2012 Healthcare Benchmarks Yearbook: Metrics, Measurements and Innovations

Transcription

1 Note: This is an authorized excerpt from the full 2012 Healthcare Benchmarks Yearbook. To download the entire yearbook, go to or call , Healthcare Intelligence Network

2 2012 Healthcare Benchmarks Yearbook: Metrics, Measurements and Innovations Contributing Speakers Toni Cesta, PhD, RN, FAAN, senior vice president of operational efficiency and capacity management at Lutheran Medical Center in Brooklyn, New York John Harris, principal, DGA Partners Carolyn Holder, MSN, RN, GCNS-BC, manager of transitional care for Summa Health System Laurel Karabatsos, deputy Medicaid director for Colorado Department of Health Care Policy and Financing Diane Littlewood, RN, BSN, CDE, regional manager of case management for health services at Geisinger Health Plan Greg Mertz, senior project director for Healthcare Strategy Group Janice Pringle, PhD, director of the program evaluation research unit at the University of Pittsburgh School of Medicine Jeffrey R. Ruggiero, Esq., partner in Arnold & Porter LLP Craig Samitt, MD, MBA, president and CEO of Dean Health System Lisa Sasko, MA, MBA, CDPHP director of clinical transformation Joanne Sciandra, RN, BSN, CCM, director, case management strategic planning, health services, Geisinger Health Plan Susan Shepard, MSN, MA, RN, CPHRM, director of patient safety education with The Doctors Management Company Mark Shields, MD, MBA, senior medical director for Advocate Physician Partners and vice president of medical management for Advocate Health Care Neal Sofian, MSPH, director of member engagement at Premera Blue Cross Gregory Spencer, chief medical officer of Crystal Run Healthcare Steven Valentine, president, The Camden Group i

3 Executive Editor Melanie Matthews HIN Executive Vice President and Chief Operating Officer Project Editors Patricia Donovan Jessica Papay Cover Design Jane Salmon

4 Table of Contents Note from the Executive Editor Chapter 1: Healthcare Trends for 2012 Reacting to Healthcare Reform Physician-Hospital Integration Physicians Major Movers and Shakers Advice: Capture the Population CMS Medicare Bundled Payments Pilots in Comprehensive Primary Care Trends in Physician Alignment Checklist for Health IT The Physician Perspective What Younger Physicians Think Q&A: Ask the Experts Glossary For More Information About the Speaker Chapter 2: Tobacco Cessation and Prevention Executive Summary Survey Highlights Key Findings Identifying Populations for Tobacco Cessation Programs Reimbursement and ROI Program Incentives Comparison of Year-Over-Year Data Methodology Respondent Demographics Analysis of Responses Overview of Survey Results Comparing Responses of Top 4 Sectors The Hospital/Health System Perspective The Health Plan Perspective The Employer Perspective The Wellness Perspective Respondents in Their Own Words Goals and Components of Future Tobacco Cessation Programs Most Successful Tobacco Cessation Strategy Addressing Relapses iii

5 Conclusion Responses to Questions :01: Offering Tobacco Cessation Program :02: Plan to Offer Tobacco Cessation Program :03: Barriers to Program Launch :04: Targeted Population :05: Program Eligibility :06: Participant Identification Method :07: Program Delivery Formats :08: When to Offer Tobacco Cessation Advice :09: Primary Program Facilitator :10: Length of Program Enrollment :11: Program Components :12: Reimbursement :13: Measuring ROI :14: Quit Rate Achievements :15: Program ROI :16: Provider Incentives :17: Discounts Health Premiums for Non-Smokers :18: Incentives for Quitting/Remaining Smoke-Free :19: Disincentives/Penalties :20: Adopted Smoke-Free Policy :21: Organization Type Tobacco Cessation and Prevention Survey Tool Chapter 3: Reducing Readmissions Executive Summary Survey Highlights Key Findings Prevalence and Targets of Readmission Reduction Programs Program Strategies and Tools Impact and ROI Methodology Respondent Demographics Analysis of Responses Overview of Survey Continued Emphasis on Hospital Discharge New Challenge for 2010: Health Literacy a Top Barrier The Hospital Perspective The Long-Term Care Perspective iv

