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The Centers for Medicare & Medicaid Services' final rule to overhaul managed Medicaid is now under review at the Office of Management and Budget. It would, among other things, cap insurer profits, require states to more rigorously supervise the adequacy of provider networks, and encourage the growth of managed long-term care. It also could significantly improve access to behavioral health for Medicaid beneficiaries, Modern Healthcare reports. The final rule could be published by mid- to late May, a year after it was proposed. About 73 percent of all regular Medicaid beneficiaries are in managed care plans. (Modern Healthcare)
 

With IBM's planned $2.6 billion acquisition of Truven Health, the company gets a treasure trove of data--specifically, "200 million lives which we can combine with 100 million patient records. We can combine our data sets together, including one of the largest democratized health records with electronic health records from Phytel, Truven, claims data, imaging data, genetics, medical health data and from all of that we can run analysis," IBM Watson Health General Manager Deborah DiSanzo tells Fortune. It also brings IBM some big new customers, including Cigna and HCA. (Fortune)


With its new health plan, SelectHealth Share, Intermountain Healthcare promises to hold yearly rate increases to one-third to one-half less than what employers across the country typically face. Other plans could follow suit, according to The New York Times, which notes Intermountain has established itself as a health system able to track and analyze cost and quality data. The organization says it will succeed by cutting costs. "This is not a repackaging of the same old stuff. We're fundamentally changing everything," says Patricia R. Richards, chief executive of Intermountain's SelectHealth. (The New York Times; FierceHeathPayer)
Innovation & Transformation 
A simple follow-up note from a primary care doctor can keep patients involved in their own health care, according to research published in the Journal of the American Medical Informatics Association. "The key lessons of our study are that sending reminders to patients to view their medical notes may be essential to promoting patient engagement and improving patient-doctor communication, and that new health technology implementation requires additional efforts to reduce potential disparities in health," says lead author Dr. John Mafi of UCLA. (announcement; JAMIA)
 
A few basic health system reforms can and should be implemented immediately, according to the Healthcare Leadership Council, a coalition of payers, providers, patient advocates and vendors. Those changes include better care planning, increased patient engagement, reform of anti-kickback and Stark laws, improved interoperability, and changing health information flow as it relates to patient privacy. "The time for action is right now," says Mary Grealy, president of the council, noting the recommendations have strong bipartisan support and could be implemented even in an election year. (MedPageToday; report)
   
Consumers & Providers
Hospital errors in Minnesota killed four and injured 10 in 2015--the highest total in 12 years of "adverse event" reporting in Minnesota, which remains one of only five states to publicly disclose hospital errors as part of a concerted effort to prevent them. These errors are vexing, the Star Tribune reports, because they can occur at so many different points along the prescription pipeline. Moreover, the very precautions intended to prevent errors can backfire, causing "alert fatigue," because they can be oversensitive and call attention to unimportant issues. (Star Tribune)
 

"As value-based payment methods financially reward or punish practices and health care organizations on their ability to improve outcomes, the firing of patients may become more attractive to those operating on thin margins," Diana J. Mason, PhD, RN, of Hunter College and City University of New York, writes in the JAMA Forum. Physicians have reason to worry about what patients are in the denominator. This raises questions of ethics and accountability, and the patients most likely to suffer may be the ones most in need of health care. (JAMA Forum)
 
 
Most physicians reported by hospitals, medical societies and malpractice insurers to the National Practitioner Data Bank for sexual misconduct have never been disciplined by their state medical boards for that behavior, according to research from Public Citizen published in  PLOS One. The reason: Many hospitals and other groups--despite being required to do so--do not share such information with state medical boards. Changes are needed to ensure "all physicians who have committed sexual misconduct face appropriate medical-board disciplinary actions for violating this most fundamental tenet of the physician-patient relationship," researchers write. (Medscape)

In two new issue briefs, Mathematica explores how physicians and patients could make better decisions at the point of care. In "Supporting Better Physician Decisions at the Point of Care: What Payers and Purchasers Can Do," CHCE draws on previous research, interviews with physicians and discussions with stakeholders to recommend ways payers can support evidence-based decision making. "Supporting Better Patient Decisions at the Point of Care: What Payers and Delivery Systems Can Do" uses findings from consumer focus groups to highlight opportunities for payers and health care organizations to support patients at the point of care. (Mathematica)
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New & Noted   
Interoperability guidance for devices: The FDA issued new draft guidance aimed at improving interoperability among connected medical devices. The draft guidance provides connected medical device manufacturers with design considerations for developing interoperable medical devices, and information to include in pre-market submissions and device labeling. (Clinical Innovation & Technology; issued new draft guidance)

Five million kids uninsured: In 2013, 7.5 percent of youngsters were uninsured, compared to 6.3 percent in 2014. Twenty-three states had declines in 2014. But nearly 5 million Americans under age 19 still lack health insurance, according to a Robert Wood Johnson Foundation report. (Consumer Health Day) 
 
Piecemeal approach to vaccines: In the absence of a national policy about vaccinations, some states are strengthening vaccination requirements. Meanwhile, more families are opting out of vaccinations. Health Affairs explores the issue and why some say the nation's health is at risk. (Health Affairs)

Multi-media 
The recent data breach of Hollywood Presbyterian Medical Center is the latest episode highlighting the dangers of hackers targeting medical data and devices. The hospital paid nearly $17,000 in bitcoin to hackers after their communications were shut down in a "ransomware" attack. (ABC News)
 
MarketVoices...quotes worth reading
     
"When I visit my primary care clinician, she makes evidence-based recommendations for common screenings, tests, and procedures. I don't always take her advice, but tell her why. Sometimes she agrees with me, but not always. I've often wondered whether she is financially affected by my 'noncompliance.' I hope not. And I hope she doesn't fire me."

-- Diana J. Mason, PhD, RN, Rudin professor of nursing and co-director of the Center for Health, Media, and Policy at the Hunter College; professor at the City University of New York; and immediate past president of the American Academy of Nursing, quoted in the JAMA Forum   
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Wednesday, February 24, 2016