HEALTHCARE NEWS FLASH 16th August 2013
Table of Contents Sales & Marketing ................................................................................................................. 3 Finance ................................................................................................................................. 8 Technology .......................................................................................................................... 14 Strategy .............................................................................................................................. 22
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Sales & Marketing Michigan moves toward Medicaid change 27 August, 2013 | Politico http://www.politico.com/story/2013/08/michigan-medicaid-obamacare-95977.html?hp=l1 Michigan took a big step Tuesday toward signing up for Obamacare’s massive Medicaid expansion, giving GOP Gov. Rick Snyder a long-sought victory to bring billions of federal dollars to implement a major part of the president’s health care law. The measure passed after last-minute legislative maneuvering. The Republican-led state Senate initially rejected it by one vote, and then huddled privately for several hours before returning to vote 20-18 to support it with a few significant caveats. The narrow approval sends the Medicaid expansion back to the House, which has already backed a similar bill. It’s now a near-certainty that a version of Medicaid expansion will land on the desk of Snyder, who had already broken with the GOP base to support the Obamacare program. Supporters say expansion will provide nearly half a million Michiganders with basic health insurance coverage. The federal dollars will also reach a state dealing with the fallout from Detroit’s bankruptcy. “This is not Obamacare or the Affordable Care Act. This is our bill that will reform the cost of medicine in our state and be a model for our country,” said Republican Sen. Roger Kahn, chairman of the Senate Appropriations Committee. In a late Tuesday news conference, Snyder said he hopes the House will once again pass the Medicaid expansion next week and send the bill to his desk. “It’s about 470,000 Michiganders having a better life,” Snyder said, acknowledging Obamacare’s divisive politics. “Going to the ER for your health care, while we have wonderful people in the ER, is not a good solution.” Approval at the state level doesn’t guarantee expansion, though. A unique provision that would require some Medicaid recipients to leave the program after four years or face co-pays or deductibles still would need approval from federal Medicaid officials. Democrats were united in favor of expansion but Republicans split. Opponents ripped it as an unaffordable Big Government expansion, and one state senator, Patrick Colbeck, initially refused to vote in order to prevent the lieutenant governor from casting the deciding tie-breaking vote for expansion. Colbeck’s abstention left the first vote 19-18, one short of the 20 needed for passage. “It’s nothing short of government control of our health care decisions,” said Colbeck.
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The vote hands Snyder his first Obamacare victory after he whiffed twice in his effort to build an insurance exchange. Lawmakers rebuffed his plan for Michigan to construct its own exchange as well as his backup plan to partner with the feds on an exchange. Tuesday’s vote erased a setback for Snyder in June, when the Senate ignored his plea to vote before the summer break. Snyder, who at the time rushed back from Israel to pitch lawmakers on the Medicaid expansion, practically begged them not to recess without approving the House-backed plan. In the two months since, a bipartisan Senate working group had been meeting to tweak the House bill and flesh out Medicaid reforms. Lawmakers also added a provision appropriating federal funds for the Medicaid expansion — avoiding another fight over actually funding the program. “It’s a big step for us because you can imagine how difficult it would be to have a second vote on this,” said Laura Appel, vice president of federal policy at the Michigan Health and Hospital Association.
Louisiana opts out of Medicaid home care program 25 August, 2013 | Fierce Health Finance http://www.fiercehealthfinance.com/story/louisiana-opts-out-medicaid-home-careprogram/2013-08-25 Officials did not want to expand program eligibility The administration of Louisiana Gov. Bobby Jindal has refused to participate in an Affordable Care Act-linked program intended to improve home healthcare for Medicaid beneficiaries, reported the New Orleans Times-Picayune. Louisiana will not participate in the Community First Choice program, which would provide additional funding for home attendants for frail Medicaid enrollees. The intent of Community First is to keep enrollees out of more costly nursing homes and keep hospital readmissions in check. Altogether, Louisiana is forfeiting a rise in federal Medicaid cost coverage from 62 percent to 68 percent, according to the Times-Picayune. Calder Lynch, director of the Louisiana Department of Health and Hospitals, said participating in the program would have meant expanding home health eligibility to 21,000 more Medicaid recipients, which the state could not afford. "The (Centers for Medicare & Medicaid Services) just wasn't being flexible enough to make this new program work for us," Lynch told the Times-Picayune. Although Community First Choice is a three-year demonstration project, research has suggested that the use of home healthcare for patients with chronic conditions reduces hospitalizations. A 2011 study by the firm Avalere Health concluded that home health spending for patients with conditions, such as diabetes and chronic obstructive pulmonary disease cut Medicare costs substantially compared to patients who did not receive such services.
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NYU Langone Medical Center announces opening of new wound healing center 23 August, 2013 | News Medical http://www.news-medical.net/news/20130823/NYU-Langone-Medical-Center-announcesopening-of-new-wound-healing-center.aspx NYU Langone Medical Center announces the opening of the new Helen L. and Martin S. Kimmel Hyperbaric and Advanced Wound Healing Center at 240 East 38th Street. One of only two Hyperbaric Centers in Manhattan providing treatment to patients with chronic non-healing wounds, patients now have access to surgical and non-surgical expertise within one location. The state-of-the-art facility offers Hyperbaric Oxygen Therapy (HBOT), used to treat chronic and nonhealing wounds such as diabetic foot ulcers, bone infection, soft tissue radiation injuries and carbon monoxide poisoning burns. For patients with inadequate circulation, poorly functioning veins and those who are immobile due to severe wounds or medical conditions, wound healing can be a critically important part of treatment. The new Hyperbaric and Advanced Wound Healing Center is led by Ernest S. Chiu, MD, FACS, director of the Center and associate professor, Department of Plastic Surgery. Frank L. Ross, MD, FACS, associate director of the Center and assistant professor, Department of Surgery, is board certified in both General Surgery as well as Underseas & Hyperbaric Medicine. Both are full-time faculty members at NYU Langone Medical Center and have over 20 years of experience in the treatment of difficult wounds. "Our multidisciplinary team of experts assesses each patient individually and by using cutting-edge surgical and non-surgical techniques, helps to ensure patients do not needlessly suffer from nonhealing wounds," said Dr. Chiu. "The consequences of not treating unhealed wounds can be serious and potentially devastating, even resulting in the loss of limbs. With the use of specialized techniques including our new hyperbaric oxygen therapy chambers, we help support our patients return to a normal, healthy lifestyle," Dr. Ross said. "We've already seen tremendous results and a significant change in the quality of life for our patients. With the opening of this new center, we believe we can continue to make this a reality." Tissue in the body needs an adequate supply of oxygen to function, and when injured, requires greater levels of oxygen to survive. The facility provides individual monoplace units where patients lay in a pressurized chamber with 100 percent pure oxygen, which helps to deliver high concentrations of oxygen to the bloodstream. The increased oxygen carried throughout the body promotes healing and helps fight infection, thereby accelerating the wound regenerative process. Impaired wound repair occurs most frequently in the elderly and in diabetic patients. The Center focuses on advanced techniques to ensure that diabetic patients with open wounds are given treatments to prevent limb amputation, one of the most devastating complications of diabetes.