6 Future Programs Comparison of 2009 Data to 2010 Data Respondents in Their Own Words Most Effective Readmission Reduction Strategy Additional Comments on Reducing Hospital Readmissions Conclusion Responses to Questions Part I: Overall Survey Responses :1: Respondents with Programs to Reduce Readmissions :2: Targeted Populations :3: Targeted Conditions :4: Patient Identification Tools :5: Readmission Prevention Strategies :6: Steps Performed at Hospital Discharge :7: Primary Program Responsibility :8: Program-Related Reduction in Hospital Readmissions :9: Program ROI :10: Reduced Payment for 30-Day Readmissions :11: Barriers to Reducing Readmission Rates :12: Planning Program in Next 12 Months :13: No Program: Barrier to Program Launch Part II: Responses from Hospitals :14: Respondent Demographics :15: Hospitals: Targeted Populations :16: Hospitals: Targeted Conditions :17: Hospitals: Patient Identification Tools :18: Hospitals: Readmission Prevention Strategies :19: Hospitals: Steps Performed at Hospital Discharge :20: Hospitals: Primary Program Responsibility :21: Hospitals: Reduction in Hospital Readmissions :22: Hospitals: Program ROI :23: Hospitals: Reduced Payment for 30-Day Readmissions Part III: Responses from Long-Term Care :24: Hospitals: Barriers to Reducing Readmissions :25: Long-term Care: Targeted Populations :26: Long-term Care: Targeted Conditions :27: Long-term Care: Patient Identification Tools :28: Long-term Care: Readmission Prevention Strategies :29: Long-term Care: Steps Performed at Discharge :30: Long-term Care: Primary Program Responsibility :31: Long-term Care: Reduction in Hospital Readmissions v

7 3:32: Long-term Care: Program ROI :33: Longterm Care: Reduced Payment for 30-Day Readmissions :34: Longterm Care: Barriers to Reducing Readmissions Glossary Reducing Hospital Readmissions Benchmark Survey Tool About the Speakers Chapter 4: Healthcare Case Management Executive Summary Survey Highlights Key Findings Case Management Program Details Case Management Results and ROI Methodology Respondent Demographics Comparison of 2010 Data to 2011 Data Analysis of 2011 Responses Overview of Survey The Health Plan Perspective The Hospital Perspective Respondents in Their Own Words Key Case Manager Responsibility: Health Plans Key Case Manager Responsibility: Hospitals Successful Interventions and Partnerships: Health Plans Successful Interventions and Partnerships: Hospitals Program Success Factors: Health Plans Program Success Factors: Hospitals Key Contribution of the Case Manager: Health Plans Key Contribution of the Case Manager: Hospitals Planned Program Expansions: Health Plans Planned Program Expansions: Hospitals Conclusion Responses to Questions Part I: Overall Survey Responses :01: Utilizing Case Managers :02: Adding Case Managers in the Next 12 Months :03: Populations Targeted by Case Managers :04: Case Manager Work Locations :05: Participant Referral Methods :06: Average Monthly Case Load :07: Case Manager Duties vi

8 4:08: Case Manager Communication Tools :09: Case Manager Educational Background :10: Evaluating Case Manager Performance :11: Diagnosis Most Impacted by Case Management :12: Impact of Case Management :13: Case Management ROI Part II: Responses from Health Plans :14: Respondent Organization Type :15: Health Plans: Utilizing Case Managers :16: Health Plans: Populations Targeted by Case Managers :17: Health Plans - Case Manager Work Locations :18: Health Plans - Participant Referral Methods :19: Health Plans - Average Monthly Case Load :20: Health Plans - Case Manager Duties :21: Health Plans - Case Manager Communication Tools :22: Health Plans - Case Manager Educational Background :23: Health Plans - Evaluating Case Manager Performance :24: Health Plans - Diagnosis Most Impacted by Case Management :25: Health Plans - Impact of Case Management Part III: Responses from Hospitals :26: Health Plans - Case Management ROI :27: Hospitals - Utilizing Case Managers :28: Hospitals - Populations Targeted by Case Managers :29: Hospitals - Case Manager Work Locations :30: Hospitals - Participant Referral Methods :31: Hospitals - Average Monthly Case Load :32: Hospitals - Case Manager Duties :33: Hospitals - Case Manager Communication Tools :34: Hospitals - Case Manager Educational Background :35: Hospitals - Evaluating Case Manager Performance :36: Hospitals - Diagnosis Most Impacted by Case Management :37: Hospitals - Impact of Case Management :38: Hospitals - Case Management ROI Glossary Healthcare Case Management Benchmark Survey Tool About the Speaker vii

