The Centers for Medicare & Medicaid Services (CMS) took additional actions to ensure America’s patients, healthcare facilities and clinical laboratories are prepared to respond to the 2019-Novel Coronavirus (COVID-19).
CMS has developed a second Healthcare Common Procedure Coding System (HCPCS) code that can be used by laboratories to bill for certain COVID-19 diagnostic tests to help increase testing and track new cases.
In addition, CMS released new fact sheets that explain Medicare, Medicaid, Children’s Health Insurance Program, and Individual and Small Group Market Private Insurance coverage for services to help patients prepare as well.
“CMS continues to leverage every tool at our disposal in responding to COVID-19,” said CMS Administrator Seema Verma. “Our new code will help encourage doctors and laboratories to use these essential tests for patients who need them. At the same time, we are providing critical information to our 130 million beneficiaries, many of whom are understandably wondering what will be covered when it comes to this virus. CMS will continue to devote every available resource to this effort, as we cooperate with other government agencies to keep the American people safe.”
HCPCS is a standardized coding system that Medicare and other health insurers use to submit claims for services provided to patients. Last month, CMS developed the first HCPCS code (U0001) to bill for tests and track new cases of the virus.
This code is used specifically for CDC testing laboratories to test patients for SARS-CoV-2. The second HCPCS billing code (U0002) announced today allows laboratories to bill for non-CDC laboratory tests for SARS-CoV-2/2019-nCoV (COVID-19).
On February 29, 2020, the Food and Drug Administration (FDA) issued a new, streamlined policy for certain laboratories to develop their own validated COVID-19 diagnostics. This second HCPCS code may be used for tests developed by these additional laboratories when submitting claims to Medicare or health insurers. CMS expects that having specific codes for these tests will encourage testing and improve tracking.
The Medicare claims processing systems will be able to accept these codes starting on April 1, 2020, for dates of service on or after February 4, 2020. Local Medicare Administrative Contractors (MACs) are responsible for developing the payment amount for claims they receive for these newly created HCPCS codes in their respective jurisdictions until Medicare establishes national payment rates.
Laboratories may seek guidance from their MAC on payment for these tests prior to billing for them. As with other laboratory tests, there is generally no beneficiary cost sharing under Original Medicare.
To ensure the public has clear information on coverage and benefits under CMS programs, the agency also released three fact sheets that cover diagnostic laboratory tests, immunizations and vaccines, telemedicine, drugs, and cost-sharing policies.
Medicare Fact Sheet Highlights: In addition to the diagnostic tests described above, Medicare covers all medically necessary hospitalizations, as well as brief “virtual check-ins,” which allows patients and their doctors to connect by phone or video chat.
Medicaid and Children’s Health Insurance Program (CHIP) Fact Sheet Highlights: Testing and diagnostic services are commonly covered services, and laboratory and x-ray services are a mandatory benefit covered and reimbursed in all states. States are required to provide both inpatient and outpatient hospital services to beneficiaries. All states provide coverage of hospital care for children and pregnant women enrolled in CHIP. Specific questions on covered benefits should be directed to the respective state Medicaid and CHIP agency.
Individual and Small Group Market Insurance Coverage: Existing federal rules governing health insurance coverage, including with respect to viral infections, apply to the diagnosis and treatment of with Coronavirus (COVID-19). This includes plans purchased through HealthCare.gov. Patients should contact their insurer to determine specific benefits and coverage policies. Benefit and coverage details may vary by state and by plan. States may choose to work with plans and issuers to determine the coverage and cost-sharing parameters for COVID-19 related diagnoses, treatments, equipment, telehealth and home health services, and other related costs.
Summary of CMS Public Health Action on COVID-19 to date:
On Mar. 4, 2020, CMS issued a call to action to healthcare providers nationwide to ensure they are implementing longstanding infection control procedures and issued important guidance to help State Survey Agencies and Accrediting Organizations prioritize their inspections of healthcare facilities to focus exclusively on issues related to infection control and other serious health and safety threats. For more information on CMS actions to prepare for and respond to COVID-19, visit: https://www.cms.gov/newsroom/press-releases/cms-announces-actions-address-spread-coronavirus
“We recognize all the hard work that so many have put into preparing for their presentations and panels that accompany every HIMSS conference,” said Hal Wolf, president and CEO of HIMSS. “Based on evaluation of evolving circumstances and coordination with an external advisory panel of medical professionals to support evidence-based decision making, it is clear that it would be an unacceptable risk to bring so many thousands of people together in Orlando next week.”
