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Across the country, doctors, hospitals and insurers are forming new health care entities to increase the efficiency and quality of health care, and lower the cost of it. Called accountable care organizations, these groups are gaining ground, even though critics consider them a repackaging of HMOs some of which have given managed care a bad name.

An ACO is a group of health care providers such as doctors, hospitals and others, including insurance companies, who agree to work together to provide overall care to their patients. Those providers are accountable for the quality and cost of that care. If they reduce costs while improving patient care, they share in the savings. If they dont deliver, they may risk losing money.

While the idea has many proponents, critics are concerned about the creation of large health care groups that could have too much influence over physician decisions. That could backfire and ultimately result in increased health care costs.

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Hospitals controlling and running ACOs that makes our members very nervous, said Francisco Silva, vice president and general counsel for the California Medical Association based in Sacramento.Its absolutely important that ACOs are physician led. The ACO model can be a very good thing, but it needs to be done carefully as a collaborative effort, he said. We learned from the HMO experience. There were a lot of stories of folks being denied care.

But there is increasing support for changing the way health care is delivered and making all parties in the system accountable for the cost.

Right now Id say there is a growing consensus that accountable care is the future of health care, said David Muhlestein, an analyst with Leavitt Partners, a Salt Lake City-based health care analyst firm.

But a clear definition an ACO has yet to be determined, he added.

Affordable care organizations are emerging both through Medicare and in the private sector. The Affordable Care Act required the Centers for Medicare and Medicaid Services to develop an ACO program, which, as of July 9, has 154 ACOs serving 2.4 million Medicare patients, according to the Department of Health and Human Services. These ACOs must meet patient care standards based on 33 quality measures.

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New health care groups look to cut costs and improve quality

Allison Miller was among the nurses and doctors giving free care in July in the Los Angeles area.

STORY HIGHLIGHTS

Editor's note: Aaron E. Carroll is an associate professor and vice chairman of health policy and outcomes research in the Department of Pediatrics at the Indiana University School of Medicine. He blogs about health policy at The Incidental Economist and tweets at @aaronecarroll.

(CNN) -- Unless you've been living under a rock, you know people are concerned about the deficit. Or at least they say they are. You'd also have to be willfully ignoring everything around you not to know that health care spending is a significant cause, if not the cause, of our long-term fiscal problems.

The narrative that seems to be going around Washington argues that there are two schools of thought about how to improve our financial outlook. One side wants to cut spending. The other side wants to increase taxes. Or, so it goes.

I was out to dinner on Saturday night with a friend who is rather pessimistic about compromise in our government. He believes that the chances for passing anything that might reduce spending on health care in the future are near zero. There's just one problem with his outlook. We've already passed a law that does a great deal to reduce future health care spending.

Aaron E. Carroll

I have argued many times that I don't think the Affordable Care Act does enough to contain costs. I still believe that's true. But let's not ignore the fact that it does a lot. More, in fact, than anything else passed by Congress and signed into law by a president in quite some time.

Right off the bat, we need to remember that the Affordable Care Act makes significant cuts to future Medicare spending. Reductions in overpayments for Medicare Advantage constitute almost $140 billion in savings over a decade. Changes in the fee-for-service reimbursement schedule add up to almost $200 billion. That's an enormous amount of money, so large that it scared many people into thinking that Medicare would be severely curtailed. Running against Medicare cuts helped sweep the Republicans into power in the House of Representatives in 2010. Often, such arguments came from the same people now decrying the Affordable Care Act for not cutting health care spending enough.

But that's just the tip of the iceberg. There are lots of other payment reforms (PDF) that should "bend the curve" for Medicare in the next decade. Hospitals will be punished for re-admissions for certain conditions. This is expected to save $8.2 billion. Refusing payments for hospital-acquired conditions should save another $3.2 billion. Accountable care organizations, for better or for worse, are expected to save almost $5 billion in the first eight years as well.

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Opinion: Another look at Obamacare

President Barack Obama is warning Florida retirees that Republican challenger Mitt Romney would undercut the new health care law and alter Medicare, a play for voters in one of the nation's top swing states.