9 Chapter 5: Accountable Care Organizations Executive Summary Survey Highlights Key Findings Metrics from Current ACOs Metrics from Future ACOs Methodology Respondent Demographics Analysis of Responses Sector-Specific Survey Responses Perspectives from Other Organizations The Hospital Perspective The Health Plan Perspective Future ACOs No Plans for an ACO Conclusion Getting Started with ACOs: Weighing All the Opportunities Responses to Questions Part I: Overall Survey Responses :01: Familiarity with ACOs :02: Participating in an ACO :03: Current ACOs - ACO Administrator :04: Current ACOs - Number of Physicians in ACO :05: Current ACOs - Types of Providers in ACO :06: Current ACOs - Will Participate in CMS Shared Savings :07: Current ACOs - Participating Populations :08: Current ACOs - Number of Lives in ACO :09: Current ACOs - Time Required to Create ACO :10: Current ACOs - Using Electronic Health Records :11: Current ACOs - Reimbursement Models :12: Current ACOs - Program Success Metrics :13: Current ACOs - Quality, Efficiency & Satisfaction Measures :14: Future ACOs - Launching ACO in Coming Year :15: Future ACOs - ACO Administrator :16: Future ACOs - Number of Physicians in ACO :17: Future ACOs - Types of Providers in ACO :18: Future ACOs - Will Participate in CMS Shared Savings :19: Future ACOs - Biggest Challenge of ACO Creation :20: No Plans for ACO - Biggest Program Barrier :21: Respondent Demographics :22: Respondents Geographical Location viii

10 Part II: Responses from Other Organizations :23: Other - Familiar with ACOs :24: Other - Participating in an ACO :25: Other - Launching ACO in Coming Year :26: Other - Future ACO Administrator :27: Other - Number of Physicians in Future ACO :28: Other - Types of Providers in Future ACO :29: Other - Will Participate in CMS Shared Savings :30: Other - Biggest Challenge of ACO Creation :31: Other - No Plans for ACO - Biggest Program Barrier :32: Other - Geographical Location Part III: Responses from Hospitals :33: Hospitals - Familiar with ACOs :34: Hospitals - Participating in an ACO :35: Hospitals - Launching ACO in Coming Year :36: Hospitals - Future ACO Administrator :37: Hospitals - Number of Physicians in Future ACO :38: Hospitals - Types of Providers in Future ACO :39: Hospitals - Will Participate in CMS Shared Savings :40: Hospitals - Biggest Challenge of ACO Creation :41: Hospitals - No Plans for ACO - Biggest Program Barrier :42: Hospitals - Geographical Location Part IV: Responses from Health Plans :43: Health Plans - Familiar with ACOs :44: Health Plans - Participating in an ACO :45: Health Plans - ACO Administrator :46: Health Plans - Number of Physicians in ACO :47: Health Plans - Types of Providers in ACO :48: Health Plans - Will Participate in CMS Shared Savings :49: Health Plans - Participating Populations :50: Health Plans - Number of Lives in ACO :51: Health Plans - Time Required to Create ACO :52: Health Plans - Using Electronic Health Records :53: Health Plans - Reimbursement Models :54: Health Plans - Program Success Metrics :55: Health Plans - Quality, Efficiency & Satisfaction Measures :56: Health Plans - Launching ACO in Coming Year :57: Health Plans - Future ACO Administrator :58: Health Plans - Number of Physicians in Future ACO :59: Health Plans - Types of Providers in Future ACO :60: Health Plans - Will Participate in CMS Shared Savings Download the 2011 Healthcare Benchmarks Yearbook at ix

