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"EHRs still might not be the best tools to help" integrate behavioral health and primary care, writes Mike Miliard, editor at Healthcare IT News. He cites a Journal of the American Board of Family Medicine paper finding that EHRs could pose barriers to optimal primary/ behavioral care integration. One reason is "behavioral health and primary care differ in their language, classifications, codes, data reporting requirements and regulations." Practices have workarounds, but that means duplicate work, scanning and transporting documents, and "reliance on patient or clinician recall for inaccessible EHR information." (Healthcare IT News; JABFM)

The Democratic Party is abandoning support for the "Cadillac tax," leaving President Obama as one of the last defenders of the excise tax on generous insurance plans. Sen. Harry Reid and Rep. Nancy Pelosi have been lobbying behind the scenes to kill the Cadillac tax, The Hill reports, "putting the imprimatur of Democratic leadership onto an effort that had previously been limited to the rank and file." (The Hill)

Agency for Healthcare Research and Quality continues to invest in research and evidence to understand how health IT can make health care safer and improve quality, while providing measures and data to evaluate and improve its use, according to Arlene Bierman, MD, director of AHRQ's Center for Evidence and Practice Improvement. She told AHRQ's National Advisory Council that, more than ever, there is a need to better understand which health IT designs can lead to higher adoption and use, and why some health IT has been shown to affect certain outcomes but not others. (Health Data Management)
Innovation & Transformation 
More physicians are turning to--or at least exploring--a direct-pay model, USA Today reports. It cites a 2014 Physicians' Foundation survey that found 7 percent of doctors run a direct-pay practice and another 13 percent plan to transition to some form of direct-pay model. Providers say the approach allows them to spend more time with fewer patients, providing better care--and avoiding paperwork. Critics--including insurers--warn that direct-pay medicine will drive up medical costs. (USA Today)
Allan Wilke, MD, of the Western Michigan University Homer Stryker M.D. School of Medicine, wants his residents to stay in the Kalamazoo community after their residency. As both chair of the medical school's Family and Community Medicine Department and director of its family medicine residency program, he's working to make that happen. He's recruiting residents who agree to stay in the community after training; he's also grooming some to be future faculty members. He transferred the family medicine program's clinical operations to the newly renovated federally qualified health center on the school's main campus. (AAFP News)
Paper: Targeted patient engagement essential to value-based models
A Pharmacy Times piece by Avelere's Joshua Seidman, PhD, GlaxoSmithKline's Jon Easter, BSPharm, RPh, and Tanisha Carino, PhD, focuses on the importance of patient engagement and "Information Therapy" to value-based models of care. Payment reform, practice support and other elements are necessary, but "before an organization invests in that core support, it's imperative that they know what patients want." That means identifying patients' information gaps, targeting information to particular moments in care, tailoring the content to patients' particular circumstances and needs and delivering it in a way that the information is understandable, actionable and meaningful--"Information Therapy." (Pharmacy Times)
Consumers & Providers
Logan Franck, a pharmacy student blogging on the Primary Care Progress site, describes the role of pharmacists in innovative, team-based primary. "People must wonder why I'm studying to be a pharmacist if I'm interested in a career in primary care. But pharmacists can bring a wealth of expertise to primary care practices and greatly improve care delivery and outcomes." (Primary Care Progress)
The Department of Health and Human Services' Office of Inspector General continues to scrutinize health IT. It has added two EHR-related issues to its new 2016 work plan. For the first time it will review the U.S. Food and Drug Administration's oversight of medical devices networked to EHRs. OIG will also review the adequacy of the Office for Civil Rights' oversight of the security of electronic protected health information. (FierceEMR; work plan)
High deductibles on some HIX plans are anything but affordable: In many states, more than half the plans offered through HealthCare.gov have a deductible of $3,000 or more, according to The New York Times. "Sky-high deductibles ... are leaving some newly insured feeling nearly as vulnerable as they were before they had coverage." This is creating concerns among Democrats who supported the Affordable Care Act and some Republicans, who had pushed high-deductible health plans as a way to give consumers more "skin in the game." (The New York Times)
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New & Noted   
Check those assumptions: Writing inThe Wall Street Journal, Drew Altman, president and CEO of the Kaiser Family Foundation, points out that most Republicans--52 percent--favor Medicaid expansion. "We don't know from the polling why most Republicans say they support expansion. Gov. [John] Kasich has argued that expansion is a moral imperative and that he sees it as broadening Ohio's Medicaid program rather than embracing Obamacare, which he opposes." (WSJ)
New HIX tool: The Doctor Lookup, a beta feature on HealthCare.gov, lets one in four shoppers search for health plans by preferred provider or health care facility. (CMS announcement)
Scrutiny for failed co-op:New York is investigating Health Republic, one of 12 out of 23 Obamacare non-profits known as co-ops that are shutting down because of financial problems. At issue: "inaccurate" financial representations. (The Hill)
This two-minute video features Pam Halvorson, regional vice president of clinic operations with Trinity Pioneer ACO. She identifies three things essential to a successful ACO: "the science of the work, the finance of the work... [and] the heart of the work." Partnerships matter, she adds. "I think that we will see with ACOs that those partners who learn to work well together, who develop strong links and relationships between their partners, will be the strongest." (The American Journal of Managed Care video)
MarketVoices...quotes worth reading
"When they said affordable, I thought they really meant affordable." -- Anne Cornwell of Chattanooga, Tenn., talking about her Affordable Care Act plan with a $10,000 deductible, quoted in The New York Times
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Roxanna Guilford-Blake
Sandy Mau




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Wednesday, November 18, 2015