The advisory panel recognized that industry understanding of the potential reach of the virus has changed significantly in the last 24 hours, which has made it impossible to accurately assess risk. Additionally, there are concerns about disproportionate risk to the healthcare system given the unique medical profile of Global Conference attendees and the consequences of potentially displacing healthcare workers during a critical time, as well as stressing the local health systems were there to be an adverse event.
This will be the first time in 58 years the event has been cancelled, but it is now clear that cancellation is unavoidable in order to meet HIMSS’ obligation to protect the health and safety of the global HIMSS community, employees and local residents, as well as for the healthcare providers tasked with keeping our U.S. and global communities healthy.
HIMSS20 exhibitors and attendees will be contacted with further information regarding booth contracts and registrations. Please contact exhibitors@himss.org for immediate booth concerns. Any further updates regarding HIMSS20 will be published on himssconference.org.
Adoption of digital health tools has grown significantly among all physicians since 2016 when the American Medical Association (AMA) first benchmarked the integration of emerging health technology into clinical practice. New AMA research released today shows more physicians than ever recognize digital health tools as an advantage for driving improved efficiency and safety in healthcare.
“The rise of the digital-native physician will have a profound impact on healthcare and patient outcomes, and will place digital health technologies under pressure to perform according to higher expectations,” said AMA board chair Jesse M. Ehrenfeld, M.D., M.P.H. “The AMA survey provides deep insight into the emerging requirements that physicians expect from digital technologies and sets an industry guidepost for understanding what a growing number of physicians require to adopt new technology.”
The AMA Digital Health Research investigates shifts in physician adoption of digital health tools during the last three years, along with current attitudes and expectations among physicians. The research examines seven categories of digital health tools that engage patients for clinical purposes, interpret and use clinical data, and manage outcomes and other measures of care quality.According to the AMA survey, adoption trends in the following seven categories are helping to propel the digital transformation of healthcare.
Tele-visits/virtual visits – Physician adoption doubled from 14% in 2016 to 28% in 2019, the largest growth among the digital health tool categories. This category includes audio/video connections used to see patients remotely.
Remote monitoring and management for improved care – Physician adoption jumped from 13% in 2016 to 22% in 2019. This category includes mobile applications and devices for use by chronic disease patients for daily measurement of vital signs, such as weight, blood pressure, blood glucose, etc. Readings are visible to patients and transmitted to the physician’s office. Alerts are generated as appropriate for missing or out of range readings.
Remote monitoring for efficiency – Physician adoption modestly grew from 12% in 2016 to 16% in 2019. This category includes smart versions of common clinical devices such as thermometers, blood pressure cuffs, and scales that automatically enter readings in the patient medical record.
Clinical decision support – Physician adoption climbed from 28% in 2016 to 37% in 2019. This category includes modules used in conjunction with the EHR, or mobile applications integrated with an EHR, that highlight potentially significant changes in patient data, such as weight gain/loss, change in blood chemistry, etc.
Patient engagement – Physician adoption rose from 26% in 2016 to 32% in 2019. This category includes solutions to promote patient wellness and active participation in their care for chronic diseases, such as adherence to treatment regimens.
Point of care/workflow enhancement – Physician adoption modestly increased from 42% in 2016 to 47% in 2019. This category includes communication and sharing of electronic clinical data to consult with specialists, make referrals and/or transitions of care.
Consumer access to clinical data – Physician adoption rose from 53% in 2016 to 58% in 2019, the highest adoption rate among the digital health tool categories. This category includes secure access allowing patients to view clinical information such as routine lab results, receive appointment reminders and treatment prompts, and to ask for prescription refills, appointments and to speak with their physician.
While all digital health tools have seen increases in physician adoption since 2016, the biggest growth in adoption was among digital tools in the categories of tele-visits/virtual visits and remote monitoring for improved patient care. Driving this adoption is a significant increase in the importance physicians place in providing remote care to patients. To speed implementation of remote patient monitoring, the AMA’s Digital Health Implementation Playbook packages the key steps, best practices and resources to help physicians extend care beyond the exam room.
Improved efficiency and increased patient safety remain the most important factors driving physician interest in digital health tools, although addressing patient adherence, convenience and physician burnout have increased in importance as factors driving physician interest.
Liability coverage remains the most important requirement for physician adoption of digital health tools, and this requirement has significantly increased in importance during the last three years. Electronic medical record (EHR) integration and data privacy rounded out the three most important physician requirements for digital health tools. There was a notable increase in the importance of peer review validation as a physician requirement for digital health tools.
