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Industry News
Competition among providers and among vendors isn't leading to information blocking, according to the Health IT Policy Committee's interoperability task force. It based its conclusion on feedback from two recent hearings. The findings contradict an April 2015 ONC report that found some EHR vendors are preventing the exchange of health information with competitors and that some providers engage in information blocking to control referrals and enhance market dominance. It also contradicted committee testimony from Mathematica senior fellow Ann O'Malley. "EHR vendor competitionis overt and per providers we've interviewed for several different studies...this is a leading barrier to HIE." (Health Data Management; testimony) 
NCQA's 2016 accreditation standards for health plans have been toughened to better ensure access to and timeliness of care, AAFP News reports. The updated standards include a network-management section designed to more closely scrutinize a plan's provider network; the standards pay particular attention to high-volume and high-impact specialties, including primary care. They also require plans to assess the accuracy of provider directories. (AAFP News) 

Insight from Wal-Mart: Pharmacies less profitable under ACA
Wal-Mart's second quarter earnings provided an insight into one of the results more people becoming insured: Its pharmacies are no longer as profitable. The company saw lower reimbursement rates from druginsurance plans and a decline in high-margin cash transactions. Adam Fein, president of Pembroke Consulting, explains that uninsured people frequently pay more for drugs than do the insured, because drug plans can negotiate lower reimbursement rates with the pharmacies. (Washington Post Wonkblog) 
Innovation & Transformation 
CVS Health announces collaboration with three telehealth companies
CVS Health announced late last month it will work with three leading telehealth companies to provide consultations remotely via the Internet or over the phone. American Well, Teladoc and Doctor On Demand will receive referred CVS customers, and they will be referring their own customers to 150 CVS walk-in clinics in six states. The deals aim to expand upon a successful pilot program CVS recently ended in a handful of its MinuteClinics. (CNBC) 

Employers may want to look to local pharmacies for help in boosting employees' satisfaction with wellness benefits, based on satisfaction ratings found by J.D. Power and Associates' survey. Employers "thinking about things like vouchers for flu vaccines or some of the other types of access that they can grant their employees" should be sure "they haven't limited that type of access to a doctor's office," says Rick Johnson, J.D. Power's director of health care practice. "For certain things, making sure that the employees can get those services taken care of at a pharmacy would make a lot of sense." (Employee Benefit News)
Some practices are training medical assistants to handle more patient care tasks, AAFP News reports. Representatives from two such practices discussed their experiences at a recent Brookings Institution webinar. An estimated 500,000 medical assistants are employed nationwide. Their scope of practice is defined in only six states, however, and low pay and limited opportunity means high turnover. But some practices hope to increase patient and staff satisfaction by giving MAs more training. For example, in one health system they became patient coaches and process advocates. (AAFP News; webinar
Consumers & Providers
Large physician practices' satisfaction with their EHR platforms rose from 8 percent in 2013 to 67 percent in the second quarter of 2015, according to Black Book Rankings. Putting that in a larger context, in 2013, 92 percent of multispecialty groups using EHRs said they were "very dissatisfied" with their EHR systems' ability to improve clinical workload, documentation and user functionalities. (Becker's Health IT and CIO Review)

Aetna's ACO CEO talks about accountable care
In this interview with HealthLeaders Media, Daniel Finke, CEO of Aetna's ACO business unit, discusses accountable care contracting. Aetna has established dozens of accountable care collaborations with health care providers across the country, and an internal business unit, Accountable Care Solutions, is working with providers who want to assume greater risk. There are three basic steps, he says: contracting at the right level of risk for the provider, establishing the right infrastructure for data and technology, and determining the right mix of clinical services for care management at the local level and point of care. (HealthLeaders Media) 

Leavitt Partners predicts a change in the direction of M&A activity. "We are leaving a period of horizontal payer M&A, focused on nascent, highly strategic transactions, and entering a period where faster and more pervasive consolidation is likely." The virtual commoditization of traditional payer functions (medical management, lives aggregation, administration, network management, etc.) is "rapidly recasting the relative value payers offer in the health care dollar." Among the drivers: New underwriting rules, insurance exchanges, increased consumerism and medical loss ratio requirements. These changes--plus expansion of government-sponsored coverage--are relegating payers to regulated utilities. (Leavitt Partners blog) 
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New & Noted   
Video trumps the human? A survey published in the Journal of General Internal Medicine finds that one-third of telehealth users at CVS' MinuteClinic preferred the remote video visit to an in-person visit. (FierceHealthIT; JGIM)
Cost controls?  Americans, regardless of party affiliation, strongly support government action to control prescription drug costs, according to a Kaiser Family Foundation survey. (AP)
Disparities remain in coverage:  Fifteen percent fewer Californians younger than 65 were uninsured in 2014 than in 2013, but Latinos and Asians are still less likely to have private insurance or public coverage than non-Hispanic whites, according to the California Health Interview Survey. (Kaiser Health News)
Underused tools could improve care:  A variety of underused health technologies could help providers enhance care quality while cutting costs, according to Matt Schuchardt of HIMSS Analytics. In Healthcare IT News, he identifies 18, including bed management, speech recognition, nurse scheduling and communications, single sign-on and business intelligence systems. (Healthcare IT News)
Dr. Stephen Dubner of Freakonomics fame poses a question: "What if someone was suffering from a terminal illness and they had the option to forego standard-end-of-life medical care, and instead they could get a cash medical rebate from their insurance companies?" He discussed his "Glorious Sunset" idea--including a fake commercial for it--on Marketplace. He also shared some of the responses, including negative ones from Dr. Uwe Reinhardt and Dr. Zeke Emanuel. (Marketplace) 
MarketVoices...quotes worth reading
"The medical home is not the goal. It's the strategy to achieve the goal."-- Sharon Lucie, BSN, vice president of operations for the North Shore Physicians Group in Massachusetts, in a webinar, quoted in AAFP News 

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Wednesday, September 2, 2015



Colorado RCCO video: Making a Medical Neighborhood Happen