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Industry News

Going against national trend, Texas restricts telemedicine; feds unhappy 

The Texas Medical Board has drastically limited telemedicine. Earlier this month, it voted to ban physicians from diagnosing conditions or prescribing drugs to patients they've never seen in person. The only exception: The patient could be at a health facility, accompanied by a health care professional. The decision runs counter to the direction being taken in most states--and the feds aren't happy. Federal officials told Texas its decision will play into whether the administration extends a waiver that helps the state's hospitals cover uninsured patients. (Houston Chronicle; Modern Healthcare)

 

 

One year post-scandal, VA issues persist

A year after the scandal at Carl T. Hayden VA Medical Center in Phoenix triggered a total overhaul of the Department of Veterans Affairs, it is still unclear whether the problems have been solved. According to VA reports, 97 percent of veterans' appointments in February were completed within 30 days and wait times were reduced. However, the Associated Press concluded the number of patients experiencing long waits for appointments at VA facilities has not decreased at all. "We're making progress. [But] we are not where we want to be," reports VA Secretary Robert McDonald. (AZ Central)

 

 

Narrow networks an increasingly popular option

Consumers are foregoing costlier options and turning to narrow network health plans to save money, The New York Times reports. In 2015 nearly half of all plans offered by public health care exchanges fall into the narrow network category, with as many as a fifth of plans being considered "ultra-narrow networks" that offer even fewer choices. Narrow networks dramatically decrease the number of services covered, but employers are also taking this route to lower health care costs. (The New York Times)

 

Innovation & Transformation

Paper explores payer collaboration, data aggregation in Colorado

Industry alignment in a competitive market can produce powerful results. Last year, a group of Colorado payers convened to explore a data-aggregation solution. As a result, this year, they will release a jointly funded analytic tool for use by advanced primary care practices--a tool that will give providers access to patient claims data from a single portal. A new issue brief, featuring insights from Rocky Mountain Health Plans, Aetna, Colorado Medicaid and others, recounts that process and explores how that effort could transform the way data is used, creating value across the Colorado health care market. (RMHP issue brief)

   

 

Multipayer medical homes are feasible "when committed stakeholders negotiate strategies that are responsive to local market and policy environments." The 17 multipayer medical home initiatives launched between 2008 and 2014 all navigated critical decision-making points: convening stakeholders; establishing provider participation criteria; determining payment; and measuring performance. Four lessons for success emerged: involve the state and/or the federal government as a convener, payer or key stakeholder; find common ground to create momentum; align payers from the start for a unified vision for reform; and share implementation within the local insurance market and policy environment. (Health Affairs; NASHP--free access through May 11)

   

 

Chase: Health systems taking same approach that crippled newspapers 

Newspaper executives oversaw the demise of one of the major institutions of their cities, and health system executives are on the verge of doing the same thing, David Chase writes in Forbes. "The most notable parallel is myopia regarding their competitive set. In the late 90s, newspaper companies ... primarily worried about other newspaper companies as competitive threats. ... Instead it was a litany of competitors who chipped away at their primacy in delivering information to consumers." The "chippers" at traditional health care delivery include onsite workplace clinics, direct primary care providers, retail clinics and medical tourism. (Forbes)   

 

Consumers & Providers

The power of personal data: Giving patients access to their records

The New York Times recently profiled Steven Keating, a doctoral student at M.I.T. who collected and researched his own patient data, which led to the discovery of a brain tumor. "Data can heal. There is a huge healing power to patients understanding and seeing the effects of treatments and medications," he says. But he struggled to get access to that data, taking on a medical culture resistant to sharing data for issues related not only to business and legal concerns, but also because of tradition. "The person with the least access to data in the system is the patient," he says. (The New York Times)

   

 

Blumenthal: "Good health hygiene" to guard against data breaches

The privacy of more than 29 million health records has been compromised by nearly 1,000 breaches to health entities between 2010 and 2013, according to a recent study published in JAMA. David Blumenthal, MD, Commonwealth Fund president, calls on providers and payers to implement "good health hygiene" to fix the problem. Many currently do not take simple precautions to protect sensitive information. HIPAA audits may also offer solutions; however, they remain on hold with the Health and Human Services Department's Office for Civil Rights. (FierceHealthIT;  JAMA report)

 

Prescription drug spending skyrockets to record $374 billion 

Prescription drug spending made a record leap in 2014, up 13 percent to a staggering $374 billion, the LA Times reports. Accounting for more than $11 billion of the spending increase are new hepatitis C drugs produced by Gilead Sciences Inc. which cost more than $80,000 per patient for a 12-week regimen. Despite predictions, millions of newly insured patients covered by the Affordable Care Act only accounted for about $1 billion of spending growth. Michael Kleinrock, director of research development at IMS health, does not believe the steep increase is likely to be repeated. (LA Times)

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New & Noted   

More than semantics: What do we talk about when we talk about population health? According to David A. Kindig, MD, PhD, emeritus professor of population health sciences at the University of Wisconsin-Madison School of Medicine, it's not always clear. He discusses the history of the term and how it's come to have two different meanings. It may be time to rethink our definitions, he says. (Health Affairs Blog)

 

 

ADA and workplace wellness: The Equal Employment Opportunity Commission last week issued a proposed rule to clarify how the Americans with Disabilities Act applies to workplace wellness programs that are part of group health plans. (proposed rulefact sheet)

  

 

Roughly 15 million newly insured: Approximately 15 million U.S. adults gained health coverage between September 2013 and March 2015, according to the Urban Institute's latest Health Reform Monitoring Survey. The proportion of working-age uninsured adults declined 7.5 percentage points over the period, to 10.1 percent. Medicaid expansion states reported the largest decline. (AHA News Now; survey)

 
Multi-media

Athenahealth's Park discusses interoperability

The "interoperability floodgates" are beginning to open, Athenahealth COO Ed Park tells
Modern Healthcare. In this eight-minute interview, he talks about interoperability and the next generation of patient-centered information exchange. (Modern Healthcare)
 

MarketVoices...quotes worth reading

    

"While health systems dawdle, their lunch is being eaten by an array of new entrants reminiscent of what happened to newspapers." -- David Chase, writing in Forbes


 

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Wednesday, April 22, 2015













 

 

 

 

 

 

 

 

 

 

 

 

 

 

    

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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