Health innovations

MetroHealth Medicaid pilot showing signs of success

In the first nine months after Cleveland’s MetroHealth redirected more than $30 million from Cuyahoga County taxpayers to create its very own Medicaid program for residents, health outcomes have already started to improve, according to the public hospital system (Source: “Cleveland's Early Medicaid Expansion Paying Off,” WCPN radio via Kaiser Health News, Aug. 5, 2014).

"All of the clinical outcomes are really amazing," said Dr. Randy Cebul, a researcher at MetroHealth.

In nine months, emergency department visits dropped 60 percent and primary care visits went up 50 percent. The hospital also ended up spending less than it budgeted, saving an average of $150 on each patient every month.

National telemedicine guideline stirs controversy

New guidelines issued this week by the Federation of State Medical Boards have stirred controversy among some patient advocated and health care providers (Source: “Telemedicine Policy Draws Opposition From Patient Advocates, Health Care Providers,” Kaiser Health News, May 2, 2014).

As part of a wide-reaching April 26 policy statement, FSMB changed the definition of telemedicine to care that “typically involves the application of secure videoconferencing… to provide or support healthcare delivery by replicating the interaction of a traditional encounter in person between provider and a patient.” It is not, according to the federation, “an audio-only, telephone conversation, e-mail/instant messaging conversation or fax.”

The statement, which is not a legal document but is intended to help state medical boards’ develop professional policies and standards for their members, triggered a backlash from some stakeholders.

Eight patient advocacy and provider groups wrote FSMB Chairman Donald Polk May 1 asking that the policy be reconsidered.

“We believe the policy … did not account for many of the safe, secure ways patients are accessing health care today, including ‘audio-only’ telephone. Our goal is patient access to safe, secure telemedicine and this may be thwarted if the existing policy is allowed to stand,” the groups write.

But Humayun Chudhry, FSMB’s CEO, said the “policy is not designed to limit the use of the telephone,” adding that “The concern is that … patient safety not be forgotten. Just because you’re using [technology] you should not be able to cut corners. It’s a cautionary note for physicians and for patients.”

Study: Modest care coordination improvements can lead to big savings

Even modest improvements in care coordination could fuel a decline in hospital admissions, complications and use of emergency medical services among older people with chronic conditions, according to a study published in the journal JAMA Internal Medicine (Source: “Coordinated Care Helps Elderly With Chronic Diseases,” HealthDay News, March 17, 2014),

The study, which involved almost 300,000 Medicare patients with type 2 diabetes, emphysema or congestive heart failure suggests that improvements in coordination of care for elderly patients could help Medicare save as much as $1.5 billion annually.

"Improving the coordination of care for patients with chronic illnesses can be difficult to achieve, but our findings suggest that it can have benefits for both patients and the health care system," said study lead author Peter Hussey, a senior policy researcher at RAND.

HPIO forum to explore benefits of active living

The Health Policy Institute of Ohio, the Ohio Department of Health and the Association of Ohio Health Commissioners are hosting a forum April 23 in Kettering (near Dayton) to highlight the positive impact of physical activity on many aspects of health and wellbeing, including mental health, school success and healthy aging.

“Roadmaps to Health: Active living for the body and brain,” which is sponsored by County Health Rankings and Roadmaps, also will showcase local projects from the southern half of Ohio that can share successes and lessons learned. HPIO Gold series sponsors for the event are OhioHealth, Health Quality Forum and Cincinnati Children's Hospital.

Featured Speakers:

  • Dr. Bernadette Melnyk: "Active Living to Promote Physical and Mental Health: From Evidence to Action"
  • Dr. Steven T. Devor: "Exercise is Medicine: Writing the Prescription for Older Adults"
  • Dr. Catherine Ramstetter: "The Importance of Physical Activity in Schools" 

Registration for the forum begins at 9 a.m. There is a $25 registration fee and lunch is provided.

Click here for more information or to register for the event

Ohio gets $10.8 million fed bonus for enrolling kids in Medicaid

Last week federal officials awarded Ohio a “performance bonus” of more than $10.8 million in recognition of the state’s efforts to insure poor children and streamline the state’s juvenile health coverage program (Source: “Feds award Ohio a $10.8 million bonus for enrolling children in Medicaid,” Cleveland Plain Dealer, Dec. 30, 2013).

Ohio was one of 23 states that received a bonus for enrolling children in Medicaid and improving access to coverage, according to a release from the federal Centers for Medicare & Medicaid Services.

State health officials haven’t yet decided how the money will be spent, according to Ohio Department of Medicaid spokesman Sam Rossi.

The state has used $33.9 million in previous bonus money to help expand temporary Medicaid eligibility to pregnant women, fund research into diseases such as asthma, and pay for addiction treatment services, among other things, according to the Governor's Office of Health Transformation.

Ohio VA hospitals tout telehealth program

Officials at the Chillicothe VA Medical Center this week touted their use of new telehealth technology that enables staff at the Cincinnati VA to remotely offer second opinions (Source: “VA provides long-distance diagnoses for patients,” Chillicothe Gazette, Sept. 18, 2013).

