Health care industry warming to role of keeping you healthy

Kaiser Health News reports from the Associated Press, that big players in the health industry are seeing the cost benefits of nabbing problems before they start.  That hot lunch delivered to your door? Your health insurer might pick up the tab. The cleaning crew that fixed up your apartment while you recovered from a stroke? The hospital staff helped set that up.

Some insurers are paying for rides to fitness centers and checking in with customers to help ward off loneliness. Hospital networks are hiring more workers to visit people at home and learn about their lives, not just their illnesses.

The health care system is becoming more focused on keeping patients healthy instead of waiting to treat them once they become sick or wind up in the hospital. This isn’t a new concept, but it’s growing. Insurers are expanding what they pay for to confront rising costs, realizing that a person’s health depends mostly on what happens outside a doctor’s visit.

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Vermont is a model health system under review for lowering costs

According to ABC news, OneCare Vermont covered about 24,000 Medicaid patients and now covers about 112,000 patients whose health care is provided through Medicare, Medicaid and commercial insurance.

The long-term goal is to expand it so that about 70 percent of health care services provided in Vermont are covered by the system, which encourages patients to stay healthier using specialized care, such as helping them manage chronic conditions like diabetes so they don't wind up needing more expensive treatment. Officials consider 70 percent a realistic goal.

In a switch from when providers were paid for each service performed, providers are allocated a set amount of money to cover the people in the program. This year, $580 million has been allocated to OneCare Vermont, an organization of health care providers tasked by the state with carrying out the spirit of the program.

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IOM report establishes framework for standardized measures set

A recent Institute of Medicine (IOM) report, Vital Signs: Core Metrics for Health and Health Care Progress, identifies fundamental problems with the current state of health care quality measures as too many, unfocused, and unorganized and identifies a framework to streamline the measures.
The IOM report uses four domains—healthy people, care quality, lower cost, and engaged people—to propose the following 15 standardized measure sets that represent a more wholistic, organized and focused approach for required measures at the national, state, and local levels and recommends steps to implement the measures:
1. Life expectancy
2. Well-being
3. Overweight and obesity
4. Addictive behavior
5. Unintended pregnancy
6. Healthy communities
7. Preventive services
8. Care access
9. Patient safety
10. Evidence-based care
11. Care match with patient
12. Personal spending
13. Population spending
14. Individual engagement
15. Community engagement
The  report was published online April 28, 2015 in The Journal of the American Medical Association by the Commonwealth Fund's David Blumenthal, M.D. and the Institute of Medicine's J. Michael McGinnis, M.D. 

High-intensity primary care may help lower costs and improve quality

“High-intensity” primary care, a model of care similar to the Patient-Centered Medical Home specifically for patients with chronic and multiple conditions, shows promise in lowering costs and improving quality, according to a press release by the National Institute for Healthcare Reform.
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Commonwealth Fund calls for government to develop a vision for improving population health

A Commonwealth Fund report calls for the federal government to develop a comprehensive, disciplined implementation plan that takes full advantage of the new opportunities provided by the Affordable Care Act, the American Recovery and Reinvestment Act, and the Health Information Technology for Economic and Clinical Health (HITECH) Act.
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U.S. Adults with chronic conditions more likely to forego care than those in other high-income nations

Adults living with chronic health problems who live in the U.S. are more likely to forego care than those with chronic health problems living in other high-income nations, according to a report by the Commonwealth Fund.
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$40 Million available to prevent chronic diseases

The Department of Health and Human Services has announced that it will be granting $40 million to help prevent chronic diseases and promote good health, according to a press release. This initiative was created by the Affordable Care Act, and addresses the nation’s five leading chronic disease-related causes of death and disability: heart disease, cancer, stroke, diabetes, and arthritis.
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