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Obama, Romney tangle on health care, jobs

The Supreme Court decision upholding the 2010 health care law has left more American voters feeling "worried" than "reassured" about their personal health care situation. Meanwhile, majorities still want at least part of the health care law repealed.

The latest Fox News poll, released Thursday, shows 58 percent of voters think the Affordable Care Act needs to be changed and Congress should keep at it. Forty percent disagree: It's done and lawmakers should "move on."

Not surprisingly, most Republicans (84 percent) think lawmakers should keep working on the law. A 53-percent majority of independents agree -- as do 35 percent of Democrats.

Overall, a 57-percent majority of voters would like Congress to repeal at least part of the health care law: 29 percent want complete repeal and another 28 percent favor repealing parts of it.

That's down slightly from a high of 61 percent wanting to repeal at least part of the law in January 2011. Since 2010, when this question was first asked, a majority has favored repealing at least some of the law.

Of the four voters in ten who want Congress to keep or expand the law, 18 percent favor expanding it, while 22 percent say leave it as is. That's a new high for the number favoring keeping the law in its current form, up from the previous high of 16 percent (in both April 2011 and December 2010).

Almost all Republicans want Congress to repeal all (57 percent) or parts of the health care law (30 percent).

Two-thirds of Democrats want the law expanded (29 percent) or left as-is (36 percent). One in four Democrats favors repealing parts of the law (24 percent).

Among independents, a 57-percent majority thinks at least some of the law should be repealed, while 39 percent favor keeping or expanding the law.

The Supreme Court ruled most of the 2010 health care law constitutional on June 28.

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Voters 'Worried' About Health Care After Ruling

By MARY SHEDDEN | The Tampa Tribune Published: July 20, 2012 Updated: July 20, 2012 - 12:00 AM

Florida's governor has no plans to expand health care for the state's poor, but Hillsborough County health advocates say they still plan to help struggling uninsured residents.

Last month, the U.S. Supreme Court ruled that states can decide whether to implement the federal Affordable Care Act's expansion of Medicaid for uninsured residents, many between the ages of 19 and 64.

Gov. Rick Scott, a staunch opponent of the Affordable Care Act, swiftly announced that Florida will not participate.

However, more than 10,000 county residents living at or below the federal poverty line already participate in a 20-year-old free local health care plan similar to what the expansion would offer.

Advisors to the Hillsborough County Health Care Plan said Thursday they are moving forward with plans to reach even more eligible participants.

"There are people who are clearly eligible for our plan and don't know about it," said Gene Earley, the county director of health care services.

Thursday's meeting provided the first clue about how many local adults are eligible but missing out on the free preventive and acute medical care and prescription drug assistance. Preliminary reviews of census and Medicaid rolls show that more than 40,000 eligible and uninsured residents are being missed.

Who they are, where they live and each person's specific medical needs will be identified within three months as part of an education and recruitment strategic plan, Earley said.

Since voters backed its creation in 1991, a half-cent county sales tax and trust fund now more than $94 million and $47.3 million, respectively have covered the plan's costs. In 2011, expenses totaled $72.5 million.

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County has free health plan for poor

COEUR d'ALENE - Business consultants have been facing "a lot of nervous business owners" following the upholding of the new health care reform, said Lance Fenton, CPA at Cooper Norman.

Speaking on a health care reform panel on Thursday morning at North Idaho College, Fenton said most companies worry how they'll be impacted financially.

"We're trying to put their minds at ease," Fenton said.

Thursday morning's forum on the Affordable Care Act, presented by PacificSource Health Plans, glossed over the law's requirements for businesses.

Companies with at least 50 employees will have to provide workers with health care coverage. Or, they can pay a $2,000 penalty per employee they don't insure, who will instead seek coverage through health insurance exchanges provided by the state or federal government.

Companies of any size must educate their employees about their insurance options.

The Congressional Budget Office has projected that under the new act, the number of uninsured will drop from 50 million today to 22 million by 2016.

Panelist Stephen Cilley, CEO of Ataraxis, Inc., said he didn't think many Idaho businesses would be dramatically affected by the new law.

"Most businesses in Idaho aren't over 50 people," said Cilley, whose Boise company handles employee services for businesses.