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Medicare ACOs growing faster than non-Medicare ACOs 21 August, 2013 | Fierce Healthcare http://www.fiercehealthcare.com/story/medicare-acos-growing-faster-non-medicare-acos/201308-21 Medicare accountable care organizations outnumber non-Medicare ACO contracts and make up more than half of the 488 ACOs nationwide, according to an August 2013 update from Leavitt Partners, a healthcare consultancy that follows ACO development. The report, Growth and Dispersion of Accountable Care Organizations: August 2013 Update, reveals three significant findings: 1. The number of accountable care entities is increasing. Since the healthcare reform law passed three years ago, 488 ACOs have formed--and more than doubled since June 2012. 2. Medicare ACOs are growing faster than non-Medicare ACOs and make up more than half of all accountable care contracts nationwide. 3. No single model has emerged as most successful and as accountable care expands, the agency expects to continue to see variety in models and execution. These ACOs are transforming the way healthcare is delivered but many of the estimated 27 million people in ACOs aren't even aware they are in one, according to U.S. News & World Report. However, they do notice their physicians and other care providers are more attentive to their needs, the article stated, a result of the Affordable Care Act, which is forcing healthcare professionals to provide more coordinated, high-quality care at lower costs. U.S. News points to 73-year-old James Conway, a Medicare beneficiary, as an example of how an ACO improved patient care. The Massachusetts resident suffers from high blood pressure, needs a catheter that has led to several urinary tract infections and a condition that causes spinal fluid to build up in the base of his skull. He has been to the hospital four times in the last year. But recently he noticed an improvement in his care. Since the spring, pharmacists have visited Conway at home to examine his medicines, cut out five of the drugs from his 18-drug regimen, explained the purpose of each drug, and created a spreadsheet to remind him when to take the medication, the article said. In addition, the pharmacists check in with him weekly as does a nurse who helps organize his care and arranged for an aide to change his catheter on a regular basis. The change in his care occurred when Conway's primary care physician decided to take part in a Pioneer ACO sponsored by Boston-based Steward Health Care System, an integrated delivery network of 11 hospitals and 2,900 doctors. The Pioneer ACO arrangement calls for Medicare to pay Steward hospitals and doctors based on their successful treatment of 47,000 beneficiaries within the ACO, with a goal of keeping them out of the hospital.
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"ACOs are very interested in reducing acute care, episodic hospitalizations," Andrew Croshaw, managing director of Leavitt Partners, told U.S. News. "It is one of the key ways to have an ACO succeed financially." Dominique Morgan-Solomon, director of care management at Steward, told U.S. News that reducing hospitalizations and readmissions is one of the system's top priorities. "Our objective is meeting the patients' needs and providing care wrapped around patients," she said, adding that often it's less expensive and better to provide that care at a patient's home.
New ad encourages NYers to enroll in insurance 20 August, 2013 | The Wall Street Journal http://online.wsj.com/article/APb27d2cc15337489da3a58e71692552f8.html?KEYWORDS=health+ overhaul New York's health benefit exchange has a new name, logo and look. Officials said Tuesday the federal overhaul expected to bring coverage to more than a million people statewide is now dubbed "NY State of Health." In a one-minute-long ad, a narrator tells viewers that everyone deserves affordable health insurance and then directs them to the state's website for the official exchange marketplace. Last month, officials approved health insurance rates for 17 insurers planning to offer coverage through the exchange. The monthly premium rates for individual plans range from an average of $170 for the cheapest coverage for single adults to $965 for the most expensive coverage. The Syracuse Post-Standard says (http://bit.ly/12mp46j ) officials hired ad agency DDB New York to develop the name, logo and ad campaign.
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Finance OIG: Alabama Received $88.2M in Unallowable CHIP Bonus Payments 29 August, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/legal-regulatory-issues/oig-alabama-received-88-2m-inunallowable-chip-bonus-payments.html Alabama received $88.2 million in unallowable performance bonus payments under the Children's Health Insurance Program Reauthorization Act of 2009, according to a report from the HHS Office of Inspector General. Under CHIPRA, qualifying states may receive bonus payments for fiscal years 2009 through 2013 to offset the cost of increased enrollment of children in Medicaid. CMS determines whether states meet the requirements to receive bonus payments, and if they do, the amount of the bonus payment is distributed to them. In FYs 2009 and 2010, Alabama received bonus payments totaling $39.8 million and $55.6 million, respectively. Ninety-two percent of those payments were not allowable in accordance with federal requirements, according to the OIG, as the state agency overstated its enrollment when requesting bonus payments. Instead of reporting the monthly average enrollment of qualifying children in CHIP for the current fiscal year, Alabama reported the total number of qualifying children enrolled in the program for each fiscal year. Alabama's enrollment figures for FYs 2009 and 2010 were overstated by 92,370 lives and 92,231 lives, respectively. The overstated enrollment numbers caused CMS to calculate bonus payments for FYs 2009 and 2010 that were considerably more than allowable, according to the OIG. Based on the numbers Alabama reported, CMS determined the state qualified not only for a "Tier 1" bonus but also for a "Tier 2" bonus under the bonus payment calculation methodology. Qualifying for the "Tier 2" bonus magnified the effect of the state agency's enrollment overstatement. The OIG calculated that Alabama should have received bonus payments of $1.5 million and $5.7 million for FYs 2009 and 2010, respectively. The OIG recommended Alabama refund the $88.2 million to the federal government and ensure future requests for bonus payments are calculated using the proper monthly average enrollment figures.
