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HIT Newser: CMS & AMA Agree to be Odd ICD-10 Bedfellows

CMS agrees to first-year flexibility in ICD-10 claims processing

CMS releases guidance that will allow for flexibility in the claims auditing and quality reporting process for the new ICD-10 codeset. CMS will keep the October 1 deadline for the transition, but adopt four AMA-proposed steps that include: an agreement that claims lacking specificity will not be denied; an easing of quality reporting and other penalties due to improper coding; an agreement to authorize advance payments to physicians if contractors are unable to process claims; and, the addition of an ICD-10 Ombudman to navigate transition problems.

CMS seemingly recognized that unless some concessions were made, the AMA and other ICD-10 critics would continue to fight for another delay. Maybe now everyone will stay focused and get ready for the inevitable.

HealthStream CEO shares his wealth with employees

HealthStream CEO Bobby Frist gives about 600 of his employees $1.5 million of his personal stock. All of the employees are non-executives and will be given stock that is worth between $300 and $10,000, depending on the employees’ tenure and role.

Frist gets my vote for boss of the year. What a way to boost employee morale and build loyalty.Continue reading…

HIT Newser: ACA upheld – Can We Talk Health IT Now?

AMGA requests funds and policies to support care for chronically ill

In a letter to members of the Senate Finance Committee Chronic Care Workgroup, the AMGA asks Congress to consider policies and financial and operational technologies that support care for the chronically ill. The AMGA stressed that clinical data from EHRs and details from administrative claims are valuable for analyzing trends on utilization and outcomes.

The AMGA supports the development and use of sophisticated predictive analytic software that have the potential to improve care coordination, cut hospital re-admissions, and reduce the overall cost of patient care. The organization is also encouraging the use of telehealth to care for the chronically ill, as well as financial incentives to encourage provider investment in care management tools.

And now back to us

On the heels of the Supreme Court ruling on the ACA, several health IT organizations express hope that Congress will renew its focus on interoperability, telehealth, Meaningful Use, and other HIT-related issues. Politico reports that Health IT Now Coalition executive Joel White is hoping for a “continued bipartisan focus on interoperability and telemedicine,” while HIMSS believes the decision will create more predictability in the healthcare sector, which may facilitate the advancement of its IT agenda.

It’s great to be optimistic, but I’m sure no one will be shocked if lawmakers find alternative distractions.

Continue reading…

HIT Newser: Prison time for HITECH fraud

CVS Health acquires Target’s healthcare biz

CVS Health will pay $1.9 billion to acquire Target’s healthcare businesses, including 1,600 pharmacies and 80 MinuteClinic health clinics.

CVS Health also just opened its Boston-based Digital Innovation Lab, which will focus on developing cutting-edge digital services and personalized capabilities that offer an accessible and integrated personal pharmacy and health experience.

CVS is making big strides to position itself as both a digital innovator and major provider of primary care services. Look for them to continue to build on existing partnerships with regional health systems. What’s next – maybe more integration of its health apps into EMRs, patient portals, and HIEs?

Former hospital CFO sentenced to prison for attestation fraud

Joe White, the former CFO of Shelby Regional Medical Center in Texas, is sentenced to 23 months in federal prison for falsely attesting that the hospital was a meaningful user of EHR. White was also ordered to pay almost $4.5 million in restitution to Medicare’s EHR Incentive program. Continue reading…

The M Word

Insurance carriers large and small have started submitting premium hikes for the next 12 months for approval by federal and state officials. The picture is not pretty particularly for companies that sell the new plans designed under the Affordable Care Act. Those premiums are destined to climb 40 percent or more in some states in 2016.

Health insurance companies are getting squeezed as spending goes up and not enough young, healthy people enroll and pay premiums. As result, healthcare premiums, co-pays, deductibles and out-of-pocket co-insurance costs for individuals, employers and taxpayers will continue to soar ever-higher.

Estimates are that the ACA will add between $140 billion and $500 billion to the deficit over the first decade of the law’s existence. That’s because more will be spent on Medicaid and subsidies than is found in cost savings to healthcare. All truth be told, the ACA did nothing substantive to ensure healthcare cost savings.

