Morning Headlines 6/9/15

Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations

CMS publishes its final rule addressing changes to the Medicare Shared Savings Program. The final rule introduces a new program, called Track 3, based on the successful aspects of the Pioneer ACO Model. The rule also beings to address performance benchmarking concerns, and promises additional performance benchmarking regulations later this year.

Back to the Future

Outgoing AMA president Robert Wah, MD, rails against the Meaningful Use program and ICD-10 implementation at the AMA Annual Conference this weekend in Chicago, saying “the Meaningful Use requirements for electronic records are a heavy burden and a prison for innovation,” and “We believe ICD-10 will further disrupt physician practices when we’re already facing headaches like Meaningful Use.”

ICD-10 ‘Grace Period’ Bill Introduced in US House

Representative Gary Palmer (R-AL) introduces HR 2652, titled Protecting Patients and Physicians Against Coding Act of 2015, which if passed would establish a two-year grace period during which both ICD-9 and ICD-10 codes would be accepted. It is the third bill introduced in the last two months that attempts to delay the upcoming ICD-10 switchover.

Morning Headlines 6/8/15

CSC to pay $190 million to settle SEC charges

CSC will pay a $190 million to settle fraud allegations after the SEC charged the company with manipulating financial results and hiding problems with its largest contract, the UK’s now defunct NPfIT program, from investors. CSC signed a $4.5 billion contract with the NHS to deploy its Lorenzo EHR across 166 hospitals, but a poor implementation track record led to the program being shut down.

Evolent Health Stock Closed at $18.86 in IPO Debut

Evolent Health finishes its first day of trading on the NYSE at $18.86, up 11 percent from the start of the day.

Hawaii Pulls The Plug On Embattled Health Insurance Exchange

Hawaii will shut down its $130 million, state-run health insurance exchange and migrate to Healthcare.gov after a series of technical failures kept it from meeting key ACA requirements. With one of the lowest uninsured rates in the country, administrators acknowledged that the sites 40,000 users would no generate enough revenue to continue operations after federal subsidies ran out.

Data hacked from U.S. government dates back to 1985: U.S. official

Chinese hackers breach the severs of the US Office of Personnel Management, stealing security clearance and background check data going back to 1985 and affecting nearly four million current and former government employees.  

Morning Headlines 6/4/15

ICD-10 Medicare FFS End-to-End Testing: April 27 through May 1, 2015

CMS reports the results of its latest end-to-end ICD-10 testing period: 88 percent of the test claims were accepted, up from the 81 percent in February. Two percent were rejected due to invalid ICD-10 codes, while the remaining rejections were due to errors unrelated to ICD-10.

Why CMS should stop Stage 3 of meaningful use

AMA joins the growing list of industry organizations calling on ONC to delay MU3. AMA proposes a one-year pause in the program in 2017, giving providers and vendors a much needed break, before moving forward with MU3 in 2018.

We the people want easy, electronic access to our health information

Farzad Mostashari, MD and former National Coordinator for Health IT, unveils a new petition called Get My Health Data that is soliciting signatures from people that are passionate about patient’s access to medical data. He also encourages patients to test the current environment by requesting their medical records from local health facilities and then reporting issues they run into under the Twitter hashtag #tracer.

Morning Headlines 6/3/15

Partners’ $1.2b patient data system seen as key to future

Partners Healthcare goes live on Epic across nearly all locations except for its Massachusetts General Hospital facility. The total cost of the implementation grew to $1.2 billion, double the $600 million initially budgeted, making it the largest investment the health system has ever made.

Revisit Rates and Associated Costs After an Emergency Department Encounter: A Multistate Analysis

A study published in the Annals of Internal Medicine finds that 8.2 percent of ED patients will readmit within three-days, often going to a different hospital for the second visit. Skin infections generated the highest rate of revisits at 23 percent, and the second visit was typically far more expensive than the initial encounter.

Comvest Partners Acquires McKesson Care Management Business

McKesson sells its care management system, marketed to payors and risk-bearing health systems, to investors for an undisclosed sum.

Governor: Update fixes health exchange delays

Vermont updates its health insurance exchange to fix problems that were causing delays of up to two-hours for users trying to update their coverage mid-year due to life changes such as marriage or the birth of a new child. The HIE is still unable to enroll businesses, a requirement of ACA, and the governor has reported that he will push to have the requirement dropped before attempting to add the functionality to the site.

