Guest post Ken Perez, vice president of healthcare policy, Omnicell.
“Politics is the art of the possible.” -Otto von Bismarck
This was supposed to be the year for permanent repeal of the sustainable growth rate (SGR), a formulaic approach intended to restrain the growth of Medicare spending on physician services. There was the rare cosmic convergence of bipartisan and bicameral support for SGR reform proposals at the end of 2013, and cost estimates by the Congressional Budget Office of a long-term “doc fix” reached new lows earlier this year.
But those hopes were dashed, as permanent SGR reform bills from both sides of the aisle died in the Senate. Instead, Congress agreed upon yet another short-term SGR patch. On March 27, 2014, the House, under a suspension of normal rules, approved via a voice vote a one-year patch to the SGR that would avoid a 24.4 percent reduction to Medicare’s Physician Fee Schedule (PFS) slated to take effect April 1, 2014 (replacing it with a 0.5 percent increase to the PFS for 12 months). Then on March 31, the Senate approved the patch via a roll-call vote, and President Barack Obama signed the bill into law that same day.
Why did the efforts to pass a permanent doc fix fail? The aforementioned bipartisan and bicameral support of SGR reform proposals was limited to “policy,” i.e., the future system by which physicians will be reimbursed by Medicare. Congressional Democrats and Republicans did not see eye to eye on the so-called “pay-fors” that would offset the increased government spending that would result with repeal of the SGR and allow the reform legislation to be deficit-neutral.
Guest post by Ken Perez, vice president of healthcare policy, Omnicell.
Years ago, I worked in a business unit of a large technology company that was involved in mergers, acquisitions and partnerships. In the course of our work, even when some proposed deals would fall through and some partnerships would not come together, the strategic intent of the company remained clear to us. It was like a beacon that we kept pursuing no matter what.
With healthcare-related legislation, all too often we can lose sight of the strategic intent of CMS. We immerse ourselves in the debate over details, but often fail to step back and reflect on the “end game” that one can hang their hat on. What is CMS signaling to healthcare providers?
Currently, there is bipartisan and bicameral support for permanent repeal of the unpopular, annually overridden sustainable growth rate (SGR) provision, a formulaic approach intended to restrain the growth of Medicare spending on physician services. The SGR threatens to impose a 24.4 percent reduction to the Medicare physician fee schedule (PFS) effective April 1, 2014.
Lawmakers from the House Ways and Means, House Energy and Commerce, and Senate Finance committees have worked together to consolidate separate bills that their respective committees passed toward the end of 2013. The result is H.R. 4015, the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, which was introduced by Rep. Michael C. Burgess, a Texas Republican and physician on Jan. 6, 2014.
Day 2 at HIMSS14 was much the same as day 1: Lots of walking, talking and great meetings with great organizations. I can’t thank enough vendors like Verisk Health, Omnicell, Amazing Charts and SAS for the great information they’ve shared, and for the perspectives about the market, trends and what’s ahead (and what’s behind).
Electronic health records are now foundational, and in many cases, they’ve lost their sex appeal. Though there’s an obvious and huge presence by them here, this year’s HIMSS doesn’t seem to have the same energy around the technology, from my point-of-view, that they did two or three years ago, for obvious reasons. Though their importance is still great, as we all know, other issues are taking center stage. ICD-10 is the obvious elephant in the room.
“Risk” is the biggest buzz word I’ve heard here in Orlando. I’ve heard it dozens of times. “Patient engagement” seems overcooked, according to those I’ve spoken to; an aspirational concept, yes, but actionable in an an entirely different story. Lofty goals and strategy, fewer practical best practices approaches for proceeding.
Patient engagement has only just begun, or at least is just developing past its infancy, and I look forward to seeing how it matures as a concept. Remember, just a couple years ago, those with vested interest claim patient portals would solve the ever elusive patient engagement issue. Portals clearly have not done so. Why would they? I remain skeptical that the actual patient is at the heart of this conversation rather how a systems can implement “best practices.” We’ll see, I suppose.
That said, HIMSS14 remains a wonderful experience and I’m glad to be here and meeting some wonderful people. I look forward to what today brings. Likely, more walking!
Guest post by Mohammad (Mo) Kharbat, RPh, MBA, director of pharmacy, ProHealth Care Inc.
Managing medications throughout several facilities within an integrated delivery network (IDN) or accountable care organization (ACO) is challenging. Recent Joint Commission surveys show that appropriate medication storage is the most common regulatory standard hospitals struggle with. As director of pharmacy at ProHealth Care Inc. (ProHealth), a regional integrated health network in Wisconsin with about 400 hospital beds, this is a challenge that I am all too familiar with.
One of my primary responsibilities is ensuring that all medications are well-managed throughout our facilities. As ProHealth has expanded to include a wider array of care delivery sites, medication management has increasingly become associated with high financial stakes. If medications are not well managed, hospitals lose money. Every pill that is unaccounted for translates to dollars lost for a provider. And when facilities fail to meet Joint Commission medication management standards, they risk valuable Medicare reimbursement funds.
