regular product development arena; (D) Sponsoring crowd-sourced, problem-solving fairs for internal and external participation; (E) Surveying employees to gain an understanding of internal practices that block or prevent innovation; (F)                 Rewarding innovation in each department of an organization.” But Joanna reminds us, “the real secret sauce to an innovative culture is very basic: Management must pay attention.”

 

Finally, Summerpal Kahlon, M.D., Director of Care Innovation at Oracle Health Sciences, based in Satellite Beach, Florida, says we need to listen. “Listening is a key skill in healthcare.” In particular he advocates listening to data through analytics. He cites these as examples that can drive innovation – “There are a few high-value, rich sources of information that can provide interesting lifestyle insight: Demographic information, including occupation, income and family/social environment; Environmental data, including census, local crime statistics and accessible parks/recreation; and Retail data, particularly for grocery and drugstores.”

 
Friday
Apr212017

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

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Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Lawmakers revisiting requiring those on Medicaid to work

A simple question — should adults who are able to work be required to do so to get taxpayer-provided health insurance? — could lead to major changes in the social safety net. AP News. Friday, April 21, 2017

 

How G.O.P. in 2 States Coaxed the Health Law to Success or Crisis

In Oklahoma, which has raged against the Affordable Care Act, insurance premiums are among the nation’s highest. New Mexico, which oversees its marketplace, has one of the lowest average premium costs. The New York Times. Friday, April 21, 2017

 

White House pressures GOP leaders on Obamacare showdown next week

A frantic and impatient White House is pressuring House GOP leaders for another showdown vote on repealing Obamacare next week so it can notch a legislative win before President Donald Trump’s first 100 days in office. Politico. Thursday, April 20, 2017

 

Sen. Grassley Demands Scrutiny Of Medicare Advantage Plans

Sen. Chuck Grassley (R-Iowa) wants federal health officials to tighten scrutiny of private Medicare Advantage health plans amid ongoing concern that insurers overbill the government by billions of dollars every year. Kaiser Health News. Tuesday, April 18, 2017

 

G.O.P. Bill Would Make Medical Malpractice Suits Harder to Win

Low-income people and older Americans would find it more difficult to win lawsuits for injuries caused by medical malpractice or defective drugs or medical devices under a bill drafted by House Republicans as part of their plan to replace the Affordable Care Act.

The New York Times. Saturday, April 15, 2017

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 

 
Friday
Apr142017

Reducing Emergency Visits and Admissions for Epilepsy Patients: Nationwide Children’s Dr. Anup Patel Answers Our Questions

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By Clive Riddle, April 14, 2017

 

What can a single quality improvement project accomplish at a single hospital? Just ask Nationwide Children’s, who  performed a quality improvement project and found new, simple ways to significantly decrease the number of emergency department visits and hospitalizations in pediatric patients with epilepsy.” They achieved a 28% decline in emergency visits, a 43% decline in admissions and saved $2 million in costs for these patients.

 

By sharing their research findings in the current issue of Pediatrics, and highlighted in Nationwide Children’s research publication Research Now, hospitals, physicians and purchasers performing care management can adopt Nationwide’s approach to their own settings.

 

We are told that “Nationwide Children’s Hospital serves almost 3,500 children diagnosed with epilepsy. In 2012 and much of 2013, the Emergency Department was experiencing approximately 17 visits per 1,000 epilepsy patients per month. In the minds of both Emergency Medicine physicians and epilepsy subspecialists, that was too many.”

 

The hospital shares that “the QI team identified ‘key drivers’ (or contributing factors) of ED visits, and found they centered on provider-to-provider communication issues and patient/family resources, education, beliefs and comorbidities. Then the team began interventions to target those key drivers. Most important was the establishment of an Urgent Epilepsy Clinic,” which they tell us involved family visits lasting 90 minutes or longer, with as little as three days’ notice.

 

Nationwide Children’s also identified that “abortive seizure medication was under dosed (or not given at all). Nationwide Children’s built an alert system into its electronic health records – when a provider entered what appeared to be an incorrect dosage based on size and age, the provider would be notified of the proper dose.”  Their additional interventions developed from the project included a color-coded seizure action plan, which helped caregivers understand what a baseline seizure looks like and when to call Neurology; and a personalized magnet giving caregivers information about how to give abortive seizure medications.”

 

The results? Emergency visits reduced from 17.0 to 12.2 per month per 1,000 children epilepsy patients during the past year. The average number of inpatient epilepsy children hospitalizations per month was reduced from 7 admissions per month per 1000 patients to 4 admissions per month per 1000 patients. 

