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Health Management Technology News
May 28, 2014

In this issue:
 

 Dem candidates slow to embrace Obama's healthcare offensive

 Aver Informatics raises $8.5 million to tackle healthcare payments

 6 of the cheapest cities for healthcare in the U.S.

 Design thinking in healthcare: One step at a time

 Veterans may soon go outside the VA for healthcare

 3 key findings on the newly insured


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Dem candidates slow to embrace Obama's healthcare offensive

Democratic candidates are trying to figure out whether to embrace or avoid President Barack Obama's health care overhaul — or land somewhere in between.

The president says his party shouldn't apologize or go on the defensive about the Affordable Care Act.

Candidates aren't so sure.

Two top recruits for Senate races — Michelle Nunn in Georgia and Alison Lundergan Grimes in Kentucky — won't say how they would have voted when the Senate passed the bill in 2010. Their refusals are overshadowing their endorsements of individual parts of the law that are more popular than the law itself.

In Montana, Sen. John Walsh, appointed to office in February and now running for a full term, reminds voters that he was nowhere near Congress in 2010.

In Alaska, an advertisement by an outside group defends part of the law without mentioning it by name. Also, several incumbents who voted for the overhaul four years ago highlight some of its benefits and promise to tweak other parts.

Obama knows the law and this year's elections will have much to say about his legacy, and he says, "There is a strong, good, right story to tell" about the law.

Read the full article from The Huffington Post
here


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Aver Informatics raises $8.5 million to tackle healthcare payments

If you’ve ever been to a doctor in the U.S., you know the befuddling bundle of bills that awaits at the end of the road for your treatment.

The ugly truth is that those bills aren’t just confusing to you. Even most hospitals don’t know how much a given procedure is supposed to cost, according to a 2013 study from the Journal of the American Medical Association.

It’s gotten so bad that even health insurance executives are writing opinion pieces about ways to reduce waste on healthcare payments, which totaled $765 billion in 2009 alone.

Investors in the new $8.5 million round for Aver Informatics thinks that the company’s new billing management software can provide some semblance of a solution.

The Green Bay, Wis.-based company sells software that groups treatments into what it calls “episodes of care”, and then generates a bill for the entire process of treating a health condition, rather than generating a separate charge for each discrete step in the process.

Launched by Kurt Brenkus, a former auditor with a boutique claims audit firm who also worked at United Healthcare, in June 2010, Aver Informatics’ approach stems from Brenkus’ own knowledge of the healthcare system.

Read the full article from Techcrunch.com
here


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6 of the cheapest cities for healthcare in the U.S.

Healthcare is a source of financial stress and strain for many U.S. consumers. A Centers for Disease Control and Prevention report indicates that more than one out of four families recently experienced a financial burden due to medical care costs.

Between 1998 and 2008, the average cost of healthcare rose from $2,800 per person to $7,500 per person (according to Forbes), and by 2012, consumers were spending $8,233 per year on healthcare costs. In the U.S., consumers as a whole spend more than any other country on healthcare, according to Organization for Economic Co-operation and Development reports. The cost of a doctor’s appointment ranges from $60 to $250 before the costs of any diagnostic tests, lab work, or prescription medications. Today, with the birth of the Affordable Care Act, the requirement to have health insurance and the penalty you face for declining coverage is yet an additional cost.

How much do you pay each year for health care? If you live in a city like Aspen, Colorado, where insurance premiums are higher, your cost may be extremely steep. If you live in an area such as McAllen, Texas, or Miami, you may have high costs for doctor’s visits, hospital visits, and healthcare in general.

What can you do to lower your costs? Well, you could move to a cheaper market, but that’s not necessarily the most practical solution. The best way to reduce your costs is to remain proactive. Shop around, compare your spending to others’, and do a little research to find the best healthcare professionals and insurance companies with the best pricing. However, considering your location plays such as large role in how much your healthcare costs, let’s take a look at some of the more inexpensive markets. These cities were chosen based on a publication by Livability entitled the “Top 10 Cities for Affordable Health Care.”

Read the full article from Wall St. Cheat Sheet
here


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Design thinking in healthcare: One step at a time

More and more individuals and families will enter the U.S. healthcare system in coming years, and it seems obvious that this in and of itself is a good thing. But as this trend continues, total healthcare expenditures will likely rise as well, which is not such a good thing. So, there is a rather clear and important question to be answered: How do we provide more and higher quality healthcare, to more and more people, while simultaneously lowering the cost of delivering that care? Is that even a possibility?

As with most big challenges, the answer is more likely to be found in little steps and little changes, rather than grand strategies and grand ideas. The use of innovative design thinking and strategies can be a big contributor to creating more efficient healthcare delivery, continuous improvement in quality, and lower total cost. Here’s a story that can illustrate how design principles applied to planning can lead to higher quality and lower cost health care.

I recently talked with a team of healthcare providers and a team of design thinking consultants who joined together to solve some interesting health care delivery challenges.Venice Family Clinic, a leading community health center in Venice, California, faced the challenge of opening a new children’s clinic serving low-income families, many on Medicaid, and many uninsured. A typical clinic patient would be struggling to balance work, family and school responsibilities, as well as financial, transportation and language barriers. As clinic leaders began the planning process, they made a commitment to addressing patient issues in advance, and to staying mindful of the need to control cost without compromising quality.

Laney Kapgan is the chief development officer for the clinic, and she recognized at the outset the need to avoid a business-as-usual approach. But how to do this? “We know,” Kapgan observed, “that more Americans than ever have health care coverage through the Affordable Care Act. But now the real work begins. How can we keep our families well and maintain a responsible position relative to cost?”

Read the full article from Forbes here

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Veterans may soon go outside the VA for healthcare

More military veterans may get health care outside of Veterans Affairs facilities. That's the word from the White House trying to ease VA hospital backlogs.

News 3's Fatima Rahmatullah Spoke with a local veteran who worries this will mean even more red tape.

An amputated toe and deformed foot has former airman Donald Kem desperate for help.

"I wish to God I wasn't here," Kem said.

Kem is diabetic and his walk through the Veterans Affairs hospital system has him running on empty.

"It hurts everyday so bad and all I want is the pain to stop. I don't want your pills. I don't want your medications. I just want the pain to stop," Kem says.

Kem has been dealing with an endless delay of red tape which has slowed down any chance of healing he once hoped for.

"We're waiting," Kem said. "The waiting list here at VA is long."

Read the full report from mynews3.com here

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3 key findings on the newly insured

Earlier this month, HHS announced more than 8 million people had signed up for health plans through the Patient Protection and Affordable Care Act exchanges, surpassing the Congressional Budget Office's initial projection of 7 million for the first year.

The characteristics of the newly insured population can be used to assess how well the PPACA is working at expanding health insurance coverage, according to The Urban Institute. In a study funded by the Robert Wood Johnson Foundation, Urban Institute researchers analyzed data collected through their March 2014 Health Reform Monitoring Survey to examine the demographic characteristics and health status of the newly insured under the PPACA. Here are three of their key findings.

1. Most of the newly insured are in the income brackets targeted by the health insurance exchanges and Medicaid expansion. Nearly half of the newly insured adults have annual incomes at or below 138 percent of the federal poverty level, and 40.1 percent have incomes between 139 percent and 399 percent of the poverty level.

2. The newly insured are more likely to report fair or poor health (17.4 percent) than adults who had coverage for the full year at the time of the monitoring survey (11.8 percent).

Read the full article from Becker’s Hospital Review here

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