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CHS to Acquire Sharon Regional Health System 28 August, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-transactions-and-valuation/chs-to-acquiresharon-regional-health-system.html Franklin, Tenn.-based Community Health Systems and Sharon (Pa.) Regional Health System have signed a nonbinding letter of intent, which would add Sharon Regional to CHS' hospital network. Under the deal, CHS would acquire all assets of Sharon Regional, which includes a 251-bed hospital and 23 satellite centers. In addition, CHS would invest capital to improve facilities, services and technology. Financial details of the potential sale were not disclosed. As part of an alliance with CHS, Cleveland Clinic will also be a strategic medical partner with Sharon Regional. Cleveland Clinic executives and physicians will support Sharon Regional's clinical program development and quality improvement. However, Cleveland Clinic will not be an owner of Sharon Regional. Sharon Regional would still retain a local board of trustees, comprised of the hospital's medical staff and local community members. CHS and Sharon Regional executives will now conduct due diligence, and a definitive agreement is expected to be signed later this year. The transaction also must obtain regulatory approvals. CHS has been aggressive in the hospital merger and acquisition market as of late. Last week, CHS and Cleveland Clinic entered into a joint venture acquisition of Akron (Ohio) General Health System. CHS also is in the process of finalizing its purchase of Naples, Fla.-based Health Management Associates in a deal worth roughly $7.6 billion.
$6.1 million agreement will keep neighborhood health care alive in New Orleans through 2014 23 August, 2013 | The Times-Picayune The Times-Picayune http://www.nola.com/health/index.ssf/2013/08/61_million_agreement_to_keep_n.html Most of the low-income residents who have depended on New Orleans’ system of primary care and mental health clinics for their medical needs should continue to receive that government-subsidized care in 2014, thanks to a new agreement reached by state and local health officials. Louisiana Department of Health and Hospitals officials late Friday announced plans to extend $6.1 million next year to the Greater New Orleans Community Health Connection, a Medicaid waiver program that enables 60,000 people who don’t otherwise qualify for Medicaid to access care at 40 area clinics.
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“It’s really good news for more than 60,000 people,” said Dr. Karen DeSalvo, health commissioner for the city. Long-term funding for the program has been in question ever since Gov. Bobby Jindal refused to implement Medicaid expansion as allowed under the Patient Protection and Affordable Care Act, often called called Obamacare. Since 2010, a Medicaid waiver has enabled people in the New Orleans area with incomes up to 200 percent of the federal poverty level to get free primary and mental health care at these neighborhood centers. But with that waiver set to expire on Dec. 31, clinic leaders have been fretting over future funding. Friday’s news offered some hope for public health advocates, but it didn’t come without concessions. Essentially, health care providers agreed to take some funding cuts in order to ensure the program can continue through 2014, DeSalvo said. Under the terms of the funding extension, one third of the 60,000 people currently receiving care will no longer be eligible, said Department of Health and Hospitals spokeswoman Olivia Watkins. Only those whose incomes fall below 100 percent of the federal poverty level will be able to participate. The thinking behind that is that those who make more than the poverty level should be able to access health care coverage though the federal health care exchange — an online insurance marketplace available to the uninsured as a provision of the Affordable Care Act. In addition, health care providers will no longer get any money -- currently $3 million per year -- to help them pay for facilities and equipment needed to serve patients in local neighborhoods. DeSalvo said, however, that while that funding was an important component of the program in the early stages, the need for it has tapered off as the clinics have become more established. Also ending under the new arrangement will be supplemental dollars paid to health care providers at the end of the year based on the number of patients they served. Finally, the rates paid for services provided will drop by 13 percent. Herschel Abbott, an attorney who chairs the St. Thomas Community Health Center in the Lower Garden District, said he was encouraged by the news that centers like his will be able to continue to serve people in need. “If it does what they say it will do, I’m delighted to hear it,” he said. Both Abbott and DeSalvo said they are optimistic that the extension will provide the time needed to find a long-term funding solution for the patients who use these services. In a written statement announcing the news, DHH Secretary Kathy Kleibert said the agreement came about in part because of local officials’ commitment to find long-term funding beyond 2014.
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Maine Hospitals to Receive $484M in Backlogged Medicaid Payments 23 August, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/maine-hospitals-to-receive-484min-backlogged-medicaid-payments.html Maine is ready to sell a revenue bond that will go toward repaying $484 million in Medicaid debt owed to the state's 39 hospitals. Standard & Poor's Ratings Services and Moody's Investors Service each assigned ratings to the revenue bond, which is expected to be sold next week, according to a release from Gov. Paul LePage. According to a Bangor Daily News report, hospitals are expected to receive payments by Sept. 30. "As a result of these new bond ratings, our administration is one step closer to repaying Maine's hospitals the $484 million in welfare debt that is owed to them," said Gov. LePage. "Maine hospitals provide good jobs and are vital to the local economy. Repaying our hospitals is the right thing to do, and I am proud to deliver on my promise to finally pay off this burdensome debt." Maine's hospitals have been clamoring to receive their Medicaid payments over the past year. The state's portion, roughly $184 million, will result in a $300 million match from the federal government.
