» Telehealth

Humana and Intel are teaming up on a project to monitor patients with congestive heart failure.

With 75% of healthcare costs stemming from chronic illness, insurers are finding new ways to monitor high-cost patient populations. Humana recently launched an 18-month telehealth pilot program with Intel to monitor the weight, heart rate, blood pressure and other vitals of some 2,000 patients with congestive heart failure.

Each Humana member in the program is equipped with an Intel Health Guide, an electronic computer device that patients use daily to submit their weight, blood pressure and other health data. Nurses with Humana Cares track the information and interact with the patients through web video, phone and e-mail. "You get to insert yourself into the member conditions right at the time when it's happening — you're not trying to educate people about managing their condition when they're in the hospital," says Kate Marcus, telehealth pilot project manager for Humana Cares.

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» On-Site Care

Florida cities, counties and school districts are increasingly relying on on-site medical clinics to provide less costly access to medical care for their employees. In January, the Pasco County School District opened the first of three employee and family Health and Wellness Centers in Pasco County. The school district hopes that the $4-million expense of the clinic — staffed by a doctor, an RN and an X-ray technician — will be offset by healthcare savings generated by employees using the on-site clinic rather than more costly outside providers. Crowne Consulting Group in Ocoee, an employee benefits consulting firm that collaborates with Tennessee-based CareHere to operate on-site clinics throughout Florida, including the ones in Pasco County, will open its 19th clinic in Florida this year. Ray Tomlinson, president of Crowne Consulting Group, says his clinics can provide treatment for both chronic and acute/urgent illnesses. Visits to the clinics are voluntary, but incentives for employees to use them include zero co-pays and no deductibles.

» Digital Docs

As doctors migrate from paper to electronic records, they're turning to companies like Sage Healthcare Division to help them digitize their operations and take advantage of federal stimulus dollars. The Tampa company has a product called Sage Intergy Meaningful Use Edition that allows doctors to track key medical conditions and exchange and report key clinical measures and public health information. Patients, meanwhile, have 24/7 access to the practice and their own health information and can go through the "practice portal" to set appointments, ask for referrals, make prescription requests, as well as view statements and pay bills online. Using Sage's software, Florida Medical Clinic, which employees 100 clinicians at six clinics in Zephyrhills, has reduced its annual transcription costs by nearly $1 million.

» Group Therapy

At Cleveland Clinic Florida, patients who don't mind seeing the doctor in a group setting for routine check-ins can cut waiting time for an appointment by weeks, says Dr. Jose Cabral. Cabral, who chairs the clinic's department of endocrinology, has been conducting "shared medical appointments" for patients since 2004 and says the group visits have not only improved access, but also have helped motivate his patients with type 2 diabetes to better manage their conditions. Cabral holds shared appointments once every two weeks. Approximately nine to 12 patients attend the 90- to 120-minute sessions, which are facilitated by Cabral and a dietitian, a nurse and a patient educator. The appointments are billed at the same rate as a 15-minute one-on-one appointment with the doctor, but Cabral says satisfaction levels are higher. "What's really fascinating to us is that once a patient attends one group session, approximately 85% will not want to be seen any other way."

Dr. Jose Cabral conducts "shared medical appointments" at Cleveland Clinic. The program improves access to doctors and motivates patients, Cabral says.

» Phone Home

To help crack down on Medicaid fraud, as required under Senate Bill 1986 passed by the Florida Legislature in 2009, the Agency for Health Care Administration last year implemented a home health telephonic monitoring system to help verify that home health services in Miami-Dade County are actually being provided to Medicaid recipients. Sandata, a New York-based company provides monitoring services. At the beginning and end of each home health visit, home health agency personnel (such as nurses and home health aides) confirm they're providing services.

The 2010 federal Small Business Jobs Act law includes an amendment by former Sen. George LeMieux that requires the Centers for Medicare & Medicaid Services (CMS) to use modeling technology to help the Medicare and Medicaid programs detect fraud, waste and abuse before it pays for services.

"CMS has not implemented that program yet, but presumably there will be a degree of focus on Florida," says Craig Smith, a partner with Hogan Lovells and former general counsel for the Agency for Health Care Administration. Smith recently testified before Congress that the federal government should use predictive modeling and technologies that the credit card industry uses to prevent fraud.

» Cost Savers

With the help from Med-Vision, a 6-year-old Tampa-based medical consulting company that uses data analytics to create wellness and disease management programs, Sarasota County government was able to pass on a 3% decrease in health insurance premiums to its employees this year. One key aspect of Med-Vision's work with the county was honing in on cost drivers. To manage the costs of cancer care Med-Vision partners with Biologics, a North Carolina-based cancer management service provider that relies on "evidence-based guidelines" and "integrated clinical oncology professionals" to achieve lower costs for payers and higher rates of patient satisfaction.

» Dental Tools

Intelimedix, a Lakeland-based healthcare analytics provider, has launched a reporting tool that allows companies to integrate and analyze dental, medical and pharmacy information with an eye toward reducing overall healthcare costs. Oral health can provide important clues about a patient's overall condition, and early treatment of periodontal disease can help lower the risk and reduce the costs of chronic diseases such as diabetes, coronary artery disease and cerebrovascular disease.

» Premium on Efficiency

AAJ Technologies, a Fort Lauderdale-based healthcare consulting firm, has introduced JET InsureFuse, an automated medical underwriting process system to help insurance companies quickly process applications of the millions of new customers who'll be seeking coverage under the individual health insurance mandate. Under the new law, health insurers are now required to spend 80% to 85% of the premiums collected on medical care, as opposed to administrative costs.

» über Operations

As public and private entities in the healthcare arena look to get better connected, Über Operations, an 8-year-old Tallahassee-based IT consulting firm, has worked closely with clients like the Florida Department of Health to automate their information exchange capabilities. Mercy Hospital in Miami will use a product called ÜberXchange to electronically report cases of "notifiable" diseases such as tuberculosis and influenza to the Florida Department of Health. Über Operations has also been leading the Florida and Texas pandemic influenza project, which is aimed at preventing or delaying the spread of illnesses by electronically sharing data, such as influenza surveillance laboratory test orders and results.

» Retail Health

Blue Cross Blue Shield of Florida plans to open four more "Florida Blue" retail stores this year in Fort Lauderdale, Pensacola, Fort Myers and Tallahassee. The health insurance provider launched its first "Florida Blue" store four years ago in Jacksonville and has since opened stores in Miami, Tampa, Winter Park and Pembroke Pines. At the stores, customers can shop for a policy, speak with a nurse/care consultant about treatment options, find out how their benefit plan works, compare costs on healthcare services and prescriptions or take a personal health assessment.