To view this email in your browser, please click here.
HMT on Facebook HMT on Twitter   HMT on LinkedIn 
Health Management Technology News
  June 2, 2014
In this issue:
 
 HMT exclusive: HL7 FHIR when ready

 Successful results from CMS ICD-10 acknowledgement testing week

 Few Americans say healthcare law has helped them

 3 lessons in rapid change from an unlikely source: Healthcare

 Study questions need for employer healthcare requirement

 Making costs clear: How hospitals can help drive price transparency tool development

 Three factors that corrupted VA healthcare and threaten the rest of American medicine

What you need to know about ICD-10
Download this white paper on switching from using ICD-9 to ICD-10 codes for all medical services. The deadline for completing the switch is October 1, 2015, which will be here sooner than you think. Healthcare facilities need to start planning their communication strategy now to be fully prepared to meet the upcoming transition.

Read the white paper.   Sponsor


Seven Strategies to Improve Patient Satisfaction
Hospital reimbursements are now influenced, in part, by patient satisfaction scores. Read about seven areas to target in your hospital for happier, more satisfied patients.

Read the white paper.   Sponsor


HMT exclusive: HL7 FHIR when ready

When you think about the massive impact technology has made on how we approach and solve problems, it is incredible. A quick web-ex meeting enables us to instantly share desktop screens, files and images, while we simultaneously talk through complications and work through roadblocks with coworkers or clients halfway around the globe. In healthcare, when electronic health record (EHR) implementation caused a decline in physician productivity, the introduction of speech recognition was a game-changer, streamlining workflows, improving EHR adoption rates and removing the complexity of check boxes and the need for structured data.  Sometimes the simplest solution is the best, and while speech recognition tools are widely used by physicians today to speed the communication of information, in other areas of healthcare, things have stalled. What is truly remarkable is that when it comes to the transmission of vital, life-impacting information in healthcare, especially communicating X-rays, CAT scans and other patient images, we might as well be using carrier pigeons to communicate.

As a society that is always looking for “the next big thing,” we constantly think about ways to build upon existing technology to create something better, but sometimes there is lag between vision and execution. Arguably, no industry feels this painful gap as keenly as healthcare. The primary goal of healthcare organizations, after all, is delivering the best care to their patients. Everything else comes second. Outdated systems, incompatible platforms, disparity in employees’ IT savvy, and lack of time and resources have created a perfect storm of frustration for physician practices, hospitals, clinics and health systems alike - regardless of size or revenue.

Unfortunately, in our current healthcare system, barriers to sharing information often are tied to technological incompatibility or systems that don’t talk to each other. In fact, Dr. John Halamka, CIO at Beth Israel Deaconess Medical Center and Co-Chair of the Federal Health IT Standards Committee, recently remarked to Dr. Keith Dreyer, Vice Chairman of Radiology at Massachusetts General Hospital at a technology panel, “Our institutions are actually 50 feet away from each other. How often in the last 10 years have we exchanged images electronically between our two institutions? Not so much.” Although this elicited a laugh from those in attendance, the underlying truth is unnerving.

And that is what is so promising about HL7’s Fast Health Interoperable Resource (FHIR) initiative. While some have pointed out it is too flexible to be a standard, I would note its intrinsic value to healthcare. It allows organizations to develop customized bridges between systems, leveraging cloud-based apps and device integration to drive more tailored workflows for clinical teams. The end result is better information in less time, collaborative care and better patient outcomes.

Read the full article from Health Management Technology here  

Return to the table of contents  


Successful results from CMS ICD-10 acknowledgement testing week

This past March, the Centers for Medicare & Medicaid Services (CMS) conducted a successful ICD-10 testing week. Testers submitted more than 127,000 claims with ICD-10 codes to the Medicare Fee-for-service (FFS) claims systems and received electronic acknowledgements confirming that their claims were accepted.

Approximately 2,600 participating providers, suppliers, billing companies and clearinghouses participated in the testing week, representing about five percent of all submitters. Clearinghouses, which submit claims on behalf of providers, were the largest group of testers, submitting 50 percent of all test claims. Other testers included large and small physician practices, small and large hospitals, labs, ambulatory surgical centers, dialysis facilities, home health providers, and ambulance providers.

Nationally, CMS accepted 89 percent of the test claims, with some regions reporting acceptance rates as high as 99 percent. The normal FFS Medicare claims acceptance rates average 95-98 percent. Testing did not identify any issues with the Medicare FFS claims systems.

This testing week allowed an opportunity for testers and CMS alike to learn valuable lessons about ICD-10 claims processing.  In many cases, testers intentionally included such errors in their claims to make sure that the claim would be rejected, a process often referred to as negative testing. To be processed correctly, all claims must have a valid diagnosis code that matches the date of service and a valid national provider identifier. Additionally, the claims using ICD-10 had to have an ICD-10 companion qualifier code and the claims using ICD-9 had to use the ICD-9 qualifier code.  Claims that did not meet these requirements were rejected.