Morning Headlines 6/2/15

New Medicare data available to increase transparency on hospital and physician utilization

CMS releases its latest Medicare payment dataset, covering all inpatient and outpatient hospital billing and reimbursement figures for 2013. The latest data breaks down what hospitals charged, and what Medicare reimbursed, for the 100 most common inpatient DRGs and outpatient procedures.

AMA Weighs Ethical Telehealth, Doctor Care Via iPhone

At the 2015 AMA Annual Meeting this week, the AMA’s Council on Ethical and Judicial Affairs will debate and vote on a new telehealth policy that will advise doctors on everything from patient privacy, diagnostic procedures, and follow up care.

Providers want CMS to slow down EHR superhighway

Several provider organizations weigh in with their concerns over the proposed MU3 rules, with Catholic Health Initiatives saying “We are concerned that CMS is trying to force providers to move toward meaningful use of EHRs at a pace that is too fast and impossible to meet,” and the AHA saying “We do not yet have sufficient experience at Stage 2 to be confident that the proposals for Stage 3 are feasible and appropriate.”

Morning Headlines 6/1/15

Federal Court rules in favor of Teladoc, blocking Texas Medical Board rule and preserving telehealth in Texas

Dallas-based Teladoc wins an early victory in its anti-trust lawsuit against the Texas Medical Board, which passed a rule earlier this month requiring a face-to-face consultation before any telehealth services could be provided in the state. A US District Court has blocked the rule from going into effect until after the trial.

Report of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs

The American Medical Informatics Association publishes the recommendations of its EHR 2020 Task Force in a report on the status and future direction of EHRs.

Erlanger spending $91 million on major IT overhaul

Erlanger Health System approves a $91 million contract to implement Epic across its system, with an additional $97 million budgeted to maintain the system over the next 10 years. The hospital’s selection committee, made up of clinical and operational leaders, voted in favor of Epic 28 to two over Cerner.

Big Data Beats Cancer

IEEE Spectrum profiles John Halamka, MD, CIO of Beth Israel Deaconess Medical Center, who helped pioneer several big data initiatives in healthcare and in 2011 turned to big data to help create a personalized treatment plan for his wife when she was diagnosed with stage III breast cancer.

Morning Headlines 5/29/15

I’m the New CTO of HHS

Patient advocate and former associate director at the Pew Research Center Susannah Fox is named the next CTO of HHS. Fox will be the third person to hold the position, following Bryan Sivak and Todd Park, and will be the first female CTO.

The Wealthiest Female Techies In America

Judy Faulkner is named the richest woman in technology, with a net worth of $2.6 billion.

Allscripts to build 12-story tower at North Hills

Allscripts will move its 1,000 Raleigh, NC-based employees into a new 12-story, 250,000 square foot office tower, scheduled to open in early 2017.

Cambia Health Solutions Leads New Round of Investment in lifeIMAGE

LifeImage, a medical image exchange platform vendor, closes a $17.5 million funding round led by investor Cambria Health Solutions. The company will use the new funding to grow its support staff and further develop its functional capabilities.

Morning Headlines 5/28/15

Medicaid rule could extend health IT support to behavioral health, long-term care

A newly proposed CMS rule governing Medicaid managed-care plans has implications on health IT. The rule authorizes state Medicaid programs to offer incentive payments for organizations that do not qualify to participate in the Meaningful Use program, like behavioral health providers and long-term care providers, to purchase and implement EHRs. The new rule also authorizes states to mandate participation in health information exchanges as part of their contracts with Medicaid managed care organizations.

Telemedicine exams result in antibiotics as often as regular exams, study finds

A new RAND corporation study published in JAMA Internal Medicine finds that antibiotic prescribing rates are comparable between office-based visits and telehealth visits, but notes that virtually-treated patients were more likely to be prescribed a broad-spectrum antibiotic, which is concerning because use of these drugs drives up costs and contributes to antibiotic resistance.

Antitrust Lawsuits Target Blue Cross and Blue Shield

Two antitrust lawsuits filed independently by health care providers and employers is advancing in federal court in Alabama. The suits charge Blue Cross and Blue Shield with acting as a single, illegal cartel, rather than as 37 independently owned companies to minimize competition. BCBS currently covers one-third of all Americans.

Early Marketplace Enrollees Were Older And Used More Medication Than Later Enrollees; Marketplaces Pooled Risk

Researchers assessed the medication needs of the 7.3 million Americans that signed up for health insurance through the 2014 Affordable Care Act marketplaces and found that marketplace enrollees had a lower average drug spending and were less likely to use most medication classes than an employer-sponsored comparison group.