Amid Health Law Expansion, Some States Trim Medicaid Rolls 18 August, 2013 | Kaiser Health News http://www.kaiserhealthnews.org/Stories/2013/August/19/medicaid-cuts-in-four-states.aspx While millions of adults nationwide will gain Medicaid coverage next year under the federal health law, more than 150,000 people could lose their coverage in the state-federal health insurance program for the poor as four states reduce eligibility. The states planning to make the cuts in January are Maine, Rhode Island, Wisconsin and Vermont. Most people losing access to Medicaid will be eligible for federal subsidies to help buy private coverage in the law’s online insurance marketplaces also starting in January, but advocates worry some will struggle to afford higher premiums and other cost-sharing expenses. "It is sad that as we look to expand coverage to more people, we are taking a step backward and taking away coverage to a significant amount of low income adults," said Linda Katz, policy director with the Economic Progress Institute, a Providence, R.I.-based advocacy group. Kaiser Health News collected enrollment data from the four states. The changes they plan still need federal approval, which is expected.
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Rhode Island is expanding Medicaid under the health law's provision to cover all childless adults making up to 138 percent of the poverty level. That will add about 45,000 people to the program. These expansion costs are fully covered by the federal government through 2016 and then the state will pay a small portion but no more than 10 percent. At the same time, though, Rhode Island is scaling back its Medicaid eligibility for parents of minor children from the current income threshold of 175 percent of the poverty level to 138 percent, affecting 6,700 people. They will be directed to shop for coverage on the state's insurance marketplace, also called an exchange. Rhode Island, like other states, expects this shift to reduce state spending. That's because states split the cost of Medicaid with the federal government, which picks up about 57 percent of Medicaid spending. But the subsidies in the marketplace are funded totally by the federal government. Meanwhile, in Maine, not everyone being cut from Medicaid will have access to the subsidies to buy private insurance. About 10,000 childless adults in the state, a little less than a third of those losing Medicaid coverage, won't qualify for those federal subsidies because they have incomes below the poverty level, $11,490 for an individual. The health law makes those subsidies available only to people with incomes between the poverty level and four times that amount. The law was written that way because it was assumed all states would expand Medicaid eligibility to cover everyone with incomes up to 138 percent of the poverty level, but the Supreme Court last year made that provision optional. Only about half the states are expanding Medicaid for 2014. Many states led by Republicans have balked at expanding Medicaid, citing how spending for the program has outpaced inflation and even a modest increase in spending over the next decade could be difficult. Stacey Jacobsohn, 52, of Augusta, Maine, is worried about losing her Medicaid coverage particularly since she had a stroke last year. With a $5,000 annual income, she said she will have to rely on her doctors to cut their prices so she can keep seeing them. "It's going to be very hard for me," she said. "It's a lot of fear right now." For the past four years, states have been limited in their ability to reduce the size of their Medicaid programs because of a requirement called "maintenance of effort," which first took effect in the 2009 federal stimulus law that provided billions of dollars to states during the recession as long as they didn't restrict standards for eligibility. That restriction was extended in the 2010 Affordable Care Act. But that provision ends for adults in 2014. That's why Maine next year will be able to reduce its Medicaid coverage for childless adults. In addition, Maine next year plans to reduce eligibility for parents and caretakers from 133 percent of the poverty level to 100 percent of the poverty level, which affects 15,000 adults. Maine Gov. Paul LePage, a Republican, says his state can't afford its current Medicaid program nor take on an expanded one, even if all the costs are paid for the first three years by the federal government. LePage this year vetoed a measure passed by the legislature to expand Medicaid under the health law's provision. Supporters of the measure could not get enough votes to override his veto. "Adding non-disabled individuals to our welfare program when we are failing to provide core services to thousands of disabled and elderly Mainers is unacceptable," LePage said in his veto message.
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In the other two states, the Medicaid cutbacks are the result of the expiration of federal waivers that allowed for demonstration programs designed to expand coverage. In Vermont, about 19,000 people will fall off the Medicaid rolls as the state ends two such initiatives geared toward helping people with incomes as high as 300 percent of the poverty level, or a little more than $34,000. Mark Larson, commissioner of the Vermont Department of Health Access, said the programs are ending to save the state dollars since those populations next year can qualify for federal assistance to buy coverage in the state exchange. Wisconsin would cut more people from Medicaid than any other state as part of a plan advanced by Republican Gov. Scott Walker and still awaiting federal approval. About 92,000 people -- 87,000 parents and caretaker relatives, and 5,000 childless adults with incomes above the federal poverty level -- would lose the Medicaid coverage they previously had as a result of a wavier and be sent to the online insurance marketplace. At the same time, the state is planning to add 100,000 Wisconsin childless adults with incomes below the poverty level to Medicaid. "The governor's reforms balance the need to maintain a strong and sustainable health care safety net with ensuring the greatest number of people possible can afford to remain in the private health insurance market and maintain their independence," according to a statement by the Wisconsin Department of Health. Many of the 92,000 Wisconsin adults losing Medicaid coverage already pay small monthly premiums. It's unclear how much those rates will increase in the online marketplace. "The products designed for the marketplace were never designed for people in these low-income categories," said Donna Friedsam, health policy program director at the University of Wisconsin. "Even with the federal subsidies, the cost sharing will still be quite onerous."