But panelist Shelli Stayner, with Mercer human resource consultant, said there is debate among small employers over whether to rely on a state insurance exchange, if one is created.

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Health care worries businesses

17-07-2012 08:24 There has never been a better time to be a health care innovator than right now. Information is transforming healthcare at all levels -- from the care in provider settings and in the home, population health management, and public and community health initiatives. Wil Yu will discuss how incentives in the health care system are shifting to reward improvements in quality, health, and value, and how key information to power these improvements is being liberated at multiple levels. As the magnitude of data liquidity increases, it becomes essential to create a robust infrastructure to adequately secure, analyze, and communicate. Learn more about the growing "ecosystem" of innovators who are embracing this historic opportunity to help reinvent American health care and improve health. This presentation will spotlight the ways that the US Health and Human Services Department is supporting, enabling and engaged in innovation.

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Wil Yu - Innovation's Long Summer: The Coming Opportunities and Challenges for Healthcare Innovation - Video

By Randy Dotinga HealthDay Reporter

TUESDAY, July 17 (HealthDay News) -- A new study finds that so-called "safety-net" hospitals that serve the poor do a worse job overall than other hospitals, a potentially big problem as health care reform boosts the number of people who have insurance and more choice about where they can go for care.

Medicare used to give these hospitals extra payments for taking care of poor people. But under health care reform, they'll get less of that funding and more for how they perform on a variety of measurements, including how patients rate them.

"Our results suggest that safety-net hospitals are struggling on this important metric. As a result, safety-net hospitals are likely to get penalized under the new payment scheme," said Paula Chatterjee, a medical student at Harvard School of Public Health. "Given that safety-net hospitals are already financially stretched, even small losses can be potentially devastating for these hospitals."

At issue are hospitals that serve poor people, often including those who don't have health insurance. According to the study, they tend to be sicker than other patients and have less trust in the health care system.

Under health care reform, the federal government punishes hospitals that perform poorly on a variety of measures by not giving them some Medicare payments.

The researchers studied 3,096 hospitals and examined answers that patients gave to surveys about their experiences at the hospitals. The safety-net hospitals -- 769 of the total -- were slightly less likely than other hospitals to be in urban areas (many are in rural parts of the country), much more likely to serve Medicaid patients and more likely to have fewer nurses per patient.

The safety-net hospitals had the lowest overall rating among patients and ranked a bit lower in the patient perception of things such as communication with medical staff and management of their condition.

"Safety-net hospitals are a critical part of our health care system. They provide care to everyone, irrespective of the patient's ability to pay. The new payment scheme, which ties part of the hospital payments to how those hospitals do on patient-reported scores, is laudable in its goals," Chatterjee said. "Our paper says that under the new scheme, safety-net hospitals are likely to do poorly. We need new strategies to help these hospitals improve."

What could be done? Chatterjee said Medicare should work with hospitals to help them do a better job of caring for patients. "Given the challenges of caring for a relatively poor population and the low reimbursement rates, we suspect that many hospitals have not been able to focus on optimizing patient experience," she said. "It's time to help these hospitals do so."

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Hospitals for Poor May Struggle Further Under Health Care Reform

VANCOUVER, July 18, 2012 /CNW/ - Vancouver Coastal Health and Providence Health Care unveiled a bold new campaign today to stop HIV in Vancouver. CHANGE HIVSTORY makes Vancouver the epicenter of a movement that will change history: the beginning of the end of HIV.

Building on the momentum of It's Different Now, an HIV awareness campaign that helped increase testing rates in Vancouver by 37%, CHANGE HIVSTORY aims to inspire and empower people via a social media campaign featuring a moving and dramatic video. The campaign enables individuals to power the movement, by encouraging every person who's ever been sexually active to have an HIV test.

"CHANGE HIVSTORY is about creating a movement here in Vancouver to change the course of history by changing the course of HIV," says Dr. Rka Gustafson, Medical Health Officer and Medical Director of Communicable Disease Control for Vancouver Coastal Health. "And with people in Vancouver requesting HIV tests and doctors recommending them as part of everyone's routine health care, we are getting closer to making the end of HIV a reality."

