HEALTHCARE NEWS FLASH April 16, 2014
Table of Contents Sales & Marketing ...........................................................................................................................3 Finance.............................................................................................................................................7 Technology.....................................................................................................................................12 Strategy..........................................................................................................................................17
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Sales & Marketing Oconee Medical Center to Affiliate With Greenville Health System April 15, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-transactions-and-valuation/oconee-medicalcenter-to-affiliate-with-greenville-health-system.html Oconee Medical Center in Seneca, S.C., and Greenville (N.C.) Health System have approved a nonbinding letter of intent under which Oconee would join GHS. Under the preliminary agreement, the affiliation could involve a lease of at least 50 years and full integration of the 169-bed hospital into GHS, according to a news release. Oconee would retain its own medical staff. Oconee and GHS signed a memorandum of understanding in January to explore an affiliation. If the transaction is finalized, Oconee will become the seventh hospital within the health system. The Oconee board decided to explore integrating with GHS because it's a South Carolina-based organization with similar values and commitment to the health of the local population, according to the release. "We are fortunate to have the opportunity to affiliate within our region with an organization of the caliber of Greenville Health System," Jeanne Ward, Oconee's president and CEO, said in the release. "By working together and sharing resources, we will be better able to improve the health of the communities we serve." GHS and Oconee will perform due diligence pre-integration planning during the next two months. They expect to have a final agreement ready for consideration in June.
Doctors Hospital at Renaissance Affiliates With Cleveland Clinic's Bariatric & Metabolic Institute April 14, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-physician-relationships/doctors-hospital-atrenaissance-affiliates-with-cleveland-clinic-s-bariatric-metabolic-institute.html In an effort to combat obesity and diabetes in the region, Edinburg, Texas-based Doctors Hospital at Renaissance has affiliated with Cleveland Clinic's Bariatric and Metabolic Institute. More than half of Americans are overweight, and 22 million have type 2 diabetes, according to a news release. Additionally, DHR's metro area ranked in the top two in the country for the most obese residents this year, according to a Gallup poll. Another study shows the metro area pays more than $400 million in unnecessary healthcare costs because of the high obesity rates.
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"This exciting affiliation will provide us with new tools, cutting-edge technology and evidence-based medicine to combat diabetes and obesity in the Rio Grande Valley," said Israel Rocha, CEO of physician-owned DHR, in the release. This affiliation is the first of its kind for the Cleveland Clinic's Bariatric and Metabolic Institute. "We are thrilled to work with Doctors Hospital at Renaissance to develop a bariatric surgery program with the highest standards for patient care, safety and efficient operations," said Philip Schauer, MD, the Institute's director, in the release. "Our mission is to be a resource for patients and healthcare providers at DHR, to provide guidance and share our expertise, to enable the delivery of world-class treatment for individuals suffering from obesity and diabetes. Together, we can best combat the 'diabesity' epidemic."
PPACA Exchange Enrollment Reaches 7.5M April 11, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/news-analysis/ppaca-exchange-enrollment-reaches-75m.html Since March 31, roughly 400,000 more people have enrolled in health plans through the Patient Protection and Affordable Care Act exchanges, HHS Secretary Kathleen Sebelius told the Senate Finance Committee yesterday, according to an AHA News report. That means a total of 7.5 million people have signed up for coverage through the exchanges. Although the 2014 open enrollment period officially ended on the last day of March, the Obama administration extended the deadline to April 15 for people who started signing up for coverage before the deadline but were unable to complete the process. Additionally, federal officials have indicated people who encounter more serious technical problems, such as system errors while trying to prove immigration status or applications getting lost in transfer to health plans, will have at least 60 days from the occurrence of the problem to sign up. Last week, President Barack Obama announced the exchanges had enrolled 7.1 million people as of March 31, well beyond the most recent Congressional Budget Office projection of 6 million. Despite the exchanges' ultimate success in exceeding enrollment goals, Ms. Sebelius is resigning today, months after the glitch-ridden rollout for the federal health insurance exchange website, HealthCare.gov. Although Ms. Sebelius and the White House have stood firm against Republican lawmakers' calls for her to step down over the exchange site's bumpy rollout, she reportedly informed the president in early March of her decision to step down. Denis R. McDonough, the White House chief of staff, told The New York Times that Ms. Sebelius told the president it would be better to have someone running HHS who wasn't the target of so much political animosity.
