Category: Healthcare Industry News

  • Supreme Court Upholds Subsidies in King v. Burwell

    Date: June 25th, 2015Source: Modern Healthcare (free registration may be required to view)Topics: Healthcare Policy
    Insurance premium subsidies will continue to flow to Americans in all states under the Affordable Care Act, the U.S. Supreme Court decided 6-3 in King v. Burwell on Thursday. The justices sided with the Obama administration in the historic decision, saying the healthcare law allows Americans in all states—not just those that established their own exchanges—to receive the subsidies.
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  • Patient-Centered Medical Home Is a “Pragmatic” Shift in Care

    Date: June 23rd, 2015Source: Health IT AnalyticsTopics: EHRs, Care Coordination, Medical Home Model
    Becoming a patient-centered medical home takes a great deal of hard work and a steady commitment to continual practice improvement. To achieve the coveted Level III NCQA recognition, providers must operate at peak performance, leveraging health IT to bring coordinated, high-quality population health management to their communities. But the patient-centered medical home (PCMH) recognition brings more than bragging rights to successful organizations. As payers get serious about value-based reimbursement, providers that align themselves with emerging care delivery strategies may be in line for some financial success, as well.
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  • As Big Data Grows, the Need for AI Comes Into Focus

    Date: June 19th, 2015Source: Healthcare IT NewsTopics: Health IT, Population Health, Data Analytics
    No one questions that the era of big data is here, but Dr. Anthony Chang warns that the deluge of medical information is just beginning. "By 2020, there will be 200 times more data than any physician can absorb," said Chang, a practicing pediatric cardiologist. "And its doubling every two years." In his keynote address at the National Healthcare Innovation Summit in Chicago Wednesday morning, Chang said he worries that lives are being lost from the unrealized opportunity.
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  • Population Health: The Path Forward

    Date: June 16th, 2015Source: Healthcare InformaticsTopics: Health IT, Population Health, Long-Term Care, Accountable Care
    What does the future hold for the population health management concept? The present moment in U.S. healthcare is filled with both challenge and opportunity in this absolutely critical area of endeavor. On the one hand, the population health idea has taken off as it has never before. It is embedded in virtually all the main policy initiatives coming out of all the major public and private purchasers and payers of healthcare, whether in some of the mandates coming out of the Affordable Care Act (ACA), or embedded in the value-based purchasing (VBP) initiatives coming out of the federal Centers for Medicare and Medicaid Services (CMS) for the Medicare program, or from nearly any of the major VBP programs sponsored by virtually all of the major U.S. health plans.
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  • Medicare ACO Regulations Look to Accelerate HIE

    Date: June 10th, 2015Source: HIE WatchTopics: HIE, Centers for Medicare & Medicaid Services, Accountable Care
    The final rule for the Medicare Shared Savings Program is out, aiming to help craft the next generation of Medicare ACOs. CMS' MSSP final rule is aimed at enhancing primary care services and offering more flexibility in order to increase participation. The agency wants to improve the program in a number of areas, including through a new ACO track based on some of the successful features of the Pioneer ACO Model; streamlining data sharing between CMS and ACOs to help ACOs more easily access data secure patient data; refining policies for resetting ACO benchmarks enable incentives for improving patient care and generating cost savings.
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  • Lawmakers Introduce Bill to Extend MU to Behavioral Health Providers

    Date: June 9th, 2015Source: FierceEMRTopics: Meaningful Use, Healthcare Policy, Behavioral Health
    Reps. Tim Murphy (R-Pa.) and Eddie Bernice Johnson (D-Texas) have reintroduced a bill that would, among other things, add behavioral health providers to the Meaningful Use program. The bill, Helping Families in Mental Health Crisis Act, H.R. 2646, is a revamped and softer version than its 2013 predecessor. It would expand the Meaningful Use program to clinical psychologists and licensed social workers, as well as to mental health treatment centers, substance abuse treatment facilities and psychiatric hospitals. It also would extend the timelines accordingly by five years for these new entrants to the program.
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  • Up to 70% of Small Physician Practices May Switch EHRs