"We already made history in June when St. Paul's Hospital was the first emergency department in Canada to offer routine HIV testing to every patient," says Scott Harrison, Program Director, Urban Health, HIV/AIDS, at Providence Health Care. "Now, we want to change history on a local and global level, and finally put an end to HIV. Forty per cent of people infected with HIV in Vancouver are diagnosed late with advanced HIV disease. By diagnosing people earlier, we can link them to treatment sooner, ensuring optimal health outcomes for infected individuals and greatly reducing the likelihood of transmission to those not infected."

World-renowned HIV expert and Director of BC's Centre for Excellence in HIV/AIDS (BC-CfE) at St. Paul's Hospital, Dr. Julio Montaner, says that stopping HIV in its tracks is possible, especially since Highly Active Anti-retroviral Therapy (HAART) treatment is available to all B.C. residents for free. "The work we have undertaken at BC-CfE for the past 20 years has helped dramatically improve HIV treatment and proven, without doubt, that HAART is highly effective in preventing the transmission of HIV between people," said Dr. Montaner. "And if we can stop the transmission, we can stop the disease. The world agrees, this is the way forward - changing history is this simple."

An HIV positive person on their prescribed medication is 96 per cent less likely to transmit the disease. It is estimated there are 3,500 people in British Columbia who are infected with HIV but don't know it.

The campaign also features print advertising and TV and radio commercials, developed by FCV, a Vancouver-based interactive, digital advertising agency. To learn more, visit http://www.itsdifferentnow.org. Local media outlets have generously donated more than $500,000 of free ad space and air time, to help spread awareness.

The CHANGE HIVSTORY campaign is a part of BC-CfE pioneered Treatment as Prevention strategy of which STOP HIV/AIDS (Seek and Treat for Optimal Prevention of HIV/AIDS) is one component. STOP HIV/AIDS is a four-year, $48-million pilot program funded by the British Columbia Ministry of Health to improve access to HIV testing, treatment, and support services in Vancouver and Prince George.

Vancouver Coastal Health (VCH) is responsible for the delivery of $2.9 billion in community, hospital and residential care to more than one million people in communities including Richmond, Vancouver, the North Shore, Sunshine Coast, Sea to Sky corridor, Powell River, Bella Bella and Bella Coola.

Providence Health Care (PHC) is one of Canada's largest faith-based health care organizations, operating 16 health care facilities in Greater Vancouver. PHC operates one of two adult academic health science centres in the province, performs cutting-edge research in more than 30 clinical specialties, and focuses its services on six "populations of emphasis": cardio-pulmonary risks and illnesses, HIV/AIDS, mental health, renal risks and illness, specialized needs in aging and urban health and is hometo theB.C. Centre

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Vancouver Coastal Health & Providence Health Care aim to change the course of "HIVstory"

Michael Wheeler, Naples

Challenge

I don't understand comments sent to your newspaper regarding the Affordable Health Care Act.

While I am a conservative Republican, we need to address the health-care needs of the country, not just criticize Obamacare or the Supreme Court decision.

Those who have written those letters just don't understand the problems of the current health-care system. If any of those people had friends or relatives who had the misfortune of having health-care problems and not working for a business that supplies health-care insurance or the government, they might understand that reform is necessary.

Insurance companies are in the business to make money so they don't have to insure anyone with health issues. If the insurance companies do offer insurance to individuals with health issues, they add a rider to the policy so they don't have to cover those issues.

As far as the new Health Care Act being a tax, yes, it is a penalty tax for those who do not have insurance. There is no new tax for people who maintain health insurance. Why is that any different than requiring auto insurance?

I really don't want to pay health-care costs for people who do not have insurance so I am glad the government is requiring people to have it.

I challenge any of those writers of negative letters to go to an insurance company and try to get health insurance.

If they can find affordable health care, for a reasonable cost, I will gladly go on board for Mitt Romney and all other Republican candidates who can't seem to think beyond the party line.

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Letter: Challenge

WASHINGTON -- For Gov. Rick Perry, saying "no" to the federal health care law could also mean turning away up to 1.3 million Texans, nearly half the uninsured people who could be newly eligible for coverage in his state.

Gov. Chris Christie not only would be saying "no" to President Barack Obama, but to as many as 245,000 uninsured New Jersey residents as well.