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Independence Blue Cross, DaVita HealthCare Partners Form New Company to Boost Coordinated Care April 10, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/accountable-care-organizations/independence-blue-crossdavita-healthcare-partners-form-new-company-to-boost-coordinated-care.html A new joint venture between Philadelphia-based Independence Blue Cross and DaVita HealthCare Partners, called Tandigm Health, will work with physicians in the Philadelphia area to help them provide better coordinated care while lowering the cost of healthcare in the region. The company will provide analytical tools real-time data to primary care physicians to help them and their patients better manage chronic conditions. Together as Tandigm Health, IBX and HealthCare Partners will "work in tandem with primary care physicians to create a new paradigm of high-quality, affordable healthcare," said Daniel Hilferty, president and CEO of IBX, in a news release. The company is looking for success in three areas, he says: a more personalized healthcare experience for patients and physicians, better health outcomes and more affordable care. DaVita HealthCare Partners is the parent company of Denver-based DaVita, a leading provider of kidney care services, and Torrance, Calif.-based HealthCare Partners, an operator of medical groups and physician networks. DaVita and HealthCare Partners merged in 2012 in a $4.42 billion deal. Tandigm Health hopes to have a network of 300 primary care physicians when it officially launches Jan. 1, 2015, said Anthony Coletta, MD, Tandigm president and CEO, in a Tuesday conference call. The goal in the next five years is to have somewhere from 500 to 700 physicians in the network. "Tandigm Health will reward doctors for the quality of care they provide, not the quantity of care," Craig Samitt, MD, CEO of HealthCare Partners, said in the release. "This creates an incentive system based on improving quality and lowering costs that benefits everyone: patients, doctors, hospitals and the community." The joint venture will go at-risk for the cost and quality of care delivered to patients attributed to the company. However, IBX and DaVita officials shied from calling it an accountable care organization or patient-centered medical home. Dr. Coletta likened the company to "building the neighborhood or homeowners association," like a PCMH on a larger scale. HealthCare Partners and IBX each bring distinct expertise to Tandigm Health that will help the joint venture be successful. For example, IBX brings member and physician relationships in the market, as well as an expertise in managing insurance, Dr. Coletta said. On the other hand, HealthCare Partners, which serves 765,000 patients in five states, brings three primary areas of expertise, according to Dr. Samitt. The medical group operator has experience developing and deploying integrated clinical programs to deliver better care at a lower cost; leading partnerships between primary care physicians, specialist and hospitals; and deploying population health management technologies, he said.
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Stormont-Vail HealthCare Joins Mayo Clinic Care Network April 07, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-transactions-and-valuation/stormont-vailhealthcare-joins-mayo-clinic-care-network.html Stormont-Vail HealthCare, based in Topeka, Kan., has joined the Mayo Clinic Care Network. The Mayo Clinic Care Network, established by Rochester, Minn.-based Mayo Clinic, is a network of hospitals and health systems that work to improve the quality and delivery of care in their regions. The collaboration gives providers around the nation access to Mayo Clinic's expertise. Stormont-Vail specialists now have access to various Mayo Clinic resources such as the AskMayoExpert database and electronic consulting that connects physicians with Mayo Clinic experts to answer questions about diagnosis, care management or therapy, according to a news release. The deal does not involve a change in ownership. The network launched in 2011 and has member organizations in Arizona, California, Colorado, Florida, Georgia, Illinois, Kentucky, Michigan, Minnesota, Missouri, Montana, New Hampshire, North Dakota and Wisconsin, as well as Puerto Rico and Mexico. Stormont-Vail is the first health system in Kansas to join.
