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Industry News

GAO calls to task federal IT programs, including HealthCare.gov

"Federal investments in information technology (IT) have often resulted in multimillion dollar cost overruns and years-long schedule delays, with questionable mission-related achievements. Further, the implementation of initiatives to improve IT acquisitions has been inconsistent," says a recent Government Accountability Office report. It calls for urgent action and identifies various wasteful health IT investments. Among those projects: HealthCare.gov, which experienced "significant cost increases, schedule slips and delayed functionality." According to the report, "These and other failed IT projects often suffered from a lack of disciplined and effective management, such as project planning, requirements definition, and program oversight and governance." (iHealthBeat; report)



CBO: ACA repeal would hike deficit a bit, drastically increase uninsured

Repealing the Affordable Care Act would modestly increase the budget deficit--adding $137 billion over the coming decade--and increase the number of uninsured Americans by about 24 million, according to a new Congressional Budget Office study. The share of U.S. adults with health insurance would drop from roughly 90 percent to about 82 percent. Repeal would boost the economy by 0.7 percent a year after the start of the '20s--mostly because more people would enter the workforce or work more hours to make up for the lack of subsidies. (Associated Press)

Leavitt Partners and the Brookings Institution are joining forces to form what they call the largest accountable care collaborative in the world. The nonprofit Accountable Care Learning Collaborative will be co-chaired by former Health and Human Services Secretary Mike Leavitt and former CMS Administrator Dr. Mark McClellan. It will be housed at Western Governors University. (KUER)

Innovation & Transformation 

Resistance appears futile: Telemedicine keeps advancing 

Despite resistance from regulators, licensing rules in multiple states that make it difficult for doctors to practice, and even physicians' opposition, telemedicine continues to advance,
HealthLeaders Media reports. But nothing seems to be able to stop it, and hospitals are starting to move from "downright skepticism" to "healthy skepticism," says Joseph Kvedar, MD, vice president of the Partners' Center for Connected Health. "The tenor of the discussion is essentially, 'We know this is coming, we have to learn by doing, we'll figure out the details of how we are going to get paid and how it will work [so we won't] miss the boat." (HealthLeaders Media)



Crowdfunding--the latest approach to collecting payments from patients? 

HealthLeaders Media recently looked at two health systems innovating how patients pay. Pennsylvania-based PinnacleHealth System leveraged the popularity of crowdfunding sites. Its HOPE Card program helps patients pay large medical bills through online donations. The vendor takes a 6 percent administrative fee. Wisconsin's Gundersen Health System offers self-service payment options via email and the MyChart patient portal. It's "designed to engage patients earlier with more transparent and friendlier information and offer easier and more flexible means to complete payments on their own," says Laurie Hurwitz, executive director for revenue cycle. (HealthLeaders Media) 
Yesterday, six Colorado health insurers and the state's Medicaid program announced plans to adopt reforms that set the stage for broader integration of behavioral and physical health care in Colorado. The insurers--Anthem Blue Cross Blue Shield, Cigna, Colorado Access, Colorado Choice Health Plans, Rocky Mountain Health Plans and UnitedHealthcare--have crafted different plans, but all support Colorado's State Innovation Model, an effort to integrate medical and behavioral health care and ensure the payment structures are in place to make that happen. (The Business Journals) 
Consumers & Providers

ACOs just "bobbing" along, say Bay Area experts 

Madeleine Phipps-Taylor, writing in the Health Affairs Blog on behalf of the West Coast Harkness Policy Forum, considers how much momentum has been gathered behind ACOs and whether the movement is going to reach a tipping point. Her team queried San Francisco Bay Area health policy researchers and health executives, asking "In the current environment which is the most likely scenario for the future of ACOs?" Their options: Catastrophic failure, all-out success or "bobbing along with a thousand weeds blooming alongside a thousand flowers." The consensus? Bobbing along. The reason ACOs aren't more successful, they said, is the tension of moving to a population health model while still living in a fee-for-service world. (Health Affairs Blog)


Study: NPs, physicians show little difference in quality of cardiac care 

A recent study conducted at 130 VA hospitals demonstrated there is no significant difference in the quality of care given to cardiac patients by nurse practitioners and physicians assistants, rather than doctors. The passage of the Affordable Care Act is projected to increase the number of patients with health coverage by 34 million by 2016, and the projected physician shortage is expected to reach 45,000 by 2020. The increased use of NPs and PAs could help close the gap, according to Dr. Brahmajee Nallamothu, spokesperson for the American Heart Association. 


In an interview with The Advisory Board, Bret Jorgensen, chair and CEO of MDVIP, a membership-based concierge medicine provider, discusses his firm's approach to health and wellness. "The primary foundation of our model is that the member gets a host of non-covered services," he explains. The basis is the annual wellness exam. Patients can also make same-day appointments and have phone and email access. "The high-deductible plans are by far the fastest growing plans out there, and they are starting to get paired with more awareness of prevention and wellness engagement tools." MDVIP offers "the flexibility of spending within those plans." (Advisory Board Daily Briefing)

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New & Noted   

Employers to expand onsite clinicsThirty-eight large U.S. employers with onsite health facilities plan to add new centers over the next two years, according to the Towers Watson 2015 Employer-Sponsored Health Care Centers Survey. It also found these employers to be confident that onsite or near-site health centers improve the health and productivity of their employees. (BenefitsPro)


AHRQ's fate: A spending bill, being considered today by the House Appropriations Committee, would eliminate the Agency for  Healthcare Research and Quality. However, its counterpart bill in the Senate, discussed yesterday, does not appear to de-fund the agency.(Inside Health Policy--subscription required) 


In a Health Affairs Narrative Matters essay, Dr. Jessica Taylor Goldstein, assistant professor of family and community medicine at the Medical College of Wisconsin--and a family physician who delivers babies--discusses her decision to have a home birth and the issues that raises. "I consider my decision [...] a personal, not professional, one, yet I could not completely divorce the realities of my day job from my private choices. In the medical community, there is a great deal of opposition regarding home birth and an unwillingness on the part of some obstetricians to even discuss home birth as an option." (Health Affairs podcast; Health Affairs text)

MarketVoices...quotes worth reading


"Women should be able to choose their birth settings and practitioners based on weighing the risks and benefits according to their own values. The system can and needs to be safer. Collaboration will make it safer, and placing blame on pregnant women is not the answer."

-- Dr. Jessica Taylor Goldstein, assistant professor of family 
and community medicine at the Medical College of Wisconsin, and a family physician who delivers babies, in a 
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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, June 24, 2015































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