Morning Headlines 5/27/15

Chronic Care and Population Health Company Persivia Acquires Alere Analytics to Help Healthcare Organizations Manage Clinical and Financial Outcomes Risk

Chronic care management vendor Persivia buys back Alere Analytics, the population analytics solution that it sold to Alere in 2014 for $600 million, for an undisclosed sum.

Varian Medical Systems and Flatiron Health to Develop Next Generation of Cloud-based Oncology Software

Varian Medical Systems is partnering with Flatiron Health to develop a cloud-based oncology EHR.

The Triple Aimers have missed the mark

Former Beth Israel Deaconess Medical Center CEO Paul Levy writes an article claiming that the Triple Aim has been hijacked by ACOs and, more specifically, by the academic medical institutions that tend to be the dominant player in them.

Drugmakers funnel payments to high-prescribing doctors

Modern Healthcare publishes an article claiming that nearly one-quarter of Medicare’s top-prescribing physicians received non-research related payments from the manufacturers of the drugs they prescribed in 2013.

Morning Headlines 5/26/15

EHRA Recommends Changes To ONC’s Standards Advisory Proposal

The HIMSS EHR Association responds to ONC’s Standards Advisory Proposal, citing concerns that the newly established standards, and their intended uses, could be unintentionally misinterpreted without explicit clarifications.

America’s Health Rankings Senior Report

The United Health Foundation publishes a report on senior’s health, finding that preventable hospitalizations within this sub-group have dropped 6.8 percent since 2014, and 11 percent since 2013.

Why We Need Design Thinking In Healthcare

Deonard D’Avolio, PhD and Director of Informatics at Airadne Labs, a joint venture between Harvard School of Public Health and Brigham and Women’s Hospital, authors a piece in InformationWeek calling for better design in healthcare, rather than a re-engineering of systems and processes. He uses the recent debacle at Texas Health Presbyterian Hospital Dallas in which an ER doctor missed the travel history of a patient with Ebola and sent him home, and argues that the systems being implemented work as designed, but the design is not always inline with clinical workflows or expectations.

Morning Headlines 5/25/15

Patterson: No intersection has ‘more potential than what we’re at’ — health care, IT

Cerner booked $4.25 billion in new sales in 2014, beating its previous record of $3.8 billion. The company also reports that it expects its Siemens acquisition to return $1 billion in revenue in 2015.

Thompson and Rangel Introduce Veterans E-Health & Telemedicine Support Act of 2015

Representatives Glenn Thompson (R- PA) and Charles Rangel (D-NY) introduce H.R. 2516, the Veterans E-Health and Telemedicine Support Act of 2015, which would expand access to telehealth services for veterans by authorizing VA clinicians to practice medicine across state lines without running afoul of state or local regulations.

Connecticut Senate adopts major health care changes

Connecticut’s state Senate has passed a bipartisan bill that funds the development of a health information exchange for the state, replacing its failed $4.3 million first attempt.

eQHealth Solutions Selected by Colorado Department of Health Care Policy and Financing to Provide Medical Management Services

Colorado selects non-profit population health vendor eQHealth Solutions to provide solutions for Colorado’s Medicaid program.

Morning Headlines 5/21/15

CareFirst BlueCross BlueShield has been the target of a cyberattack

CareFirst BlueCross BlueShield, which provides insurance to residents in Maryland and Washington DC, is the latest victim of a targeted cyberattack. The attack was carried out in June 2014 but was only just discovered during a system-wide security audit.  Hackers gained access to a total of 1.1 million patient records.

AHA recommends changes to 21st Century Cures interoperability provisions

In a letter to the House Energy and Commerce Committee, AHA Executive Vice President Rick Pollack expresses concerns over interoperability requirements outlined in the 21st Century Cures Act currently being debated in Congress, suggesting that instead of establishing information blocking penalties that could be applied to providers, which he calls duplicative, the bill simply funds the FTC to investigate and address anti-competitive information blocking practices among EHR vendors.

Health IT Standards Committee and Task Forces

ONC announces that it will sunset the Health IT Standards Committee’s permanent workgroups, replacing them with a series of time-limited task forces that will study and make recommendations on specific issues. The intent is to create a more agile HITSC and to increase public engagement by offering an opportunity to participate in smaller, less time-intensive projects.   

Morning Headlines 5/20/15

Allscripts layoffs to impact Raleigh headcount

Allscripts lays off 250 employees across its service, support, solutions management, sales, and G&A departments as part of a wider “rebalancing” effort. The layoffs were alluded to during the company’s Q1 earnings call and were reported via reader tips on HIStalk earlier in the month.