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Technology Health IT spending on pace to top $34.5B 29 August, 2013 | Fierce HealthIT http://www.fiercehealthit.com/story/health-it-spending-pace-top-345b/2013-08-29 Healthcare IT spending will top $34.5 billion in North America in 2014, according to a new report by research firm Technology Business Research. The Hampton, N.H.-based firm attributes the spending to regulatory mandates' demand for modernization of infrastructure to meet new healthcare guidelines, according to an announcement, and lays out how the money will be spent. "The wide variety of regulatory mandates and changes coming into force in the near term in the U.S. magnifies the pressure on healthcare providers, commercial payers and public sector agencies to maximize the value and ROI of their IT spend to meet these requirements," TBR healthcare analyst Joseph Walent said in the announcement. "Health IT vendors able to recognize the IT spending habits of the market segments, and adjust accordingly, will be best positioned to secure market share." For the report, TBR interviewed 25 IT decision makers across the C-Suite. The more than 30 vendors covered in the report include: Accenture, Cerner, Citrix, HP, GE Healthcare, Lawson, IBM, McKesson, Microsoft, Oracle and Salesforce.com. Health IT spending is up across the board. In April, it was reported that the U.S. Department of Veterans Affairs' $152.7 billion budget request for 2014 included $3.683 billion for IT projects, the largest increase in IT spending among government agencies. Meanwhile, a report from Mercom Capital Group published in July revealed that venture capital funding in the healthcare IT sector continued to grow rapidly in the Q2 of 2013, with $623 million raised. There were 168 funding deals in Q2, compared to 104 the previous quarter, and 163 total in 2012 totaling $1.2 billion.
RL Solutions announces availability of new incident and patient feedback reporting app 28 August, 2013 | News Medical http://www.news-medical.net/news/20130828/RL-Solutions-announces-availability-of-newincident-and-patient-feedback-reporting-app.aspx RL6:Mobile will allow all hospital staff to participate in patient safety by making it easier than ever to submit patient feedback or incident reports directly from their mobile devices
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RL Solutions, creators of innovative and easy-to-use healthcare quality and safety software, announced today the general availability of its new incident and patient feedback reporting app, RL6:Mobile. Healthcare organizations that want to increase the quantity of safety reports being submitted, as well as those who want to engrain a culture of safety, will look to leverage the app. RL6:Mobile compliments the functionality already found in RL6, which has been exclusively endorsed by the American Hospital Association for incident management reporting. RL6:Mobile allows hospital staff to submit patient feedback and incidents at the point of occurrence using their smartphone or tablet. The app leverages the features found in today's mobile devices, to allow users to quickly type the details of an event, capture photos with the camera, or record information with the built-in voice recorder. Once an incident is submitted, it is sent directly to RL6:Risk and / or RL6:Feedback, where it can enter normal hospital workflows set up by the RL Solutions system administrator. With RL6:Mobile, organizations now have the potential to engage all staff in patient safety, and can expect to find additional insights into areas that may have been previously missed through traditional event reporting. In addition, RL6:Mobile is ideal for staff who are not normally close to a workstation, such as home health workers or rounding physicians. "The beauty of RL6:Mobile is that it allows all hospital staff another, easier way, to participate in making the hospital safer," said Lucy Feng, Mobile Product Manager at RL Solutions. "It is designed to engage the busiest physicians and frontline staff in reporting the type of events they would otherwise put off submitting, or not submit at all." Key features and benefits of RL6:Mobile •
Extremely intuitive and easy-to-use interface to make submission as fast and as simple as possible
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Users can track their submissions to ensure that action is being taken to rectify the situation
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Attach photos or audio files to add additional context to the information being submitted
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Significantly increases the quantity of event reporting
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Reduces the time front-line staff spend entering an event
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Complete flexibility: Events can be submitted anywhere and by any employee
"The growth in the use of mobile devices has lead to a shift in how healthcare workers interact with technology", added Sanjay Malaviya, President & CEO, RL Solutions. "We feel that patient feedback and incident reporting on a mobile device just makes sense, and are confident that organizations will leverage RL6:Mobile for their patient safety efforts." RL6:Mobile is available today for Apple devices, including iPhone® and iPad®, and in Q1 2014 for Android devices. RL6:Mobile can be downloaded directly from the Apple App store.
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New York looks to EHRs to enhance public health surveillance 27 August, 2013 | Fierce EMR http://www.fierceemr.com/story/new-york-looks-ehrs-enhance-public-health-surveillance/201308-27 The New York City Public Health Department, in partnership with the City University of New York School of Public Health, is launching a pilot project to aggregate electronic health record data into a surveillance tool to improve public health. The project, known as the NYC Macroscope, will be the first U.S. program to use EHRs in this manner, according to a blog post from the Robert Wood Johnson Foundation, which has provided support for the effort. NYC Macroscope will compile EHR data from primary care practices involved in New York's Primary Care Information Project to help the city monitor the prevalence of chronic conditions, such as obesity and hypertension, as well as smoking rates and flu vaccinations. It will not replace traditional public health surveillance, but has the potential to provide a lot of information on chronic and other conditions in real time, while increasing connections between public health and clinical care, according to NYC Macroscope's Carolyn Greene, M.D., deputy commissioner of the NYC Department of Health. "[I]n public health, one of our jobs is to monitor the health of the population, and electronic health records offer a very useful tool to do this," Greene told Brian Quinn, a senior program officer with RWJF. "In turn, it is our responsibility to feed data back to policymakers, to those who come up with clinical guidelines, to providers, to the public, and we hope that the data we gather and monitor using electronic health records will have an impact on clinical care." EHRs continue to demonstrate their potential benefit beyond individual patient care, not only in public health, but also in areas such as research and quality management.
State medical records network preparing to go live 23 August, 2013 | JS Online http://www.jsonline.com/business/wishin-allows-health-providers-secure-access-to-patientmedical-records-b9977355z1-220763741.html Wisconsin Statewide Health Information Network, or WISHIN, expects to begin adding hospitals to the network this year Wisconsin now has in place the basic building blocks for a statewide network that could enable hospitals, clinics, nursing homes and other health care settings to exchange key information from patients' medical records securely and effortlessly.
