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Industry News

SGR: One down, one to go 

After years of patches and fixes, Medicare payment reform may finally happen. In a 392-37 vote, House lawmakers passed a bill to end the sustainable growth rate. This is the closest Congress has come to repealing the SGR since 2002. It's not a done deal, however: The Senate still needs to act, but with Congress on vacation, that won't happen until later this month. The House bill also extends the Children's Health Insurance Program for two years and seeks to move Medicare toward the use of more alternate payment models. (MedPage TodayD Healthcare Daily)



Mobile health apps raise security concerns; HIPAA doesn't always apply

Mobile device health apps have the potential to transform health care, but they are also raising concerns about privacy and security, Managed Healthcare Executive reports. Covered entities are liable for the security of personal health information when the data is on the entity's servers, says Adam H. Greene, JD, MPH, a partner in the Health IT/HIPAA practice at global law firm Davis Wright Tremain. But he adds that once the information reaches the consumer's phone--via an app issued by a HIPAA-covered entity--"it arguably is no longer subject to HIPAA." (Managed Healthcare Executive)



Use of care coordinators continues to expand

Modern Healthcare looks at how a growing number of health systems, ACOs and medical homes are deploying care coordinators, freeing doctors, advanced practice nurses and physician assistants to focus on clinical duties. But there are challenges, both cultural and financial. "One of the issues is making sure [you're] not involving so many people and collecting so much information that you're actually complicating the continuity of care," says Dr. Eugene Rich, a Mathematica senior fellow who studies care coordination. Covering the cost of these services remains challenging, too--mostly because many insurers still rely on fee-for-service payment and won't reimburse for nonmedical care-management services. (Modern Healthcare)


Innovation & Transformation

Conway: Some innovation models ready for prime time 

CMS Chief Medical Officer Patrick Conway, MD, attributes a 2 percent decline in admissions and emergency department visits to the agency's increased support for primary care providers in recent years. He adds that many of the nearly 60 demonstration projects run by the CMS Innovation Center are ready to be scaled up to be offered across the country, HealthLeaders Media reports. To some, 2 percent doesn't sound like much, he acknowledges. But "if we shifted our trend nationally by 2 percent across the board, we would be in a different fiscal place" across the country. (HealthLeaders Media)


CHIME to launch patient ID competition

The College of Health Information Management Executives (CHIME) is raising $1 million to begin its National Patient ID Challenge by summer 2015, which will incentivize innovators to create a solution to correctly match patients to medical records. A task force of health IT leaders is currently defining competition guidelines and criteria for winning. "There is a growing consensus among payers and providers that a unique patient ID would radically reduce medical errors and save lives," says CHIME President and CEO Russell Branzell. (Healthcare Informatics)



Rural Maine hospitals collaborate for better care

Five Maine hospitals have joined to form the Maine Rural Health Collaborative with the following mission: Enhance the quality of care in their respective communities. Tom Moakler, CEO of Houlton Regional Hospital, a Collaborative member, cites the changing health care landscape as a main reason for the group's formation. According to a recent American Hospital Association report, 22 percent of the nation's population live in rural areas and frequently rely on local hospitals as their only source of care. "By working together in a collaborative fashion we can benefit from each other's experience, standardize best practices and protect quality, accessible care," says Moakler. (Bangor Daily News)


Consumers & Providers

Study: Physicians' unconscious bias may not affect course of treatment

Doctors' unconscious bias toward a patient's race or socioeconomic status may not have a significant effect on care delivered, according to research published in JAMA Surgery. The new study was based on hypothetical patients and the course of action elected by 215 doctors from the trauma unit at Johns Hopkins Hospital. The findings are not definitive: "[W]e need to do formal observational trials to see what's happening in real life and also look at other provider associated mechanisms such as empathy and mindfulness," says Dr. Adil Haider of Boston's Brigham and Women's Hospital. (Reuters; JAMA Surgery)


ACA not resulting in overwhelmed primary care docs

New-patient visits for primary care rose to 22.9 percent of all patient visits last year, compared with 22.6 percent in 2013, indicating the Affordable Care Act did not overwhelm physicians with new patients, according to a Robert Wood Johnson Foundation and Athenahealth study. New patients also did not increase the percentage of those with chronic conditions such as high blood pressure or diabetes. "It really suggests that, even though there's been a big increase in coverage, it's a relatively small part of the market and the delivery system is able to handle the demand," says Kathy Hempstead, RWJF's director. (USA Today)


Binder: Price transparency without context is meaningless

The insurance industry's growing movement to disclose prices to consumers might be flawed and could potentially backfire. Without context, the recent price transparency initiatives are essentially meaningless, Leah Binder, CEO of Leapfrog Group, writes in a Wall Street Journal commentary. Many transparency initiatives lack vital, corresponding quality information. All consumers, regardless of the industry, want to know what they can get for the money they spend. She cites a survey from the Journal of Patient Safety that finds 97 percent of consumers preferred hospitals with the highest safety grades. Pricing was relevant, but less important. (WSJ editorial--subscription required; FierceHealth Payer)


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New & Noted   

Transformation 101: HealthITAnalytics offers a basic overview of the ACO and the PCMH, explaining the similarities and differences and discussing the role of analytics and population health management. (HealthITAnalytics)



EEOC readies wellness rules: The Equal Employment Opportunity Commission has completed rule revisions to address conflicts in the regulations governing use of financial incentives in workplace wellness programs. Once approved by the Office of Management and Budget, the proposed rule will be added to the Federal Register for a 60-day public review and comment period. (Society for Human Resource Management)



AHRQ data on first-time insured: Between the first part of 2013 and the first part of 2014, 30.2 percent of non-elderly adults who were uninsured gained coverage, according to the Agency for Healthcare Research and Quality. This is a higher rate of acquiring coverage than for similar time periods in 2012 and 2013 (24.6 percent). (AHRQ Statistical Brief #467)



Encouraging doctors to be more open about their mistakes

In this TED talk, emergency room physician Dr. Brian Goldman argues that medicine's culture of denial and shame keeps doctors from talking about--and learning from--mistakes. (TEDxToronto)


MarketVoices...quotes worth reading


"Don't look now, but we're actually governing." -- Renee Ellmers, R-N.C.


"We are legislating. We are working together to get the job done for the American people." -- Minority Leader Nancy Pelosi, D-Calif.


-- Lawmakers congratulating themselves for passing the SGR deal, quoted in Roll Call      


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Wednesday, April 1, 2015































New Colorado RCCO video: Making a Medical Neighborhood Happen 


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