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Finance Study: Collaborative Care Model for Depression, Dementia Could Save Billions April 15, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/finance/study-collaborative-care-model-for-depressiondementia-could-save-billions.html Implementing a nationwide collaborative care model for patients with dementia and/or depression could potentially save billions in healthcare spending, according to a Health Affairs study. Researchers analyzed the cost savings impact of the Healthy Aging Brain Center, a memory care clinic that is part of Indianapolis-based Eskenazi Health. Since 2008, the HABC has integrated various collaborative care model features, including a trained care coordinator who works with patients, families and primary care providers; individualized care protocols and education about selfmanagement; resources and counseling for caregivers; and standardized tools to measure patients' biopsychosocial needs and assess the care plans' effectiveness. Forty-nine percent of the HABC's patients have dementia, 27 percent have mild cognitive impairment and 24 percent suffer from minor or major depression. The study's authors compared 303 Eskenazi patients who received care through the HABC with 1,453 other Eskenazi patients who didn't receive care at the HABC. The researchers concluded the HABC led to net annual savings ranging from $980 to $2,856 per patient. Fifty-three percent of the savings came from reduced inpatient spending, while 47 percent came from reductions in emergency department and related outpatient care spending. The cost of HABC is just $618 per member per year or $1.69 per day. Study co-author Dustin French, PhD —an assistant professor in the department of ophthalmology and the Center for Healthcare Studies at Northwestern University's Feinberg School of Medicine in Chicago — says that "amounts to less than the cost of a cup of coffee per day to care for our most vulnerable community dwelling seniors." Additionally, the collaborative care model has other positive effects, such as reducing patients' symptoms, easing the burden shouldered by informal caregivers and enhancing quality of care, according to the study. Given that more than 4.7 million patients in the U.S. have dementia or depression, the collaborative care model could save billions if enacted nationwide, the study concluded. Currently, dementia and depression account for approximately $30 billion in annual Medicare spending. However, the study states the care model "has not been widely adopted because it requires an extensive redesign of the practice environment, including the development of a new workforce of care coordinators and a new payment system." Dr. French says providers would need to adjust their delivery models and staff training to support the collaborative care model. That would involve having, for instance, pharmacists on board to optimize patients' medication. Providers would also need frontline staff members that could provide telephone support and outreach services for informal caregivers.
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Additionally, he says Medicare payments must be redesigned in order for the collaborative care model to work on a larger scale. He says he and his colleagues are keeping an eye on healthcare reform efforts that are driving a shift toward the kind of payment model needed to support collaborative care. "We're going to be watching in the coming months what CMS does with the [Patient Protection and Affordable Care Act] and what the accountable care organizations are going to do with the hospital environment," he says. The new reimbursement models will need to provide hospitals with motivation for aligning themselves with practices like the HABC so that there is a financial win-win, according to Dr. French. "We have to think about what drives the hospitals," he says. "Hospitals may benefit with HABC through reduced lengths of stay that preserve the hospital payment for patients with related dementias. However, HABC may also altogether reduce their hospitalizations and emergency room care. That may have large financial implications." Dr. French says we need new payment models (such as bundled payments) from the payers like CMS to align the financial incentives to provide care like HABC while preserving the financial integrity of the payer, hospital and possibly practice environment for shared economic savings. "Hospitals and the medical environment will adopt programs that have sound business and management principles, and without this, there will be little redesign of services that fully addresses the needs of our most vulnerable senior citizens," he says.
Hospital Prices Up 1.3% Year-Over-Year in March April 14, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/finance/hospital-prices-up-1-3-year-over-year-inmarch.html The producer price index for acute-care hospitals increased 1.3 percent between March 2013 and March 2014, according to figures from the Bureau of Labor Statistics. Overall hospital prices also went up by 0.1 percent between February and March. The Producer Price Index for hospitals measures "changes in actual or expected reimbursement received for services across the full range of payer types," according to the American Hospital Association. "This includes the negotiated contract rate from the payer plus any portion expected to be paid by the patient."
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Fitch: For-Profit Hospital Earnings Likely to Remain Weak April 11, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/finance/fitch-for-profit-hospital-earnings-likely-toremain-weak.html Although the for-profit hospital industry is on the precipice of positive shifts, Fitch Ratings is not optimistic that 2014 first-quarter earnings from the chains will show much improvement from last year. According to a Fitch report, the big six chains — Hospital Corporation of America in Nashville, Tenn., Community Health Systems in Franklin, Tenn., Tenet Healthcare Corp. in Dallas, LifePoint Hospitals in Brentwood, Tenn., Universal Health Services in King of Prussia, Pa., and IASIS Healthcare in Franklin, Tenn. — generally posted weak growth in inpatient volumes last year. In the fourth quarter of 2013, those companies recorded a cumulative 4.7 percent drop in admissions — the biggest decline since 2011. For-profit hospitals do have some trends working in their favor: The Patient Protection and Affordable Care Act's health insurance exchanges exceeded expectations by enrolling more than 7 million Americans. Hospitals have also been benefiting from a higher acuity patient mix, which has helped improve net revenue per adjusted admission. However, Fitch said those developments have to be taken with a grain of salt because "the actual influence of the insurance expansion on hospital industry operating trends is far from certain, since the effects of narrow networks, employer dumping and incremental utilization by the previously uninsured are still unknowns." In fiscal year 2013, the big six chains posted more than $71.6 billion in revenue. HCA represented almost half of that total. Including revenue from Naples, Fla.-based Health Management Associates, which was bought out by CHS this year, the big for-profit hospital players recorded more than $77 billion in revenue in 2013.