    Date: June 8th, 2015Source: Health IT InteroperabilityTopics: EHRs, Interoperability, Accountable Care
    In a pair of new industry surveys, Black Book Rankings examines why cloud-based, integrated, interoperable clinical and practice management technologies are in such high demand among providers angling for a leg up on meaningful use requirements, population health management, and shifting opportunities for value-based reimbursement. “The majority (70%) of smaller and solo practice physicians have still not settled on a technology suite or set of products that delivers to their expectations on meaningful use, clinician usability, and coordinated billing and claims, hence, the relentlessly moving EHR marketplace,” said Doug Brown, Managing Partner of Black Book.
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  • FDA-Approved Digital Health Solutions Saving Billions in Healthcare Costs

    Date: June 4th, 2015Source: Accenture NewsroomTopics: Mobile Health, Patient Engagement
    FDA-regulated digital health solutions are expected to save the U.S. healthcare system more than $100 billion over the next four years, according to new research from Accenture. “A digital disruption is playing out in healthcare, as witnessed by the emergence of new business models and technology that will change the nature of patient interactions, alter consumer expectations and ultimately improve health outcomes,” said Rick Ratliff, managing director of digital health solutions, Accenture. Accenture estimates that FDA-approved digital health solutions – an internet-connected device or software created for detection or treatment of a medical indication – achieved $6 billion in cost savings in 2014, primarily driven by medication adherence, behavior modifications and fewer emergency room visits. The company expects that figure to rise to $50 billion in 2018.
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  • Health Information Exchange Reduced Radiology Exams by 47%

    Date: May 28th, 2015Source: EHR IntelligenceTopics: HIE, Radiology, Duplicate Testing
    Brookings Institution fellow Niam Yaraghi looked at a health information exchange platform among two emergency departments in western New York and considered the effects of accessing patient data through the health information exchange (HIE). The results from the Brookings Institution research shows that using a HIE led to a 25% decrease in the number of laboratory tests conducted as well as 26% drop in the amount of radiology examinations. When looking at the second emergency care department, Yaraghi found that the number of radiology exams fell by a total of 47% after the implementation of the HIE platform.
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  • Five Ways Mobile is Moving Mountains in Patient Engagement

    Date: May 27th, 2015Source: Becker's Health IT & CIO ReviewTopics: Mobile Health, Patient Engagement, Telehealth
    From EMRs to wearables, transformative technologies are reshaping the way healthcare is delivered today. And mobile devices are a critical cog in the modern healthcare machine: 90% of Americans now own a mobile device, and they spend an average of 43 minutes per month on those devices, compared with just 22 minutes at an average doctor's visit. Mobile devices make information instantly available to far more people, integrating them with our daily lives more than traditional desktop computers ever did. In fact, for the first time, people are searching for information more on mobile devices than on laptops or desktops, according to Google. With nearly all the information in the world just clicks away, more patients – especially those with chronic conditions – are lobbying for on-demand access to their personal medical information.
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  • Information Blocking: A New Term and the Promise of a New Era in Electronic Health Information Sharing

    Date: May 20th, 2015Source: Health Affairs BlogTopics: HIE, Interoperability, Information Blocking
    With the breakneck pace at which new health information technology reports and regulations are released, the recent report from the Office of the National Coordinator for Health Information Technology (“ONC”) — on health information blocking — may have failed to hit the radar. But it should have. When it comes to sharing electronic patient health information, public good should trump private gain. While it may seem like an obvious statement, it represents a tectonic shift in the narrative surrounding health information exchange (“HIE” – the electronic sharing of patient data across unaffiliated provider organizations).
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  • 10 Things to Know About Medicare's New Payment Programs

    Date: May 14th, 2015Source: Medical Practice InsiderTopics: MACRA, Provider Reimbursement, Centers for Medicare & Medicaid Services, Merit-Based Incentive Payment System (MIPS)
    Physicians who treat Medicare beneficiaries no longer need to worry about practice-threatening reimbursement cuts tied to governmental economic measures, as was the case for 13 years under the recently repealed SGR-based payment system. The Medicare Access and Children's Health Insurance Reauthorization Act (MACRA), which became law on April 16, sets forth in statute the immediate and future pathways to physician payment. Although the legislation may at first seem a bit intimidating in its scope, the key payment details break down as follows...
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  • Life After SGR: Medical Home Concept Looms Larger