Welltok Acquires Leading Healthcare Analytics Company Predilytics

Population health vendor Welltok acquires Predilytics, an analytics company that uses machine learning to segment patients based on risk. Financial details were not disclosed.

Detecting Unplanned Care From Clinician Notes in Electronic Health Records

Researchers at Stanford University use natural language processing to analyze free-text clinical notes to detect patients with reported unplanned episodes of care at outside locations, increasing identification of patients with one or more unplanned care visits by 32 percent.

Morning Headlines 5/19/15

Interoperability Roadmap Public Comments

ONC publishes all of the public comments it received on its interoperability roadmap (PDF).

ICD-10 Transition Testing Proposed

Rep. Diane Black (R-TN) introduces the ICD-TEN Act, a bill that would introduce an 18-month period during which providers could submit claims in either ICD-9 or ICD-10 format, and during which CMS would be barred from denying claims due to inaccurate ICD-10 sub-coding.

Interstate telehealth licensing compact set to become reality

A compact drafted by the Federation of State Medical Boards that would allow providers to practice medicine across state lines looks likely to be enacted. The compact was written in an effort to ease regulatory barriers to broader telemedicine adoption. The compact required that seven states formally adopt it before it would become active.  Alabama has just passed legislation adopting the compact and as soon as the Alabama governor signs the bill into law, the compact will have met its seven-state requirement and will be enacted nationally.

Morning Headlines 5/18/15

AMA Letter To Representative Ted Poe

The AMA sends a letter to Representative Ted Poe (R-TX) supporting his bill, Cutting Costly Codes Act of 2015, which would cancel the migration to ICD-10 completely, and instead instruct CMS to wait for the international adoption of ICD-11 in a few years. 

HealthCare.gov Contractor Optum Declares Its Job Done

Optum, the contractor tapped to rescue the failing Healthcare.gov site just after its troubled launch, announces that it will not bid to continue on in its role as senior administrator once its current contract expires. 

Can the state build a better system to get your medical records to your doctors?

Connecticut will reportedly scrap its state health information exchange after spending $4 million but failing to achieve its interoperability goals.

Population Health Management Weekly Wrap Up 5/15/15

Jenn publishes the third installment in her comprehensive weekly recap of the emerging population health management market.

Morning Headlines 5/15/15

vRad to be acquired by MEDNAX

vRad, an outsourced radiology and telemedicine services company, will be acquired by MEDNAX, Inc for $500 million. MEDNAX is a national medical group specializing in anesthesia, maternal, neonatal and pediatric specialties.

McKesson (MCK) John H. Hammergren on Q4 2015 Results – Earnings Call Transcript

In its 2015 year end earnings call, McKesson CEO John Hammergren reports that the company’s Technology Solutions business revenue was down eight percent, to $3.8 billion, driven by anticipated declines in hospital software sales.

Here’s A Radical Approach To Big Hospital Bills: Set Your Own Price

NPR Shots covers ELAP Services, a benefits consulting firm that helps employers negotiate lower hospital bills by calculating the actual cost of services provided and then adding a reasonable profit margin.

New Company Announces Revolutionary Approach to Scribe Services in Healthcare, Finalist Spot on TiE50 Top Start-Up List

Skywriter MD launches to provide physician practices with remote scribes that listen in on exams through a microphone and navigate the physicians EHR through a remote connection. The scribes also document the encounter and enter any orders or prescriptions referenced during the visit. At the end of the session, the physician reviews the work and signs off on the chart.

Morning Headlines 5/14/15

Stiff Interoperability penalties in new 21st Century Cures Act

The revised 21st Century Cures Act was introduced in Congress today, and the new changes included funding to develop metrics to quantify and report on the exact state of interoperability available between EHR systems today, and then report on whether each EHR vendor was in compliance with new interoperability certification criteria that would go into effect in 2018.

Meaningful Use Stage 3 NPRM Comments

At Tuesday’s Health IT Policy Committee meeting, four workgroups shared comments on the Stage 3 MU proposed rule, with three of the four expressing some form of concern over the increases to the view, download, or transmit requirement.

Patients six to ten times more likely to get HPV vaccine after electronic health record prompts

Researchers with the University of Michigan find that pediatric patients are three times more likely to start the three-dose series of HPV vaccinations, and are 10 times more likely to complete them, if their pediatrician receives EHR alerts reminding them to start or continue the regimen.