THE BE T
Bullets to Bite On
Wrestling the Alligators
Like our pair of cover stories in March and April of this year, the “Wolters Kluwer Health 2013 Physician Outlook Survey” shows US physicians continue to wrestle with some mighty big problems. According to this annual survey of more than 300 practicing physicians in the fields of primary care, family medicine, and internal medicine: T he top three business challenges are shifting reimbursement models (91%), financial management (90%), and spending time with patients (88%) 8 3% of physicians find it challenging to keep up with the latest research 4 3% called dealing with impacts of the Affordable Care Act “very challenging” A s for the likelihood of leaving practice/group in the near future, 15% of physicians called it “very likely” and 19% said it was somewhat likely T he leading reason for leaving practice/group: hard to make a profit (29%) 6 8% of physicians think cost of care is going up and the top contributor: Health care IT adoption I ncreasing practice efficiency is the #1 focus area for physicians over the next 3 to 5 years, cited by 48% as a top focus
The Weight of the Nation
Two-thirds of adults and one-third of children are overweight or obese. Left unchecked, obesity’s effects on health, health care costs, and our productivity as a nation could be catastrophic. On that happy note, the Institute of Medicine on August 2, 2013, released “a concise and actionable plan for measuring the nation’s progress in obesity prevention efforts”—specifically, the success of policy and environmental strategies recommended in the 2012 IOM report Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. The IOM says health care providers should: Adopt standards of practice (evi dence-based or consensus guidelines) for prevention, screening, diagnosis, and treatment of overweight and obesity to help children, adolescents, and adults achieve and maintain a healthy weight, avoid obesity-related complications, and reduce the psychosocial consequences of obesity. Ensure coverage of, access to, and incentives for routine obesity prevention, screening, diagnosis, and treatment. Encourage active living and healthy eating at work. Increase the pr??ortion of ph ysicians who regularly measure the body mass index of their patients, offer nutrition/weight counseling, and counseling or education related to nutrition or physical activity.
Source: Glickman D, et al. Evaluating Obesity Prevention Efforts: A Plan for Measuring Progress.
Targeting Readmit Roulette
One in five patients hospitalized for HF will be rehospitalized within 30 days of discharge, although 2013 data from the Dartmouth Atlas shows the range varies wildly across the nation from 11.9% to 26.9%. In July, investigators evaluated a national sample of 599 hospitals enrolled in the Hospital-to-Home quality campaign sponsored by the ACC. Six strategies employed by these centers were significantly associated with lower risk-standardized 30-day readmission rates in multivariable analysis: Partnering with community physi cians and physician groups Partnering with local hospitals Having nurses responsible for medi cation reconciliation Arranging for follow-up visits before discharge Having a process in place to send all discharge or electronic summaries directly to the patient’s primary care physician Assigning staff to follow up on test results after the patient is discharged
Source: Bradley EH, et al. Circ Cardiovasc Qual Outcomes. 2013;6:444-50.
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CardioSource WorldNews
August 2013
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8/19/13 5:00 PM