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April 20, 2017

ACO roundup: Zeroing in on super-utilizers

Daily Briefing
  • Zeroing in on super-utilizers. Better care coordination, including awareness of comorbidities associated with super-utilizers, could help curb the overuse of health care services, according to a new study by Rutgers Robert Wood Johnson Medical School researchers. The study assessed data from 45,316 patients who visited Robert Wood Johnson University Hospital and Saint Peter's University Hospital between 2012 and 2013. According to the researchers, 3 percent of patients were Medicaid "high utilizers," and such patients were clustered in so-called geographic hotspots, such as apartment complexes and skilled nursing facilities. The researchers concluded that "the existence of hotspots ... argues for coordinated targeting of health services for patients in particular geographies in a different way, including possible residentially based preventive and chronic care services."

  • CMS expands MACRA support. CMS has released three new resources for providers who want to participate in the Merit-based Incentive Payment System (MIPS) under MACRA. The resources include a fact sheet on choosing and submitting improvement activities, a list of registries approved to report 2017 MIPS performance data, and a fact sheet on participating in the program.

  • Hospitalist nurse practitioners are growing even more important. Some hospitals are launching hospitalist programs that innovatively incorporate nurse practitioners (NPs) to cut costs. For instance, at Rusk County Memorial Hospital—a 25-bed hospital in Ladysmith, Wisconsin—an offsite physician oversees the NP-run hospitalist program, while several small hosptials in Indiana and Ohio have contracted with an outside hospitalist group that employees several NPs. According to some health care executives, pairing NP hospitalists with physicians is an effective way to cut readmissions, cut costs, and improve patient satisfaction.

From Advisory Board:

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  • What's next in telehealth. Join us April 25 to learn about how the telehealth landscape has changed since 2016. We'll share the latest news on telehealth adoption trends, current activity across major stakeholder groups, and common pitfalls in telehealth program planning and implementation.

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  • The 2017 cardiovascular State of the Union. Join us April 27 to learn the key market forces impacting CV services and how to adapt program strategy to maintain market leadership in light of increasing mandates for value-based, patient-centered care.

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