June’s Hot Topics in Health Care

  • Health care spending expected to grow 7.5% in 2013
  • Wisconsin Supreme Court decision on Alzheimer’s patient leaves uncertainty
  • Wisconsin hospitals press forward with reform regardless of ACA
  • New ED admission system alerts PC docs on high-risk patients
  • CMS reports reform law helped seniors with Medicare get free prevention service

Health care spending expected to grow 7.5% in 2013

PricewaterhouseCoopers (PwC) LLC said in a recent report that heath care spending is expected to grow at a “historically” low rate in 2013. On of those reasons is because of medical inflation. For example, as more jobs are added in the economy, newly hired workers will likely tap into their new health care benefits. Second, many patients who’ve postponed elective surgery over the past few years may feel more confident about spending in 2013 as the economy slowly recovers.

HealthLeaders Media said in a recent article that PwC’s Health Research Institute in a survey and report released in May attributes much of the projected slower growth to the tepid economy, the health care industry’s broad focus on cost containment, higher out-of-pocket costs and, therefore, lower utilization for health care consumers, and efforts by employers to keep their health insurance expenses down.

PwC’s survey also found:

  • 57% of employers are considering increasing employee contributions to health plans.
  • Half of employers are considering increasing cost-sharing through plan design, such as higher deductibles. The average emergency room co-pay is now $125 or more.
  • More than half of employers are considering raising employee prescription drug plan costs.
  • Average enrollment in high deductible plans coupled with a Health Reimbursement Account has increased to 43.2% in 2012 from 34.2% in 2010.
  • 72% of employers offer wellness programs, and half say they are considering expanding those programs next year.

To read the HealthLeaders Media article, CLICK HERE.

Court ruling for Alzheimer’s patient leaves much uncertainty

The Wisconsin Supreme Court said on May  it was wrong for an 86-year-old Fond du Lac woman to be detained under the state’s involuntary commitment law known as “Chapter-51.”As a result, the State Supreme Court says people living in Wisconsin who have Alzheimer’s disease cannot be involuntarily confined. Those with mental illnesses and drug dependencies can be detained for treatment if they pose a risk to themselves or others. The justices agreed with an appeals court ruling from last year, which said that Alzheimer’s is not a qualifying mental illness – because there’s no cure for Alzheimer’s.

Justice Michael Gableman said it would have been more appropriate to place the woman under Chapter-55 with a place more tailored to her needs, which provides necessary protections.

Chief Justice Shirley Abrahamson and Justice Ann Walsh Bradley explained in a different opinion why they agreed. The court did not say how it might have ruled had the case involved more than one condition besides Alzheimer’s. As of last year, Wisconsin had around 110-thousand Alzheimer’s patients. After last April’s appellate court ruling, patient advocates praised the decision. They said it would end the variations in the way different counties apply the law – and it would end the practice of nursing homes calling law enforcement when they have an Alzheimer’s patient lash out.

To read more, click HERE.

Wisconsin hospitals press forward on health care reform regardless of ACA

Regardless of what happens with the Affordable Care Act, many Wisconsin hospitals are moving ahead with health care reform. On May 22, Eric Borgerding, Wisconsin Hospital Association (WHA) executive vice president told the Assembly Health Committee hearing that Wisconsin is a leader in transforming from fee-for-service towards a payment model that rewards better quality and better outcomes.

The hearing was called by Committee Chairman Representative Jeff Stone (R-Greendale) to provide Committee members an opportunity to learn about and discuss the many positive trends and developments in Wisconsin health care.

“Wisconsin is making an effort to repurpose and retool the structures in health care delivery and finance, away from volume-driven, fee-for-service reimbursement toward a system that demands and rewards better quality and better outcomes and that will produce more value for our health care dollars,” Borgerding said. “Improving health care value and quality is health reform.”

According to a press release posted on Wisconsin Health News, Borgerding called Wisconsin’s leadership an economic advantage, highlighting WHA’s involvement in Partnerships for Patients. All but two of the state’s hospitals have signed up to participate in the federal health reform law funded-initiative aiming to reduce hospital admissions and hospital acquired infections. CMS expects to save $35 billion nationwide.

“This is reform that began in Wisconsin prior to the passage of the Accountable Care Act, and that will continue regardless of how the Supreme Court rules next month,” Borgerding said.

“The current fee-for-service system is a dinosaur that has got to go,” Gundersen Lutheran CEO Dr. Jeff Thompson told the Assembly Health Committee.

To read what other Wisconsin hospital CEOs and legislators said, CLICK HERE. To read WHA’s article on the hearing, CLICK HERE.

New ED admission system alerts PC docs on high risk patients

A new information alert system is paving the way for hospitals in Cincinnati. A new system called the New ED Admit Alert System, alerts primary care physicians on their high-risk patients.

The new ED admission system, developed through the Greater Cincinnati Beacon Collaboration (GCBC), was launched by HealthBridge, the nation’s largest, most advanced health information exchanges. HealthBridge officials say it will improve care by helping to reduce unnecessary emergency department and hospital visits and promoting better care in the doctor’s office.

In a press announcement released May 29, HealthBridge says that 33 primary care practices are currently receiving alerts and a total of 85 are expected to go-live in the coming weeks. “Whether a medication adjustment, patient education or more routine primary care appointments are needed, providers now have better information to reach out to patients and determine exactly what the best next step should be,” states Pattie Bondurant, DNPc MN RN, Director of the Greater Cincinnati Beacon Collaboration. “This innovative approach to care has the potential to not only reduce ED visits and hospital admissions, but greatly improve the patient-provider relationship.”

HealthBridge receives messages from 21 area hospitals when a patient goes to the ED or is admitted. The patient’s name is then matched against lists of patients with diabetes or asthma in the participating practices. If the patient has one of those conditions, the HIE sends a real-time alert to the patient’s primary care physician.

Practices are using the alerts in a variety of ways. Some follow up directly with high-risk diabetes patients. In other offices, staff members use a phone script or mail a letter to the patients, reminding them to make follow-up appointments with their physicians.

FierceHealthIT reports HealthBridge has also been internationally trading its HIE expertise to other health information exchanges for years. Recently, it announced that it would expand its offering to include analytics and business intelligence tools designed for population health management.

CMS reports reform law helped seniors with Medicare get free prevention service

The federal health reform law helped 232,685 Wisconsin seniors with Medicare get at least one free preventive service during the first five months of 2012, according to the Centers for Medicare and Medicaid Services. That also includes 20,642 who have taken advantage of the law’s annual wellness visit.

Nearly 40 percent of Wisconsin seniors with Medicare have taken advantage of the benefit. To read more visit WisconsinHealthNews.com or CLICK HERE.

Feel free to connect Trish Skram on my Facebook page at Trish Skram “PR Gal” or on LinkedIn.

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