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Health Management Technology News
  February 14, 2014
In this issue:
 

 HIMSS welcomes first CCHIT Summit

 One-fifth of new enrollees under health care law fail to pay first premium

 Seven leading health organizations join Optum Labs research collaborative

 IHE North American Connectathon continues to expand interoperability testing


HIMSS welcomes first CCHIT Summit

CCHIT is launching its first Summit, “The Decade of Health IT”, on February 26, 2014 at the HIMSS14 Annual Conference and Exhibition in Orlando, Fla.  This discussion with newly appointed National Coordinator, Dr. Karen DeSalvo, and past National Coordinators Dr. David Brailer, Dr. Robert Kolodner, and Dr. Farzad Mostashari, will offer a critical look back at the last decade of health IT progress, with an opportunity for Summit participants to provide input on the desired role of health IT in the decade to come.  The Summit will be moderated by Christopher Weaver, covering the business of health care for The Wall Street Journal.

“Last month CCHIT announced its plan to return to our independent work, convening stakeholders to engage in dialogue that will provide guidance to the healthcare community,“ said Alisa Ray, CCHIT’s executive director. “With this inaugural Summit, we are delighted to be able to offer HIMSS14 Annual Conference attendees the opportunity to engage with this exceptional panel of national health IT leaders.”

Recognizing a substantial information gap between the potential benefits of medical knowledge and the reality of healthcare delivery, President George W. Bush announced in April 2004 a goal to provide most Americans with EHRs within the next 10 years to enable the transformation of healthcare.  He appointed Dr. David Brailer to serve as the first National Coordinator for Health Information Technology.  Soon after, a Framework for Strategic Action was released to guide that vision.  As the decade closes on that work – a decade that now includes four successive National Coordinators and a significant increase in health IT policy making – CCHIT has invited the National Coordinators who have guided and implemented health IT policy to take stock.  Dr. Karen DeSalvo will join past National Coordinators for that discussion.

The goal of the Summit is to highlight what worked, what more is needed, why we are where we are, and what we’ve learned that could improve chances of success for future policy makers, providers, consumers and the health IT industry.  Participants of the Summit will share in the discussion and will be asked to directly contribute to creating guidance for future policy makers.

More information is available at himssconference.org

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One-fifth of new enrollees under health care law fail to pay first premium

One in five people who signed up for health insurance under the new health care law failed to pay their premiums on time and therefore did not receive coverage in January, insurance companies and industry experts say.

Paying the first month’s premium is the final step in completing an enrollment. Under federal rules, people must pay the initial premium to have coverage take effect. In view of the chaotic debut of the federal marketplace and many state exchanges, the White House urged insurers to give people more time, and many agreed to do so. But, insurers said, some people missed even the extended deadlines.

Lindy Wagner, a spokeswoman for Blue Shield of California, said that 80 percent of those who signed up for its plans had paid by the due date, Jan. 15. Blue Shield has about 30 percent of the exchange market in the state.

Matthew N. Wiggin, a spokesman for Aetna, said that about 70 percent of people who signed up for its health plans paid their premiums. For Aetna policies taking effect on Jan. 1, the deadline for payment was Jan. 14, and for products sold by Coventry Health Care, which is now part of Aetna, the deadline was Jan. 17.

Mark T. Bertolini, the chief executive of Aetna, said last week that the company had 135,000 “paid members,” out of 200,000 who began to enroll through the exchanges. “I think people are enrolling in multiple places,” he said in a conference call. “They are shopping. And what happens is that they never really get back on HealthCare.gov to disenroll from plans they prior enrolled in.”

Kristin E. Binns, a vice president of WellPoint, said that 76 percent of people selecting its health plans on an exchange had paid their share of the first month’s premium by the due date of Jan. 31. The company had received more than 500,000 applications for individual coverage through the exchanges in 14 states, she said.

Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, which runs the federal exchange and supervises state marketplaces, said the government did not know how many people had paid their premiums and thus “effectuated” coverage. But in interviews and in the quarterly reports on their financial performance, insurers provided data indicating that four-fifths of applicants had met payment deadlines.

One big company, Humana, said it had received 200,000 applications for insurance through the exchanges. “About 75 percent of the people paid, and 25 percent did not pay,” said Thomas T. Noland Jr., a senior vice president there. Customers had until Jan. 31 to pay for coverage that took effect on Jan. 1.

Greg Thompson, a spokesman for the Health Care Service Corporation, which offers Blue Cross and Blue Shield plans in Illinois, Texas and three other states, said that “around 80 percent” of people choosing those plans had paid their first month’s premium by the Jan. 30 due date.

Local and regional health plans are sometimes more effective in contacting consumers.

Elizabeth A. W. Williams, spokeswoman for Independence Blue Cross, in Philadelphia, said the company had extended the payment deadline to Jan. 28, then extended it again to Feb. 15 and made many phone calls urging people to pay.

