Archive for October 28, 2010

Can Accountable Care Organizations deliver low-cost, high-quality care?

If you are a healthcare professional, you have likely heard of “accountable care organizations” or “ACOs.” If not, here are the basics of this key piece of the healthcare legislation.

Today, most hospitals and doctors work independently, which some claim can drive up costs and compromise quality. ACOs were conceived to promote coordination and cooperation among providers with the intention of boosting the quality of care for Medicare beneficiaries and cutting costs.

It works like this: Your organization is paid to cover the cost of care for Medicare beneficiaries in a given area, and if you are able to meet quality and cost-saving targets, you earn financial rewards for doing so. It’s an idea that grew out of research conducted by Dr. Elliot Fisher as part of his Dartmouth Atlas Project, a 30-year investigation into the variations in care across the country.

A few healthcare systems around the country are already exploring the possible benefits of ACOs, including two competing hospitals in Omaha, Nebr., and a large hospital system and health insurer in Louisville, Ky.

While shared savings programs and ACOs for Medicare and Medicaid beneficiaries are an important parts of the new health reform law, antikickback laws, antitrust laws, and other federal rules are proving a challenge as government agencies seek to write the rules for ACOs.

The legislation calls for ACOs to roll out by January 1, 2012. To learn more about ACOs and which organizations are eligible, check out the Q&A from the Centers for Medicare & Medicaid Services (CMS).

Till next time,

Independent healthcare plan helping innovate in Minnesota

These days the issue of healthcare too often tends to devolve into a fractious back and forth about healthcare reform. Unfortunately, this means that all the great and innovative work so many healthcare professionals are doing to better serve patients can be overlooked.

I’m glad that as a part of the work we do at viaLanguage I get to be in regular contact with a great many of these innovators. UCare and its efforts with the Minnesota Health Care Programs (MHCP) is just one example.

An independent non-profit health plan, (and a viaLanguage client!), UCare provides healthcare and administrative services to more than 160,000 members. It partners with healthcare providers, counties, and community organizations to create and deliver innovative health coverage products addressing a variety of Medicare, special needs plans, and state public programs members.

Part of UCare’s efforts includes offering incentives to clinics and care systems that deliver improved quality of care. This means rewarding providers serving Medicaid beneficiaries enrolled in MHCP, and expanding pay for performance (P4P) to include providers serving Medicare members.

What’s more, UCare’s MHCP P4P Plan and Medicare P4P Plan reward providers that show, within certain identified areas, any improvement over the previous year. It analyzes member health outcomes, while identifying those areas where improvement incentives are warranted. In 2009, UCare made P4P payments to 60 percent of the eligible care systems serving MHCP members.

It’s stories like this that inspire the industry to continue think creatively about meeting patient needs. And that can be powerful indeed. To learn more, check out the full UCare case study.

Till next time,

Recent studies conclude that race impacts cancer care

A series of recent studies reveals some alarming realities about apparent inequities in healthcare access among different races in the U.S. The investigations addressed cancer care specifically, looking into how racial factors, in addition to financial influences, impact diagnosis, treatment and survival.

In one report conducted at George Washington University School of Public Health and Health Services, it was determined that race played a larger role than insurance in a woman’s getting a timely breast cancer diagnosis.

Of the almost 1,000 women examined, the study found that white women with private insurance waited on average almost 16 days between testing and diagnosis, while privately insured black women waited more than 27 days and Hispanics more than 51 days. The numbers are even more disparate when you get to women on Medicare/Medicaid (11.9, 39.4, and 70.8 days respectively) and uninsured women (44.5, 59.7, and 66.5 days, respectively).

The research team, surprised at the results, concluded that the current barriers, especially those faced by black and Hispanic women, and by extension, we assume, non-white women generally, deserve additional study.

One of those barriers has already been identified and is not surprising to multicultural marketers: cultural differences. We can predict as well that lurking just behind that heading reside the myriad challenges attendant to embracing and overcoming linguistic and language differences.

For more on the studies and what they found, check out the HealthDay story.

Till next time,

National Board of Certification for Medical Interpreters launches registry

Anyone who has faced the challenge of visiting a hospital in a non-English-speaking country knows both how frustrating and how frightening it can be. When there is any impediment to the healthcare professional’s ability to discuss your situation and options or your own ability to ask questions, the likelihood of receiving the care you need is compromised, sometimes dangerously.

Ensuring that communication is not a job for the untrained or the inexperienced; the risks are obvious. To help promote patient access and safety, the National Board of Certification for Medical Interpreters recently took an important step forward by launching its National Registry of Certified Medical Interpreters.

The registry is a searchable database of medical translators who have passed the board’s oral and written examinations. Interpreters can be searched by a range of criteria, including city, credentials, language, and state, among other details. And if you are a healthcare organization or employer, you can do so for free.

The move is part of a larger effort by the board to promote greater patient safety. Starting in October 2009, the board initiated the exams, with successful applicants earning their Certified Medical Interpreter (CMI) designation. To date, approximately 300 interpreters have either completed the exams or are in the process of doing so.

The principal responsibility of healthcare organizations is the health of the patients they serve. The CMI certification and registry mark a significant advancement in that effort, alerting both the industry and those who rely on it that experience and training are central to effective medical translation. Learn more about the CMI designation in the board’s press release.

Till next time,