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The Wisconsin Statewide Health Information Network, or WISHIN, a private nonprofit organization, expects to begin adding hospitals, including several in Milwaukee, to the network this year. "There are a number of things that affect the go-live date, but we are very close," said Joe Kachelski, chief executive officer. The network eventually could give doctors and other health care providers secure access to such information as a patient's medical problems, prescriptions, allergies, test results, radiology reports and physician notes. The information would enable doctors to make better decisions as well as improve the coordination of care and reduce duplicitive tests. The network could be particularly useful for emergency physicians who often treat patients with little information on their medical history. Most of the major health systems throughout the state have committed to becoming part of the network. In the Milwaukee area, Aurora Health Care, Children's Hospital of Wisconsin and Columbia St. Mary's are expected to be the first health systems to begin sending information to WISHIN. "We are very far down the road in Milwaukee in terms of our implementation," Kachelski said. In Milwaukee, WISHIN will replace the Wisconsin Health Information Exchange, a network that included 13 hospitals. The network, founded in 2008, was shut down after the health systems in the Milwaukee area decided that becoming part of a statewide network was more efficient than building and then linking two different networks. WISHIN began receiving information from UW Health Partners Watertown Regional Medical Center in July. The health system was familiar with the Wisconsin Health Information Exchange and knew the potential value in being able to share information, said Jennifer Laughlin, its vice president and chief information officer. Kachelski likens the medical center to "the first people in town with a telephone" — though the first person on Twitter or Facebook might be a more apt analogy. As with any network, its value will increase as more hospitals and clinics are added. WISHIN was founded in December 2010 with initial funding from the American Recovery and Reinvestment Act of 2009. The initial planning was done by the Wisconsin Relay of Electronic Data for Health, known as WIRED for Health, an initiative overseen by the Wisconsin Department of Health Services. Medicity Inc. was hired to oversee the design of the network. The company, based in Salt Lake City, was bought by Aetna Inc. in 2011 and is building health information exchanges in a number of states.
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The organizations that become part of the network will send basic health information to WISHIN. The information initially will vary depending on the health system. The number of health systems and clinics with electronic health records will be an advantage. Wisconsin is well ahead of most states in the move from paper to electronic health records. Incentives included in the recovery act to encourage hospitals and clinics to make the transition provided an additional push. To earn the incentives — and avoid potential penalties beginning in 2015 — the electronic health records must be able to perform specific tasks, including the electronic exchange of information in a standardized format. Patients will have the option of not having their medical information sent to the network. For decades, the information has been faxed — but only a patients' medical records have been tracked down, long a source of frustration for doctors and their staffs. "What WISHIN allows you to do is access information no matter what the source," said John Fangman, medical director of the AIDS Resource Center of Wisconsin, and an associate professor at the Medical College of Wisconsin. The network eventually could alert physicians when one of their patients has been hospitalized or seen at an emergency department or another clinic. That doesn't always happen now, and even when physicians are told, they sometimes don't get copies of the medical records. "That's what's exciting about it to me," Fangman said. "Everybody wants to do right by patients. We just need tools to make it easier." All of the health systems in the Milwaukee area as well as the community health centers and the AIDS Resource Center have committed to joining the network, said Joy Tapper, executive director of the Milwaukee Health Care Partnership, a coalition of health care organizations. The health systems and other providers on the network will pay an annual subscription fee based on their size. WISHIN hopes that eventually nursing homes and other health care providers, such as the Milwaukee County Behavioral Health Division, will become part of the network. That will take years. One challenge is each organization has to devote resources to the project. And to some degree, adding a nursing home or physician clinic to the network will take as much work as adding a large health system. WISHIN could easily spend the next decade — or longer — adding health care providers and new features to the network. But, for now, the basic structure is in place. "We are on the cusp of doing some good things," Kachelski said.
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Hospitals turn to social media for 'virtual' patient advice 21 August, 2013 | Fierce Healthcare http://www.fiercehealthcare.com/story/hospitals-turn-social-media-virtual-patient-advice/201308-21 Patients offer opinions on care, services and facility names Hospitals may have been slow to use social media platforms but many are finally taking advantage of all they have to offer and seeking input from patients on how they can improve care and services, reported the Wall Street Journal. The article cites examples of hospitals across the country turning to Facebook, Twitter, YouTube and Pinterest to recruit patients and their families to serve as advisors, asking for their opinions via questionnaires and surveys on planned improvements in care, new services and even facility names. Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., for example, has set up a "virtual advisory council" on a private social network, so it can ask parents to voice opinions and advice regarding appointment scheduling, doctors' bedside manners and other hospital concerns, according to WSJ. Similarly, the University of Michigan Health System, which encompasses three hospitals, 40 outpatient locations and more than 120 clinics throughout Michigan and northern Ohio, relies on "eadvisors" to answer approximately 35 online surveys a year, and a teen council communicates by responding to questions via its own Facebook page. Concord (N.H.) Hospital, which includes 295 licensed beds and 238 staffed beds, is using social media to develop meaningful, two-way conversations and, in turn, build brand awareness and customer loyalty, according to the Concord Monitor. And Dartmouth-Hitchcock Medical Center, an academic medical center also located in New Hampshire, has hired a full-time social media coordinator to reach out to patients and their families. These endeavors, while helpful on a local level, are part of a larger movement from the federal Medicare program to use patient satisfaction surveys, including questions on the hospital's responsiveness to concerns, to determine hospital payments. According to a guide recently released by the Agency for Healthcare Research and Quality (AHRQ), patient engagement, including the incorporation of the patient's perspective into the planning, delivery and evaluation of healthcare services, is essential to eliminate communication gaps. Furthermore, AHRQ instructs hospitals to form patient-family advisory councils. The idea behind this recommendation is that getting to know patients facilitates focusing on the aspects of the hospital experience that mean the most to the patients.
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Instead of having to recruit patients and family members to advise on services and facilities at the institutions, through social media, hospitals can obtain input from patients and families more efficiently. "The avenues through which patient voices can be captured and heard are expanding in rapid and creative ways," said Jason Wolf, president of the Beryl Institute, a membership organization providing grants and resources to help hospitals improve patient satisfaction, to the WSJ. But Roddy Young, Dartmouth-Hitchcock's vice president for communications and marketing, said not all social media interactions are positive, reported Concord Monitor. Patients sometimes change their opinions from one day to the next, and often use the platform to voice complaints.
