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Last week, CMS announced the Medicare-Medicaid Accountable Care Organization Model, a new initiative designed to improve the quality of care and lower costs for beneficiaries who are enrolled in both Medicare and Medicaid. It builds on the current Medicare Shared Savings Program and advances efforts to partner with states in transforming the health care delivery system. CMS is accepting letters of intent from states that wish to work with CMS to design certain state-specific elements of the model. (Medicare-Medicaid ACO Model web page )

Sometimes, Medicare recipients--and Medicare itself--end up paying more for an outpatient procedure than they would for the same inpatient one, according to a report from the Health and Human Services' inspector general. Heart stents topped the list; the next three most common service categories for which outpatients wound up paying more were cardiovascular procedures without stents, cardiac defibrillator implants and cardiac pacemaker implants. For most procedures, however, the Medicare program and beneficiaries both paid less when services were provided on an outpatient basis. (AP )

In 2017, health care leaders will continue their work on value-based care, prepare for emerging technologies and collaborate with former competitors. That's the forecast from the PwC Health Research Institute. In an interview with  Fierce Healthcare Rick Judy, management consulting leader, health industries, PwC, explains that traditional players will come together to form nontraditional partnerships that will let them quickly adapt to the changing environment. Through joint ventures, partnerships, strategic alliances and clinical affiliations, they will also reduce the potential downside risk of full ownership. (FierceHealthcare PWC report )
Innovation & Transformation    
Although there is a rapidly growing market of mHealth apps that target high-cost, high-need health conditions, most don't go beyond a basic level of patient engagement that would be clinically effective in helping consumers manage specific chronic illnesses, according to research published in  Health Affairs . Involving both clinicians and patients in usability ratings and tailoring app recommendations based on patient needs would improve development and help target the best apps for specific illnesses. (FierceHealthcare Health Affairs )

Partnerships between pediatric tertiary care centers and a community emergency department can improve pediatric asthma care, according to research published in  Pediatrics . "Because the overwhelming majority of pediatric emergency visits occur in community EDs, partnerships with these EDs can broaden the impact of quality improvement activities and should be part of future quality improvement efforts," the investigators conclude. ( MD Edge ; Pediatrics )

ACOs generally have stronger health IT and EHR use than non-ACOs, suggesting the incentives in those care models foster higher quality care than others, according to research published in the  American Journal of Managed Care . ACOs used patient engagement health IT tools and health information exchanges more often than non-ACOs and had greater Meaningful Use success, compared with non-ACOs. "The growth of ACOs may be driving the push toward technology that empowers patients," researchers note. (EHR Intelligence AJMC)
  The H2RMinutes team is taking the week off to enjoy the holidays. We'll r multicolor-ornaments.jpg esume publication on January 4.   
Consumers & Providers
Asking the right questions is at the heart of trauma-informed care. Replacing "What's wrong with you?" with "What happened to you?" can change not only the conversation and the relationship with a patient or client; it can change the trajectory of a person's life, Allison Sampson-Jackson, PhD, LCSW, LICSW, CSOTP explains in this issue brief from the Commission for Case Manager Certification. She discusses trauma-informed care, explains the background and use of the Adverse Childhood Experiences survey, and offers practical guidance and resources to case managers and other health care professionals. (issue brief; related webinar)
Patients are unhappy there is no central location for their health records and are frustrated trying to access and share them, according to Surescripts' 2016 Connected Care and the Patient survey. Patients are typically spending an average of eight minutes telling their doctor their medical history (up from six minutes in 2015) and eight minutes filling out paperwork at a typical doctor visit (up from six minutes in 2015). Additionally, 94 percent of patients surveyed want their health data to be stored electronically in a single location. (Healthcare IT News )
The hassle factor, followed by cosmetic concerns, are the most common modifiable barriers keeping people with type 1 diabetes from opting for insulin pumps and continuous glucose monitors (CGMs), according to research published in  Diabetes Care . Overall, cost and lack of insurance were the most often-cited reasons.(Medscape Medical News Diabetes Care )
New & Noted   
Colorectal cancer up in young:  Cases of colon and rectal cancer are on the rise in people under the age of 50, a group that's rarely screened for them. According to a recent study, rates among younger people increased by more than 11 percent between 2004 and 2014. (Medscape Medical News )

Application reopen for two APMs:  CMS has reopened applications for physicians to join one of two value-based care models in 2018: the Next Generation ACO model or the Comprehensive Primary Care Plus model. (Becker''s Hospital Review )

Diabetes and psychosocial needs: The American Diabetes Association guidelines addressing the psychosocial needs of persons with diabetes are being well received, but some question whether endocrinologists and others are can provide the extensive mental health services the guidelines call for. (Internal Medicine News;   ADA guidelines )
Fresh Air 's Terry Gross recently interviewed Dr. Anna Lembke, the psychiatrist who wrote Drug Dealer, M.D. The book and the interview explore the origins of the prescription drug epidemic from a doctor's perspective and make the case that misunderstandings and good intentions fueled the opioid epidemic. ( NPR)
MarketVoices...quotes worth reading
"Despite major medical and technological advancements in our country, and the fact that patients are more active consumers of care, healthcare is still inefficient, complex and unsatisfying for them."

--Surescripts CEO Tom Skelton, quoted in Healthcare IT News
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Wednesday, December 21, 2016