CMS Data: 25% of Physicians Account for Most Medicare Spending April 09, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/finance/cms-data-25-of-physicians-account-for-mostmedicare-spending.html CMS gave the public unprecedented access to Medicare physician payment data today. The newly released data set includes information on more than 880,000 healthcare professionals across the country who received a total of $77 billion in Medicare Part B fee-for-service payments in 2012. With the data, it's possible to compare 6,000 different types of services, procedures and payments received by individual providers, according to HHS.
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The New York Times has already analyzed the data and found a small fraction of physicians account for a significant amount of Medicare spending. According to the Times, about 2 percent of physicians received about $15 billion in Medicare payments. Furthermore, only 25 percent of physicians accounted for 75 percent of Medicare spending. In 2012, 100 physicians — mainly eye and cancer specialists —received a total of $610 million from Medicare, according to the analysis. The American Medical Association has released a statement saying that while the organization is "committed to transparency and the availability of information for patients to make informed decisions about their medical care," it has some concerns about CMS' release of physician data. "We believe that the broad data dump today by CMS has significant short-comings regarding the accuracy and value of the medical services rendered by physicians," AMA President Ardis Dee Hoven, MD, said in the statement. "Releasing the data without context will likely lead to inaccuracies, misinterpretations, false conclusions and other unintended consequences." The Medical Group Management Association also released a statement from Susan Turney, MD president and CEO of MGMA, expressing concerns about the data. "MGMA supports the constructive release of cost and quality data information to benefit Medicare beneficiaries," Dr. Turney said in the statement. "However, the decision by [CMS] to release Medicare physician claims data is problematic, and without the proper context and safeguards in place, it will be detrimental to patients and physicians." CMS' landmark release of physician payment data builds on the agency's decision earlier this year to evaluate Freedom of Information Act, or FOIA, requests from the media on a case-by-case basis for individual Medicare payments made to physicians, effective this past March. Previously, HHS said that "considering the two competing interests of public transparency and privacy," Medicare physician data could not be provided through FOIA requests. The decision to disclose the data was spurred by a federal judge's decision last year to lift a 1979 injunction that barred the release of individual physicians' annual Medicare payments. That court decision stems from a January 2011 request from Dow Jones, publisher of The Wall Street Journal. Last year, HHS and CMS also released hospital charge data for the 100 most common inpatient services and 30 most common outpatient services.
RAND: ACA may drive malpractice claims up 5% April 09, 2014 | Fierce Practice Management http://www.fiercepracticemanagement.com/story/rand-aca-may-drive-malpractice-claims5/2014-04-09 The increased number of insured patients under the Affordable Care Act could result in an accompanying 5 percent rise in malpractice claims, according to a new RAND Corporation study. In turn, physicians could see their liability premiums go up as well.
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RAND researchers hypothesized that higher numbers of procedures and interactions would translate into more opportunities for patients to sue, noted an article in Internal Medicine News. They confirmed this theory by comparing National Practitioner Data Bank data on liability claims from 2008 to 2010 to insurance coverage data from the Census Bureau's American Community Survey, which resulted in a 2 percent to 10 percent increase in malpractice activity. They determined, therefore, that if 10 percent of a state's population gains coverage, there will be a corresponding 5 percent rise in malpractice claims. "This study highlights the far-reaching impacts of the Affordable Care Act," Jayne Plunkett, head of casualty reinsurance for Swiss Re, an international reinsurance company that sponsored the study, told IMN. "Businesses and policymakers need to understand how and why their risk profiles might change as the Affordable Care Act is implemented." But some liability insurers warn that this forecast is too simplistic, as a myriad of factors could influence the insurance marketplace in a particular state. In addition, some experts believe that new patients entering the healthcare system may be so appreciative of previously absent care that they would be reluctant to sue, noted Frank O'Neil, senior vice president and chief communications officer for ProAssurance, a national medical liability insurer. Overall, researchers concluded that the impacts of the ACA on malpractice insurance would be small in the short run, but may have broader implications, such as on tort law and population health, over time. "To effectively understand the long-term health and trajectory of the U.S. liability insurance marketplace, stakeholders will need to continue to monitor ACA implementation and how it progresses," they wrote.