Continue reading…

HIT Newser: We Need Interoperability, Says HELP

Judy Faulkner pledges to donate her wealth

Epic founder and CEO Judy Faulkner announces plans to give away 99% of her estimated $2.3 billion wealth to charity. Faulkner joins 136 other individuals and families in the Giving Pledge, which was launched by Warren Buffett and Bill and Melinda Gates to encourage billionaires to give the majority of their wealth to philanthropic causes.

What’s not to like about that? Good to know that if Epic wins the $11 billion bid for the VA’s EHR system, some of the government’s money will eventually trickle back down to charity.

Are EHRs creating disparity in care?

A study from Weill Cornell Medical College looks at “systematic differences” between physicians who participated in the Meaningful Use program and those who did not, noting that the differences “could lead to disparities in care.”

The researchers suggest that providers participating in the MU program may provide higher quality care to their patients as physicians using paper records “have less reliable documentation and weaker communication” between providers and won’t benefit from EHR-enabled quality improvements.

I suspect that physicians relying on paper records would balk at the suggestion that the care they provide is inferior to their more digitally-equipped peers. However, it’s hard not believe that the overall care process would be enhanced if all providers could electronically share critical patient information.

News Flash: Government is wasteful in its spending

The Government Accountability Office releases a report calling for urgent action on federal IT Continue reading…

HIT Newser: Will Stage 3 Meaningful Use Be Delayed?

CMS Releases Final Update to ACO Program

CMS releases a final rule updating the Medicare Shared Savings Program, which includes a new higher-risk, higher-reward Track 3 option; streamlines data sharing between CMS and ACOs; and adds a requirement that ACOs applying for the program describe how they will promote the use of health IT to boost care coordination.

Organizations Urge Stage 3 Delay

The AMA and MGMA join the AHA and CHIME in calling for a delay in finalizing Stage 3 Meaningful Use requirements. The current version is largely viewed as too burdensome for providers with the potential to impede the use of health IT to improve quality and efficiency.

Quite simply, Stage 3 will not be successful without provider buy-in. There have been delays before; look for another oneContinue reading…

Creative Minds: Building a Better Electronic Health Record

Is 5 too few and 40 too many? That’s one of many questions that researcher David Chan is asking about the clinical reminders embedded into those electronic health record (EHR) systems increasingly used at your doctor’s office or local hospital. Electronic reminders, which are similar to the popups that appear when installing software on your computer, flag items for healthcare professionals to consider when they are seeing patients. Depending on the type of reminder used in the EHR—and there are many types—these timely messages may range from a simple prompt to write a prescription to complex recommendations for follow-up testing and specialist referrals.

Chan became interested in this topic when he was a resident at Brigham and Women’s Hospital in Boston, where he experienced the challenges of seeing many patients and keeping up with a deluge of health information in a primary-care setting. He had to write prescriptions, schedule lab tests, manage chronic conditions, and follow up on suggested lifestyle changes, such as weight loss and smoking cessation. In many instances, he says electronic reminders eased his burden and facilitated his efforts to provide high quality care to patients.

Still, Chan was troubled by the lack of quantitative evidence Continue reading…

An Interview with BID-Plymouth CIO Ron Rutherford and Clinical Informatics Nurse Jean Marie Grupillion

An Interview with BID-Plymouth CIO Ron Rutherford and Clinical Informatics Nurse Jean Marie Grupillion

Michelle Noteboom: Give me a bit of background on your hospital.

Ron Rutherford: Jordan Hospital is a 100-plus-year-old, 155-bed community hospital that was acquired and became a part of the Beth Israel Deaconess Health System in January of 2014. We’re a full-service community hospital serving approximately 200,000 residents in eleven communities. There are few healthcare services we don’t provide.

MN: You recently implemented the Voalte smartphone solution. What led you to seek a new communication platform?

