House Republicans unveil their plan to repeal and replace the Affordable Care Act, which they have named the American Health Care Act. It would:
- Roll back the Medicaid expansion that insures 10 million people
- Eliminate the requirement that people carry health insurance
- Allow large employers to opt out of providing coverage to their full-time employees
- Penalize those who let their insurance lapse and then sign up again
- Replace premium subsidies with income tax credits
- Allow insurers to charge much higher rates to older people
- Change Medicaid from an open-ended entitlement to a per-person block grant to each state
- Repeal the ACA-imposed tax surcharges on insurance companies, drug and device manufacturers, and citizens who earn more than $250,000.
The proposal would continue to prohibit denial of coverage for pre-existing conditions and lifetime caps and would allowing parents to keep children through age 26 on their insurance. It would eliminate ACA-mandated basic coverage provisions, allowing insurers to issue catastrophic-only plans as they did pre-ACA.
Two House committees plan to vote on the legislation without first asking the Congressional Budget Office to perform a cost estimate or to project how many Americans would become uninsured with the changes.
From Under My Wheels: “Re: Epic’s App Orchard. A former Epic executive tells me that the legal terms of participating give Epic all intellectual property rights to the app. It might seem that they are protecting themselves in case they decide to create functionality that would compete with an App Orchard app. But another perspective is that Epic is taking customer heat for lack of innovation and App Orchard gives Epic a way to look over another company’s innovation and then squash it. It also makes customers happy because they might think they can monetize what they’ve been giving Epic for free. Judy made some big statements about openness through cozy journalists at HIMSS, but App Orchard isn’t as open as Epic would like everyone to believe.” Unverified.
HIStalk Announcements and Requests
Welcome to new HIStalk Gold Sponsor Saturn Care. The company’s clinician-developed, patient-centric CDMP (Chronic Disease Management Program) supports value-based diabetes management for primary care by bringing together EHR and patient data into a single view with risk scoring and decision support tools, allowing care teams to improve both clinical (HbA1c) and behavioral (diabetes stress) outcomes. Patients provide behavioral data via mobile and other tools that the primary care team then reviews via CDMP to improve visit and care management efficiency. The company’s technology was developed with organizations such as UPMC, the VA, and Joslin Diabetes Center and has been clinically validated in an NIH study. It was designed to work within programs such as CPC+ and MACRA, which require measuring quality and cost metrics and for which the ADA guidelines are the best evidence-based means to improve outcomes. Practices can choose between a per-patient, per-month licensing structure or a turnkey services solution. Sign up for their April 12 webinar for more information. Thanks to Saturn Care for supporting HIStalk.
We funded the DonorsChoose grant request of Ms. M in Minnesota, who asked for STEAM-related books for her fourth grade class to use in a book club-like small group exercise. She declares them to be “awesome,” as they are being used in “lit circles” in the class’s unit on sustainability, environmentalism, and conservation.
Interest has been muted (non-existent, to be precise) in my quest for contributors in these areas that I mentioned in Monday’s post. Contact me if you are interested – compensation and anonymity issues can be worked out.
- Experts in nursing, laboratory, and pharmacy IT to provide updates in their respective subject areas at least quarterly
- Someone to write a digital health summary every so often
- An expert in non-US healthcare IT to write a regular summary of what’s going on outside the US
- A leader, provider, or technologist in their 20s or 30s who can represent that point of view
March 9 (Thursday) 1:00 ET. “PAMA: The 2017 MPFS Final Rule.” Sponsored by National Decision Support Company. Presenter: Erin Lane, senior analyst, The Advisory Board Company. The Protecting Access to Medicare Act of 2014 instructed CMS to require physicians to consult with a qualified clinical decision support (CDS) mechanism that relies on established appropriate use criteria (AUC) when ordering certain imaging exams. Providers must report AUC interactions beginning January 1, 2018 to receive payment for Medicare Advanced Imaging studies, with the CDS recording a unique number. Outliers will be measured against a set of Priority Clinical Areas and interaction with the AUC. This webinar will review the requirements for Medicare Advanced Imaging compliance and will review how to ensure that CDS tools submit the information needed for reimbursement.
Acquisitions, Funding, Business, and Stock
Talent management software vendor HealthcareSource will acquire Centricity Contingent Staffing (formerly API Healthcare’s Clearview) from GE Healthcare.