The Supreme Court's recent ruling gave governors new flexibility to reject what some Republicans deride as "Obamacare." But there's a downside, too.

States that reject the law's Medicaid expansion risk leaving behind many of their low-income uninsured residents in a coverage gap already being called the new "doughnut hole" -- a reference to a Medicare gap faced by seniors.

Medicaid is a giant federal-state health insurance program for the poor, now mostly covering children, mothers and disabled people. The expansion in Obama's health care overhaul was originally expected to add roughly 15 million uninsured low-income people, mainly adults without children, who currently are not eligible in most states. Washington would pick up the entire cost for the first three years, with the federal share then dropping to 90 percent. The Medicaid expansion accounts for about half the total number of uninsured people projected to get coverage under the law.

If every state were to reject that Medicaid expansion -- as the Supreme Court ruling now allows -- some low-income people would still be picked up by

But nearly 11.5 million uninsured people below the federal poverty line would be left behind in a new coverage gap, according to recent estimates from the Urban Institute. That brings to mind the infamous "doughnut hole" in the Medicare prescription drug benefit, in which seniors with high drug costs find themselves paying out of pocket much of the year.

Those who fall into the new gap would neither qualify for Medicaid in their states under current rules nor be eligible for subsidized private insurance in new state marketplaces that Obama's law calls exchanges.

Low-income children and mothers would continue to have insurance through Medicaid. Then, starting in 2014, millions of people over the poverty line would have subsidized private coverage through the new exchanges. "And then this group in the middle has nothing," said Matt Salo, executive director of the National Association of Medicaid Directors. His organization takes no position on what states should do.

Things only get trickier from there.

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Refusal of health care law can be risky

IT managers aren't prepared to handle the deluge of data in health care, Oracle revealed in its new report, "From Overload to Impact: An Industry Scorecard on Big Data Business Challenges," released July 17.

More than three-fourths (77 percent) of health care executives gave their organization a "C" or below for managing the "data deluge," according to the report, which is based on a poll of 333 U.S. and Canadian C-level executives from health care and 10 other industries. For all industries, 60 percent of the executives assigned organizations a "C" or lower for managing the flood of data.

Following the Supreme Court's June 28 decision to uphold the Patient Protection and Affordable Care Act (ACA), known as "Obamacare," data volume will grow as providers form accountable care organizations (ACOs), according to Marc Perlman, global vice president of Oracle Healthcare.

"With the rise of [ACOs], a greater focus on personalized medicine and the rollout of health care reform, data volumes will continue to grow," Perlman said in a statement.

Companies such as Dell, IBM and Oracle provide the IT infrastructure to store genomic data in the cloud used for drug discovery. This data will allow doctors to develop personalized medicine for patients.

"This report demonstrates the challenges that health care organizations face in managing their rapidly growing information stores and their approach to addressing this issue, including deploying industry-specific and analytical applications that help them glean insight and put timely information in the hands of line-of-business personnel when and where they need it," Perlman's statement said.

Of health care executives interviewed, 0 percent gave their organizations an "A" for data "preparedness," and only 8 percent of executives in all industries gave their companies an "A" for this category.

Health care organizations are accumulating 85 percent more data than two years ago, according to the C-level health care executives Oracle interviewed.

Of the data managed in all industries, 48 percent came from customer information, 34 percent from operations, and 33 percent from sales and marketing, according to the report.

Despite EHRs being a top priority for health care organizations, they're struggling to make use of the data from the health records, according to the survey.

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Health Care Organizations Unprepared for Big Data Challenges: Oracle Report

BASKING RIDGE, N.J., July 18, 2012 /PRNewswire/ --A major problem in the provision of health care is how to improve the quality of care without increasing costs. With advances in health information technology, there is an opportunity to leverage it to improve the provision of care and enhance the patient experience and outcome.

"This is an unprecedented time for transition in the health care ecosystem through the use of technology," said Dr. Peter Tippett, chief medical officer and vice president of Verizon Connected Healthcare. "Advances in telemedicine, wireless networks, virtual care solutions, information exchanges and cloud computing are empowering health care providers to improve their business operations while giving them more time to provide quality care."