11 5:61: Health Plans - Biggest Challenge of ACO Creation :62: Health Plans - No Plans for ACO - Biggest Program Barrier :63: Health Plans - Geographical Location Glossary Accountable Care Organizations Benchmark Survey Tool About the Speakers Chapter 6: Health and Wellness Incentives Executive Summary Survey Highlights Key Findings Types of Incentives Offered The Role of HRAs in Health Improvement Programs Incentive Programs Communication, Impact and ROI New Research for Comparison of Year-Over-Year Data Methodology Respondent Demographics Analysis of Responses Overview of Survey Results Comparing Responses of Top 3 Sectors The Employer Perspective The Consultant Perspective The Health Plan Perspective Respondents in Their Own Words Challenges in Program Development Most Successful Incentives Strategy Conclusion Responses to Questions Part I: Overall Survey Responses :01: All - Offering Incentives Program :02: All - Incentivized Health Improvement Programs :03: All - Economic Incentives Offered :04: All - Benefit-Based Incentives :05: All - Top Three Financial and Benefit-Based Incentives :06: All - Most Effective Incentives :07: All - Ways Incentives Are Used :08: All - Penalties for Health Risks :09: All - Program Promotion Methods :10: All - Participant Identification Methods :11: All - Program Eligibility Download the 2011 Healthcare Benchmarks Yearbook at x

12 6:12: All - Future Programs :13: All - Program Success Measurement :14: All - Most Positive Response :15: All - Program Impact :16: All - Program ROI :17: All - Organization Type Part II: Responses from Employers :18: Employers - Offering Incentives Program :19: Employers - Incentivized Health Improvement Programs :20: Employers - Economic Incentives :21: Employers - Benefit-Based Incentives :22: Employers - Top Three Financial and Benefit-Based Incentives :23: Employers - Most Effective Incentives :24: Employers - Ways Incentives Are Used :25: Employers - Penalties for Health Risks :26: Employers - Program Promotion Methods :27: Employers - Participant Identification Methods :28: Employers - Program Eligibility :29: Employers - Future Programs :30: Employers - Program Success Measurement :31: Employers - Most Positive Response :32: Employers - Program Impact :33: Employers - Program ROI :34: Consultants - Offering Incentives Program :35: Consultants - Health Improvement Activities :36: Consultants - Economic Incentives :37: Consultants - Benefit-Based Incentives :38: Consultants - Top Three Financial and Benefit-Based Incentives :39: Consultants - Most Effective Incentives :40: Consultants - Ways Incentives Are Used :41: Consultants - Penalties for Health Risks :42: Consultants - Program Promotion Methods :43: Consultants - Participant Identification Methods :44: Consultants - Program Eligibility :45: Consultants - Future Programs :46: Consultants - Program Success Measurement :47: Consultants - Most Positive Response :48: Consultants - Program Impact :49: Consultants - Program ROI Part IV: Responses from Health Plans :50: Health Plans - Offering Incentives Program Download the 2011 Healthcare Benchmarks Yearbook at xi

13 6:51: Health Plans - Incentivized Health Improvement Programs :52: Health Plans - Economic Incentives :53: Health Plans - Benefit-Based Incentives :54: Health Plans - Top Three Economic Incentives :55: Health Plans - Top Three Benefit-Based Incentives :56: Health Plans - Most Effective Incentives :57: Health Plans - Ways Incentives Are Used :58: Health Plans - Penalties for Health Risks :59: Health Plans - Program Promotion Methods :60: Health Plans - Participant Identification Methods :61: Health Plans - Program Eligibility :62: Health Plans - Future Programs :63: Health Plans - Program Success Measurement :64: Health Plans - Most Positive Response :65: Health Plans - Program Impact :66: Health Plans - Program ROI New Perspectives in Benefit-Based Incentives About the Speaker Chapter 7: Patient-Centered Medical Homes Executive Summary Survey Highlights Key Findings PCMH Populations and Program Components Supporting the Medical Home PCMH Outcomes Methodology Analysis of Responses Overview of Survey Comparing Medical Home Trends from 2009 to Overall Trends PCMHs Under Construction Medical Home Cost and ROI The Hospital Perspective The Health Plan Perspective The Physician Perspective Other Perspective Respondents in Their Own Words Single Greatest Outcome from Medical Homes Effect of 2010 PPACA Law on Medical Homes Additional Comments Download the 2011 Healthcare Benchmarks Yearbook at xii

