Heart failure pathway reduces readmissions, study says | Study: MA patients have fewer ER visits, hospital stays | Gaps in insurance coverage tied to higher utilization in diabetes
July 12, 2018
CV Quality SmartBrief
Transforming Health Care from the Inside Out
First Focus
Heart failure pathway reduces readmissions, study says
The Acutely Decompensated Heart Failure Clinical Pathway program led to a 13.1% reduction in hospital readmissions from the emergency department among heart failure patients compared with a control group, researchers reported in the American Journal of Emergency Medicine. The intervention included an immediate consult with a cardiologist when a patient presented at the ED.
HealthLeaders Media (7/9) 
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Study: MA patients have fewer ER visits, hospital stays
An Avalere Health report found Medicare Advantage plan members had 33% fewer hospital emergency room visits and 23% fewer hospital stays, compared with fee-for-service Medicare beneficiaries. Researchers said MA plans do a better job encouraging patients to see a primary care provider and have higher rates for tests and screenings.
Forbes (7/11) 
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Gaps in insurance coverage tied to higher utilization in diabetes
A study in Health Affairs found that adults with type 1 diabetes who had private health insurance coverage gaps of 30 to 60 days were five times as likely to land in an emergency department, hospital or urgent care facility after again obtaining coverage, and risk was increased more than sevenfold over baseline after a gap of 91 to 120 days. Researchers examined data from almost 169,000 adult patients with type 1 diabetes and found one-fourth had experienced at least one coverage gap of at least 30 days over an average of three years, and gaps were more prevalent among patients in their 20s and 30s.
HealthDay News (7/11) 
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Practice & Hospital Management
Study evaluates physician communication surveys
Research published in the Annals of Family Medicine showed no relationship between physician and patient scores on post-appointment surveys rating physician communication skills or between scores of physicians and trained peer clinical raters. Researchers said there was significant correlation between patient and clinical rater scores, however, and that outside peer assessment is effective in identifying gaps in communication and improving care quality.
Medscape (free registration) (7/9) 
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E-Health Watch
EHR adoption tied to lower mortality over time, study finds
Researchers found an association between baseline EHR adoption and 0.11% higher 30-day mortality rate per function, but as baseline functions matured overtime, EHR adoption correlated with a 0.09% lower rate of mortality per function per year. The findings, published in Health Affairs and based on data collected between 2008 and 2013 from 3,249 hospitals, showed a 0.21% reduction in mortality rate per year per function over the study period for every new EHR function adopted.
Becker's Health IT & CIO Report (7/10) 
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Program brings Rx data sharing to Alaska hospitals
As part of an effort to enable safer prescribing practices, hospitals throughout Alaska are now sharing data with the state's prescription drug monitoring program through the Collective Medical care collaboration network. The data-sharing program is expected to help curb the opioid epidemic, support better care coordination, and enhance clinical decision-making and prescribing.
EHR Intelligence (7/11) 
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Other News Highlights
Spotlight on Innovation
Research on pigs leads to heart repair technique
Eight of 11 babies with life-threatening heart defects or heart damage survived, and all but one was able to come off an extracorporeal membrane oxygenator after undergoing autologous mitochondrial transplants. The procedure, which has regenerated heart muscle in pigs, involves harvesting mitochondria from healthy muscle and injecting it into the injured part of the heart, and a clinical trial of adult bypass and valve surgery patients may begin soon.
The New York Times (tiered subscription model) (7/10) 
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Costs & Reimbursement
Report underscores importance of social issues in VBC models
Value-based care models aim to reduce costs and improve patient outcomes, and a recent report from Families USA says models that address the social determinants of health are key to ensuring communities that already face systematic inequities reap the benefits of VBC. The report says care models should be designed to ensure health care providers that treat a high proportion of disadvantaged, high-risk patients are not penalized; risk adjustment algorithms account for social factors; and mechanisms exist for measuring health equity and social determinants of health.
Patient Engagement HIT (7/10) 
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Cost control is top priority for hospital, health system CEOs
Cost control is the top priority for US hospitals and health systems this year, with 62% of executives indicating it is their main concern, according to the Advisory Board's Annual Health Care CEO Survey. Other priorities include innovative approaches to expense reduction and revenue streams, increasing outpatient procedural market share and meeting increasing consumer demands for service.
Becker's Hospital Review (7/11) 
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Spotlight on JACC Journals
ACC News
CMS Delays Due Dates For BPCI Advanced Participation, Will Allow Participants to Withdraw in March
The CMS recently announced the deadline for submitting signed participation agreements and selecting clinical episodes for the Bundled Payments for Care Improvement Advanced model has been extended to Aug. 8. In addition, CMS announced that the agency will allow BPCI Advanced participants to retroactively withdraw all or some episode initiators and clinical episodes from the model in March 2019. Last month, the College joined the American Medical Association, American College of Physicians and American College of Surgeons in submitting a letter calling for CMS to offer two additional start date options for participation in the BPCI Advanced alternative payment model in 2019, noting that many applicants had yet to receive data from the agency on episode target prices and summary and raw claims data. Read more on ACC.org. Is your practice considering participating in an APM? ACC's APM Framework is your guide for navigating the most critical implications the cardiovascular care community should consider when evaluating preparedness for APM participation. Learn more at ACC.org/APM.
Sign Up For HeartCARE Center Webinar
Learn about ACC's new HeartCARE Center National Distinction of Excellence recognition program during a webinar on Wednesday, July 25, at 2 p.m. ET. The webinar will provide an overview and describe how the program validates the hard work of forward-thinking, high-performing institutions that are driving sustainable quality improvement. Join us to discover how the program's eligibility requirements compliment the processes many cardiovascular teams already use to demonstrate exceptional cardiovascular care. Register now to find out how to shine a light on consistently superior, goal-focused care.
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If there is no struggle, there is no progress. Those who profess to favor freedom and yet depreciate agitation are men who want crops without plowing up the ground.
Frederick Douglass,
orator, writer and abolitionist
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This news roundup is provided as a timely update to ACC members and partners interested in quality health care topics in the news media. Links to articles are provided for the convenience of the health care professionals who may find them of use in discussions with patients or colleagues. Opinions expressed in ACC Quality First SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American College of Cardiology. On occasion, media articles may include or imply incorrect information about the ACC and its policies, positions, or relationships. For clarification on ACC positions and policies, we refer you to ACC.org.
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