Anup Patel, MD, a pediatric epileptologist and member of the Division of Neurology at Nationwide Children’s, and leader of the QI project and resulting research paper was nice enough to respond to some follow-up questions I asked after reading about the project.

 

First, I asked  him what is the approximate epilepsy incidence/1,000 population (pediatric preferably). He shared this information from Epilepsy.com which he recommends as a great source information on epilepsy:

 

Epilepsy is the 4th most common neurological problem – only migraine, stroke, and Alzheimer’s disease occurs more frequently. There are many different ways to explain how often a disease occurs. Here’s a few points to consider.

What is the incidence of epilepsy in the United States?

·         The average incidence of epilepsy each year in the U. S is estimated at 150,000 or 48 for every 100,000 people.

·         Another way of saying this- each year, 150,000 or 48 out of 100,000 people will develop epilepsy.

·         The incidence of epilepsy is higher in young children and older adults. This means that epilepsy starts more often in these age groups.

·         When the incidence of epilepsy is looked at over a lifetime, 1 in 26 people will develop epilepsy at sometime in their life.

·         Seizures are the number on most common Neurologic Emergency that we see in children.

What is the prevalence of epilepsy in the United States?

There are many different estimates of the prevalence of epilepsy. These numbers vary depending on when the studies were done, who was included, and a host of other factors.

·         The number of people with epilepsy, using prevalence numbers, ranges from 1.3 million to 2.8 million (or 5 to 8.4 for every 1,000 people).

·         The estimate currently thought to be most accurate is 2.2 million people or 7.1 for every 1,000 people.

·         However, higher numbers of people report that they have active epilepsy, 8.4 out of 1,000 people. These numbers are even higher when people are asked if they have ever had epilepsy (called lifetime prevalence). 16.5 per 1,000 people reported that they had epilepsy at some point in their life.

 

Next I asked him about the second intervention in the project regarding abortive seizure medication under dosed or not given. How much is medication adherence/compliance an issue for this population?  Dr. Patel responds that “We know that medication adherence to daily seizure medications is a risk factor for ED visits in patients with epilepsy.  In regards to abortive seizure medication (medication given for long or repeat seizures), we found under dosing was an issue (previous literature – Patel in Epilepsy and Behavior 2014) and that parents were either anxious, did not remember, or did not get proper instruction on how to give medications.”

 

Noting that the project identified comorbidities as a key driver, I asked him what are the typical comorbidities? He replied “Developmental delay, autism, cerebral palsy, depression, and anxiety.”

I asked Dr, Patel to elaborate on the calculation that their interventions yielded $2 million in annual savings. He responded that “our average ED visit was $640 and a subsequent hospitalization averaged $14,500 in claims paid. When you look at the reduction of both ED visits and the hospitalizations associated with the ED visit, you get the $2 million savings per year”.

 

Lastly, I asked if a similar approach work for an adult population as well. The short answer is yes. 

 
Friday
Apr142017

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

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Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Bipartisan Senate Bill Takes Step Against Opioid Epidemic

Morning Consult reports: A bipartisan Senate bill unveiled Thursday would impose strict limits on some opioid prescriptions, a small tweak to federal law that is part of an ongoing effort in Congress to curb overuse of the drugs. Morning Consult. Thursday, April 13, 2017

 

States Moving More Medicaid Patients To Managed Care

Private health insurance companies stand to reap a bigger share of the Medicaid business as states deal with budget shortfalls and increased spending on medical care. Forbes. Thursday, April 13, 2017

 

Trump Signs Law Giving States Option To Deny Funding For Planned Parenthood

President Trump quietly signed legislation Thursday that rolls back an Obama-era rule protecting certain federal funds for Planned Parenthood and other organizations that provide legal abortions. NPR. Thursday, April 13, 2017

 

Trump administration issues final rule on stricter Obamacare enrollment

The Trump administration on Thursday issued a final rule that will shorten the Obamacare enrollment period and give insurers more of what they say they need in the individual insurance market, likely making it harder for some consumers to purchase insurance, healthcare experts said. Reuters. Thursday, April 13, 2017

 

Repeal, Replace … Revise: Your Guide To How A Trump Proposal Might Change ACA Insurance

Repeal and replace is on-again, off-again, but that doesn’t mean the rules affecting your insurance will remain unchanged. The Trump administration’s proposed rule aimed at stabilizing the health law’s insurance marketplace could have rapid, dramatic effects on people who do not get insurance through work and buy it on the Affordable Care Act’s exchanges. Kaiser Health News. Thursday, April 13, 2017

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 
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