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Industry News
Pay-for-performance payment models don't necessarily lead to positive health outcomes, according to a meta-analysis published in the Annals of Internal Medicine. After reviewing 69 studies, researchers "found low-strength, contradictory evidence that P4P programs could improve processes of care, but we found no clear evidence to suggest that they improve patient outcomes." (Annals of Internal Medicine)

In an interview with the  Washington Post published this week, President-elect Trump offered the following assurance:  "We're going to have insurance for everybody. There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us." He declined to offer details, but said his plan for replacing the ACA includes "lower numbers, much lower deductibles." He also promised not to cut Medicare benefits. ( Washington Post )

A draft white paper from the ONC identifies opportunities and challenges to collecting, using and sharing patient-generated health data (PGHD) in research and clinical care. PGHD includes biometric data, treatment and health history, symptoms and lifestyle habits recorded outside of a clinical setting. Looking to 2024, ONC notes that while PGHD use for clinical care and research is currently in the early adoption stage, some organizations are piloting and beginning to understand its value. "In the future, a fully functional health ecosystem will have digital capabilities to seamlessly and electronically capture and share PGHD among patients, clinicians, and researchers." (Healthcare Informatics white paper)
Innovation & Transformation    
Medicare ACO-affiliated hospitals reduce 30-day readmissions from skilled nursing facilities at a faster rate than non-ACO hospitals, according to research published in  Health Affairs . During the study period, non-ACO hospitals reduced readmissions by 13.1 percent, Pioneer ACOs by 14.9, and MSSP ACOs by 17.7. "The reductions suggest that ACO-affiliated hospitals are either discharging to the nursing facilities more effectively compared to other hospitals or targeting at-risk patients better, or enhancing information sharing and communication between hospitals and skilled nursing facilities," according to the researchers. More research is needed, however, to determine what exactly led to the improvements. (Health Affairs)

Digital technologies and the massive volume of all types of data fueled by the Internet of Things (IoT) are driving vertical integration within health care, according to a recent Frost & Sullivan report. It's creating a "heated health care deal landscape for traditional mergers and acquisitions, joint ventures, and new types of less-formal partnerships," says analyst Nancy Fabozzi. "Flexible deal structures like joint ventures and partnerships, in particular, offer a faster, less-risky path to growth and innovation for health care companies." ( Frost & Sullivan)

The Department of Veterans Affairs is developing a proof of concept for its Digital Health Platform. The DHP is designed to integrate data from VA, military and commercial EHRs-- and apps, devices and wearables--making data available to providers in real time. "DHP leverages a network of application programming interfaces (APIs) to integrate military and commercial health data, while unifying VA's data stores, connecting patient to provider in real-time, and predicting the most successful care to provide a better experience to the veteran," according to the VA. ( Health Data Management)
Consumers & Providers
Many male-dominated jobs are disappearing, but predominantly female jobs are growing, especially in health care. However, because unemployed men are looking for jobs they used to have--and are often unwilling to do "women's work"--they're missing opportunities for greater stability, higher pay and faster promotions than women in these fields,  The  New York Times reports. Nursing, in particular, has a dramatic gender imbalance--even though a new Gallup poll ranks nursing as America's most trusted profession for the 15th year in a row. (The New York Times; Advisory Board)
In 2008 Dr. Rana Awdish nearly died when a tumor ruptured in her liver; she also lost the baby she was carrying. The experience was wrenching; it also revealed the health care system's failings. "I was privy to failures that I'd been blind to as a clinician," she writes in the New England Journal of Medicine. "There were disturbing deficits in communication, dis-coordinated care, occasionally an apparently complete absence of empathy. I recognized myself in many of those failures." Awdish, director of the Henry Ford Hospital's Pulmonary Hypertension Program, describes how her experience inspired her to transform her health system by helping professionals demonstrate more empathy to their patients. ( New England Journal of Medicine)
Greater involvement by primary care physicians in end-of-life care was associated with less intensive care and lower costs, according to research published in Annals of Family Medicine. This could account for regional variations in end-of-life care. However, physician reimbursement is a significant barrier to optimizing the role of PCPs in coordinating end-of-life care, lead author Clair Ankuda, MD, tells  Medscape . "I think it is really important to pay for the kind of care that matters to patients and families." (Annals of Family Medicine; Medscape Today)
New & Noted   
Colorado HIX to vanish?  Colorado Senate Health and Human Services Committee Chairman Jim Smallwood recently introduced legislation to repeal Connect for Health Colorado.  ( Denver Business Journal )

Brisk walking is good for you:  Walking briskly may reduce the risk of heart disease, according to a small study published in Creative Nursing. Participants were asked to walk briskly for at least 150 minutes per week. After 10 weeks, weight, blood pressure and cholesterol levels had improved, suggesting  that walking can help lower heart disease risk in a short time. ( HealthDay ; Creative Nursing )

Snowbirds and care coordination:   During the winter, when older northerners flock to Florida, hospitals see a jump in patients from outside the region. "The key is the coordination of care, because typically, snowbirds don't have their families with them," says Dr. Frank Lauro, West Florida Healthcare medical director. "Coordinating post-acute care with family members who are probably out of town plays a crucial role in the recovery phase." (Pensacola News Journal)
Last week, the American Enterprise Institute, along with the Brookings Institution and the Pacific Business Group on Health, offered an "outside-the-beltway perspective on fixing the American health care system." Among the speakers and panelists were representatives from Boeing, Walmart and Wells Fargo.  Michael Burgess , chairman of the House Energy and Commerce Subcommittee on Health, gave the keynote. (AEI)
MarketVoices...quotes worth reading
"I learned that though we do many difficult, technical things so perfectly right, we fail our patients in many ways."--Rana Awdish, MD, on how her near-death experience gave her insights on how health systems fail patients, in NEJM

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Wednesday, January 18, 2017