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Industry News

Open for comments: ONC roadmap calls for interoperability by 2017

The Office of the National Coordinator for Health IT has released for public comment its shared nationwide roadmap for interoperability. One of the main objectives of the 140-page roadmap is to enable "a majority of individuals and providers across the care continuum to send, receive, find and use a common set of electronic clinical information at the nationwide level by the end of 2017." (FierceHealthIT; roadmap)

CMS blinks, proposes shortening MU reporting period

CMS announced last week that it is considering proposals to shorten the Meaningful Use reporting period to 90 days in 2015. The College of Healthcare Information Management Executives, the Medical Group Management Association and the American Medical Association, among others, praised the move. CMS noted that the rulemaking on reporting period flexibility will be separate from the upcoming Meaningful Use Stage 3 rule, which may be released in March, Modern Healthcare reports. (Modern Healthcare)


Brief explains "two-midnight rule"

A new policy brief from Health Affairs and the Robert Wood Johnson Foundation examines the "two-midnight rule," which takes effect on April 1. The rule is an effort by the Centers for Medicare and Medicaid Services to clarify when Medicare will consider a patient an "inpatient" for hospital billing purposes. Under this rule, only patients a doctor expects to need two nights' hospitalization would be considered Medicare-eligible inpatients. This brief describes CMS' need for the two-midnight rule, how it will work, the implications for Medicare payment and the hospital industry's heated response to it. (policy brief)

Innovation & transformation

PCPCC: Latest evidence document supports value of PCMH

During a  Capitol Hill briefing last week, the Patient-Centered Primary Care Collaborative released The Patient-Centered Medical Home's Impact on Cost and Quality, Annual Review of Evidence, 2013-2014. The third annual Milbank-funded report includes an aggregation of PCMH outcomes from 28 peer-reviewed studies, state government program evaluations and industry reports. Despite the "growing evidence base that ties the medical home model of care to reductions in health care costs and improvements in quality," more is needed, Christopher Koller, president of the Milbank Memorial Fund, said in a prepared statement. "[F]or the PCMH to be sustainable, we need greater investment in primary care and less reliance on the fee-for-service payment system." (the review; announcement)
Kaiser Health News offers a round on Medicaid expansion news from Ohio, Indiana, Iowa and Missouri. In Iowa, some enrollees will be asked to pay small monthly premiums because they have not yet completed a required physical exam and health questionnaire. Indiana's recently approved plan creates different tiers of coverage--and includes a monthly fee for some participants. The approach riles some patient advocates, but it may be a blueprint for other states. (Kaiser Health News)
Three hospitals in western Pennsylvania had a 43 percent reduction in excessive emergency department visits by using patient navigators. These navigators--trained members of the community who connect patients with essential care services--were part of a one-year pilot study conducted by Accenture and the Highmark Foundation. The navigators took on necessary, non-clinical tasks-- e.g., conducting post-discharge follow-ups, connecting patients to local care services and scheduling physician appointments--allowing physicians to focus more on the care of patients. (Accenture announcement)
Consumers & Providers

Harris Poll: About 20 percent of insured skip doctor visits due to cost

About 20 percent of insured U.S. patients avoided seeing physicians in the past year due in part to concern about costs, according to a survey conducted on behalf of SCIO Health Analytics. Other findings: Thirty-seven percent of patients get information about health care costs and services from their insurance provider, while 31 percent get it from their physician. "While Americans are spending more time researching health plans, the survey reveals a significant knowledge gap in the specifics of their health care options that may eventually lead to unnecessary risks and costs," says Siva Namasivayam, CEO, SCIO Health Analytics. (Becker's Hospital Reviewsurvey announcement)
Primary care, specialists face barriers to making cancer referrals
Three out of five physicians surveyed reported encountering barriers to cancer patient specialty referrals, according to recent research published in Cancer. Barriers included restricted provider networks, preauthorization requirements and lack of surgical subspecialists, among others. "Uniform systems for providing and tracking timely referrals may enhance care and promote physician career satisfaction," the authors suggest. (Physician's Briefing; Cancer)
Despite more than 70 percent of U.S. physicians using electronic health records, as many as half do not routinely receive data necessary to effectively coordinate patient care. According to a recent study published in Medical Care, doctors using EHRs were only slightly more likely to receive patient data than those who did not use them at all. Fax and other non-electronic means of receiving data were reported by three-fourths of doctors receiving information from other practices and about half from hospitals. (HealthData Management; Medical Care)
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New & Noted   

NP ranks continue to grow: Over the last decade, the ranks of licensed nurse practitioners have nearly doubled in the U.S., from 106,000 in 2004 to 205,000 by the end of last year, according to the American Association of Nurse Practitioners. (Becker's Hospital Review)



Medicaid expansion fuels Anthem growth: Anthem--the country's second-largest health insurer--said it far outpaced its enrollment expectations in 2014; most of that growth came from Medicaid expansion. Insurance giant Anthem enrolled 1.8 million new customers in 2014, with nearly half of the new plans coming from Medicaid programs. (The Hill)



Sitting will kill you: the video

Dr. Sanjay Gupta offers insights on the most recent study about the risks of sitting. This one, published in the Annals of Internal Medicine, finds that sedentary behavior increases the chances of premature death, even for those who exercise regularly. He offers tips for counteracting the dangers of a sedentary life. (CNN; Annals study)


MarketVoices...quotes worth reading


"It's like buying a car without a manual or taking a test drive. You are left somewhat disoriented in the driver's seat. Health insurance companies need to adopt customized solutions based on big data to understand and reach these new members." --  Dave Hom, chief solutions and business development officer at SCIO Health Analytics, on the lack of knowledge individuals have about their insurance coverage, in a prepared statement  


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Wednesday, Feb. 4, 2014





























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