14 Conclusion Responses to Questions Part I: Overall Survey Responses Part II: Responses from Hospitals Part III: Responses from Health Plans Part IV: Responses from Primary Care Providers Part V: Responses from Other Organizations Glossary Medical Homes Benchmark Survey Tool About the Speakers... 7:01: Established Medical Homes :02: Percentage of Population in Medical Homes :03: Targeted Populations of Program :04: Lives Covered by Program :05: Participating Physicians :06: Time Needed for Medical Home Conversion :07: Tech Tools Used in Medical Homes :08: Medical Home Education and Engagement :09: Professionals on the PCMH Team :10: Embedded Case Manager :11: Effect of the PCMH :12: Medical Home Impact :13: Medical Home Adoption Challenges :14: ACO Participation :15: Medical Home Reimbursement :16: PCMH Participation Incentives :17: Measuring Medical Home Effectiveness :18: Medical Home ROI :19: Medical Home Accreditation/Recognition :20: Future Medical Homes :21: Barrier to PCMH Adoption :22: Respondents by Organization Type :23: Hospitals - Established Medical Homes :24: Hospitals - Percentage of Population in Medical Homes :25: Hospitals - Targeted Populations of Program :26: Hospitals - Lives Covered by Program :27: Hospitals - Participating Physicians :28: Hospitals - Time Needed for Medical Home Conversion :29: Hospitals - Tech Tools Used in Medical Homes :30: Hospitals - Medical Home Education and Engagement :31: Hospitals - Professionals on the PCMH Team xiii

15 7:32: Hospitals - Embedded Case Manager :33: Hospitals - Effect of the PCMH :34: Hospitals - Medical Home Impact :35: Hospitals - Medical Home Adoption Challenges :36: Hospitals - ACO Participation :37: Hospitals - Medical Home Reimbursement :38: Hospitals - PCMH Participation Incentives :39: Hospitals - Measuring Medical Home Effectiveness :40: Hospitals - Medical Home ROI :41: Hospitals - Medical Home Accreditation/Recognition :42: Hospitals - Future Medical Homes :43: Hospitals - Barrier to PCMH Adoption :44: Health Plans - Percentage of Population in Medical Homes :45: Health Plans - Established Medical Homes :46: Health Plans - Targeted Populations of Program :47: Health Plans - Lives Covered by Program :48: Health Plans - Participating Physicians :49: Health Plans - Time Needed for Medical Home Conversion :50: Health Plans - Tech Tools Used in Medical Homes :51: Health Plans - Medical Home Education and Engagement :52: Health Plans - Professionals on the PCMH Team :53: Health Plans - Embedded Case Manager :54: Health Plans - Effect of the PCMH :55: Health Plans - Medical Home Impact :56: Health Plans - Medical Home Adoption Challenges :57: Health Plans - ACO Participation :58: Health Plans - Medical Home Reimbursement :59: Health Plans - PCMH Participation Incentives :60: Health Plans - Measuring Medical Home Effectiveness :61: Health Plans - Medical Home ROI :62: Health Plans - Medical Home Accreditation/Recognition :63: Health Plans - Future Medical Homes :64: Health Plans - Barrier to PCMH Adoption :65: Primary Care Provider - Established Medical Homes :66: Primary Care Provider - Percentage of Patients in Medical Homes :67: Primary Care Provider - Targeted Populations of Program :68: Primary Care Provider - Lives Covered by Program :69: Primary Care Provider - Participating Physicians :70: Primary Care Provider - Time for Medical Home Conversion :71: Primary Care Provider - Tech Tools Used in Medical Homes xiv

16 7:72: Primary Care Provider - Medical Home Education and Engagement :73: Primary Care Provider - Professionals on the PCMH Team :74: Primary Care Provider - Embedded Case Manager :75: Primary Care Provider - Effect of the PCMH :76: Primary Care Provider - Medical Home Impact :77: Primary Care Provider - Medical Home Adoption Challenges :78: Primary Care Provider - ACO Participation :79: Primary Care Provider - Medical Home Reimbursement :80: Primary Care Provider - PCMH Participation Incentives :81: Primary Care Provider - Measuring Medical Home Effectiveness :82: Primary Care Provider - Medical Home ROI :83: Primary Care Provider - Medical Home Accreditation/ Recognition :84: Primary Care Provider - Future Medical Homes :85: Primary Care Provider - Barrier to PCMH Adoption :86: Other - Established Medical Homes :87: Other - Percentage of Population in Medical Homes :88: Other - Targeted Populations of Program :89: Other - Lives Covered by Program :90: Other - Participating Physicians :91: Other - Time Required for Medical Home Conversion :92: Other - Tech Tools Used in Medical Homes :93: Other - Medical Home Education and Engagement :94: Other - Professionals on the PCMH Team :95: Other - Embedded Case Manager :96: Other - Effect of the PCMH :97: Other - Medical Home Impact :98: Other - Medical Home Adoption Challenges :99: Other - ACO Participation :100: Other - Medical Home Reimbursement :101: Other - PCMH Participation Incentives :102: Other - Measuring Medical Home Effectiveness :103: Other - Medical Home ROI :104: Other - Medical Home Accreditation/Recognition :105: Other - Future Medical Homes :106: Other - Barrier to PCMH Adoption xv

