Guest post by Tom Giannulli, MS, MD, chief medical information officer, Kareo.
It seems like everywhere you look there is a new piece of wearable technology to help people monitor their health and lifestyle. The latest and greatest, of course, is the Apple Watch, which hit the newswire with a bang last month.
There is no doubt that mobile health apps and wearable technology and devices are big business. Both patients and clinicians are using mHealth apps on their smartphones and other devices. There are tens of thousands of these apps, and the Robert Wood Johnson Foundation says this number will grow by 25 percent a year. Their research also shows that by 2018 1.7 billion people worldwide will download a health app.
Despite what the media may say, the fact is most people aren’t using these apps and devices yet according to a new study from Technology Advice. Their research found that nearly 75 percent of adults do not track their weight, diet, or exercise using a fitness tracking device or app and most cited reason was general lack of interest.
However, one interesting thing to note is that more than half said they would be more likely to use a health tracking app or device if there was a possibility of lowering their insurance premiums. Just over 40 percent said better advice from their healthcare provider would be a possible incentive to use a fitness tracker.
Guest post by Allison Errickson, CPC-H, director of coding compliance, ProVation Medical, with Wolters Kluwer Health.
Never before have effective revenue cycle management strategies been so critical to future positioning in hospitals and health networks. In today’s lean environment of declining and unpredictable reimbursement, effective oversight of timely billing practices can simply be a make or break element to success.
Because the revenue cycle is dependent on the time-to-bill for procedures and diagnostic care, healthcare organizations must enact processes to support the most efficient coding practices to speed receipt of payment. Success in this area remains an obstacle for many organizations struggling with how to allocate limited resources to ensure the most accurate coding and efficient turn-around.
Denials plague the industry in terms of maintaining consistent cash flow. Inaccurate or incomplete documentation can impact as much as 5 percent of revenues if a healthcare organization is experiencing denial rates of 25 percent or more. Revenue is also negatively impacted when documentation does not support the highest level of acuity, minimizing reimbursement potential.
While accurate documentation remains an ongoing issue, resource allocation to effectively address the issue will likely be further impacted with the introduction of ICD-10. The industry has been granted a reprieve with the recent deadline extension of Oct. 1, 2015, but the reality of the transition will be coming into focus very soon. Coding challenges will be exacerbated as coders will now have 72,000 unique procedure codes to choose from, increasing the complexities associated with specificity and accurately coding to the highest level of reimbursement.
As part of its ongoing effort to increase transparency and accountability in healthcare, the Centers for Medicare & Medicaid Services (CMS) released today the first round of Open Payments data to help consumers understand the financial relationships between the healthcare industry, and physicians and teaching hospitals.
This release is part of the Open Payments program, created by the Affordable Care Act, and lists consulting fees, research grants, travel reimbursements and other gifts the health care industry, such as medical device manufacturers and pharmaceutical companies – provided to physicians and teaching hospitals during the last five months of 2013. The data contains 4.4 million payments valued at nearly $3.5 billion attributable to 546,000 individual physicians and almost 1,360 teaching hospitals. Future reports will be published annually and will include a full 12 months of payment data, beginning in June 2015.
“CMS is committed to transparency and this is an opportunity for the public to learn about the relationships among health care providers, and pharmaceutical and device companies,” CMS Administrator Marilyn Tavenner said. “This initial public posting of data is only the first phase of the Open Payments program. In coming weeks, we will be adding additional data and tools that will give consumers, researchers, and others a detailed look into this industry and its financial arrangements.”
Financial ties among medical manufacturers’ payments and health care providers do not necessarily signal wrongdoing. Given the importance of discouraging inappropriate relationships without harming beneficial ones, CMS is working closely with stakeholders to better understand the current scope of the interactions among physicians, teaching hospitals, and industry manufacturers. CMS encourages patients to discuss these relationships with their healthcare providers.
BD (NYSE: BDX) and CareFusion (NYSE: CFN) announced today a definitive agreement under which BD will acquire CareFusion for $58.00 per share in cash and stock, or a total of $12.2 billion, to create a global leader in medication management and patient safety solutions. The agreement has been unanimously approved by the Boards of both companies.
The combination of the two companies’ complementary product portfolios will offer integrated medication management solutions and smart devices, from drug preparation in the pharmacy, to dispensing on the hospital floor, administration to the patient, and subsequent monitoring. The combination will improve the quality of patient care and reduce healthcare costs by addressing unmet needs in hospitals, hospital pharmacies and alternate sites of care to increase efficiencies, reduce medication administration errors and improve patient and healthcare worker safety. In addition, the Company will have solid positions in patient safety to maximize outcomes in infection prevention, respiratory care, and acute care procedural effectiveness.
Under the terms of the transaction, CareFusion shareholders will receive $49.00 in cash and 0.0777 of a share of BD for each share of CareFusion, or a total of $58.00 per CareFusion share based on BD’s closing price as of October 3, 2014. The transaction is subject to regulatory and CareFusion shareholder approvals and customary closing conditions, and is expected to close in the first half of calendar year 2015. Upon closing, BD shareholders will own approximately 92 percent of the combined company and CareFusion shareholders will own approximately 8 percent.
If for no other reason, the following open letter seems worthy of publication. It was sent by HIMSS to HHS’ secretary Sylvia Mathews Burwell on Sept. 30, 2014. The four-page letter, published below for your review, lays out the organization’s professional and political goals for the near term.
HIMSS makes three specific recommendations to HHS, suggesting to the feds where their attention should focus. HIMSS’ recommends immediately pulling three key policy levers: the EHR incentive program, interoperability leading to secure electronic exchange of health information, and electronic reporting of clinical quality measures (CQMs).