Verizon believes the following ten areas offer the most promise to enhance patient care and reduce cost through the strategic use of technology:

Verizon Enterprise Solutions creates global connections that generate growth, drive business innovation and move society forward. With industry-specific solutions and a full range of global wholesale products and services offered over the company's secure mobility, cloud, strategic networking and advanced communications platforms, Verizon Enterprise Solutions helps open new opportunities around the world for innovation, investment and business transformation. Visit verizon.com/enterprise to learn more.

About Verizon

Verizon Communications Inc. (NYSE, Nasdaq: VZ), headquartered in New York, is a global leader in delivering broadband and other wireless and wireline communications services to consumer, business, government and wholesale customers. Verizon Wireless operates America's most reliable wireless network, with 93 million retail customers nationwide. Verizon also provides converged communications, information and entertainment services over America's most advanced fiber-optic network, and delivers integrated business solutions to customers in more than 150 countries, including all of the Fortune 500. A Dow 30 company with $111 billion in 2011 revenues, Verizon employs a diverse workforce of nearly 192,000. For more information, visit http://www.verizon.com.

VERIZON'S ONLINE NEWS CENTER: Verizon news releases, executive speeches and biographies, media contacts, high-quality video and images, and other information are available at Verizon's News Center on the World Wide Web at http://www.verizon.com/news. To receive news releases by email, visit the News Center and register for customized automatic delivery of Verizon news releases.

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Verizon Identifies 10 Most Promising Ways to Use Health IT to Enhance Patient Care, Reduce Costs

BLOOMFIELD, Conn. & BURLINGTON, Vt.--(BUSINESS WIRE)--

Cigna (CI), Fletcher Allen Health Care and Central Vermont Medical Center (CVMC) have launched a collaborative accountable care program to expand patient access to health care, improve care coordination, and achieve the triple aim of improved health outcomes (quality), lower total medical costs and increased patient satisfaction. Collaborative accountable care is Cigna's approach to achieving the same population health goals as accountable care organizations, or ACOs.

Accountable care is a variation on the patient-centered medical home model of health care already in place at both Fletcher Allen and CVMC. This model rewards primary care doctors for improved outcomes and reduced medical costs. Cigna's collaboration with Fletcher Allen and CVMC is one of the first patient-centered accountable care programs in Vermont involving an integrated delivery system and a health plan.

The program will benefit approximately 10,500 individuals covered by a Cigna health plan in Vermont who receive care from among 144 primary care health professionals at 21 practice locations.

This agreement with Cigna is part of Fletcher Allens comprehensive strategy to be a leader in the transformation of health care, said John Brumsted, M.D., Fletcher Allens president and chief executive officer. Cignas program is consistent with our ongoing efforts to work with all stakeholders to make Vermonts future health care delivery system fulfill the promise of higher quality care, improved access and reduced rates of increasing costs.

The joint collaboration of CVMC and Fletcher Allen with Cigna and their accountable care program is another great example of the value of the integrated delivery system that we created with Fletcher Allen Partners last October, said Judy Tartaglia, president and chief executive officer, CVMC. We are just beginning to see the potential that can be achieved by this system in the years ahead.

Fletcher Allen and CVMC health care professionals will monitor and coordinate an individuals medical care in a more comprehensive way with support from Cigna tools and information resources. Patients will continue to go to their current physician and will automatically receive the benefits of the program. There also are no changes in any plan requirements regarding referrals to specialists. Patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes or heart disease.

Critical to the programs benefits are registered nurse clinical care coordinators who help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators enhance care by using patient-specific data from both organizations and from Cigna to identify patients being discharged from the hospital who might be at risk for readmission, as well as patients who may be overdue for important health screenings or who may have skipped a prescription refill. The care coordinators will work collaboratively with the Primary Care Medical Home and Community Health Teams regionally to help patients get the follow-up care or screenings they need, identify any issues related to medications and help prevent chronic conditions from worsening.

The care coordinators will also help patients schedule appointments, provide health education and refer patients to Cigna's clinical programs, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.

Through our collaborative accountable care programs, Cigna hopes to create a patient-centered health care system that emphasizes prevention and primary care while rewarding physicians for quality of care and improved health outcomes, said Dr. Robert Hockmuth, Cignas senior medical director in Vermont. A system thats focused on delivering value rather than volume of services will ultimately result in a healthier population and lower medical costs, which is good for individuals, families, employers and doctors.