17 Chapter 8: Patient Satisfaction and Experience Executive Summary Survey Highlights Key Findings Data on Patient Satisfaction Surveys Program Results and ROI Methodology Respondent Demographics Analysis of Responses Overview of Survey Results Comparing All Responses to Top 2 Sectors The Hospital Perspective Perspectives from Other Healthcare Providers Respondents in Their Own Words Greatest Strategy to Improve Patient Satisfaction Programs Planned to Improve Patient Satisfaction Most Critical Satisfaction Issue Staff Training Ideas Challenges of Patient Satisfaction Surveys Additional Comments Conclusion Responses to Questions Part I: Overall Survey Responses :01: All - Program to Improve Patient Satisfaction :02: All - Future Program to Improve Patient Satisfaction :03: All - Most Important Care Delivery Aspects :04: All - Area Most in Need of Improvement :05: All - Changes Made to Improve Patient Satisfaction :06: All - Responsibility for Improving Patient Satisfaction :07: All - Conducting Patient Satisfaction Surveys :08: All - Audiences for Satisfaction Survey :09: All - Point in Care for Survey Administration :10: All - Survey Formats :11: All - Model for Satisfaction Survey :12: All - Topics Covered in Satisfaction Survey :13: All - Using Results from Satisfaction Surveys :14: All - Impact of Efforts to Improve Satisfaction :15: All - Patient Satisfaction Program ROI :16: All - Organization Type :17: All - Satisfied with Patient Satisfaction Scores :18: All - Services to Enhance Patient Experience xvi

18 8:19: All - Patient Satisfaction Ratings Linked to Payments Part II: Responses from Hospitals :20: Hospitals - Program to Improve Patient Satisfaction :21: Hospitals - Future Program to Improve Patient Satisfaction :22: Hospitals - Most Important Care Delivery Aspects :23: Hospitals - Area Most in Need of Improvement :24: Hospitals - Changes Made to Improve Patient Satisfaction :25: Hospitals - Responsibility for Improving Patient Satisfaction :26: Hospitals - Conducting Patient Satisfaction Surveys :27: Hospitals - Audiences for Satisfaction Survey :28: Hospitals - Points in Care for Survey Administration :29: Hospitals - Survey Formats :30: Hospitals - Model for Satisfaction Survey :31: Hospitals - Topics Covered in Satisfaction Survey :32: Hospitals - Using Results from Satisfaction Surveys :33: Hospitals - Impact of Efforts to Improve Satisfaction :34: Hospitals - Patient Satisfaction Program ROI :35: Hospitals - Satisfied with Patient Satisfaction Scores :36: Hospitals - Services to Enhance Patient Experience :37: Hospitals - Patient Satisfaction Ratings Linked to Payments Part III: Responses from Other Healthcare Providers :38: Other Providers - Program to Improve Patient Satisfaction :39: Other Providers - Future Program to Improve Patient Satisfaction :40: Other Providers - Most Important Care Delivery Aspects :41: Other Providers - Area Most in Need of Improvement :42: Other Providers - Changes Made to Improve Patient Satisfaction :43: Other Providers - Responsibility for Improving Patient Satisfaction :44: Other Providers - Conducting Patient Satisfaction Surveys :45: Other Providers - Audiences for Satisfaction Survey :46: Other Providers - Point in Care for Survey Administration :47: Other Providers - Survey Formats :48: Other Providers - Model for Satisfaction Survey :49: Other Providers - Topics Covered in Satisfaction Survey :50: Other Providers - Using Results from Satisfaction Surveys :51: Other Providers - Impact of Efforts to Improve Satisfaction :52: Other Providers - Patient Satisfaction Program ROI :53: Other Providers - Patient Satisfaction Ratings Linked to Payments xvii