Telemedicine improves care for kids seen in rural Ers 19 August, 2013 | Reuters http://www.reuters.com/article/2013/08/19/us-telemedicine-kids-idUSBRE97I0VK20130819 Telemedicine consults can help rural emergency room doctors provide better care to seriously ill or injured young patients, new research confirms. Rural hospitals and doctors' offices are increasingly using telemedicine - essentially, videoconferencing with another doctor from a remote location - to gain access to specialty care, Dr. James Marcin of the University of California Davis Children's Hospital in Sacramento, the senior author of the new study, told Reuters Health. "It's a great way to leverage technology to improve the quality of care that we provide," he said. Seeking expert help can be especially vital for emergency treatment of children, Marcin added, because rural ER doctors may see only a handful of pediatric patients a year, and guidelines on how to care for them are lacking. "For a three-month-old that comes in for wheezing or for a six-monthold that comes in for a fever, there are very few evidence-based guidelines," he said. Marcin and his colleagues worked with five rural hospitals to install telemedicine systems to help them care for young ER patients. Dedicated videoconferencing systems were set up in each rural hospital ER and in the UC Davis Children's Hospital pediatric intensive care unit, where a critical care doctor is always on duty. To investigate whether the telemedicine consultations were improving care, the researchers looked at pediatric patients who arrived at the rural ERs in the highest triage category, meaning they needed immediate assessment and treatment. Marcin and his team gathered records for the two years before the telemedicine systems were installed in each hospital and for at least two years after the systems were installed. They identified records for 320 patients, including 58 who had telemedicine consultations, 63 who had phone consultations and 199 who had no consultation. After information indicating whether a consultation had taken place was removed from the records, two study authors who are specialists in pediatric critical care medicine independently rated the quality of care provided to each patient.
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The average quality of care score was 5.76 on a scale of 1 to 7 for patients who received telemedicine consults, versus 5.38 for patients who received phone consultations and 5.26 for those who received no consultation. Parents also were more satisfied with the care provided to their child when they had received a telemedicine consultation versus a phone consultation, according to findings published in Critical Care Medicine. Real-time videoconferencing provides consulting doctors with far more information than a telephone call, Marcin noted. "We tend to spend more time on the videoconferencing calls than we do on the telephone. When I'm on a videoconferencing call I can see the child moving, I can see the monitors. There's a lot more information that we're gathering when we use videoconferencing than when we're relying on what the doctor is telling us." In addition to improving the quality of care, Marcin added, it's likely that telemedicine can sometimes lower unnecessary costs, too. For example, he explained, the expert consultant can help determine whether a patient needs helicopter transport to a higher-level trauma center. "Many times if we're able to see the kids, we can say, ‘We can use an ambulance, we can help you watch that kid, he can also be admitted locally,'" he said. "Sometimes we'll recommend that they go to an intermediate community hospital as opposed to the big city children's hospital."
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Strategy Orlando Health, Walgreens Form Clinical Collaboration 28 August, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/strategic-planning/orlando-health-walgreens-formclinical-collaboration.html Walgreens and Orlando (Fla.) Health announced a clinical collaboration to increase access to convenient healthcare services. The agreement includes 13 Healthcare Clinics, previously called Take Care Clinics, at select Walgreens. The clinics and Orlando Health will coordinate care for acute, chronic and preventive services and will increase patients' awareness about their services. In the future, Walgreens and Orlando Health may share electronic medical records and offer online or call center scheduling, according to the release.
MultiCare Health System, Regence BlueShield Partner for Accountable Care 28 August, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/accountable-care-organizations/multicare-healthsystem-regence-blueshield-partner-for-accountable-care.html Tacoma, Wash.-based MultiCare Health System and Regence BlueShield in Washington have announced a new accountable care initiative. The two organizations plan to work together on new networks and health insurance products to help reduce healthcare costs. The accountable care agreement includes a shared incentive reimbursement arrangement. "Working together, Regence and MultiCare can transform the healthcare system through innovative collaborative care programs such as this new model, and future initiatives as we continue our joint efforts," Mary Kay O'Neill, MD, MBA, executive medical director for Regence, said in the news release. "We are excited to partner with Regence to develop innovative care models that will enhance the quality of care for our patients. Our providers are committed to improving access to care, quality outcomes and efficiency," Claire Spain-Remy, MD, senior vice president for MultiCare Medical Associates, MultiCare's provider network, said in the release.
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Marin General, UCSF form pediatric partnership 26 August, 2013 | San Francisco Business Times http://www.bizjournals.com/sanfrancisco/blog/2013/08/marin-general-ucsf-form-pediatric.html Marin General Hospital and UCSF Medical Center have agreed to form a pediatric partnership in Marin County. The Business Times lifted the curtain on the two hospitals' closed door talks earlier this month. The new collaboration involves UCSF perinatologists and neonatologists working on site at Greenbrae-based Marin General, which is run by the Marin Healthcare District. The UCSF specialists will also see patients at an outpatient multi-specialty practice. "This affiliation means our patients can benefit from a world-class pediatric hospital and medical center without having to leave Marin," Kara Ornstein, M.D., chair of Marin General's pediatrics department, said in an Aug. 26 statement. Pediatric hospitalists — doctors who specialize in hospital care for kids — at each hospital will be integrated into both UCSF's and Marin General's medical staffs, said Stephen Wilson, M.D., associate chief medical officer for the UCSF Benioff Children's Hospital, part of UCSF Medical Center. In addition, Wilson said in the statement, the two will develop joint practice standards for the most common pediatric conditions treated at Marin General's inpatient pediatric and emergency units, and for obstetrics, perinatology and neonatology, involving care for mothers and babies at the Marin hospital. Financial aspects of the partnership were not disclosed. Mark Laret is CEO of UCSF Medical Center; Lee Domanico has the same title at Marin General and the Marin Healthcare District.
