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In the News: June 14–21

Readmission Rates Vary Among BPCI Advanced Conditions

According to an Avalere Health analysis, 90-day Medicare readmission rates in 2017 varied between 7% and 43% for conditions that will be included in CMS’s new voluntary program, Bundled Payments for Care Improvement (BPCI) Advanced. Readmission for liver disorders topped the list of BCPI Advanced conditions studied, while major joint replacements had the lowest readmission rate. The program will begin October 1, 2018, and will initially include 32 clinical episodes.

The next application period for participation in CMS BPCI Advanced will be January 2020. Organizations will need to prepare by reviewing data analyses and financial protections for clinical episodes, taking inventory of necessary infrastructure, educating their physician leaders, and more. To learn more about BPCI Advanced, watch the Sg2 on-demand Experts Live Q&A Implications of CMS BPCI Advanced.


2016 Chronic Health Condition Costs Totaled $1.1 Trillion

According to a Milken Institute report, the total US costs for direct health care treatment of chronic health conditions equaled $1.1 trillion in 2016. When indirect costs of lost economic productivity are included, the total costs of these conditions increase to $3.7 trillion or about one-fifth of the US gross domestic product. This trend is expected to get worse as an estimated 83.4 million people in the US will suffer from 3 or more chronic diseases in 2030 compared to 30.8 million in 2015.

Chronic disease management is an important area for health systems to understand, especially as the shift to value-based care continues. Sg2 recommends providers adopt an analytic approach to better understand their chronic care population and to assess their capabilities in this area. For more on chronic care strategies, check out the Expert Insight Sg2 Strategic Countdown: Developing a Market-Driven Chronic Care Strategy.


Rising Maternal Health Risks Are Impacting Women’s Health Care

A recent article in The Hill describes lawmakers’ concerted effort to address rising maternal health risks, as evidence suggests deaths related to pregnancy are rising in the US, and rates are higher than other developed nations. Furthermore, the CDC found racial disparities in pregnancy-related mortality rates, with African American women suffering 3 to 4 times greater risk of death than Caucasian women.

In response to this crisis, lawmakers have put forth a bill allocating funding for state-based investigation and reporting of pregnancy-related deaths. Specifically, the bill would establish Maternal Mortality Review Committees responsible for data collection and examination for every incidence of maternal death. By creating national databases, lawmakers hope health officials will be able to better understand why women are dying, and what interventions can reverse this trend.

As maternal health risks continue to rise, health providers can expect to see an increase in the proportion of high-risk pregnancies. Sg2 believes that health systems can strategically deploy market segmentation analysis to create opportunities for growth within the changing women’s health landscape. To learn more about emerging trends in women’s health care, register for the upcoming Sg2 webinar Women’s Health Landscape 2018.

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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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