19 Glossary Improving Patient Experience & Satisfaction Survey Tool Chapter 9: Medication Adherence and Compliance Executive Summary Survey Highlights Key Findings Program Challenges and Components Program Results and ROI Methodology Respondent Demographics Analysis of Responses Overview of Survey Results Comparing All Responses to Top 2 Sectors The Hospital Perspective Perspectives from Other Healthcare Providers Respondents in Their Own Words Description of Future Programs to Improve Medication Adherence Greatest Program Challenge and Solution Additional Comments Conclusion Responses to Questions Part I: Overall Survey Responses :01: All - Program to Improve Medication Adherence :02: All - Target Population :03: All - Conditions Receptive to Program :04: All - Barriers to Medication Adherence :05: All - Program Components :06: All - Technology Supporting Program :07: All - Tools to Assess/Monitor Adherence :08: All - Care Points for Program Delivery :09: All - Responsibility for Improving Adherence :10: All - Pharmacist on Medication Adherence Team :11: All - Retail/Community Pharmacists :12: All - Pharmacist Tasks in Program :13: All - Reimbursed Pharmacist Tasks :14: All - Planning Future Programs :15: All - Impact of Medication Adherence Program :16: All - Medication Adherence ROI :17: All - Greatest Barrier to Program Implementation xviii

20 Part II: Responses from Health Plans :18: All - Organization Type :19: Health Plans - Program to Improve Medication Adherence :20: Health Plans - Target Population :21: Health Plans - Conditions Receptive to Program :22: Health Plans - Barriers to Medication Adherence :23: Health Plans - Program Components :24: Health Plans - Technology Supporting Program :25: Health Plans - Tools to Assess/Monitor Adherence :26: Health Plans - Care Points for Program Delivery :27: Health Plans - Responsibility for Improving Adherence :28: Health Plans - Pharmacist on Medication Adherence Team :29: Health Plans - Retail/Community Pharmacists :30: Health Plans - Pharmacist Tasks in Program :31: Health Plans - Reimbursed Pharmacist Tasks :32: Health Plans - Planning Future Programs :33: Health Plans - Impact of Medication Adherence Program :34: Health Plans - Medication Adherence ROI :35: Health Plans - Greatest Barrier to Program Implementation Part III: Responses from Other Providers :36: Other Providers - Program to Improve Medication Adherence :37: Other Providers - Target Population :38: Other Providers - Conditions Receptive to Program :39: Other Providers - Barriers to Medication Adherence :40: Other Providers - Program Components :41: Other Providers - Technology Supporting Program :42: Other Providers - Tools to Assess/Monitor Adherence :43: Other Providers - Care Points for Program Delivery :44: Other Providers - Responsibility for Improving Adherence :45: Other Providers - Pharmacist on Medication Adherence Team :46: Other Providers - Retail/Community Pharmacists :47: Other Providers - Pharmacist Tasks in Program :48: Other Providers - Reimbursed Pharmacist Tasks :49: Other Providers - Planning Future Programs :50: Other Providers - Impact of Medication Adherence Program :51: Other Providers - Medication Adherence ROI :52: Other Providers - Greatest Barrier to Program Implementation Glossary Improving Medication Adherence Survey Tool About the Speaker xix

21 Chapter 10: Using Patient Registries for Accountable Care Executive Summary Survey Highlights Key Findings Key Findings Registry-Related Successes Methodology Respondent Demographics Analysis of Responses Overview of Survey Results Respondents in Their Own Words Most Impressive Outcome Achieved Impact of Future Registry Use Additional Comments Conclusion Responses to Questions Part I: Overall Survey Responses :01: All - Use Registries :02: All - Plan to Use Registries :03: All - Reason to Not Implement a Registry :04: All - Percent of Members/Patients Included :05: All - Target Populations :06: All - Targeted Conditions :07: All - Responsibility for Populating Registry :08: All - Registry Type :09: All - Reasons for Using Registry :10: All - Registry Format :11: All - Where Registry Draws Data :12: All - Data Included :13: All - Functionalities Included :14: All - Challenge in Implementing Registry :15: All - Greatest Improvement Related to Registry Use :16: All - Requirement for Medicare/Medicaid Reimbursement :17: All - Registry ROI :18: All - Organization Type Glossary Using Registries for Quality Improvement Survey Tool xx