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Fletcher Allen Health Care, Central Vermont Medical Center and Cigna Bring Accountable Care to Vermont

16-07-2012 21:25 - Standing with Nancy Pelosi for health care, and voting to raise energy costs, Shelley Berkley is in the wrong corner for small business and Nevada taxpayers. Sign the petition for policies that will support small businesses and lower costs for Nevada -

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Shelley Berkley, In the Wrong Corner for Small Businesses in Nevada - Video

BLOOMFIELD, Conn. & DENVER--(BUSINESS WIRE)--

Cigna (CI) and New West Physicians, P.C., a large physician group in Denver, have launched a collaborative accountable care initiative to expand patient access to health care, improve care coordination, and achieve the triple aim of improved health outcomes (quality), lower total medical costs and increased patient satisfaction. Collaborative accountable care is Cigna's approach to accomplishing the same population health goals as accountable care organizations, or ACOs.

Accountable care is a variation on the patient-centered medical home model of health care that rewards primary care doctors for improved outcomes and lower medical costs.

The number one priority of our physicians is to help our patients stay healthy so they can live their lives to their full potential, said Ruth Benton, chief executive officer at New West Physicians. This collaboration with Cigna is an opportunity to achieve the triple aim while delivering well-coordinated patient care that results in health improvement.

The program will benefit nearly 7,800 individuals covered by a Cigna health plan who receive care from among approximately 60 primary care physicians and 20 mid-level providers in 16 locations throughout the Denver Metro area. Individuals who are enrolled in a Cigna health plan and later choose to seek care from a New West physician will also have access to the benefits of the program.

New West Physicians will monitor and coordinate all aspects of an individuals medical care. Patients will continue to go to their current physician and will not need to take any action to receive the benefits of the program. There also are no changes in any plan requirements regarding referrals to specialists. Patients most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes or heart disease.

Cigna is committed to supporting New West Physicians efforts to put the patient at the center of its practice, with expanded access to care, better coordination of care, patient education about chronic conditions and wellness, and access to clinical programs for health improvement, said Mark Laitos, M.D., Cigna's senior medical director for Colorado. This is an important step toward creating a health care system that rewards physicians for the quality of care they provide rather than the number of procedures they perform.

Critical to the programs benefits are registered nurses, employed by New West Physicians, who serve as clinical care coordinators and help patients with chronic conditions or other health challenges navigate the health care system. The care coordinators enhance care by using patient-specific data provided by Cigna to identify patients being discharged from the hospital who might be at risk for readmission, as well as patients who may be overdue for important health screenings or who may have skipped a prescription refill. The care coordinators contact these individuals to help them get the follow-up care or screenings they need, identify any issues related to medications and help prevent chronic conditions from worsening.

The care coordinators also help patients schedule appointments, provide health education and refer patients to Cigna's clinical programs, such as disease management programs for diabetes, heart disease and other conditions; and lifestyle management programs, such as programs for tobacco cessation, weight management and stress management.

Cigna will compensate New West Physicians for the medical and care coordination services it provides. Additionally, the practice may be rewarded through a pay for performance structure if it meets targets for improving quality and lowering medical costs.

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New West Physicians, P.C. and Cigna Bring Accountable Care to Denver

By Lee Samaha - July 17, 2012 | Tickers: ABT, COV, ISRG, JNJ | 0 Comments

Lee is a member of The Motley Fool Blog Network -- entries represent the personal opinions of our bloggers and are not formally edited.

Investors have been keen to bid up defensive sectors recently but one stock seems to have been left behind in the rush. Tyco spinoff Covidien (NYSE: COV) appears to be unloved by the market, yet its mix of stable single digit revenue growth plus double digit earnings growth and high cash flow generation is quite compelling.

Moreover, the future spinoff of its low growth pharmaceuticals division will allow the management to fully focus on medical devices. Reductions in headcount and facilities over the last few years have generated operational efficiencies that have led to margin improvement. This company is well run, it trades at a discount to its peers and I think it's well worth a look for risk adverse investors.