    Date: May 1st, 2015Source: MedPage TodayTopics: Provider Reimbursement, Merit-Based Incentive Payment System (MIPS), Medical Home Model
    "If you are not in a patient-centered medical home (PCMH) now, you should be thinking about one." That was Robert B. Doherty's advice for physicians practicing in the post-SGR world. Doherty, who is senior vice president of government affairs and public policy at the American College of Physicians, shared his views during an ACP press briefing here. Doherty's support of the PCMH is not surprising since the ACP has championed the concept for decades and succeeded in having it included in the Balanced Budget Act of 1997, the same bill that gave medicine the sustainable growth rate (SGR). But what long seemed a good concept is now poised to put money in physicians' pockets in the post-SGR era. The reason for that is that the legislation that repealed SGR -- the Medicare Access and CHIP Reauthorization Act -- grants a sort of "most favored nation" status to PCMH.
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  • Senators Announce Working Group To Address EHR Adoption Issues

    Date: April 30th, 2015Source: iHealthBeatTopics: EHRs, Interoperability, Healthcare Policy
    On Wednesday, Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) announced the formation and official launch of a bipartisan working group that will seek to identify ways to improve the state of electronic health records. According to the announcement, the group will work to find five or six ways to correct the "failed promise" of EHRs.
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  • How to prepare for bundled payments

    Date: April 16th, 2015Source: Medical Practice InsiderTopics: Value-Based Care, Provider Reimbursement
    Bundled payments for episodic care, once the domain of hospitals and large-scale providers, increasingly factor in the reimbursement of small physician practices. Just ask John Meigs, MD, speaker of the Congress of Delegates for the American Academy of Family Physicians. This alternative payment program posed a documentation dilemma for his small family practice in Centreville, Ala.
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  • SGR Repeal is a “Game-Changer” for Health IT

    Date: April 15th, 2015Source: Healthcare InformaticsTopics: Healthcare Policy, Meaningful Use, PQRS, MACRA, Provider Reimbursement
    Industry stakeholders are overwhelmingly praising Congress for passing the Medicare Access and CHIP Reauthorization Act, which repealed the Sustainable Growth Rate (SGR) formula for reimbursing physicians under Medicare.
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  • The Tangle of Coordinated Healthcare

    Date: April 13th, 2015Source: The New York TimesTopics: Care Coordination
    Who coordinates the coordinators? More specifically, who coordinates the proliferating number of health care helpers variously known as case managers, care managers, care coordinators, patient navigators or facilitators, health coaches or even — here’s a new one — “pathfinders”? Rachel Schwartz, a licensed clinical social worker for close to 20 years, came face to face with this quandary earlier this month. Employed by a home care agency in Virginia, she visited a woman in her late 70s who had recently come home from the hospital. The patient, who lives with her husband and daughter, has diabetes and dementia. Ms. Schwartz, during the scant one to three social work visits that Medicare will cover, planned to help her sign up for community services like Meals on Wheels. “We’re trying to keep people at home and out of hospitals,” she said. But the woman also had a care manager through her Medicare Advantage program, her daughter reported, handing over a business card. Not wanting to duplicate those efforts, Ms. Schwartz left the care manager a message, then later texted a former colleague who worked for the same program. Did she know this care manager? They should collaborate. No, the colleague didn’t know her. She might not be a field case manager, she texted back; she might be a telephonic manager.
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  • CMS Proposes Significant Changes to Meaningful Use Stages 1 and 2

    Date: April 12th, 2015Source: Health Data ManagementTopics: Patient Engagement, EHRs, Meaningful Use, Centers for Medicare & Medicaid Services
    The Centers for Medicare and Medicaid Services late in the day on April 10 came out with yet another proposed rule to make modifications that will ease compliance with Stages 1 and 2 of the electronic health records meaningful use program. The rule changes the reporting periods to attest for meaningful use, substantially scales back several Stage 2 measure thresholds, and eliminates the need to report multiple measures as conducting these measures has essentially become common practice.
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  • ONC Calls Out Health IT Developers for Blocking Information Exchange

