Study: Increase Patient Activation To Cut Costs & Improve Outcomes

Increased levels of patient engagement through patient activation may improve outcomes and lower healthcare costs, according to a new study published in Health Affairs. Researchers analyzed patient activation levels for more than 32,000 adult patients at Minnesota’s Fairview Health Services under the Patient Activation Measure, a “metric used to quantify a person’s knowledge, skills, and confidence in managing one’s own health and healthcare” on a scale of one to four. Researchers found patients with higher levels of activation demonstrated nine out of 13 improved healthcare outcomes. Lower activation levels were associated with significantly reduced chances of positive outcomes for seven of 13 measures compared to patients who remained at level four. The research team also found activation had similar effects on billed costs. Patients with the highest levels of activation had projected costs 31 percent lower than those at the lowest activation levels. Additionally, costs increased or decreased as patients’ activation levels changed.

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CMS Likely To Deny Coverage For Pricey New Treatments

According to a new analysis on national coverage decisions between 1999 and 2012, getting medical devices, drugs and procedures covered by Medicare is becoming more difficult. In order to justify the cost, CMS requires more evidence that the new interventions are “reasonably necessary” and should be paid under the federal healthcare program. CMS is about 20 times more likely to say no in more recent years. Researchers analyzed 213 decisions made between 1999 and August 2012 and found that a total of 74 were denied coverage during that time period. The majority of the denials happened in more recent years with Medicare being less likely to pay if there were alternative interventions and no estimate of cost-effectiveness.

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Study: Medicaid Pay Bump Helps Beneficiaries Get Appointments

According to a new study published in the New England Journal of Medicine, increasing Medicaid reimbursement for primary care services to match Medicare rates have led to increases in appointments for Medicaid patients. However, care access gains may be completely “wiped out” this year because the ACA’s provision authorizing the increase in Medicaid rates has expired. Researchers noticed an increase from 58.7% to 66.4% in the availability of primary care appointments for Medicaid beneficiaries in the surveyed areas. The increases in appointment availability were similar in states that expanded Medicaid coverage and in states that did not. With this newly available data, physicians hope the Medicaid pay bump will be extended. Average national Medicaid reimbursement to primary care physicians is expected to drop between 43% and 47% as a result of the provision ending.

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Study: Hospital Compare Scores Do Not Improve Outcomes

According to a study published in JAMA Internal Medicine, quality scores on Medicare’s Hospital Compare website aren’t likely to improve hospital outcomes. Researchers at Baystate Medical Center in Massachusetts sent 630 hospitals a 21-question poll in the fall of 2012 (before CMS implemented federal penalties affecting reimbursements) that addressed the participants’ Hospital Compare scores for measures involving cost, patient experience, process measures, volume, mortality and readmissions. 70 percent of the 380 hospitals that responded agreed that public reporting provides incentives to organizations to implement quality improvement initiatives. However, respondents did express concerns about the potential side effects of the metrics. 59 percent of respondents also expressed concerns that emphasis on publicly reported quality measures could come at the expense of other areas.

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Sleep Loss Correlates With Weight Gain

A new study researched the effects that sleep deprivation has on the brain. A group of sleep deprived participants were more inclined to eat high-calorie foods instead of healthier options when rested. The part of the brain that controls the motivation to eat was more stimulated when unhealthier junk food options were available.  Their brains also showed a decrease in the ability to weigh options and make rational decisions. Although they chose different unhealthier foods, their appetites were the same.

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Blood Pressure Medicines May Increase Risk Of Breast Cancer

Women who used a type of blood pressure drug for more than ten years may have unknowingly increased their risk of breast cancer. Calcium-channel blockers such as Norvasc produced by Pfizer Inc. increased the risk of developing breast cancer by 2.5 times when used for a decade or more. Although the study uncovered this link, more research is necessary to identify what class of medicines may increase the risk of disease.

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Physician Liability Woes

While more team-based health care groups are being formed it raises more risks for leading practitioners. Maintaining a successful health care team requires constant coordination coupled with effective communication on behalf of all team members. Sometimes when the system of controls fail it leaves team leaders in hot water. Recent research indicates that poor leadership, poor communication and insufficient documentation led to 901 sentinel events in 2012.

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