HHS publishes the final MACRA rule (2,204 pages, although much of it is draft comments with responses) with a 24-page executive summary (provided the executive in question understands a lot of jargon in sentences such as, “We are finalizing the method to calculate and disburse the lump-sum APM Incentive Payments to QPs, and we are finalizing a specific approach for calculating the APM Incentive Payment when a QP also receives non-fee-for-service payments or has received payment adjustments through the Medicare EHR Incentive Program, PQRS, VM, or MIPS during the prior period used for determining the APM Incentive Payment”) and a website explaining it.
CMS Acting Administrator Andy Slavitt summarizes the rule:
Other than a 0.5 percent fee schedule update in 2017 and 2018, there are very few changes when the program first begins in 2017. If you already participate in an Advanced APM, your participation stays the same. If you aren’t in an Advanced APM, but are interested, more options are becoming available. If you participate in the standard Medicare quality reporting and Electronic Health Records (EHR) incentive programs, you will find MIPS simpler. And, if you see Medicare patients, but have never participated in a Medicare quality program, there are paths to choose from to get started. The first couple of years are aimed at getting physicians gradually more experienced with the program and vendors more capable of supporting physicians. We have finalized this policy with a comment period so that we can continue to improve the program based on your feedback.
Like every other notable EHR-related legislation, the final rule came out on a Friday. Industry groups seemed mostly happy with it.
From The Hurricane: “Re: [vendor name omitted]. Laying off half its employees and being folded into of the parent corporation’s entities.” Unverified. I’ll keep my eye out.
HIStalk Announcements and Requests
Nearly 60 percent of poll respondents spend little to no time in their workday talking about patients and their needs. New poll to your right or here: How much work is your organization doing to prepare for Medicare’s 2019 issuance of new ID numbers to replace SSN?
Last Week’s Most Interesting News
- The Department of Defense moves back its first Project Genesis Cerner go-live from December 2016 to February 2017 and says it will involve only one Washington hospital rather than the originally planned two, although the project’s 2022 completion date remains unchanged.
- A hedge fund operator and $100 million Theranos investor sues the company for securities fraud.
- A court orders Parkview Hospital (IN) to release its chargemaster prices and insurance company discounts after an uninsured patient says his bill, which the hospital sent off to collections, is unreasonable because insurers don’t pay the full price he’s being sued over.
October 25 (Tuesday) 1:30 ET. “Data Privacy/Insider Threat Mitigation: What Hospitals Can Learn From Other Industries.” Sponsored by HIStalk. Presenters: Robert Kuller, chief commercial officer, Haystack Informatics; Mitchell Parker, CISSP, executive director of information security and compliance, Indiana University Health. Cybersecurity insurers believe that hospitals are too focused on perimeter threats, ransomware, and the threat of OCR audits instead of insider threats, which are far more common but less likely to earn media attention. Attendees will learn how behavior analytics is being used to profile insiders and detect unusual behaviors proactively and to place privacy/insider risk within the risk management matrix.
November 8 (Tuesday) 1:00 ET. “A CMIO’s Perspective on the Successful 25 Hospital Rollout of Electronic Physician Documentation.” Sponsored by Crossings Healthcare. Presenter: Ori Lotan, MD, CMIO, Universal Health Services. UHS rolled out Cerner Millennium’s electronic physician documentation to its 6,000 active medical staff members — 95 percent of them independent practitioners who also work in competitor facilities — across 25 acute care hospitals. UHS’s clinical informatics team used Cerner’s MPage development toolkit to improve the usability, efficiency, communications capability, and quality metric performance of Dynamic Documentation, embedding clinical decision support and also using Nuance’s cloud-based speech recognition product for the narrative bookends of physician notes. This CMIO-led webinar will describe how UHS achieved 70 percent voluntary physician adoption within one month of go-live, saved $3 million in annual transcription expense, and raised EHR satisfaction to 75 percent. It will include a short demonstration of the software that UHS developed to optimize the physician experience.