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Technology Deloitte Says Many Providers Disappointed By ICD-10 Delay April 14, 2014 | Health Data Management http://www.healthdatamanagement.com/news/Deloitte-Says-Many-Providers-Disappointed-ByICD-10-Delay-47818-1.html Healthcare organizations were caught flat-footed by the one-year delay in the ICD-10 implementation deadline to October 2015, according to the finding of a new poll by the health services research arm of Deloitte LLP. The poll of 1,250 health professionals conducted during a recent Deloitte Center for Health Solutions webcast found that 58 percent of respondents were disappointed by the delay. "To many in the healthcare industry, this delay falls into the category of unexpected news; after two previous delays, many were operating under 'full steam ahead' plans," states an April 14 Deloitte blog posting announcing the poll results. Not surprisingly, 59 percent of respondents expect a loss of momentum or getting off track in their ICD-10 planning and preparation, while only 30 percent plan to keep their original schedule. Fifty-eight percent of those polled expect resources and funding to be impacted most by the ICD-10 delay. At the same time, respondents indicated that the "optimal scenario" for their organization was setting the deadline for October 2015, while a mere 30 percent said it was to find a way to restore the October 1, 2014 deadline. So far, the Centers for Medicare and Medicaid Services has not communicated anything publicly regarding the code switchover process going forward. President Obama on April 1 signed into law legislation passed by the House and Senate delaying ICD-10 until at least October 1, 2015. A CMS spokesperson told Health Data Management in response to a query: "We are examining the legislation and will provide guidance to providers and other stakeholders soon."
Rock Health: Digital health funding in first quarter up 87% from Q1 2013 April 09, 2014 | Fierce Health IT http://www.fiercehealthit.com/story/rock-health-digital-health-funding-first-quarter-87-q12013/2014-04-09 Digital health funding in the first quarter of 2014 broke yet another record, with nearly $700 million pouring into the space, according to San Francisco-based digital health startup seed fund Rock Health. In their latest update, Rock Health reported that there was 87 percent year-over-year growth from Q1 2013 to Q1 2014.
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The average venture funding deal increased to $13 million, up from $10 million last year, according to Rock Health's statistics. In the first quarter, they pointed out, patient care and enterprise costsavings emerged as new themes. Still, they said, analytics and big data are still considered "heavyweights." Payer administration was the most funded category in Q1, with $120 million in deals. Companies that shined in Q1, according to Rock Health, included Health Catalyst--a data warehousing company that received funding from Kaiser Permanente Ventures and Partners Healthcare, among others--and Specialists On Call--a company that provides emergency telemedicine consultations. In terms of location, California dominated the digital health deal market, representing 32 percent of funding in the quarter. Total digital health funding in 2013 reached $1.92 billion, according to an end-of-year report from Rock Health released in January. Meanwhile, according to Mercom Capital Group, venture capital funding for healthcare IT doubled from $1.2 billion to $2.2 billion. Overall, Mercom reported, the number of VC health IT deals more than tripled from 163 in 2012 to 571 in 2013. What's more, according to Mercom, the number of investors active in funding rounds for healthcare IT companies nearly doubled, from 236 in 2012 to 466 last year.
Fitch: ICD-10 Delay Will Benefit Nonprofit Hospitals April 07, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/icd-10/fitch-icd-10-delay-will-benefit-nonprofithospitals.html Last week's ICD-10 delay is a positive development for nonprofit hospitals, according to a Fitch Ratings report. This past Tuesday, President Barack Obama signed legislation that delays the transition to ICD-10 coding by at least one year. The extension of the transition deadline will give providers and payers more time to prepare for the switch to ICD-10, according to Fitch. "While a majority of providers have made the substantial investment in technology and personnel to be ready for the transition, the readiness of both governmental and commercial payors to adequately process claims and payments in a timely manner has been questioned," Fitch states in a news release. "In our view, lower rated credits would be more susceptible to this risk as [they] have less financial resources to absorb a potential delay in reimbursement." That statement echoes a Fitch report released last month that stated the sheer magnitude of the transition within the healthcare industry would likely add pressure to nonprofit hospitals' cash flows and could cause downgrades in hospitals with weak liquidity positions or depressed profitability.