The technology, known as Tele ICU, allows medical staff at the Cincinnati VA to monitor patients using cameras that can zoom in as close as the patient’s pupil or focus on a measurement mark on a syringe.

In the past year, HPIO has focused attention on telehealth as a promising practice that can help improve health outcomes and access to care and reduce health costs. On July 16, the Institute invited key telehealth stakeholders from across the state to participate in a Telehealth Leadership Summit. To summarize the event, HPIO has released a brief titled “The Health Policy Institute of Ohio’s Telehealth Leadership Summit: Key findings and considerations” (pdf, 8 pages). 

Ohio hospitals form partnership to coordinate care

Four Ohio hospital systems announced this week that they are forming Health Innovations Ohio, an independent organization that will enable the hospitals to work together on a series of initiatives aimed at cutting costs and improving the health of their employees and patients (Source: “4 Ohio hospital systems collaborate on care, costs,” Columbus Dispatch, Sept. 5, 2013). 

The hospitals participating in the program are Columbus-based Mount Carmel Health System, Cincinnati-based Catholic Health Partners, Akron-based Summa Health System and Cleveland-based University Hospitals.

The group has worked together for more than a year but now has decided to publicize the partnership. Organizers said the collaboration aims to benefit patients by reducing fragmented, uncoordinated care and making sure the work of specialists is better connected around the needs of the patient.

HPIO releases brief on key findings from Telehealth Summit

HPIO has released a new brief titled “The Health Policy Institute of Ohio’s Telehealth Leadership Summit: Key findings and considerations” (pdf, 8 pages). 

On July 16, HPIO invited key telehealth stakeholders from across the state to participate in a Telehealth Leadership Summit. The 57 Summit participants included providers, employers, public and private insurers, state agencies and telehealth technology developers. Participants explored a number of issues surrounding telehealth including documentation, informed consent, payment, provider regulation, fraud and abuse and patient safety. HPIO’s brief outlines the key findings and recommendations arising out of the telehealth summit.

HPIO has focused attention on telehealth as a promising practice that can help improve health outcomes, access and reduce health costs.

“Stakeholders expressed a need to align telehealth policy priorities and identify realistic reforms and policy guidance that could further the implementation of telehealth in Ohio,” said HPIO Health Policy Associate Reem Aly, who leads the Institute’s work in this area. “HPIO’s Telehealth Leadership Summit sought to meet this need.”

Over the past year, HPIO has held a series of covenings on telehealth to educate, mobilize and unify telehealth stakeholders. To learn more about telehealth in Ohio, visit HPIO’s telehealth resource page.

Study shows coordinated care savings have potential to spread

A new study of an accountable care program for privately insured patients in Massachusetts found that the cost-sharing program led to lower costs for Medicare patients who were seen by the same providers (Source: “ACOs’ Coordinated Care Savings May Be Contagious,” Kaiser Health News, Aug. 28, 2013).

An accountable care organization, or ACO, is a network of doctors and hospitals that shares responsibility for providing care to a specific group of patients. The concept centers on paying providers for the quality of the services they provide, rather than the volume. The ACO is offered a bonus for giving patients high quality care at a reduced cost. But if they fail to hit certain quality targets or do not manage to reduce the cost of care, they will be paid less.

According to the study by researchers at the Harvard Medical School, within two years, providers in the private ACO-like Blue Cross Blue Shield Alternative Quality Contract, achieved  significant savings for the Medicare patients they saw, relative to a control group of Medicare patients seen by providers at other Massachusetts hospitals. The average savings in outpatient care was $73 per patient, and “included significant differential changes in spending on office visits, emergency department visits, minor procedures, imaging, and laboratory tests.”

“The spillover savings in Medicare that we found suggest that at least some of the interventions providers adopted in response to the AQC [the private BCBS Alternative Quality Contract] changed the way care was delivered for all patients,” assistant professor J. Michael McWilliams, said in a press release.

Study: Cleveland remains top Midwest metro for healthcare investment

A report released this week found that Greater Cleveland remains the leading metro area in the Midwest for health care investment (Source: “Cleveland the leading target for healthcare investment in Midwest,” Cleveland Plain Dealer, July 25, 2013).

According to the Midwest Healthcare Venture Investment Report, which is released by Cleveland-based BioEnterprise, Northeastern Ohio life-science companies attracted about $80 million in venture capital in the first six months of 2013.

While that total is significantly less than the first half of 2012, when healthcare investors poured an unprecedented $104 million into Cleveland-area companies,  observers consider last year to be an anomaly and say the 2013 showing helps solidify the region as a national player in health care innovation


According to the study, 117 Midwest healthcare companies drew about $351 million in private funding in the first half of 2013. Ohio led the Midwest, thanks largely to Cleveland's medical device-makers and bioscience companies.

Ohio attracted $155 million from investors in the first six months of the year. A little more than half of that money came to Greater Cleveland, where $79 million was spread among 27 companies.