For the first time, the AMA research surveyed physicians about their awareness and current usage of emerging technologies, such as augmented intelligence, blockchain and precision medicine. While levels of awareness greatly exceed adoption rates, more than one-third of physicians intended to adopt emerging technologies within the year. Interest is highest for use with chronic care patients.
The AMA is dedicated to shaping a future when digital health tools are evidence based, validated, interoperable, and actionable. Through its ongoing work, the AMA is committed to ensuring physicians play a greater role in leading trustworthy and equitable tech-enabled innovation that enhances patient care, shapes a better healthcare system, and improves the health of the nation. Through our research, collaborations, advocacy and leadership, the AMA is working to make the patient?physician relationship more valued than paperwork, preventive care the focus of the future, technology an asset and not a burden, and physician burnout a thing of the past. Continue Reading
More than 50 organizations – from major tech giants to startups and healthcare industry leaders – convened by the Consumer Technology Association (CTA) have developed the first-ever ANSI-accredited standard for the use of artificial intelligence in healthcare. This standard, part of CTA’s new initiative on AI, is the first in a series that will set a foundation for implementing medical and healthcare solutions built on AI.
Shapiro
“This standard creates a firm base for the growing use of AI in our healthcare—technology that will better diagnose diseases, monitor patients’ recoveries and help us all live healthier lives,” said Gary Shapiro, president and CEO, CTA. “This is a major first step – convening some of the biggest players in the digital health world – to help create a more efficient healthcare system and offer value-based healthcare to Americans.”
AI-related terms are used in different ways, leading to confusion – especially in the healthcare industry, including telehealth and remote patient monitoring. To address this problem, CTA announced the working group with 30 members less than a year ago, which now includes a wide range of decision makers from 52 organizations and member companies to develop a standard built on consensus.
The standard – 11 definitions and characteristics – provides a framework for better understanding AI technologies and common terminology so consumers, tech companies and care providers can better communicate, develop and use AI-based healthcare technologies.
A broader AI committee at CTA also published an ANSI-accredited standard that addresses the pervasiveness of AI-enabled technology across the entire consumer technology industry. The standard defines over 30 terms including machine learning, model bias, artificial neural network and trustworthiness.
“So far, common terminology has defined the intent of use — and that’s one of the most significant challenges in developing standard application of AI,” said Rene Quashie, vice president of policy and regulatory affairs, digital health, CTA. “As health systems and providers use AI tools such as machine learning to diagnose, treat and manage disease, there’s an urgent need to understand and agree on AI concepts for consistent use. This standard does exactly that.”
As the healthcare system deals with clinician shortages, an aging population and the persistence of chronic diseases in the US, technologically driven solutions, such as AI, will increasingly be used to meet clinician and patient needs, the group notes.
Xealth announced recent survey findings that examine the digital health expectations of new or expectant mothers compared to the services received from healthcare providers. The last few years have seen a movement towards offering patients a more consumer-friendly experience, with significant investments made in digital health. This new experience can assist with patient engagement, treatment compliance and patient retention.
According to the Project Beyond survey[1], commissioned by Xealth in partnership with Sid Lee and conducted among nearly 1,000 U.S. women who are new or expectant mothers, a majority (53%) who are familiar with digital health see online information as a key factor in choosing a hospital. Key findings include:
Digital tools rated most important to patients: online access to medical records (61%), online payment tools (57%), online scheduling (52%) and electronic refill of prescriptions (51%);
Digital tools most offered by hospitals: online payment tools (45%), online access to medical records (39%), online education and information (31%), and online scheduling (29%);
The widest gaps exist related to electronic refill of prescriptions (51% find this important vs. 23% actually can), online scheduling (52% vs. 29%), and price transparency (30% vs. 8%); and
Comments about what hospitals can do to improve the digital health experience involved providing greater convenience, creating patient communities, improving education and increasing transparency.
Other notable findings:
Nearly half of respondants (47%) expect some form of digital interaction with their doctor; and
Nearly 30% of respondants answered “I don’t know” when asked what the definition of digital health.
“We’re interested in how specific communities are engaging with digital health tools and how those tools impact their health experiences and choices,” said John Breen, executive director of health strategy at Sid Lee. “This survey captured the perspective of new or expectant mothers, most of whom belong to the digital native Millennial and Generation Z cohorts. As they look to manage growing families and aging parents, their expectations for a digital health experience will only continue to rise.”