RR: We recognized the need for our clinical users to communicate in the most efficient way possible, and we were aware of some technology tools that could make that happen. We also needed to make sure the solution was secure and HIPAA-compliant.Continue reading…

Ridicule Mehmet Oz, Don’t Have Him Fired

If I could invite four people for dinner, alive or dead, they would be Mark Twain, William Shackleton, Christopher Hitchens and Homer Simpson (Bart’s dad). If Mehmet Oz turned up with a bag of Garcinia Cambogia I would excuse myself.

Few things drive me to the abyss more reliably than the banality of status updates on Facebook and the monotony of health freaks. I would rather face the aftermath of Vindaloo followed by industrial strength Picolax than watch an episode of the Dr. Oz Show.

Did you catch that? Show. Like Dog and Pony show. Punch and Judy show. The Dr. Oz Show is a show. Not to put too fine a point, but physicians asking Columbia University to fire Dr. Oz are giving his show more profundity than it self-evidently deserves.

The obvious retort is that Oz is using his position as faculty of a prestigious university to promote dodgy metaphysical claims. Ah, the narcissism of academics! Priceless! As the saying goes, for everything else there is master card…Continue reading…

Independent Practice Equals Higher Satisfaction

Tom Guillani

Thinking of starting a new practice?  Is the lure of independence calling to you?  There are more reasons than every why independent practice is a great option. Being your own boss is not only easier than it once was, it can actually make you happier.

Independent physicians have many more options available to help them today than they used to. Affordable technology has revolutionized private practice from EHRs to easy-to-use practice management and billing software, adding flexibility to staffing and simplifying paperwork needs. And, the increased availability and ease of outsourcing has further reduced the burden of running your own practice. Physicians can now choose to outsource inbound calls, reminder calls, pre-authorizations, marketing, and of course, billing. In addition, independent providers can transition to new agile practice models such as concierge and hybrid that can offer higher incomes and smaller patient census and reduce some of the headaches associated with traditional practice structures.

Added to the fact that starting and running a private practice is now easier than ever, is the higher level of happiness experienced by independent physicians. In fact, a study done by Medscape in March 2014 reported that 74% of self-employed doctors are satisfied in their practice and that of the physicians who left employment in favor of independent practice, 70% felt happier in their new practice while only 9% were less happy being self-employed. Seventy-four percent of these self-employed doctors also said that their opportunity to practice quality medicine met or exceeded their expectations.

There are many factors contributing to these high satisfaction rates in independent physicians but one of the biggest is the control these doctors have over their practice, their schedule, their treatment of patients, and their destiny. A survey in Hospital Topics on the impact of practice arrangements on physician’s satisfaction backs this up, reporting that physicians who work for HMO’s have much less autonomy and decision-making power than self-employed physicians. And, the report by Health Affairs found that 85% of doctors in private practice felt free to control their schedules compared to only 39% of HMO physicians.

Self-employed doctors also avoided the pitfalls of employment cited by the Medscape study while the doctors working for hospitals and group practices listed administrative headaches, added rules, and a more limited income potential as reasons for dissatisfaction in their careers. It’s easy to see why the 2014 Great American Physician Survey conducted by Physician’s Practice found that over half of independent physicians would do things the same way all over again. This isn’t to say independent providers done have regulatory challenges or administrative responsibilities. However, they have more control over the day-to-day operations and administration, eliminating frustrating bureaucracy.

Better, more affordable, easier-to-use technology, simple outsourcing options, greater autonomy and control, and higher levels of satisfaction…all of these factors make private practice a more attractive option than ever. So, if you are considering starting a new medical practice, now is the time. Just remember, doing it right from the beginning will save you from unnecessary stress, making the process of opening your new practice a much more enjoyable experience.

By joining the ranks of independent physicians, you will be in control of both your practice and your life. You will be free to set your own schedule, manage patient care to your standards, work with a staff of your choosing, and have the final control over your income potential. All new practices will face challenges along the way but you will find a wealth of resources to make your life easier and guide you to success in your new venture.

Tom Giannulli, MD, MS, is the chief medical information officer at Kareo. He is a respected innovator in the medical technology arena with more than 15 years of experience in mobile technology and medical software development. Previously, Giannulli was the founder and chief executive officer of Caretools, which developed the first iPhone-based EHR.

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