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Not everyone views the delay as beneficial. Industry stakeholders and organizations — including the American Health Information Management Association, College of Healthcare Information Management Executives and vendors NextGen and athenahealth — have criticized lawmakers' decision to delay the switch, calling it irresponsible and disruptive to preparation efforts.
Report: State-Based Marketplaces More Successful Than HealthCare.gov April 04, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/finance/report-state-based-marketplaces-moresuccessful-than-healthcare-gov.html Through March 1, the state-based health insurance marketplaces were generally more successful in achieving enrollment projections than the federally facilitated marketplaces, according to a report from the Robert Wood Johnson Foundation and the Urban Institute. As of March 1, HHS reported more than 4.2 million people had selected health plans through the PPACA marketplaces (as of April 1, that number had risen to 7.1 million). Researchers compared that enrollment data on a state-specific level with projected enrollment for 2014 and 2016 based on survey data. They found that, overall, state-based marketplaces had achieved 76 percent of projected 2014 enrollment by March 1, compared with 54 percent for the federally facilitated marketplaces. Three of the 17 state-based marketplaces — Vermont, Connecticut and the District of Columbia — had already exceeded their projected 2014 enrollment. Meanwhile, none of the 34 states with federally facilitated marketplaces had reached enrollment projections by March 1, according to the report. Report co-author and Urban Institute fellow John Holahan, PhD, says that for the most part, the states that opted to run their own exchanges developed their systems earlier and faced little opposition to the marketplaces, and they received a boost from federal funds made available for outreach efforts and website construction. "There wasn't a hostile reaction to the [PPACA] in most of these states," Dr. Holahan says. Still, not all state-based exchanges have fared well. For instance, Maryland recently decided to revamp its health insurance exchange, which crashed soon after it launched last fall and has performed poorly since: As of last Friday, only 49,293 people had enrolled in private health plans through the exchange, far short of the 150,000 people Maryland had hoped to sign up. The exchanges in Oregon, Hawaii and Massachusetts have also floundered. Within the state-based marketplace and federally facilitated marketplace categories, enrollment varied significantly, according to the report. In the state-based marketplaces, progress ranged from 14.8 percent of projected 2014 enrollment in Massachusetts to 178.9 percent in Vermont. Meanwhile, in states that relied on the federal facilitation, actual enrollment as a share of 2014 projections ranged from 26.2 percent in North Dakota to 81.5 percent in North Carolina.
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Regardless of their marketplace type, the report concludes all states will likely see "substantial" enrollment increases in the coming years as people become more familiar with the exchanges, more outreach efforts are conducted and exchange glitches from the first year get fixed. Dr. Holahan also says healthcare providers and others in the industry will likely play a part in boosting enrollment. "Hospitals, insurers and other people will have big outreach campaigns now that the system is working," he says.
Satisfaction with HIE solutions drops April 03, 2014 | Healthcare IT News http://www.healthcareitnews.com/news/satisfaction-hie-solutions-drops Overall provider satisfaction with HIE solutions has dropped an average of 8 percent since last year as provider demands have outpaced vendor delivery, according to a new report from research firm KLAS. "What is surprising is that despite the millions of dollars HIE vendors invested to add needed functionality, only about half of them are seeing their provider satisfaction scores improve," said report author Mark Allphin, in a news release. "Payment reform and the future of accountable care continue to keep many vendors struggling to keep up with provider demands." For the report HIE 2014: Revisiting Great Expectations, KLAS interviewed 219 HIE providers, both public and private. Providers gave feedback on three main areas: reliability, relevance and transformation. The HIE products compared are from Allscripts, Cerner, eClinicalWorks, Epic, ICA, InterSystems, Medicity, NextGen, Optum (Axolotl), Orion Health, RelayHealth and Siemens. Cambridge, Mass.-based InterSystems was so pleased with the outcomes of the KLAS report and the comments from its customers that the company issued a news release highlighting how its HIE product HealthShare fared in the study and listing customer comments. "HealthShare was the only product for which 100 percent of customers surveyed said HealthShare is both a 'part of their long-term plans,' and they 'would buy this again,'" Intersystems executives stated in the news release. "According to preliminary data from the report, InterSystems HealthShare received an overall early data score of 86.6, indicating strength in both 'relevance' and 'reliability.'" The KLAS report noted, "Initially used by public HIEs, InterSystems HealthShare builds on its historical strength in interface engines (Ensemble) and databases (CachĂŠ), as well as on its international experience." On the topic of vendor reliability, KLAS added, "InterSystems is described as a customer-centric partner, but the power and flexibility of the technology is the premier attraction."
