In the News: September 14–20

ED Visits Hit All-Time High During ACA Implementation

A record 141.4 million ED visits occurred in 2014, the same year the insurance expansion for the Patient Protection and Affordable Care Act (ACA) went into effect, according to recently released data from the Center for Disease Control and Prevention. These numbers contradict policy experts’ beliefs that unnecessary ED utilization would decrease with more people gaining health insurance under the ACA.

Despite this recent increase, Sg2’s Impact of Change® forecast projects that ED demand across the country will flatten as nonemergent visits begin shifting to lower-cost settings. Read more about our ED utilization forecast and some of the factors driving our prediction in the Sg2 Expert Insight: Sg2 Projects Flattening ED Demand Nationally, Despite Recent Increase in ED Use.

Kidney Transplant Centers Turn to Innovative Donor Strategies

Over 93,000 people in the US are currently on the wait list for kidney transplants. The process for a successful transplant is long—patients must wait for available kidneys from live or deceased donors, and the kidney must be genetically compatible. As patients, doctors and transplant centers are devising new ways to increase the supply of donors, one idea has gained circulation: a kidney voucher program.

Called the “delayed kidney swap,” this program encourages donors to donate, even if they may not be a match for their intended recipient (eg, friend or family member). By donating to another recipient who is a match, the donor will receive a voucher for priority on the kidney transplant list, which they can give to their intended recipient for future use. Essentially, the donor gives to a stranger now so a family member or loved one may receive a kidney in the future. This voucher program is now administered by the National Kidney Registry, with over 30 hospitals participating nationwide.

Sg2 believes innovative approaches to kidney transplant and donor strategy will be key to programmatic success given the overall limited supply of organs. To learn more about the kidney transplant landscape and how to grow your organization’s kidney transplant program, check out the Sg2 FAQ: Kidney Transplant Landscape.

Providers Embrace Data and Collaboration to Limit Waste

Over the past 3 years, MemorialCare Health System has taken strides to reduce nonessential c-section rates. The health system partnered with Anthem to leverage Vivity, a new care coordination platform to identify best practices in patient care. The data revealed gaps in care, flagged high-risk members and helped identify strategies to reduce unnecessary procedures. As a result, nonessential c-section rates dove below the state goal of 23.9%.

In recent years, providers have focused on reducing unnecessary c-sections and understanding episodic payments as strategies for improving value-based care. To learn more about the latest trends in obstetrics, check out the Sg2 Expert Insights: C-Sections Emerge as a Cost and Quality Measure: What Is Your Hospital’s Rate? and Episodic Payment Drives New Approaches to Obstetrics Care.

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As of February 11, 2016, Vizient, Inc. has completed its purchase of MedAssets Sg2 and spend and clinical resource management segments from Pamplona Capital Management, LLC. MedAssets revenue cycle business will continue to operate as a wholly-owned subsidiary of Pamplona Capital Management LLP.

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