Saint Francis HealthCare Partners, Cigna Join for Collaborative Accountable Care 26 August, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/accountable-care-organizations/saint-francis-healthcarepartners-cigna-join-for-collaborative-accountable-care.html Health insurer Cigna and Hartford, Conn.-based Saint Francis HealthCare Partners, a joint venture between Saint Francis Hospital and Medical Center and about 900 care providers, have launched a collaborative accountable care initiative, Cigna's version of an accountable care organization.
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The new partnership, effective Oct. 1, will cover about 20,000 patients covered by a Cigna plan who receive care from a Saint Francis HealthCare Partners provider. As part of the program, Saint Francis HealthCare Partners will coordinate care for patients through clinical care coordinators — registered nurses employed by Saint Francis HealthCare Partners. The coordinators will use patient-specific data from Cigna to enhance care quality. Cigna will pay Saint Francis HealthCare Partners for the medical care and care coordination services they provide. Additionally, Saint Francis HealthCare Partners can receive payment under a pay-forvalue system if providers meet certain quality and cost targets. This is not the only accountable care contract Saint Francis HealthCare partners has: the joint venture joined the Medicare Shared Savings Program in January.
Health First insurance extends reach 24 August, 2013 | Florida Today http://www.floridatoday.com/article/20130825/NEWS01/308250053/Health-First-insuranceextends-reach?nclick_check=1 Health First insurance extends reach Health care plans to be offered in Volusia, Flagler in agreement with Florida Hospital Health First Health Plans, in one of the boldest moves in its 17-year existence, is partnering with Florida Hospital to sell its Brevard County health plans through Central Florida’s largest nonprofit provider. The agreement has the potential over the next few years to add tens of thousands of policyholders to the more than 60,000 who are currently enrolled in Health First insurance plans in Brevard and Indian River counties. Marketing of the plans likely will begin in October in Volusia and Flagler counties, where Florida Hospital operates five facilities. The timetable for completing the expansion to other Florida Hospital properties in eight additional counties is three to five years. Under the agreement, Health First will administer the plans for policyholders while Florida Hospital will contine to provide the care in the communities it serves. A Florida Hospital executive in Orlando said Health First Health Plan’s reputation among insurers was a deciding factor in the agreement.
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“Health First has shown itself to be one of the top health plans in the state,” said Mike Schultz, CEO of the Florida division of Adventist Health System, parent company of Florida Hospital. “Albeit in only two counties, but they are a high-rated Medicare Advantage Plan, (and) they are rated among the top in the state in terms of being able to administer a health plan,” Schultz said. Faced with continuing multimillion-dollar declines in Medicare and Medicaid reimbursements from the federal government, the expansion is one of two phases of a strategy to help keep Health First financially stable and strengthen its integrated delivery system, chairman of the board James Shaw said. “We had to grow the health plan,” he said. “It was absolutely critical to the success of the strategy.” He also emphasized the importance of Health First remaining a viable and vibrant health care provider in Brevard. “Our purpose is to improve the health and welfare of the citizens of Brevard and to maintain local control of our organization,” Shaw said. “This allows us to do that.” An integrated health system aims to keep people healthy over the long term by stressing preventive care and managing chronic diseases, not only treating patients when they become sick or need to be hospitalized. The second part of the initiative, increasing the physicians group, was accomplished this year when Health First purchased MIMA, Shaw said. Steve Johnson, president and CEO of Health First, said he contacted four nonprofit providers in the state about a potential insurance partnership before selecting Florida Hospital. “They’ve got a fantastic name, significant market presence . . . (and) they’re people of integrity,” Johnson said. “They’re very serious about their mission. They’re serious about not-for-profit health care and keeping control of health care in local communities, and that’s what we are all about.” Florida Hospital’s Schultz said by offering a health insurance plan, its hospitals can initiate patient care early by focusing on policyholders’ health long before it becomes critical. “We believe this is an opportunity to become more involved with the overall health of a community,” he said. “It will keep (policyholders) healthier as well as being able to control health care expenses in the future.” Johnson described the Florida Hospital plan as a “private label product,” comparing it with a grocery store’s brand of a food item, such as when green beans are grown, processed and packaged by one company, but sold under the name of another. “When we all go into Publix . . . and go for the GreenWise product, that is the Publix-named product,” he said. “They didn’t grow the beans, they didn’t make the cans, they didn’t make the label. Delmonte did. But it has a Publix brand on it.
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“That’s essentially what we’re doing with the health plan. It’s our health plan, we own it and we administer it.” The new plans will be called Florida Hospital Care Advantage. Under the name on the logo in smaller print is “Administered by Health First Health Plans.” Johnson said the added policyholders to Health First Health Plans will be a boost to the Brevard economy, because the premiums will not be paid to an insurer outside the county.
Wellness program helps Blue Cross secure state contract 23 August, 2013 | Fierce Health Payer http://www.fiercehealthpayer.com/story/wellness-program-helps-blue-cross-secure-statecontract/2013-08-23 Blue Cross Blue Shield of Vermont won a contract to administer health coverage for more than 23,000 state employees and their dependents by including a strong wellness model and lower costs. Vermont Gov. Peter Shumlin said Wednesday Blue Cross would replace Cigna as the insurer for the state's employees as of Jan. 1. He said the switch, along with contracts for dental and pharmacy benefits, would save $10 million annually, reported VT Digger. The state chose Blue Cross primarily due to its wellness plan, which provides education and assistance for behaviors like smoking cessation. "We know that the best way to contain healthcare costs is to help people change risk factors like smoking and obesity that contribute to bad health outcomes," Shumlin said in a statement. "I am confident Blue Cross's new Accountable Blue program will help us save costs, and more importantly, improve the health of our state employees and their families." Human Resources Commissioner Kate Duffy said all the bids were competitive, but "Blue Cross had the most attractive overall cost, wellness plan and commitment" to the state's own Blueprint for Health reform effort. Plus, the Blue Cross proposal had lower provider rates than Cigna. That means Vermont, which paid $119 million in medical claims last year, could have spent $5 million less if the Blue Cross contract was in place, the Vermont Press Bureau reported.
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