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Health Management Technology News
  March 18, 2014
In this issue:
 

► (HMT Exclusive) Bundled payments: Quality measurement and the role of analytics

► (HMT Exclusive) Taming today's superbugs

► SGR patch looms as debate rages on

► Obama team uses March Madness to sell health care plan

► Official: Dollar-driven health care  causes harm

► Some HealthCare.gov shoppers may get enrollment extension


(HMT Exclusive) Bundled payments: Quality measurement and the role of analytics

In January 2013, CMS put its weight behind bundled payments by launching the Bundled Payments for Care Improvement (BPCI) initiative, subsequently enrolling more than 500 healthcare organizations into the program.

The widespread adoption of bundled payments has the potential to benefit multiple stakeholders within the healthcare system by shifting accountability and financial risk from the payer to the provider. However, in order to implement an effective bundled payment program, healthcare organizations will have to navigate multiple challenges, such as accurately defining care episodes, bundle pricing, aligning care team members and capturing information across all service levels. Both payer and provider infrastructure will also need to be modified to calculate claims based on the new reimbursement model. It will be necessary for an effective mechanism to distribute gains – based on performance and level of care provided – to different stakeholders in the care bundle.

Despite these challenges, hospitals are fast realizing that the benefits of a well-managed bundled payments program significantly outweigh the risks.

Read the full HMT article here ► 

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(HMT Exclusive) Taming today's superbugs

Antimicrobial resistance is a growing, worldwide issue. According to the World Health Organization, a high percentage of hospital-acquired infections (HAIs) are caused by highly drug resistant bacteria that can result from inappropriate use of antimicrobial medicines.

To address this issue, the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society of America (PIDS) issued a joint policy statement in 2007 recommending that clinicians improve antimicrobial stewardship through better coordination of interventions. The joint policy statement defines antimicrobial stewardship as “coordinated interventions designed to improve and measure the appropriate use of antimicrobial agents by promoting the selection of the optimal antimicrobial drug regimen including dosing, duration of therapy, and route of administration.”

Antimicrobial management can be both a complicated and costly undertaking for hospitals and caregivers — yet is an ever-increasing necessity for delivering quality patient care. Traditionally, antimicrobial stewardship programs have relied on manual management methods, including clinical oversight and intervention to monitor and contain HAIs. As healthcare digitizes and incorporates electronic health records (EHR),clinical decision support (CDS)is becoming an essential component for antimicrobial stewardship programs. CDS can greatly help alleviate clinicians’ pain points in managing infectious diseases.

Read the full HMT article here ► 

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SGR patch looms as debate rages on

An overhaul of the way Medicare pays physicians cleared a significant barrier Friday, but suddenly became bloodied in a partisan political battle over healthcare.

A full repeal of Medicare's sustainable growth rate (SGR) payment formula hit a snag Friday, but political insiders say another temporary stay from drastic cuts in Medicare reimbursement is likely on its way.

The House passed a bill in a 238-181 vote that repeals the SGR and replaces it with a system that rewards quality and provides incentives to physicians participating in alternative payment models. However, Republicans attached it to a measure that delays for 5 years the Affordable Care Act's mandate requiring that all individuals obtain health insurance.

But with most Democrats in the Senate opposed to delaying the individual mandate, the bill is unlikely to ever come to a vote in that chamber. Furthermore, the White House has also threatened to veto the bill.

Congress will almost assuredly pass some temporary patch to prevent 24% payment cuts in Medicare from taking effect on April 1. The biggest questions facing doctors now are when will the SGR patch come, and how will Congress finance it.

Read the full medpage Today article here ► 

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Obama team uses March Madness to sell health care plan

For the Obama administration, March Madness is another chance to press young people — particularly young men — to sign up for health care.

Health care officials are launching a new marketing campaign wrapped around the NCAA men's and women's college basketball tournaments that start this week.

Starting Monday, Obama, some of his aides and celebrity athletes who back the health care plan will conduct interviews, make public service ads and use social media appeals as a key deadline looms on March 31.

Citing the popularity of college basketball during the tournament season known as March Madness, White House senior communications adviser Tara McGuinness said, "We're putting on a full-court press to remind our fellow fans that there are two weeks left to sign up for quality, affordable health insurance."

Read the full USA Today article here ► 

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Official: Dollar-driven health care  causes harm

U.S. patients not only are spending too much on medical treatments, there are still too many ways dollar-driven health care causes harm, according to a top official with the American Cancer Society.

Dr. Otis Brawley, the cancer society's chief medical and scientific officer, told an audience of physicians-to-be last week that medicine's scientific basis too often takes a backseat to superfluous concerns.

An address to students at NYIT's School of Osteopathic Medicine in Old Westbury, the lecture was designed as one in a series of talks on provocative subjects in medical care. Brawley tackled high costs and the irrational use of medical resources. A lecture scheduled for later this year, featuring another speaker, will focus on the growing doctor shortage.

Dr. Barbara Ross-Lee, the school's vice president for health sciences, said she and her colleagues purposely seek out speakers who can stimulate vigorous debate.

"This is a minefield we are walking through as practitioners and you have to remain questioning. It is the only way you can do the best job for the patient," Ross-Lee said.

Read the full News Day article here ► 

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Some HealthCare.gov shoppers may get enrollment extension

The Obama administration is planning a workaround to the health care law that would extend the March 31 enrollment deadline for health care coverage for some users if technical glitches prevent them from signing up on HealthCare.gov, The Wall Street Journal reported.

Under the plan, people who can demonstrate that they were unable to sign up for coverage before the deadline because of website problems would be able to sign up after March 31, officials familiar with the matter told the newspaper.

Details of the workaround are still being hammered out, including how long the special sign-up period would last and what documentation people might need to offer as proof they were blocked by glitches, the officials told The Journal.

Health and Human Services Secretary Kathleen Sebelius alluded to a possible workaround plan, telling a congressional panel that if potential enrollees were blocked from signing up that "they will have a special enrollment."

Read the full Fox News article here ► 

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