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"KLAS rankings are highly trusted because they are based on surveys of healthcare providers, not health IT vendors," said Paul Grabscheid, InterSystems vice president of strategic planning. "We are honored to receive this outstanding score in HIE technology from our clients, and we look forward to further serving their HIE needs with a health informatics platform that enables strategic interoperability and analytics for action. With the continued rapid growth of HealthShare, we anticipate even more customers participating in KLAS interviews this year, so that we can move from the 'preliminary data' to the 'fully ranked' category." KLAS defines HIE as at least two healthcare provider organizations actively exchanging patient data and other information (unidirectionally or bidirectionally). Information must be shared between separate organizations. HIEs that are not yet actively exchanging data are not counted as live for the purposes of this study.
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Strategy Hospital M&A Activity Grew Slightly in 2013 April 11, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-transactions-and-valuation/hospital-m-aactivity-grew-slightly-in-2013.html In 2013, there were 98 total hospital and health system transactions, an increase of 3 percent from 2012 and a 51 percent spike from 2010, according to a Kaufman Hall report. The analysis puts hard numbers to observations that have been seen extensively during the past year. A vast majority (87) of the hospital mergers and acquisitions involved the acquisition of a nonprofit organization. Of that total, 70 transactions were nonprofits buying nonprofits, while the other 17 were for-profits acquiring nonprofits. Further, Kaufman Hall researchers found the total operating revenue of the acquired hospitals equaled $32.3 billion — $18.5 billion from the 87 nonprofit transactions, and $13.8 billion from the 11 for-profit transactions. However, almost all of the operating revenue involved in the for-profit deals came from the two primary mega-mergers: Community Health Systems in Franklin, Tenn., and Health Management Associates in Naples, Fla., and Tenet Healthcare Corp. in Dallas and Vanguard Health Systems in Nashville, Tenn. "Our analysis confirms that hospitals and health systems are continuing to pursue partnership arrangements as one approach to accessing the enhanced infrastructure necessary to provide care successfully in the changing environment," Kaufman Hall Managing Director Michael Finnerty said in a news release. Kaufman Hall's analysis reiterates the findings of other healthcare M&A firms. A recent report from Ponder & Co. found hospital deals have increased, and they are not likely to stop this year, especially among large nonprofits and regional systems. PwC analysts expect to see a "heightened level of hospital deal activity" this year due to uncertainties surrounding healthcare reform, convergence in the provider and payer arenas and expanding physician alignment.
Faith-based provider giant enters insurance biz April 07, 2014 | Healthcare Payer News http://www.healthcarepayernews.com/content/faith-based-provider-giant-enters-insurance-biz Competition from provider-owned health plans is increasing, with one of the country's largest national health systems scooping up an HMO in the South that could be a platform to enter other markets.
