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The Meaningful Use program will be ending some time in 2016, the Centers for Medicare and Medicaid Services announced last week. It will, more or less, be replaced by the Medicare Access and Children's Health Insurance Program Reauthorization Act. Health IT stakeholders are largely encouraged by CMS' plan, but they want details, reports iHealthBeat. The American Academy of Family Physicians applauded the move and offered to help CMS develop new health IT policy. Meanwhile, Healthcare IT News raises--and leaves largely unanswered--this question: Did MU "spawn or stall" innovation and interoperability? (iHealthBeat; AAFP News Now; Healthcare IT News)

Stocks of Aetna, Anthem, Cigna and Humana tumbled early last week as proposed mergers received scrutiny from regulators and an antitrust watchdog. The American Antitrust Institute said it has asked federal regulators to block the mergers of Aetna with Humana and Anthem with Cigna because they "would likely harm competition and consumers." In addition, California insurance regulators have begun public hearings to look at the mergers. Meanwhile, Reuters reports more than a dozen state attorneys general have joined the U.S. Justice Department's investigation of the health plans. (Insider Louisville; Reuters)

Walgreens is selling all 56 Chicago-area in-store Healthcare Clinics to the state's largest hospital network, Advocate Health Care. Advocate will supervise and staff each retail clinic with its own nurse practitioners; this creates an important access point and referral source for its 12 hospitals and 250 sites of care, Hospitals and Health Networks reports. The clinics will open as Advocate Clinic at Walgreens in May 2016. (Hospitals & Health Networks; press release)
Innovation & Transformation 
Five-hospital MultiCare Health System in Washington has launched a virtual care service--MultiCare eCare--that allows patients across the state to complete an online form detailing minor medical conditions and, if appropriate, receive a treatment plan from a clinician. The goal is to increase medical access for patients and give appropriate care at decreased costs, says Christi McCarren, senior vice president of retail health at MultiCare. The cost is $25. It had a pilot launch with employees in December and went live for consumers earlier this month. (Health Data Management) 
A white paper from the California Department of Public Health describes the current landscape, including the delivery, use, outcome, benefits and challenges of comprehensive medication management in Southern California. According to the paper, pharmacist-provided medication management pilots have been successfully implemented in six health care systems, resulting in improvements in clinical, fiscal and quality measures. Challenges to implementing CMM include misalignment of financial incentives, lack of robust electronic health information exchange and inadequate staffing and space. A Health2 Resources/Blue Thorn Inc. market scan now in the field invites pharmacists to describe how they deliver medication therapy management and CMM. (white paper; survey)

Look for adoption of value-based models to accelerate adoption of telehealth services. According to Modern Healthcare, 2016 will be a year in which telehealth service delivery increasingly becomes central to the health care industry. It's time for telehealth, says Nathaniel Lacktman, a partner at Foley & Lardner who specializes in telehealth. One important driver is that providers are taking on more financial risk for managing the health of populations, he says. "What a provider can do on the front end is use telehealth to make the patient more likely to interact with a clinician." (Modern Healthcare)
A new RAND Corporation report raises questions about the benefits of a patient-centered medical home relative to the costs. PCMH often leads to measurable quality and patient access improvements, but it requires substantial startup and ongoing costs. Based on data from the Pennsylvania Chronic Care Initiative, RAND estimates the annual costs of PCMH transformation at between $83,829 and $346,603 a year. Median: $147,573 per practice, $64,768 per clinician, $30 per patient. A September 2015 study published in the Annals of Family Medicine found that PCMH staffing and care coordination requirements could cost providers an average of $8,600 per month. (Health IT Analyticsthe report)
Employees and contractors at VA medical centers, clinics, pharmacies and benefit centers commit thousands of privacy violations each year and have racked up more than 10,000 such incidents since 2011, according to a ProPublica analysis of VA data. The breaches range from inadvertent mistakes, such as sending documents or prescriptions to the wrong people, to employees' intentional snooping and theft of data. Not all concern medical treatment; some involve data on benefits and compensation. Many VA facilities and regional networks are chronic offenders, logging dozens of violations year after year. (NPR/ProPublica)
U.S. doctors are required to wear white lab coats; however, they present a high risk of transmitting dangerous pathogens to patients, according to the Johns Hopkins Armstrong Institute. Nearly 58 percent of physicians who participated in a survey published by Cambridge University Press reported laundering their white coats monthly or never. In addition, the coats are no longer solely associated with the medical field. "They're just a habit. And I think they should be retired," says Philip Lederer, an infectious-disease specialist from Boston. (Armstrong Institute blog post; survey results)
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New & Noted   
Dis-Kynected: Kentucky Gov. Matt Bevin has officially notified Health and Human Services that he plans to close down Kynect, the state's HIX, and transition enrollees to HealthCare.gov. (Washington Post

More time for Medicaid expansion? Full federal funding of the Medicaid expansion expires at the end of 2016, but President Barack Obama has proposed allowing any state that expands Medicaid eligibility to get three years of full federal funding regardless of when it begins the expansion. (Kaiser Health News)
New geriatric guidelines: Consensus-based guidelines released by the American College of Surgeons and American Geriatrics Society call for discussions of patient care goals and treatment preferences, advance directives and health care proxies. That includes providing patients with poor prognoses an early postoperative palliative care consultation and assessing for delirium risk factors. (Medscape Medical News; guidelines)

This table from Healthcare Intelligence Network ranks the most common strategies for identifying non-engaged patients. The most popular? Simply identifying high utilizers. Risk stratification came in second. (HIN)
MarketVoices...quotes worth reading
"Primary care is a finite resource [that is undervalued]. Our patients and our nation desperately need health care policy to enhance efficiency, complement workflow and improve our ability to deliver the best patient care. We are not alone in believing the current meaningful use program and its criteria do not embody those principles." -- AAFP Board Chair Robert Wergin, MD, on the demise of Meaningful Use, quoted in AAFP News Now 
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Roxanna Guilford-Blake
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Wednesday, January 20, 2016