HIMSS also makes the strong recommendation for one three-month reporting period in 2015 for meaningful use, as well as publicly reminding HHS that there continues to be support efforts for interoperability. The letter does little than offer a pat on the back to HHS for its efforts, and says that HIMSS offers its support for everything HHS is doing, but the letter also serves as a real reminder that HIMSS is willing to flex a little muscle on behalf of its members if HHS doesn’t listen up or do a little falling in line.
To be clear, I have nothing against HIMSS; if they can get away with telling a federal organization how it is, that’s admirable. However, the letter is soaked with arrogance and bullishness, as if HIMSS is intentionally telling all in healthcare just how big and powerful it is, dammit. No doubt, this is the type of thing that’s gone on for years. I understand how lobbyists work; in fact, I’ve worked with them and understand their game. This is probably just the first time in a while I’ve seen such a blatant outreach effort. After all, it’s not like HHS doesn’t know who or what HIMSS as an organization is, but it seems strong in a nuanced way.
Judge for yourself and read the letter below. Are you a HIMSS member? What do you think of the organization’s power push?
Representatives Diane Black (R-TN) and Peter Welch (D-VT) introduced bipartisan legislation to build upon the progress of Accountable Care Organizations (ACOs) in shifting the reimbursement of health care providers away from the traditional “fee for service” model to a focus on improving the health outcomes of patients. The ACO Improvement Act (H.R. 5558) will improve the ACO model by providing additional incentives focused on health outcomes, increasing collaboration between patients and doctors, and providing ACOs with additional tools.
“As a nurse of over forty years, I know firsthand the challenges facing health care professionals as they seek to provide their patients with the best care possible,” said Congressman Black. “It is unfortunate that the current fee for service payment system does little to encourage and incentivize providers and patients to use the most appropriate and effective health care options. By incentivizing providers to focus on improving health care outcomes instead of increasing the quantity of services provided, this legislation will help improve care coordination, increase efficiency, and mostly importantly, ensure the patient receives the best care possible.”
Rep. Peter Welch
“If we are going to reduce health care costs and increase quality, the incentives built into the provider payment system need to be changed. In short, we need to reward value, not volume,” said Rep. Welch. “Paying health care providers based on improvements in patient health rather than the number of procedures they perform is the way of the future. Our legislation will advance these payment reforms and is based on the experience of ACOs in Vermont and around the country.”
An ACO is a collaborative of health care providers working together to improve the quality and efficiency of patient care, rather than increase the number and type of services performed. The goal of ACOs is to drive down health care costs and improve patient health outcomes by creating financial incentives to provide better, more cost-effective care. Rep. Welch is the author of a provision in the Affordable Care Act that created a nationwide Medicare ACO program.
Guest post by Jason Lee, healthcare and security forums director, The Open Group.
The healthcare industry produces an abundance of data that, we are beginning to understand, can be used in a variety of ways to improve the health and wellness of populations and the quality and efficiency of Healthcare delivery to patients. Unfortunately, there are substantial (but not insurmountable) barriers to overcome. To take just one example, as mobile medical devices and wearables collect personal health information, how will these data be exploited to achieve the goals of improved health and wellness?
Health informatics professionals—in collaboration with many stakeholders in the healthcare system — build the capability for collecting and warehousing large amounts of data, but a “new breed” of data experts is needed to analyze and meaningfully interpret the data to produce useful, capability-expanding knowledge. A new workforce, with these skills, will help turn healthcare information into action and improve, outcomes and quality and reduce risk and overall costs.
One of the key issues when it comes to healthcare data is the lack of interoperability in the industry and, more often than not, the different parts of the data puzzle are not fitting together. The information from wearable devices, for example, can be used to keep people well – but only if the data so collected is properly integrated with additional clinical/personal data located in providers’ electronic medical records and payer’s administrative database. The skills of the recently trained data analyst, combined with the proven skills of healthcare informaticians, will increasingly help ensure increased interoperability.
Guest post by Peter Mansfield, director of marketing, QLess.
Healthcare is one of the primary economic engines of America’s cities and a sector where technology innovation remains a high priority. However, recent findings from a ClickSoftware study conducted by Harris Poll, revealed that Americans feel healthcare is one of the country’s most frustrating industries — because of the amount of time spent waiting to be served. So, where’s the disconnect?
It’s no secret, there are a few worse places to wait in line than the doctor’s office or urgent care, surrounded by coughers and sneezers. To this end, healthcare facilities must take a step back and ask themselves the question: How efficient are you?
For most healthcare professionals that’s a tough question. The truth is, it’s well worth giving serious consideration to the operational aspects of your healthcare practice or clinic. After all, inefficiency directly impacts your bottom line in a multitude of ways. Worst of all, a poorly run area of your business can foster a negative influence that permeates other aspects of your practice. One poorly focused or lackadaisical area will frustrate not only your patients but also your team and the employees who really want to push a practice forward.
Where to start? From hospitals to urgent care centers, healthcare businesses usually require the coordination of many different moving parts. That includes your team, systems, payers, and of course, patients. It’s worth thinking through the life cycle of a typical patient visit to identify critical points that help define and assess the overall experience your facility provides.
BD (NYSE: BDX) and CareFusion (NYSE: CFN) announced today a definitive agreement under which BD will acquire CareFusion for $58.00 per share in cash and stock, or a total of $12.2 billion, to create a global leader in medication management and patient safety solutions. The agreement has been unanimously approved by the Boards of both companies.