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Catholic Health Initiatives’ Collab Health subsidiary is acquiring QualChoice Holdings, the Arkansasbased operator of the HMO QCA Health Plan and its related insurance company, pending regulatory approval. At 87 hospitals across 18 states, Catholic Health Initiatives is the third largest religious-based health system in the country, and the stock purchase of QualChoice marks one of its early forays into the insurance business, following last year’s acquisition of Soundpath Health, a small Medicare Advantage plan in Washington State. "Making an investment in a quality health plan such as QualChoice is integral to CHI's population health strategies,” said Juan Serrano, Catholic Health Initiatives senior VP of payer strategy and operations, in a media release. Arkansas, where Catholic Health Initiatives operates St. Vincent Health System, is “a fantastic place to develop our health insurance capabilities as we strive to better serve communities here and across the nation,” Serrano said. CHI’s St. Vincent Health System has been accepting patients covered by the statewide QCA Health Plan since its inception in 1996. Since 1999, CHI has also been an investor in the insurer, along with TriZetto Corporation, the University of Arkansas for Medical Sciences, Arkansas Children’s Hospital and Tenet Healthcare. The purchase price of CHI’s buyout of those other investors is not being disclosed, and the deal is still subject to approval by Arkansas insurance regulators. The acquisition of QualChoice by a Catholic health organization raises the question of how reproductive care, such as covered abortions, will be treated, especially if the insurer is expanded into other markets. Michael Stock, QualChoice’s CEO, said in a statement that no benefit changes are anticipated, with patients still having access to the services at providers that offer them. "To the extent federal and/or state governments mandate coverage for healthcare benefits, QualChoice is required to comply with those federal and state laws where applicable," Stock said. "To the extent mandated benefits conflict with the Catholic Ethical and Religious Directives, QualChoice will institute appropriate administrative practices consistent with the way other Catholic organizations have operated health plans." In 2010, the QCA HMO’s parent organization QualChoice was set up as a holding company after the acquisition and restructuring of Community Bank Life and Health Insurance Company. One of four insurers selling individual plans through Arkansas’s public insurance exchange, the HMO now sells both fully-insured and self-insured products and also administers a health plan for state and public school employees. Today the company has about 72,000 members.
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CHI Nears Acquisition of Arkansas Health Plan April 03, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/finance/chi-nears-acquisition-of-arkansas-healthplan.html A subsidiary of Englewood, Colo.-based Catholic Health Initiatives has reached an agreement to acquire QualChoice Holdings, a health insurer based in Little Rock, Ark. Talks of a potential takeover surfaced in January. QualChoice, a licensed HMO in all 75 Arkansas counties, has been partially owned by several providers since the late 1990s, including CHI's St. Vincent Health System in Little Rock. The deal requires approval from the Arkansas Insurance Department. CHI and QualChoice executives said there will be no changes to the provider network or members if and when the state approves the transaction.
CHS Completes Sharon Regional, Munroe Hospital Deals April 02, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-transactions-and-valuation/chs-completessharon-regional-munroe-hospital-deals.html Community Health Systems, based in Franklin, Tenn., has completed two separate hospital transactions: Sharon (Pa.) Regional Health System and Munroe Regional Medical Center in Ocala, Fla. Sharon Regional includes 251-bed Sharon Regional Medical Center and several outpatient centers and affiliated physician practices. Munroe Regional, formerly a public-owned entity, is a 421-bed facility. Both acquisitions have been in the making for a while. CHS and Sharon Regional signed an initial nonbinding letter of intent in August before signing a definitive agreement in February. CHS signed a definitive agreement to enter into the 40-year, $425 million lease of Munroe Regional in March, but that was after more than a year of Munroe Regional choosing a suitor. The hospital originally selected Health Management Associates, based in Naples, Fla., and CHS took control of the deal after it acquired HMA earlier this year. CHS now owns, operates or leases 208 hospitals in 29 states — solidifying its status as the largest for-profit, acute-care hospital chain in the country by hospital count. Florida and Pennsylvania have the highest numbers of CHS-affiliated facilities.
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Catholic Health Initiatives Completes Mercy Hot Springs Acquisition April 01, 2014 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-transactions-and-valuation/catholic-healthinitiatives-completes-mercy-hot-springs-acquisition.html Mercy Hospital Hot Springs (Ark.) is officially part of Englewood, Colo.-based Catholic Health Initiatives, as CHI and Chesterfield, Mo.-based Mercy have signed a definitive acquisition agreement. Terms of the deal were not disclosed. The 282-bed Mercy Hospital Springs and its physician clinic are now part of CHI's St. Vincent Health System, based in Little Rock, Ark. The hospital's new name is St. Vincent Hot Springs, and Thomas Fitz has been named interim president. Mercy and CHI signed a letter of intent to transfer ownership of St. Vincent Hot Springs this past October. Mercy originally tried to sell its Hot Springs hospital to Franklin, Tenn.-based Capella Healthcare, but challenges from the Federal Trade Commission and Vatican squashed the deal. CHI operates 87 hospitals nationwide, while Mercy includes 33, according to their latest statistics.
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