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Value Based Care Regulations Yield Physician Discontent, No Change in Behavior

Clinicians are in a knowledge management crisis – massive amounts of data but getting the right information to clinicians, IT personnel and others at the right time is the challenge. What was missing from the RAND report were biomedical informatics perspectives.

Mobile, Analytics, Cloud, Value-Based Care, Social Dominate News at HIMSS15

Record attendance at HIMSS 2015 in Chicago - over 43,000 people. Now that HIMSS15 is over, take a look at some of the trends that dominated the headlines, the social buzz and the chatter at after show cocktail parties. Of course, there were the overarching themes of interoperability, and population health, but there were some key themes that received the most attention.

Hospital Readmissions Penalties Interactive Table

Update August 2, 2013 - CMS published a list of 2,225 hospitals in 49 states that will lose up to 2% of their Medicare reimbursement that had too many patient readmission within 30 days of discharge because of three medical conditions: heart attack, heart failure and pneumonia. Under the PPACA, the maximum penalty will increase to 3% by 2015 and expand to include re-admissions for other medical conditions. ICD-10, a standard the describes the condition of the patient, will modify these quality measures when it goes into effect. We have published an interactive, searchable version of the penalties, by city, state, county and hospital for the healthcare industry and consumers to use to easily find the data relevant to their geography or organization.

Increasing Health Data Interoperability, BigData, Cloud, Exchange, ICD-10 Lay Foundation for Accountable Care

These are important foundations that enable ubiquitous digital health data in a standard interchange, enabling in-depth analysis and increasingly, Cloud and Software as a Service methods to deploy, store and use the information to improve healthcare. These in turn are important foundations to enable Accountable Care. ICD-10 is the new data standard that will express the condition of the patient and how providers get reimbursed.

5 Experts at San Diego Healthcare Innovation Summit April 17th at Scripps La Jolla

Experts to Review Electronic Health Care Innovation, Regulations and Mobile Health at Scripps, April 17th To register and for more information: http://bit.ly/SDHIS417 A group of companies will participate in a comprehensive discussion on the current and future state of health care reform and innovation on Wednesday, April. 17.  The companies include Qualcomm, the San Diego Health [...]

State Insurance Exchanges Secure Conditional Approval from HHS

December 20, 2012 - HHS Secretary Kathleen Sebelius announced three more states that are tracking on time to implement health care law by establishing Health Insurance Exchanges (HIX). HHS issued the first conditional approval of a State Partnership Exchange to Delaware and Minnesota and Rhode Island. Second Order Effects of the HIX Movement State Exchanges [...]

By | 2017-05-04T04:06:44+00:00 December 20th, 2012|Accountable Care Organiztion, Insurance Exchange, MAGI|0 Comments

PPACA Supreme Court Hearings Coverage in Social Media Need Holistic View

If The Patient Protection and Affordable Care Act (PPACA) is repealed it will be interesting to see if it is repealed in whole or in part. The Supreme Court of the United States (SCOTUS) may excise the individual mandate requiring health insurance coverage, or it could strike it down entirely.

Stage 2 Meaningful Use, Interoperability of EMRs and ICD-10. What is CMS, ONC and HIPAA Impact on Accountable Care Organizations?

One of the key questions will be how the EMR provides a foundation with the Health Information Exchanges (HIEs) for comparative effectiveness data over the life span of a patient (sometimes called the continuum of care) and whether CDA standards currently proposed will accomplish that. Informatics people call this "longitudinal clinical data."

ICD-10 and Bundling – Study Raises Questions About Bundling To Pay Doctors

ICD-10 will drive initiatives such as bundling, as a component of health care payment reform. Therefore reimbursement, and case management and other areas must be viewed in a broader landscape. HIPAA mandates and health care reform impact one another.

ICD-10 Readiness Compromised by ICD-10 Revenue Cycle, Analytics Vendors

We find that most analytics and revenue cycle companies are ignoring the future role coordinated medical coding will have, the transition to ICD-10, and the clinical documentation and processes on the revenue cycle. The ICD-10 transition will re-write the book on revenue cycle management (RCM). RAC audits and Electronic Medical Records (EMRs) will be subject to a new paradigm with ICD-10.

Accountable Care Organizations and Medicaid

Accountable Care standards may be fluid for some time, however it is clear that there will be a need for core competencies in population management, coordination of care and other areas for an ACO to function effectively. Blum emphasized that CMS will be looking for innovative models, with different payment systems, and with different “on ramps” to formation and approval. It was also acknowledged that improving quality and reducing cost through coordination of care will at times be at odds with and the Accountable Care Act’s continued focus on patient choice of providers.