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Industry News
Connecticut became the first state to make it illegal to use EHRs to block the flow of medical information; now, that's being put to the test. Independent medical groups are accusing big hospital-based networks of using their EHRs as a tool to coerce practices to join them while punishing those who remain out of network, Politico reports. The state attorney general has reportedly opened investigations into Epic Systems and hospital networks in Connecticut. Critics say Epic--which controls more than half the state hospital EHR market--is effectively collaborating with the hospital networks to pressure practices to sell out. (Politico)

Financial integration between physicians and hospitals may help health care provider organizations meet the challenges of new payment models but, according to a study in JAMA Internal Medicine, such integration has led to higher spending on outpatient care. The authors note that consolidation is changing the balance in the health care marketplace and increasing an organization's market power with insurers. (JAMA Internal Medicine; Science Daily)

Governor-elect Matt Bevin says he will follow through on his promise to shutter Kentucky's HIX, Kynect, calling it "a redundancy that we as taxpayers in this state are paying for twice." Besides its $283 million in federal funding, Kynect is funded by a 1 percent assessment on all health insurance policies sold in the state; the assessment was first enacted to create a high-risk insurance pool. Vendors estimate the cost to dismantle Kynect's information technology alone at $23 million. Bevin also plans to roll back Medicaid expansion and apply for federal waivers to create a program that requires clients to have some "skin in the game." (Kentucky Health News)
Innovation & Transformation 
Fast Company recently profiled a program at the National Institutes of Health that involves researchers pooling their data to find diagnoses and cures for patients with extremely rare--and even undiscovered--diseases. The program recently joined with six private institutions as part of the Undiagnosed Disease Network (UDN), which links databases. What really distinguishes this: UDN sites have agreed to share patient data--including patients' names. Patients in UDN sign a consent form allowing their personal information to be available to all the researchers and clinicians in the network, combining all the institutions into a giant virtual hospital. (Fast Company)
Children with a usual source of care less likely to be readmitted
Children with a consistent place to receive well and sick care are less likely to be readmitted to a hospital--or visit the emergency department--in the weeks after discharge compared to those who don't, according to research published in Pediatrics. Researchers looked at five factors associated with the medical home. One stood out: Among children without a consistent place to receive well and sick care, 22 percent were readmitted to the hospital within a month; among those who did have a consistent place for well and sick care, just 10 percent were. (Fierce Practice Management; Pediatrics)
Consumers & Providers
A coalition of 111 medical societies--including the American Medical Association--sent letters to Senate and House leaders last week voicing strong concerns about the decision to move ahead with Stage 3 Meaningful Use "despite the widespread failure of Stage 2." Stage 3 requirements are "inconsistent with the goal of promoting better coordinated and high quality patient care," the letters argue. The coalition urged lawmakers to refocus the initiative "before physicians ... abandon the program completely." (Health Data Management; iHealthBeat)
CMS says it underpaid for "dual eligible" plans
The Centers for Medicare & Medicaid Services is developing a new model for how it pays dual-eligible health plans after an analysis showed it was underpaying these plans. It intends to modify its risk-adjustment model to make up for the underpayment. "What I want you to take away from this is that the industry brought an issue to us, and we took it seriously--there is some substance to it," says Sean Cavanaugh, director of the Center for Medicare. (Modern Healthcare; Healthcare Payer News)
Only 26 percent of practices say they have launched a chronic care management program for their Medicare patients, although another 23 percent plan to in the next year. Moreover, only 49 percent of practices that have successfully launched a CCM program have submitted a claim and been paid for CCM services. These are among the findings of a recent survey conducted by Pershing Yoakley & Associates and Enli Health Intelligence. Of the 63 percent of respondents who believed CCM would not be profitable or were unsure, insufficient reimbursement for the time and effort required was the most common reason. (FiercePracticeManagement; survey)
Death rates for white Americans ages 45-54 climbed .5 percent each year between 1999 and 2013, according to researchers using mortality data from the CDC. In the previous two decades, the death rate for this group had dropped by 2 percent annually. Middle-aged blacks and Hispanics saw a 2 percent annual decline between 1999 and 2013. Experts suggest that stress tied to the financial crisis, shifts in economics and the accessibility to opioid painkillers may be contributing factors; those with only a high school education or less saw a much larger rise in death rate than those who went to college. (CNN)
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New & Noted   
No vaccination? No doctor:  Almost all U.S. pediatricians encounter patients who refuse at least one vaccine, and about 20 percent of U.S. pediatricians regularly drop families who refuse to have their children vaccinated, according to a report published in Pediatrics. (Pediatrics)
Telehealth codes: Final CMS payment rules include some telemedicine codes. Codes 99356 and 99357 apply to prolonged care either in an observation or inpatient setting. Codes 90963-90966 cover certain at-home care for dialysis patients. They take effect next year. (Becker's Health IT & CIO Review)
Walgreens chooses EPIC: Walgreens Boots Alliance is getting rid of its proprietary EHR system and replacing it with an EPIC EHR. Nearly two years ago, CVS Health tapped the company for its MinuteClinics. (Modern Healthcare)
The New York Times has developed an interactive map to show what regions of the country have the most uninsured. "Medicaid expansion continues to be a huge predictor of how many people remain uninsured in a given state," the analysis notes. Overall, most of the uninsured are in the South and the Southwest, and they tend to be poor. (New York Times)
MarketVoices...quotes worth reading
"Our findings support the notion that medical homes that can ensure a usual source for both well and sick care, and can bolster a parent's level of confidence in caring for their child at home, might be able to better help patients avoid the need to be hospitalized again shortly after discharge." -- Dr. Thomas Klitzner, a co-author of the study and a professor of pediatric cardiology at Mattel Children's Hospital and UCLA and executive director of the UCLA Pediatric Medical Home Program, commenting on his study in Pediatrics.
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Wednesday, November 11, 2015