22 Note from the Executive Editor Welcome to the 2012 Healthcare Benchmarks Yearbook, the Healthcare Intelligence Network s third annual review of the year in healthcare. As if digesting the plethora of care delivery initiatives rolled out by CMS over the last year wasn t enough, the healthcare industry faces a presidential election, looming health IT mandates and continued economic uncertainty in the 12 months to come. What mindset will be required in 2012 to implement the new care and reimbursement reforms ACOs, bundled payments, co-management, hospitalists taking shape from PPACA? The 2012 Healthcare Benchmarks Yearbook: Metrics, Measurements and Innovations delivers all-new actionable data compiled in 2011 on 9 key areas of healthcare activity and growth: Healthcare Trends for 2012 Tobacco Cessation and Prevention Reducing Readmissions Case Management Accountable Care Organizations Health and Wellness Incentives Patient-Centered Medical Home Improving Patient Satisfaction and Experiences Medication Adherence and Compliance Patient Registries for Accountable Care Each set of benchmarks is supplemented with relevant advice from healthcare thought leaders from Premera Blue Cross, Advocate Physician Partners, Summa Health System, and many others. All in all, the full yearbook contains more than 450 charts, tables and graphs. And at more than 460 pages, we hope it will prove to be an essential planning and reference tool that you ll use to navigate the important year ahead. We wish you a prosperous and innovative year in healthcare. Melanie Matthews, HIN executive vice president and chief operating officer Download the 2011 Healthcare Benchmarks Yearbook at xxi

23 Executive Summary Accountable Care Organizations in 2011: Top Challenges of ACO Creation Top Challenges of ACO Creation Source: HIN Accountable Care Organizations Survey February, The February 2011 Accountable Care Organizations e-survey by the Healthcare Intelligence Network set out to assess the industry s awareness of and readiness for ACOs. Responses provided by 228 healthcare organizations, submitted before CMS released its proposed rule, indicate that a significant segment of the industry is reframing its care delivery structure as an ACO or will do so in the near future. According to respondents, the top five challenges of ACO creation are: Cost: 22 percent Staff/management buy-in: 20 percent Other: 18 percent Reimbursement: 12 percent Evidence-based care: 8 percent Download the 2011 Healthcare Benchmarks Yearbook at xxii

24 Patient Registries for Quality Improvement in 2011 Top Patient Registries Top Patient Registry Types Source: HIN Registry Use for Quality Improvement Survey August, HIN s e-survey on registry use for quality improvement, administered in August 2011, captured how 105 healthcare organizations are using patient registries currently and in the future, and the impact registries have on healthcare quality, efficiency and cost. According to survey respondents, the main types of patient registries being used are: Disease/condition-based: 62 percent Health services-based: 17 percent Meaningful use: 9 percent Product-based: 3 percent Medication regimen: 3 percent Appointment tracker: 3 percent Other: 3 percent xxiii

25 Improving Patient Satisfaction in 2011 Top 5 Questions Asked in Patient SatisfactionSurveys Top 5 Questions in Patient Satisfaction Surveys Source: HIN Patient Experience & Satisfaction Survey May, The May 2011 Benchmarks in Patient Satisfaction e-survey by the Healthcare Intelligence Network captured efforts to improve patients and members experience and satisfaction with their care. Responses provided by 146 healthcare organizations indicate that 91 percent conduct their own satisfaction surveys. According to respondents, the top five topics covered in patient satisfaction surveys are: Care quality: 95.7 percent Communication: 93.5 percent Staff courtesy: 84.8 percent Access: 78.3 percent Staff response: 73.9 percent xxiv

26 Tobacco Cessation and Prevention in 2011 Top 5 Ways to Measure Tobacco Cessation ROI Top 5 Ways to Measure Tobacco Cessation ROI Source: HIN Smoking Cessation and Prevention Programs Survey November, The Healthcare Intelligence Network s Smoking Cessation and Prevention Programs e-survey conducted in November 2010 captured the efforts of more than 80 organizations to curb and prevent tobacco use. According to survey respondents, the top 5 ways to measure tobacco cessation cessation ROI include: HRA changes: 44.7 percent Self-report: 39.5 percent Surveys: 36.8 percent Health claims: 28.9 percent Utilization: 21.1 percent xxv