Covidien Offers a Mixed Growth Opportunity

In this article I am going to focus on medical devices. A graphic depiction of Covidiens offerings by product line reveals the mixed performance over the last few years.

Whilst Soft Tissue Repair and Airway & Ventilation growth has been hard to come by, Vascular and in particular Energy growth has been strong. Oximetry & Monitoring and Endomechanical growth has slowed this year. The company is currently tracking ahead of its internal 2-5% overall growth for medical devices but it has been clear in articulating that headwinds would get stronger in the second half. In addition there is one less trading week this year.

Endomechanical and Energy Products are Driving Growth

Together these product lines make up 46.8% of medical device sales, and Energy has consistently generated double digit revenue returns in recent years. Endomechanical and Energy devices in surgical procedures are increasingly being used in a drive to shift surgical procedures from open toward minimally invasive surgery (MIS). The big advantage of MIS is that it tends to lead to better patient outcomes, which in turn creates shorter hospital stays and less post-surgery complications. Both of which reduce hospital costs.

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An Undervalued Health Care Stock

CHICAGO, July 17, 2012 /PRNewswire/ -- Long term care liability loss rates and claim severity reached an eight-year high and are expected to grow steadily in 2013 against a backdrop of health care provider budget constraints and uncertainty about health care reform, according to Aon Risk Solutions, the global risk management business of Aon plc (AON). This finding is illustrated in the 2012 Aon Long Term Care General Liability and Professional Liability Actuarial Analysis, released July 12 in partnership with the American Health Care Association.

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Since 2005, the annual loss rate (liability costs relative to occupied long term care beds) has grown from $1,040 to a projected $1,480 in 2012 and is expected to increase again in 2013 to $1,540, according to the report based on 19,500 individual claims from long term care facilities. Claim severity (claim size) also has grown from a low of $109,000 per claim in 2005 to a projected $168,000 per claim in 2012 and $175,000 in 2013. Claim severity and loss rates have been growing consistently since 2009 at a rate of 4 percent annually, even though claim frequency has been stable since 2008.

"Long term care and skilled nursing centers strive to provide quality care each day, but they also must find ways to cope with the ever-increasing cost of doing business and multiple rounds of funding reductions at the state and federal level. This report underscores the need to continue to utilize tools like voluntary arbitration agreements, a cost-effective option for long term care providers and their residents to resolve legal disputes," said Governor Mark Parkinson, president and CEO of AHCA/NCAL.

Liability and the Long Term Care Profession Long term care providers faced high loss rates in the late 1990s and early 2000s. Over the years, they answered this challenge by reinvesting in patient safety, developing liability defenses, advocating for limits on tort damages and implementing arbitration. While these efforts helped providers control the growth of liability costs, reductions in Medicare reimbursement rates and health care reform have had an impact on long term care provider revenue and budgets.

"With reduced revenue, providers may have difficulties funding expansion and improvements, maintaining facilities and hiring and training qualified caregivers," said Christian Coleianne, associate director and actuary at Aon Global Risk Consulting. "These competing priorities have the potential to impact liability costs. By providing access to this invaluable data, we are enhancing our clients' ability to better understand and more effectively manage these risks."

The Patient Protection and Affordable Care Act encourages closer coordination of care with additional health care providers with the expectation of reduced costs. Interaction between long term care providers and dependence on other health care providers may increase exposure as the new system is expected to operate at a lower cost.

Loss Rates by State State laws and the state judiciary have a tremendous influence on liability costs. As a result, state loss rates vary considerably. For example, tort limits on awards are constitutionally prohibited in Kentucky, which has the highest loss rate in this study ($5,120 per bed for 2012). In contrast, Texas amended its constitution to protect its tort limits and has the lowest projected loss rate ($320 per bed for 2012).

"Malpractice costs and the tort environment are often major considerations in the decision to locate and invest in long term care beds and services in a specific state," said Dom Colaizzo, chairman of the National Health Care Practice for Aon Risk Solutions. "This ultimately affects the supply of beds and cost to seniors and their families in a marketplace where demand is growing for senior care and constrained by reduced reimbursements."

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Aon forecasts eight-year high for long term care liability loss rates, claim severity

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