    Date: April 10th, 2015Source: Healthcare IT NewsTopics: Interoperability, EHRs, Healthcare Policy, Centers for Medicare & Medicaid Services
    Having received many complaints in recent months about vendors and providers engaging in information blocking, the Office of the National Coordinator for Health IT is "becoming increasingly concerned about these practices, which devalue taxpayer investments in health IT and are fundamentally incompatible with efforts to transform the nation’s health system." That's according to National Coordinator Karen DeSalvo, MD, and Jodi G. Daniel, ONC's director of the Office of Policy Planning, writing in a blog post that calls out "persons or entities (who) knowingly and unreasonably interfere with the exchange or use of electronic health information."
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  • A Hybrid Approach to Avoiding Readmissions

    Date: April 9th, 2015Source: Hospitals & Health NetworksTopics: Hospital Readmissions
    The costs associated with hospital readmission for recently discharged patients manifest themselves in many ways. It costs the hospital in resource allocation and in real dollars, particularly for the growing number of facilities that take capitated risk, participate in an accountable care organization or partner in their own health plan. It costs the government meaningful dollars (that otherwise could have been redirected toward other health care needs) in reimbursing for the costs for Medicare or Medicaid beneficiaries who are commonly the highest sources of readmission.
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  • Ten Things a Practice Needs to Be a Successful PCMH

    Date: April 2nd, 2015Source: Physicians PracticeTopics: Transformation Support Services, Medical Home Model
    Many practices are transitioning, or considering transitioning, to a Patient-Centered Medical Home (PCMH). But it can be a challenging and complex process. To help provide some guidance, we asked physicians, practice managers, and consultants familiar with the medical home transition process to share their top pieces of advice.
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  • Demand Grows for Care Coordinators

    Date: March 28th, 2015Source: Modern Healthcare (registration may be required to view)Topics: Patient Engagement, Care Coordination, Medical Home Model, Primary Care
    Dr. Grace Chen's frail and elderly patients can be bewildered by the automated phone directories of their healthcare providers and may give up before getting through for help. Understanding their new medications can overwhelm them. And they may miss medical appointments because they lack transportation. Their confusion and anxiety can end with a trip to the emergency department. Chen, a geriatrician at the UCLA Health System in Los Angeles, previously worked with clerical assistants to handle her patients' questions and help them with their healthcare logistics. That often took a lot of their time each week. This changed three years ago when UCLA Health System started hiring full-time care coordinators to work alongside doctors in its primary-care clinics.
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  • Patient-centered medical homes need better IT tools

    Date: March 23rd, 2015Source: FierceHealthITTopics: Transformation Support Services, Health IT, Medical Home Model
    To serve patient-centered medical homes (PCMHs), health IT needs to evolve from digitized patient record repositories into interoperable electronic collaboration platforms to further care coordination, according to research published in the Journal of the American Medical Informatics Association.
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  • Interoperability Key to Stage 3 Meaningful Use Requirements

    Date: March 23rd, 2015Source: Health IT InteroperabilityTopics: Meaningful Use, Interoperability
    The Department of Health & Human Services (HHS) has released its proposed conclusion to the EHR Incentive Programs with a strong emphasis on data exchange made possible through interoperable certified EHR technology and others forms of health IT. “The flow of information is fundamental to achieving a health system that delivers better care, smarter spending, and healthier people. The steps we are taking today will help to create more transparency on cost and quality information, bring electronic health information to inform care and decision making, and support population health,” HHS Secretary Sylvia M. Burwell said in a public statement.
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  • Patients Want No-Cost Health Data Exchange, Survey Finds

    Date: March 20th, 2015Source: iHealthBeatTopics: HIE, EHRs, Patient Engagement
    The majority of U.S. adults say that health care providers should be capable of easily sharing patients' health information and that such data exchange should be available at no cost to patients and providers, according to a new survey. The survey was published by the Society of Participatory Medicine. The poll included responses from 1,011 adults. Overall, 75% of respondents said it is very important that their health care providers be able to share patient health information among themselves. According to the survey, 20% of respondents said they or a family member had experienced difficulties receiving medical treatment because their records could not be shared electronically with other providers.
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