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.
Health wearables and fitness tracking devices have created an unprecedented opportunity for the healthcare community to collect valuable data that could greatly impact patient care and health insurance premiums. Still, adoption rates for such devices remain low in the U.S. adult population.
While the use of health and fitness tracking devices has more than doubled in the last two years, a new nationwide survey conducted by TechnologyAdvice shows that only 25.1 percent of adults are currently using either a fitness tracker or a smartphone app to monitor their health, weight or exercise. However, the survey also shows that nearly half of those not using such a device would be more likely to use one if it were provided free by their physician or health insurance company.
“Healthcare providers and health insurance companies are two of the largest stakeholders in the promotion of fitness tracking devices, and they have an opportunity to greatly influence their use,” said the report’s author, TechnologyAdvice managing editor Cameron Graham. “This survey revealed there are few real barriers to using health wearables, and also indicated adoption rates would increase if their use was incentivized by the healthcare community. If healthcare providers worked in tandem with health insurance companies, both stakeholders could benefit from the collected population health data.”
Nearly 44 percent of respondents did not have a specific reason for not tracking their fitness, while another 27.2 percent cited a simple lack of interest in wearing a fitness tracking device. Cost, data privacy, and device design did not prove to be overly impactful concerns. With these limited barriers to use, almost half (48.2 percent) of non-tracking adults said they would use a free fitness tracking device provided by their physicians, while 46.1 percent said they would use one provided for free by their health insurance company.
MedWand Solutions develops and distributes the MedWand solution, a patent-pending telemedicine device that easily connects to a PC or mobile device, like a cell phone or tablet. MedWand contains a set of fundamental, easy-to-use vital sign measurement and examination devices integrated into a single wand about the size of a large electric toothbrush. It includes a pulse oximeter, an otoscope camera for ear examinations with attachments to also allow views of the eyes, throat, or nose, an in-ear thermometer, a digital stethoscope and provision to support optional third party Bluetooth wireless devices, such as glucose meter or blood pressure monitor. In addition enabling remote examinations, MedWand can assemble all measurements and required information into a secure electronic health record, enabling a clinical-quality, interactive, at-home telemedicine experience for both patients and their doctors.
With all the advancements we have experienced in technology, routine telemedicine still doesn’t allow examination capabilities for all patients. With MedWand, no matter where the location, patients can experience remote examinations like never before.
MedWand is the first handheld telemedicine device that allows doctors to examine patients and gather important medical vitals, remotely, via secure Internet channels on tablets and personal computers. In the rapidly growing industry of telemedicine, the majority of remote consultations are limited to audio and video without the possibility of direct physician examination. Now, with a MedWand, doctors can listen to a patient’s heart, lungs, and abdomen; look at skin and into ears, nose, and throat with an embedded high-definition video camera; obtain basic vital signs, including blood oxygenation; and even obtain a thre-lead EKG – all remotely, with a single unit that can be cradled into the palm of a hand. In addition, MedWand provides continuous medical vitals monitoring services with alerts when patients may be headed in the wrong direction.
The MedWand telemedicine device was conceived by former Pebble Beach house doctor Samir Qamar, a family physician and founder of MedLion Direct Primary Care, one of the nation’s leading direct primary care companies. It was after being dissatisfied with current limitations of telemedicine that Dr. Qamar came up with the idea to build a compact telemedicine device capable of remote patient exams. After an extensive search, Dr. Qamar approached engineer Robert Rose, founder of Cypher Scientific engineering, formerly of Red Digital Cinema, who agreed to join the project. Together, on a mission to advance telemedicine, Dr. Qamar and Mr. Rose created the MedWand.
MedWand appeals to the entire telemedicine industry. Having already been approached by branches of the U.S. military and many large telemedicine companies worldwide, MedWand will soon be helping hospitals, accountable care organizations, and companies control healthcare costs by allowing real-time examinations to telemedicine services. A major computer manufacturer has offered to be a launch partner for MedWand, and MedWand is ripe for international distribution. Eventually, the MedWand will be distributed directly to patients and their families worldwide.
Advocate Health Care (AHC), based in Illinois, is the Midwest’s largest health system. It includes 13 hospitals, two physician groups, a home care company, a laboratory joint venture and more than 200 sites that provide care. AHC typically serves about 3.4 million patients annually – as you can imagine, that results in a lot of patient data. As such, we recently adopted a single platform approach and standardization of processes for storing and sharing information that enables us to manage patient data in a more timely, cost-effective and streamlined manner.
Patient data is the lifeblood of our IT infrastructure. Given the size of our organization, it’s essential that we have a shared vision on how we manage, access and share information across all sites. Our health system exists to provide a full spectrum of care, so it’s vital that we have a data management system in place that helps ensure patient data meets compliance requirements and is quickly recoverable. Additionally, AHC has the state’s largest physician network of primary care physicians, specialists and sub-specialists, so this organized approach to managing data serves to connect patients with providers and vice-versa, ensuring no relationship is left unmatched.
Advocate Health Care maintains a bank of internal data from payroll, financial and HR applications, as well as clinical apps. As a result, it was producing an extreme amount of information on a daily basis that needed to be stored and managed by our corporate information system. Not all data management companies and solution providers understood our desire to integrate this data into one holistic platform. When it came time to find a new data management partner in 2011, many vendors recommended disparate systems or processes that siloed, rather than integrated, our in-house data management initiative.
Although most accountable care organizations (ACOs) have the health information technology (HIT) to improve clinical quality, poor interoperability across systems and providers remains a barrier, according to an ACO survey conducted by Premier, Inc. (NASDAQ: PINC) and the eHealth Initiative. Access to data from external organizations was challenging for 100 percent of respondents.
The survey, fielded in July-August of 2014, collected responses from 62 ACOs, including members of Premier’s PACT Population Health Collaborative.
Compounding the challenge of accessing and sharing data is the fact that 88 percent of the ACOs face significant obstacles in integrating data from disparate sources, and 83 percent report challenges integrating technology analytics into workflow – barriers that become more acute as ACOs add new platforms or build on their expansive network of medical settings. As ACOs collect data from more sources, they also report concerns about interoperability and data management. Interoperability of disparate systems is a significant challenge for 95 percent of organizations using HIT, and could be limiting the abilities of ACOs to exchange data.