Managed Care

When it comes to patients’ skills and knowledge on their care, more equals less, according to the recently published findings of one research team. The study found the most tuned in patients cost 8-to-21 percent less than the costs of patients with the lowest level of activation. It’s just one more piece of evidence that supports this growing movement.

CIOs, CMIOs and other healthcare leaders have a real opportunity to help shape community-wide healthcare delivery performance improvement initiatives: just ask Jane Brock, M.D., of the Colorado Foundation for Medical Care, that state's QIO.

According to officials at CMS, December was the single largest monthly payout of EHR incentives in the program’s history. Roughly $1.2 billion went to eligible hospitals and eligible physicians in December, bringing the total estimated payout to $10.3 billion. The bulk of the payments went to EHs, who received $1 billion in Medicare and Medicaid incentive payments. EPs received $175 million in Medicare payments and $80 million in Medicaid payments.

As I write this, President Barack Obama and Speaker of the House of Representatives John Boehner are involved in complex, perhaps rather tense, negotiations over the so-called fiscal cliff and what to do about federal taxes, revenues and programs. In the past couple of days, the news reports and rumors have changed almost hourly, with estimates of possible Medicare cuts to providers shifting quite frequently. Whatever the end result of this process, analytics-facilitated continuous clinical performance improvement will soon be crucial to provider survival.

The October issue of The American Journal of Managed Care included a fascinating article, "Implementation of EHR-Based Strategies to Improve outpatient CAD Care," in which a group of researchers documented how EHR-facilitated physician alerts alone aren’t enough to improve outcomes for patients with such chronic illnesses as coronary artery disease. It turns out, success requires a savvy combination of financial incentives, IT alerts, and good data analysis.