“As a result,” Ms. Williams said, “we have received payment from 84 percent of our customers who purchased Independence Blue Cross health plans on HealthCare.gov — 84 percent of the 27,528 people who enrolled through the federal marketplace in Independence Blue Cross health plans with coverage effective Jan. 1.”

Read the full New York Times article here

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Seven leading health organizations join Optum Labs research collaborative

Optum Labs, the collaborative research and innovation center founded by Optum and Mayo Clinic, today announced the addition of seven new charter partners committed to improving the quality and value of patient care. The announcement follows the recent addition of AARP as Founding Consumer Advocate Organization of the collaborative.

These new partners, which represent a broad cross-section of health care stakeholders, are:

  • American Medical Group Association, Alexandria, Va.
  • Boston University School of Public Health, Boston, Mass.
  • Lehigh Valley Health Network, Allentown, Pa.
  • Pfizer Inc. (NYSE: PFE), New York, N.Y.
  • Rensselaer Polytechnic Institute (RPI), Troy, N.Y.
  • Tufts Medical Center, Boston, Mass.
  • University of Minnesota School of Nursing, Minneapolis, Minn.

“As the founding medical partner of Optum Labs, Mayo Clinic is excited to welcome the fresh insights and perspectives that new partners will bring to this collaboration,” said John Noseworthy, M.D., president and CEO of Mayo Clinic. “In addition to having access to large sources of clinical and claims information, all partners will now benefit freasm the unique viewpoints that others bring as we work to transform health care in the U.S. and truly meet the needs of patients in this country.”

“These additional charter partners will help Optum Labs accelerate the pace of innovation, paving the way for exciting new research initiatives that can be directly translated to improvements in patient care,” said Paul Bleicher, M.D., Ph.D., CEO of Optum Labs.

Optum Labs brings together a community of health care stakeholders dedicated to improving patient care by sharing information assets, technologies, knowledge, tools and scientific expertise. Research is linked to the clinical environment through prototyping and testing in Optum and partners’ care settings, with a goal of achieving knowledge that improves health care delivery and patient outcomes.

Optum Labs participants will have access to information resources, proprietary analytical tools and scientific expertise to help drive the discovery of new applications, testing of new care pathways and other opportunities to drive innovation in wellness and care delivery.

Read the full Business Wire news release here

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IHE North American Connectathon continues to expand interoperability testing

IHE USA held its 16th annual North American Connectathon in Chicago, January 27-31. This year’s event brought together 113 companies to test the interoperability and conformance to standards of more than 146 health IT systems. Fierce competing vendors collaboratively tested system capabilities based on IHE Profiles that are developed by IHE domain committees. Key areas of expansion included mobile access, patient care devices, laboratory systems and cross-enterprise exchange of information.

The IHE Connectathons are held across the globe and provide a cross-vendor, life, supervised and structured testing event. The IHE North American Connectathon is the largest interoperability test event in the US.

Again this year, IHE USA continued the expansion of testing services at the IHE North American (NA) Connectathon. A new testing track called New Directions was launched to foster cooperation amongst interoperability leaders and evaluate best practices for hospitals and medical offices to streamline the secure exchange of patient data. New Directions enables testing of emerging specifications developed by IHE and other standards organizations, including the HIMSS Health Story Project and a joint initiative between IHE USA and the Standards & Interoperability (S&I) Framework to develop a model for federated healthcare provider directories.

Many test participants at the NA Connectathon will also take part in the HIMSS Interoperability Showcase at the HIMSS14 Annual Conference & Exhibition in Orlando, FL, February 23-26, 2014.

“This year’s NA Connectathon brought together multiple organizations and companies to securely advance information exchange across health IT systems – whether a basic clinical summary or an in-depth review of lab results across the continuum of care,” said Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN, president, IHE USA, vice president of informatics, HIMSS. “With the rising cost of healthcare and new regulations on the Affordable Care Act, it is more important than ever to invest in interoperable systems that improve the delivery of care and health outcomes.”

The event included a one-day educational event, IHE North American Connectathon Conference, keynoted by the Chief Science Officer and Director of the ONC’s Office of Science and Technology, Doug Fridsma MD. The program also included numerous speakers from various health information exchange perspectives discussing the challenges facing their organizations and the benefits of improved access to health information. Key findings include:

  • Health information exchanges need a strong foundation in standards and interoperability to succeed
  • Forums like IHE can foster a practical approach to achieving interoperability to address critical use cases
  • Even with that foundation established, information exchange generally must be implemented at sites that have diverse systems in place
  • HIEs will need to refine their methods and practices over time
  • Starting simple and building on successes is the best way these networks can grow

The Connectathon contributes to eHealth interoperability by offering participants a structured, monitored test environment where they can refine their systems to improve healthcare interoperability and reduce the expense of repeated implementation testing at user sites. The intense five-day testing schedule allows them to refine and test their systems to ensure the interoperable exchange of patient records and medical information.

Read the full HiMSS news release here

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