1. Cameron, Joy M. MPP

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When it comes to measuring healthcare quality and keeping costs down, we need to change the conversation in Washington from "How can we keep people out of the hospital?" to "How can we keep people at home to maximize health?" This is one of the key issues the Visiting Nurse Associations of America wanted to tackle through the establishment of ElevatingHOME-a new nonprofit organization devoted to repositioning home-based care as the center of healthcare delivery in the United States.


Launched earlier this year with stakeholders across the country, ElevatingHOME brings together the home-based care industry-which includes 12,000 home healthcare agencies and 6,000 hospice organizations across the United States. As a national 501(c)6 organization, ElevatingHOME is uniting and aligning these voices to ensure America's healthcare system delivers home-based care that's safe, efficient, and effective.


Home-based healthcare delivers the care people need-in their own homes, in familiar surroundings-often with better outcomes and lower costs. This type of high-quality care can become a central part of the healthcare dialogue, but only if America's for-profit and not-for-profit home-based care providers can speak with a unified, powerful voice. After all, with healthcare reform playing such a prominent role in the President's and Congress' agenda this year, our industry cannot afford to be complacent.


With 10,000 Baby Boomers enrolling in Medicare daily, home-based care spending is expected to grow more than 70% in the next 3 years-from approximately $80 billion today to $137 billion by 2020. Healthy days at home are a priority for this population of older adults. When surveyed, 87% of America's seniors say they want to stay in their own home as they age and would prefer to receive medical care at home when possible.


ElevatingHOME is addressing these needs by demonstrating the role of home-based care teams in meeting patients' healthcare needs; developing and disseminating best practices for home-based care; establishing a high standard of operational integrity; elevating the level of public, private, foundation, academic, and legislative support for the patients and families served; and advancing financial models to support a robust home-based care industry while delivering value along the broader healthcare continuum.


We know that home-based care is carefully designed to provide the care that people want-and that works-and is generally provided at lower costs than similar care provided in a medical institution. By working directly with industry leaders, ElevatingHOME can highlight high-quality care in the field to develop innovative policies that work for both providers and patients.


To continue growing the industry, ElevatingHOME members are held to a high standard, with all providers required to adhere to a Code of Ethics and meeting quality outcomes by attesting to one or more of the following measures, accreditation recognition by either the Joint Commission; Community Health Accreditation Partner or Accreditation Commission for Health Care; or demonstration of scores at or greater than the 50th percentile on; or demonstration of Three-Star Rating or Higher in Medicare Home Health Compare; or meets minimum state Medicaid criteria or accreditation.


Within a constantly shifting health policy landscape, ElevatingHOME is looking to the industry, allies, and partners to align existing systems to improve the effectiveness of the entire healthcare continuum, and unify our collective voices to advocate for high-quality, home-based care as the foundation of a patient-centered health system.


By working together, we can ensure that we protect the interests of our industry while delivering the right care for each patient. Together, we will spark more innovation, quality, and cost-effectiveness in U.S. healthcare with home-based care as the catalyst.


Social Interaction Affects Cancer Patients' Response to Treatment

How well cancer patients fared after chemotherapy was affected by their social interaction with other patients during treatment, according to a new study by researchers at the National Human Genome Research Institute (NHGRI), part of the NIH, and the University of Oxford in the United Kingdom. Cancer patients were a little more likely to survive for 5 years or more after chemotherapy if they interacted during chemotherapy with other patients who also survived for 5 years or more. Patients were a little more likely to die in less than 5 years after chemotherapy when they interacted during chemotherapy with those who died in less than 5 years. The findings were published in the journal Network Science.

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"People model behavior based on what's around them," Jeff Lienert, lead author in NHGRI's Social and Behavioral Research Branch and a National Institutes of Health Oxford-Cambridge Scholars Program fellow. Lienert set out to see if the impact of social interaction extended to cancer patients undergoing chemotherapy. The researchers reviewed electronic medical records data from 2000 to 2009 from two major hospitals in the United Kingdom's National Health Service. They examined the total time a patient spent with the same patients undergoing chemotherapy and their 5-year survival rate. They also reviewed a room schematic to confirm the assumption that patients were potentially positioned to interact.


When patients were around those during chemotherapy who died in less than 5 years following chemotherapy, they had a 72% chance of dying within 5 years following their chemotherapy. The best outcome was when patients interacted with someone who survived for 5 years or longer: they had a 68% chance of dying within 5 years. The researchers' model also predicted that if patients were isolated from other patients, they would have a 69.5% chance of dying within 5 years.


"A two percent difference in survival - between being isolated during treatment and being with other patients - might not sound like a lot, but it's pretty substantial," Lienert said. "If you saw 5,000 patients in nine years, that 2 percent improvement would affect 100 people."


The researchers hypothesize that it may be related to stress response. "When you're stressed, stress hormones such as adrenaline are released, resulting in a fight or flight response," Lienert said. "If you are then unable to fight or fly, such as in chemotherapy, these hormones can build up."