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Not All Payment Models Work for ERs, These Three Might
With more hospitals transitioning away from fee-for-service, they may find it difficult to apply alternative payment models to the emergency departments. Challenges exist in ERs as care is not set up to follow patients after discharge, making it difficult to accurately manage costs, according to a new study in the American Journal of Managed Care. The authors note that in addition to the current model, organizations could: connect an FFS model to quality benchmarks, create a population-based payment system, and build a new payment model based on the fee-for-service system.
Epidemics Underscore the Increasing Need for Open Data-Sharing
Epidemics like Zika and Ebola emphasize the need for researchers to make data publicly available to easily facilitate communication among colleagues and teams of researchers. However, data sharing should not be restricted to times of crises. Authors in the journal PLoS Medicine believe that data-sharing in calmer times prepare the scientific community for future outbreaks. Challenges do exist to these efforts, which are explored in depth in the article. The authors conclude, "Establishing openness as the standard will help build the scientific foundation needed to contain the next outbreak.”
Who Takes Control in Healthcare? Study Attempts to Answer Question
In a recent survey from Xerox, patients and healthcare professionals showed a major disconnect as to who takes the most responsibility. Patients believe that they manage their personal healthcare, while providers and payers think it is their responsibility. Of 761 adults surveyed who purchased health insurance and make medical decisions for their households and 204 payers and providers, there are large disconnects in assessments of the other groups. Nearly 50 percent of consumers say they take are completely responsible for healthcare, but less than six percent of providers agree.
ICD-10 Flexibility to End on One Year Anniversary
The Centers for Medicare and Medicaid Services (CMS) last week updated their.2016 coding guidelines on the flexibility of ICD-10 claims. This flexibility, established last October, 2015, will expire on October 1 of this year. The end of flexibility requires providers to code and reflect clinical documentation as specifically as possible. In order to avoid rejection of claims, CMS recommends that providers review the guidance
Salesforce Invests in Pregnancy Wearable Startup
Bloomlife, a digital women’s health startup, has amassed $6 million in funding toward commercialization efforts for a smart pregnancy wearable called Belli. The wearable measures contractions and displays them visually on a smartphone. According to the company, Belli can help pregnant women by providing peace of mind during the third trimester. Currently, the wearable is only available through an Early Access Program on the company’s website.
On-Site Pharmacy Show Worth to Mental Health
On-site pharmacies co-located in community mental health centers help achieve higher medication adherence rates, among other effects, according to a new study in Journal of Managed Care & Specialty Pharmacy. Pharmacy company, Genoa, began operating on-site pharmacies for community mental health centers roughly ten years ago. They started by providing mobile management services for the antipsychotic, clozapine. This study compares data from two centers in Michigan of 2,500 patients, looking at outcomes and medication adherence. Genoa patients had a 96 percent medication adherence rate, as measured by medication possession ratio for all medications, compared with 82 percent for the control group.
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UPCOMING EVENTS
Monday, September 12, 2-3 pm ET, Interoperability Workgroup, Janine Akers, CEO, Data File Technologies
Tuesday, September 27, 9 am- 4 pm ET, Executive Advisory Board of Privacy & Security
October 4-5, 2016 Innovation Showcase at House of Sweden in Washington, D.C.
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Register now for eHI’s Innovation Showcase and Conference! Reserve your spot today to receive the early-bird rate. Attend the event that gives you more than just an Innovation Challenge – the program agenda features panels, including industry experts, innovative executives and key policymakers. Attendees will have the opportunity to meet and engage directly with speakers and fellow attendees. This is the perfect forum to have your voice heard among a multi-stakeholder group of industry executives! REGISTER TODAY, view our agenda and learn of the challenge, including how to submit an innovation proposal (deadline for submission is September 9).
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National Partnership Shares Survey Results on Engaging Patients
Last week, Mark Savage, Director of Health Information Technology Policy and Programs from the National Partnership for Women and Families, addressed eHI’s Advisory Board on Business and Clinical Motivators. He spoke about the results of their “Engaging Patients and Families” survey. Mark focused on the importance of online and mobile access to underserved populations and made the particular point that different populations need different things out of EHR even using them differently. Healthcare should include designing solutions to help all populations. Find out more here by downloading the presentation and the presentation audio.
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Stay Tuned for Podcasts Featuring eHI Members
Summer may be ending, but good things are ahead. Coming soon…Join eHI as we launch eHealth Perspectives, a new video and podcast series hosted by CEO Jennifer Covich Bordenick. Each segment will feature an interview with a different thought leader offering their unique perspective on the most important issues facing the industry, the current state of health IT, and what we need to do make meaningful change across the healthcare system. First up, you won’t want to miss the first eHealth Perspectives interview featuring Christopher Ross, CIO at Mayo Clinic. Interested in participating? Tweet us.
Mayo Clinic Expanding Emergency Telemed Offerings
eHI member, Mayo Clinic, is promulgating a new telemedicine strategy. They are expanding their emergency telemedicine practice in the hopes of standardizing the level of care the health system provides. In the past, Mayo used multiple telemed vendors, but now they will converge all services and practices to create a scalable, standardized model. First to change will be telestroke and teleneurology, with more systems and specialties coming online in the future. The project will begin in late summer, continuing through the first half of 2017.
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CMS Considers Rules on Outside Payments for Obamacare
The Centers for Medicare and Medicaid Services (CMS) announced it is seeking public comment on rules prohibiting or limiting premium payments or cost-sharing for individual marketplace plans. Concerns have been raised by insurers for third-party payments for the Affordable Care Act. “Currently, third-party payment of premiums and cost sharing of qualified health plans in the individual market by health care providers such as physicians, medical facilities or affiliated non-profit organizations are discouraged, but the ultimate decision about accepting those payments are left to health insurance companies.”
Those With ACA Plans Filled More Prescriptions, But at Lower Costs
Research recently published in the journal, Health Affairs, revealed that patients with insurance through the health insurance law filled more prescriptions at lower costs than those without. Researchers analyzed data from more than 6.7 million people who filled prescriptions in January, 2012, following medication use and out-of-pocket spending through December, 2014. They found that those who received insurance through the health law were significantly more likely to get prescriptions than they were prior to the law. And when they did, they typically ended up spending less out-of-pocket costs for those drugs.
OCR Set to Investigate More Breaches Affecting 500 or Fewer Individuals
The Health and Human Services Office for Civil Rights (OCR) will increase investigations of data breaches that affect less than 500 people. OCR currently investigates all reported breaches involving 500 or more individuals and the regional offices investigate small breaches, depending on available resources, according to the OCR. The new guidance indicates that OCR will now investigate root causes of smaller breaches more widely. When determining which to investigate, regional offices will consider the size of the breach, whether unencrypted PHI was stolen or disposed of improperly, whether the breach involved external intrusions, the amount, and the sensitivity of the PHI possibility breached.
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Tweet of the Week:
Have you seen our submissions page? Check out Amakemb Ltd’s new eHealth patient digital identity #innovation. ow.ly/5f3N303vWMU
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Ransomware Continues to Evolve, Healthcare Remains Prime Target
“Locky” ransomware continues to be a threat to the healthcare system, according to cybersecurity firm, FireEye. This type of ransomware gets its name as it scrambles victim files and renames them to have the extension .locky. In the past month, Locky has been increasingly delivered in emails, infecting hospitals, including Ottawa Hospital and Hollywood Presbyterian Medical Center. Last month, HHS published guidance that classifies attacks as data breaches.
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