Access Sid Lee’s full report and infographic here.
Methodology
This survey was conducted online within the United States by Sid Lee on behalf of Xealth from February 04-11, 2020 among 932 adults ages 18 and older who are new or expecting moms. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated.
[1] Survey conducted online within the United States by Sid Lee on behalf of Xealth from February 04-11, 2020 among 932 adults ages 18 and older who are new or expecting mothers. This online survey is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated.
InterSystems announced the launch of InterSystems HealthShare Managed Connections, a service that enables healthcare organizations to take advantage of a network of connections to a vast number of patient records via a central hub and exchange data easily. Through the HealthShare Managed Connections hub, participants can exchange information in a safe, controlled, reliable, and efficient manner.
Most healthcare organizations today rely on one-to-one connections to their partners and to national networks. InterSystems is taking the approach of “build once, use many” to create connections which keep pace with changing requirements and standards.
The HealthShare Managed Connections hub transforms healthcare interoperability with faster onboarding as well as easier maintenance, time, and cost to connect healthcare data. The HealthShare Managed Connections vendor-agnostic connectivity means it doesn’t compete with national networks; it complements them.
Woodlock
“HealthShare Managed Connections allows users to connect to each other as well as to vast national networks, ultimately providing interoperability in a reusable and economical fashion that benefits everyone,” said Don Woodlock, vice president of HealthShare. “This central hub makes it easier to create a single, unified patient record and drive better healthcare outcomes.”
As a CommonWell Connector product, HealthShare Managed Connections empowers users with the ability to access the CommonWell Health Alliance network—representing more than 15,000 provider sites and 76 million individuals.
Through CommonWell, users have the added benefit of being able to leverage the Carequality Interoperability Framework, further increasing access to patient health information. To date, the CommonWell network has more than 219 million health records accessible for exchange, and on average, exchanges more than 70 million health-related records per month.
Nanocubes are structures unfamiliar to many outside of the nanobiotechnology discipline. By name, these structures almost sound like a popular children’s toy. Illustrations of nanocubes even appear somewhat illusory, with their vivid primary colors and playful shapes. However, it was during the process of building one of these tiny cubes that revealed brand new information about how molecules bind together in natural environments.
Studying Forces
Initially, researchers at the University of Tokyo’s Department of Basic Science set out to build several tiny, self-assembling structures using the power of the interactions between the molecules that compose them. These researchers were particularly interested in how the hydrophobic effect and its associated forces caused two molecules to behave in relation to one another. Generally, two molecules that are surrounded by water tend to move toward one another, due to the chemical force of each to repel water.
By Vladimir Kuzmenko, SVP of sales and business development, NIX United.
Vladimir Kuzemko
As healthcare becomes increasingly complex, the role of technology is evolving to offer new and innovative solutions that allow healthcare practices the opportunity to better serve their patients. However, as technology evolves and changes, healthcare as a whole must also grow and adapt to thrive in a complex and ever-changing ecosystem.
As we embark on a new decade (in which we’re now well into the first year), I’d like to examine a few of the more pressing trends that forward-thinking practices embracing currently and for the foreseeable future.
Some of these adoptions may include new systems and technologies being implemented, as well as technologies that are best-placed to keep up in these rapidly-changing areas of any profitable practice.
More importantly, however, is how these technologies might impact healthcare and how forward-thinking organizations take advantage of these opportunities. With this is mind, here are six trends that may influence healthcare in 2020 and beyond.
Blockchain
You may hear the term blockchain and think, “what does cryptocurrency have to do with helping patients?” However, blockchain has evolved and has many more applications than just new forms of currency. For instance, many urgent healthcare issues may be solved by utilizing blockchain, including:
Secure health information transfer
Health data management
Reducing the number of counterfeit medicines on the market
In addition, blockchain technology can be used in innovative ways to allow organizations to access information on a secure channel that maintains privacy.
Electronic health records
For all the integration issues U.S. healthcare organizations experienced in integrating electronic health records into their practices in the last decade, there has been no more profound change in the practice of healthcare in the U.S.
These electronic records create opportunities to track and improve patient care and to find new, more efficient treatment methods by incorporating artificial intelligence technologies. Protecting a practice’s and the patient’s data privacy is also an issue that must be addressed beforehand, not after a breach has occurred.
The Centers for Medicare & Medicaid Services (CMS) took additional actions to ensure America’s patients, healthcare facilities and clinical laboratories are prepared to respond to the 2019-Novel Coronavirus (COVID-19).