November 9 (Wednesday) 1:00 ET. “How to Create Healthcare Apps That Get Used and Maybe Even Loved.” Sponsored by MedData. Presenter: Jeff Harper, founder and CEO, Duet Health. Patients, clinicians, and hospital employees are also consumers who manage many aspects of their non-medical lives on their mobile devices. Don’t crush their high technology expectations with poorly designed, seldom used apps that tarnish your carefully protected image. Your app represents your brand and carries high expectations on both sides. This webinar will describe how to build a mobile healthcare app that puts the user first, meets their needs (which are often different from their wants), creates “stickiness,” and delivers the expected benefits to everyone involved.
- Southwest General Hospital (TX) will switch from McKesson to Cerner in July 2017.
- Central Peninsula General Hospital (AK) went live with an Infor Lawson human resources system in October 2016 and will follow with time and attendance and payroll go-lives in November.
- Fisherman’s Hospital (FL) will go live with a Paycom Human Resources System in October 2016.
These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare provider
Government and Politics
A military-focused reporter’s article on the delay in the initial rollout of MHS Project Genesis at Fairchild Air Force Base (WA) says the DoD’s new Cerner system will be interfaced to legacy systems that include AHLTA, the ancillary department systems of CHCS, and CliniComp’s Essentris. It doesn’t indicate how or when those systems will be phased out by Cerner.
Intuit and CMS release Benefit Assist, open source software that determines eligibility for income-based government benefits.
Privacy and Security
- The Russians that hacked into the Democratic National Convention servers used a phony Gmail security update message that lured users to reset their passwords, then sent them to a phony log-on page that stole their credentials.
- The Vermont Health Connect insurance marketplace exposes the information of 700 users due to a payment contractor’s mistake.
- Vermont’s attorney general reaches a settlement with software vendor Entrinsik to provide more explicit instructions for its business intelligence tool, which when users run reports from their browsers, sometimes creates temporary files that are not automatically erased and fails to warn users of their existence.
Innovation and Research
CB Insights publishes a list of digital hospital technology vendors.
A UK psychiatric hospital pilots Oxehealth, which analyzes streaming video to monitor vital signs with no attached sensors and alerts staff if a patient appears to be at risk.
Surgeons at St. Vincent Hospital (MA) remove the healthy rather than the cancerous kidney of a patient after a mix-up with another patient’s CT results. Investigators also found several problems with patient ID bracelets, with a patient’s son receiving his father’s bracelet and another observed being taken to X-ray without any bracelet at all. They also noted that one patient had been registered with another patient’s name and was assigned two medical record numbers.
Texas authorities free the convicted murderer of a four-year-old boy because the county can’t afford to pay his medical bills. The inmate spent 967 days in incarceration in running up $19,000 in medical expenses, nearly 20 percent of the prison’s total annual medical budget. A local resident weighs in with the opinion that he should be just allowed to die untreated in jail as a cost for committing a crime.
- T-System, Vital Images, and VitalWare will exhibit at AHIMA through October 19 in Baltimore
- .TierPoint presents “Hackers, Superstorms, and Other Disruptions” October 19 in New York City.
- Valence Health, Verscend, and ZeOmega will exhibit at AHIP’s National Conference on Medicare, Medicaid & Duals October 23-27 in Washington, DC.
- Visage Imaging will exhibit at Health Connect Partners October 19-21 in Chicago.
- Wellsoft will exhibit at the ACEP Scientific Assembly through October 19 in Las Vegas.
- ZirMed earns Frost & Sullivan’s 2016 Technology Innovation Award for revenue cycle management.
- Zynx Health will exhibit at the 2016 Meditech Physician and CIO Forum October 20-21 in Foxborough, MA.
- AHIMA 2016: Prepared for Takeoff? (VitalWare)
- Matthew vs. Magnet. (Voalte)
- Four Tips for Encouraging Fitness in Employees with Chronic Conditions (West Corp.)