Shares in NantHealth fell 23 percent Monday and another 10 percent Tuesday following a STAT report that describes a high-profile, $12 million gift to University of Utah from founder Patrick Soon-Shiong, MD that came with strings attached – the university had to buy $10 million worth of genetic sequencing services from NantHealth in a “partnership” and also provide patient data to help the company develop a new product. The article also claims that NantHealth misled investors in its November earnings call in claiming that one-third of its GPS Cancer screening tests were purchased by the university, which the university says isn’t true since it only ordered standard genetic sequencing tests that have nothing to do with GPS Cancer. Independent attorneys asked by STAT to review the agreements questioned why the university would sign such an agreement whose wording attempted to avoid the implication of indirect self-dealing, although one was blunt in concluding, “They’re laundering the funds through the University of Utah.” Shares in NH, which closed at $18.59 on their first day of trading last June a few weeks before the University of Utah announcement, have shed 73 percent since, valuing the company at $598 million.
Announcements and Implementations
Allscripts Sunrise, CareInMotion, and 2bPrecise solutions are accepted into NHS London’s procurement program.
WebMD adds health-related topics to Amazon Alexa-powered devices. I tried it today on the Echo – just say, “Alexa, enable WebMD skill.” It’s interesting, although it doesn’t always recognize drug generic names even when it knows the brand names.
A Rand medical claims analysis concludes that employer-offered telemedicine services such as Teladoc offer convenience to users with respiratory infections, but actually raise employer healthcare costs because most of their employees would not have sought care for their self-limiting conditions otherwise.
A new searchable IRS database reveals that non-profit organizations paid 2,700 employees $1 million or more in 2014, with hospital operator Ascension leading the pack in providing $17.6 million in compensation to CEO Anthony Tersigni.
In England, a man who previously served as chair of two NHS trusts and CEO of a hospice is sentenced to two years in prison for falsifying his work history and claimed doctorate, with authorities finally discovering that his job experience was as a probation officer and a builder. The moral of the story is to always verify educational credentials, not so much because having them may or may not be a critical success factor for the job, but rather that you don’t want to hire someone who is willing earn a job by lying.
- The Intelligent Health Association recognizes NantHealth CEO Patrick Soon-Shiong, MD with its Special Recognition Award.
- Meditech participates in the Northeastern University Nurse Innovation and Entrepreneurship Advisory Board, on which EVP Hoda Sayed-Friel serves.
- Besler Consulting releases a new podcast, “Practical steps toward MACRA implementation.”
- Carevive CEO Madelyn Herzfeld, RN discusses the challenges practice face when implementing new patient engagement tech in a new video series.
- CoverMyMeds will sponsor the SPCMA Business Forum 2017 March 8-9 in Orlando.
- The Relentless Health Value podcast features Diameter Health CEO Eric Rosow.
- EClinicalWorks releases a new podcast, “Tips from a Superuser – How to Improve Functionality.”
- Evariant releases a new case study, “Lehigh Valley Health Network: Engaging Consumers and Physicians in Tandem to Drive Revenue.”
- InterSystems features a Q&A with HBI Solutions CEO Eric Widen.
- InBusiness magazine includes Healthfinch VP Leah Roe in its 2017 class of “40 under 40.”
- Is HIMSS Really Over? (Access)
- Transform how your front office engages with your patients (AdvanceMD)
- Succeed With MIPS: Improve Your Payment Adjustment In 90 Days (Optimum Healthcare IT)
- Population Health: An old-school approach to handling requests of your IT team [podcast] (Nordic)
- Get Moving in the Right Direction (Agfa Healthcare)
- Visions of the Future of Digital Health at HIMSS 2017 (Datica)
- Go For It! Everyone has Their Own Key to Success (CTG)
- Patient Access Throughput: The Strategy to Success (Culbert Healthcare Solutions)
- HIMSS 2017 Recap (Direct Consulting Associates)
- How Do You Succeed in a Value-Based World? Find a Strategic Partner. (ECG Management Consultants)
- The ACA Replacement: How the Views of Trump, Ryan, and Price Tell Us What to Expect (Hayes Management Consulting)
- Three Ways to Observe Heart Health Month Beyond February (Healthgrades)
- Four Focus Areas in Health IT for Care Coordination Workflow Success (Healthwise)