Affordable Care Act
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Apixio Illuminates The Pain of Recording Patient Risk Factors (Part 1)
Many of us strain against the bonds of tradition in our workplace, harboring a secret dream that the industry could start afresh, streamlined and free of hampering traditions. But history weighs on nearly every field, including my own (publishing) and the one I cover in this blog (health care). Applying technology in such a field often involves the legerdemain of extracting new value from the imperfect records and processes with deep roots. Along these lines, when Apixio aimed machine learning and data analytics at health care, they unveiled a business model based on measuring risk more accurately so that Medicare Advantage payments to health care payers and providers reflect their patient populations more appropriately...
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A New Meaning for Connected Health at 2016 Symposium (Part 2 of 4)
Tullman’s principles of simplicity, cited in the previous section, can be applied to a wide range of health IT. For instance, AdhereTech pill bottles can notify the patient with a phone call or text message if she misses a dose. Another example of a technology that is easily integrated into everyday life is a thermometer built into a vaginal ring that a woman can insert and use without special activation. This device was mentioned by Costantini during her keynote. The device can alert a woman–and, if she wants, her partner–to when she is most fertile. Super-compact devices and fancy interfaces are not always necessary for a useful intervention.
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Are CMS' Efforts Too Little and Too Late to Save the Collapsing US Rural Healthcare System?
With 35 percent of rural hospitals losing money and almost two-thirds running a negative operating margin, there’s simply no way rural facilities can invest in health IT without help...It’s clear that CMS understands we can’t leave rural hospitals to fend for themselves. But it also seems clear that a lot of hospitals invested in electronic health records (EHRs) they could ill afford to qualify for Meaningful Use funds—dollars that seldom covered implementation costs for solutions that didn’t yield significant cost savings and required additional technical personnel...“The high capital and operating costs associated with health IT, specifically EHRs, have put some hospitals in a difficult position,” wrote Becker’s Hospital CFO in a prescient January 2014 article. “Do they absorb the financial hit now, even if they know they can't afford it? Most organizations are doing so …”
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Halamka Does FY16 Strategic Planning
As we gather together stakeholders for strategic planning of next year’s priorities, what are we hearing and what we have learned? 1. Clinicians are overwhelmed by the current demands of Meaningful Use, hundreds of quality measures, population health, care management, and patient/family engagement. All of these are good ideas individually but the sum of their requirements overwhelms providers. In an era when we’re trying to control costs, adding more clinical FTEs to spread the work over a large team is not possible. The end result is that providers spend hours each night catching up on the day’s documentation and are demanding better tools/automation to reduce their strain.
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Harvard Law Conference Surveys Troubles With Health Care
It is salubrious to stretch oneself and regularly attend a conference in a related field. At the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, one can bask in the wisdom of experts who are truly interdisciplinary (as opposed to people like me, who is simply undisciplined). Their Tenth Anniversary Conference drew about 120 participants. The many topics–which included effects of the Supreme Court rulings on the Affordable Care Act and other cases, reasons that accountable care and other efforts haven’t lowered costs, stresses on the pharmaceutical industry, and directions in FDA regulation–contained several insights for health IT professionals...
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No, You Can’t Just Go to the Emergency Room—Unless You Want to Go Broke
Or: Why I'm so glad I have health insurance. About three weeks ago I was walking home from the grocery store when a group of teenagers demanded my wallet, cellphone, and—for reasons I can't fully explain—gallon of whole milk. Although I made no effort to resist, I ended up with a laceration on my lip that required stitches, fairly intense swelling on both sides of my head that required X-rays, and a bruised rib. [...]
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Problems with Health Information Exchange Resist Cures (Part 1)
Given that Office of the National Coordinator for Health Information Technology (ONC) received 564 million dollars in the 2009 HITECH act to promote health information exchange, one has to give them credit for carrying out a thorough evaluation of progress in that area. The results? You don’t want to know. There are certainly glass-full as well as glass-empty indications in the 98-page report that the ONC just released. But I feel that failure dominated. Basically, there has been a lot of relative growth in the use of HIE, but the starting point was so low that huge swaths of the industry remain untouched by HIE...
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Small Town Mayor Leads 283-Mile Walk from North Carolina to D.C. June 1-15 to Protest Potential Closing of 283 Rural Hospitals
In 2015, 283 of America’s rural hospitals face the very real possibly of closing down. To draw attention to a life or death situation for some 62 millionAmericans who rely on rural healthcare, The Walk will begin in Belhaven, North Carolina on June 1 and conclude on the steps of the U.S. Capitol on June 15. The Walk will be led by a most unlikely pair, conservative GOP Mayor Adam O’Neal of Belhaven and Civil Rights legend Bob Zellner, whose purpose is to keep hope alive in the rural town of Belhaven (pop. 1,687) and other small towns across the nation, as well as to encourage Congress to enact legislation to sustain rural hospitals.
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The Guy Who Rescued Obamacare’s Website Has A New Project: The VA
It was October 2013 when the Obama administration triumphantly flipped the switch on Healthcare.gov, the landing page for the White House’s landmark domestic policy achievement. It promptly crashed. As administration officials absorbed the extent of the catastrophe, they realized they had to go outside the usual government channels to get the site up and running. That’s when they brought in Paul Smith, a politically minded coder with a handful of successful startups behind him...
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Treasury Prints Money, HHS Burns It
Like invasive vines, so-called improper payments seem totally resistant to agency efforts to cut them down. You won’t find it on the home page, where most agencies put only happy news, but Health and Human Services has warned improper payments through Medicaid are rising fast. They’ll hit an estimated 11.5 percent this year, or $30 billion. The rate last year was 9.8 percent. The dollars were about $15 billion in 2013...
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Uncontrolled Health Care Costs Traced to Data and Communication Failures
The previous section of this article provided whatever detail I could find on the costs of poor communications and data exchange among health care providers. But in truth, it’s hard to imagine the toll taken by communications failures beyond certain obvious consequences, such as repeated tests and avoidable medical errors. One has to think about how the field operates and what we would be capable of with proper use of data. As patients move from PCP to specialist, from hospital to rehab facility, and from district to district, their providers need not only discharge summaries but intensive coordination to prevent relapses. Our doctors are great at fixing a diabetic episode or heart-related event...
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What Hospitals Waste
Just outside Portland, Maine, there’s a 15,000-square-foot warehouse that’s packed with reasons the U.S. health care system costs so much: Shelves climb floor to ceiling, stacked with tubs overflowing with unopened packages of syringes, diabetes supplies and shiny surgical instruments that run hundreds of dollars apiece. There are boxes of IV fluids and bags of ostomy supplies and kits with everything you’d need to perform an obstetrics surgery...
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Why AMA Supports Dr. Price to Lead HHS
The AMA supports the nomination of Dr. Tom Price based on decades of interactions with him as a member of the AMA House of Delegates, Georgia state senator and as a member of the House of Representatives since 2005. Over these years, there have been important policy issues on which we agreed (medical liability reform) and others on which we disagreed (passage of the Affordable Care Act). Two things that have been consistent are his understanding of the many challenges facing patients and physicians today, and his willingness to listen directly to concerns expressed by the AMA and other physician organizations...
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