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Despite calls for a delay, the Centers for Medicare and Medicaid Services issued its Stage 3 Meaningful Use rule yesterday. MU3 has more flexible reporting periods that are aligned with other programs and, CMS says, it's focused on interoperability and information exchange. But critics, including lawmakers and physician groups, are not pleased. The American Medical Association says it "continues to believe that Stage 3 requires significant changes to ensure successful participation, and improve the usability and interoperability of electronic health record systems." Perhaps in recognition of that, final rule includes a 60-day comment period for certain provisions. (HealthLeaders MediaHealth Data Management)

Tuesday the Office of the National Coordinator for Health Information Technology released the final version of its 10-year interoperability roadmap. It's largely similar to the version released in January. However, MedCity News reports near-term goals have been adjusted, with an eye toward achieving true, standards-based interoperability by 2017. According to the ONC, the roadmap has the support of various organizations including AHIMA, CHIME, HIMSS and Commonwell Health Alliance. (HealthLeaders MediaMedCityNewsfinal roadmap)

Doing away with the "Cadillac" tax on high-cost health insurance plans before it goes into effect in 2018 has bipartisan support. But many economists think repeal is a bad idea, The Fiscal Times reports. Recently, 101 economists and policy analysts from across the ideological spectrum sent a letter to leaders of the House Ways and Means and Senate Finance committees, urging them to reconsider proposals to do away with it. Among their arguments: "The Cadillac tax will help curtail the growth of private health insurance premiums by encouraging employers to limit the costs of plans to the tax free amount." (The Fiscal Times; letter)

Dartmouth-Hitchcock, Elliot Health System, Frisbie Memorial Hospital and Harvard Pilgrim Health Care will enter a joint venture to share clinical information and financial risk for 80,000 New Hampshire patients, Modern Healthcare reported Monday. Benevera Health--the name of the venture--will give partner providers access to analytics that can help them manage care for patients in Harvard Pilgrim's fully insured plans. Harvard Pilgrim is in talks with seven other hospitals. Premiums for Harvard Pilgrim members will be 4 percent lower than they would have been without the venture, according to the company. (Modern Healthcare)
Innovation & Transformation 
Through a pilot program called Care Connections, the Los Angeles County Department of Health Services is deploying critical care teams for its sickest and most challenging patients, according to the California Health Report. Key to the program are about 25 carefully selected community health workers whose job is to build trusting relationships with patients. One patient, Bill, had uncontrolled diabetes; he was homeless and he had no place to store his insulin. Now that he has access to food three times a day, and a place to store his insulin, his diabetes is coming under control. (California Health Report)
At the University of Virginia Medical Center, many clinical teams are taking a moment of silence together after a hospital death. Jonathan Bartels, an emergency care nurse at the center, helped spread the practice. "I just said, 'Can we stop just for a moment, to recognize this person in the bed? You know, this person before they came in here was alive--they were interacting with family, they were loved by others, they had a life.'" The idea spread throughout the hospital, and is being taught as part of the curriculum at UVA nursing school. Other organizations are trying the approach. (NPR)
Consumers & Providers
After years of discussion, debate and delay, the ICD-10 coding system went live last Thursday, expanding procedure codes from 14,000 to 70,000 for clinicians and from 4,000 to 72,000 for hospitals. Concerns about lack of readiness abound, with many predicting denials, inaccurate bills and delays. However, FiercePracticeManagement outlines some of the benefits, including  better data to improve health, the potential for less billing fraud, and connection to resources and support systems. (MedPage Today; Fierce Practice Management; Forbes)

The proposed insurance company mergers could have a deleterious impact on access to mental health care, the American Psychiatric Association warned U.S. antitrust regulators. The American Medical Association, the American Hospital Association and the American Academy of Family Physicians have already asked regulators to look at the possible impact of Anthem/Cigna and Aetna/Humana deals, Reuters reports. (Reuters)

Several obstacles remain to achieving a fully interoperable health care system, according to a report by the Government Accountability Office. The GAO interviewed representatives from 18 initiatives focused on one of three challenge areas: standards implementation, data sharing agreements, or network services. The report outlined five types of challenges: insufficiencies in health data standards; variation in state privacy rules; accurately matching patients' health records; costs; and the need for governance and trust among entities. (AHA News; GAO report)
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New & Noted   
We want to talk about the end: The public overwhelmingly supports Medicare's plan to pay for end-of-life discussions between doctors and patients, despite some GOP objections that such chats would lead to rationed care, according to a recent Kaiser Family Foundation poll. (Kaiser Family Foundation)
HIX navigators, assisters: A new policy brief from Health Affairs and the Robert Wood Johnson Foundation looks at the key role navigators and in-person assisters play in helping consumers get coverage through the insurance marketplaces. It outlines the current responsibilities and explores how these roles have evolved and may change. (policy brief)
EHR interoperability is essential to reform, but some vendors and hospitals reportedly block the sharing of health information. An iHealthBeat audio report explores these issues with Sen. Lamar Alexander (R- Tenn.); David Kibbe, president and CEO of Direct Trust; William Rich of the American Academy of Ophthalmology; and Micky Tripathi, president and CEO of the Massachusetts eHealth Collaborative. (iHealthBeat)
MarketVoices...quotes worth reading
"You may never love ICD-10, certainly not the way a mother loves her children. But you do have to live with it. It's unpacking its bags and moving into your practice." Debra Beaulieu-Volk, editor of FiercePractice Management

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Wednesday, October 7, 2015