Read the full blog entry from CMS here  

Return to the table of contents  


Few Americans say healthcare law has helped them

About one month after the new healthcare exchanges closed with over 8 million new enrollees, there has been little substantial change in Americans' perception that the healthcare law has helped them. Most Americans say the law has had no impact on their healthcare situation, while those who do perceive an effect are more likely to say it has hurt them rather than helped them.

These data are based on interviews with over 2,500 Americans in a May 21-25 Gallup poll.

The majority of Americans have reported that the Affordable Care Act has had little effect on their personal situations since Gallup first asked this question in early 2012. In more recent months, after the exchange-based enrollment opened up, Americans have gradually become more likely to indicate that the law has had an effect -- both positive and negative. The current 24% who say the law has hurt them is by one percentage point the highest measured, while the 14% who say the law has helped them is also within one point of being the highest measured on that dimension. In all instances, across seven different surveys, Americans have been at least marginally more likely to say the law has hurt them and their families than to say it has helped them.

Americans' views on how the healthcare law has affected them personally are predictably partisan, as are almost all attitudes about Obamacare. The biggest partisan effect is evident among Republicans, with 41% claiming that the law has hurt them and their family. Democrats have opposite views, although more subdued, with 23% saying that the law has helped them, while over two-thirds say it has had no effect.

Read the full article from Gallup Politics here  

Return to the table of contents  


3 lessons in rapid change from an unlikely source: Healthcare

At the end of my interview with Chip Heath, co-author of The New York Times bestsellers “Made to Stick” and “Decisive,” I asked him what topic he’d like me to cover in the future.

“I’m impressed by the culture you’ve created at Kaiser Permanente in Northern California,” he said. “You’ve generated quarter-to-quarter change that I think would have taken three years elsewhere. I don’t think most organizations know how to do that. That’s the article I’d like to read.”

I’ve been the CEO of The Permanente Medical Group for the past 15 years. Our medical group’s 8,000 physicians and 34,000 staff care for over 3.5 million Kaiser Permanente members.

I’ve never wanted my weekly Forbes blog to focus on Kaiser Permanente. I’ve tried to highlight the broader set of issues facing the culture and business of health care.

But over the past year, readers and leaders from around the country have echoed Chip’s request.

I hope the lessons I’ve learned will help leaders who want to accelerate change within their organizations, in health care or elsewhere.

Read the full Forbes article here  

Return to the table of contents  


Study questions need for employer healthcare requirement

When the Affordable Care Act was unveiled, business groups railed against the provision that requires companies with 50 or more employees to provide health insurance for their full-time workers.

The Obama administration responded by pushing back the deadline for the coverage, so it hasn't yet taken effect. Now support for this so-called employer mandate is eroding in some surprising quarters.

A study called "Why Not Just Eliminate the Employer Mandate?" has been published by the Urban Institute, a center-left think tank based in Washington, D.C. It lists a number of reasons why dropping the mandate might be a good idea.

Linda Blumberg, one of the authors, says first of all, requiring firms to offer health insurance could be a bad deal for lots of low-wage workers.

"A lower-income worker is going to do better, most likely — financially — by getting subsidized coverage through one of the health insurance marketplaces instead of through their employer," she says.

That's because many of those workers make so little that they qualify for free coverage under Medicaid. Even workers making as much as 2 1/2 times poverty-level wages would get subsidies in the Obamacare exchanges, and that could make it a better deal than the coverage provided by their company.

Read the full article from NPR.com here  

Return to the table of contents  


Making costs clear: How hospitals can help drive price transparency tool development

In 2006, Danville, Pa.-based Geisinger Health System decided to take its electronic portal for patients to the next level. The portal already offered access to patients' clinical records. However, it didn't provide price estimates. In an effort to make billing more patient friendly, Geisinger decided to change that, says Kevin Brennan, the health system's CFO and executive vice president of finance.

That's how Geisinger's MyEstimate got its start. The tool lets patients use an online estimator to find out how much they'll owe for various services. They can also fill out a form online to receive a price estimate from Geisinger. Both methods take into account the type of health insurance patients have, their individual benefit design and factors such as their year-to-date deductible information. "What the patient would get was the best estimate available for the service that was being ordered for them by a physician," Mr. Brennan says.

Like Geisinger, a number of other healthcare providers and payers have responded to the growing push for price transparency by developing tools to let patients obtain cost estimates before they receive treatment. Earlier this year, a task force (including Mr. Brennan) led by the Healthcare Financial Management Association released a report on improving healthcare price transparency that offered examples of price transparency tools, such as Geisinger's MyEstimate. Others on the list include tools developed by Maricopa Integrated Health System of Phoenix and the Wisconsin Hospital Association, as well as health insurers Aetna and UnitedHealthcare.

As out-of-pocket costs rise and patients continue to take on a greater portion of their care costs through high-deductible health plans, the demand for transparency tools (which can consist of interactive websites, brochures and apps, among other formats) will continue to rise, says Richard Gundling, vice president of HFMA. "Everybody who's an employee, every year your co-pay and deductible are just a little higher," he says. "When we talk to patients about being able to have that conversation earlier rather than later about price, it gives the opportunity to maybe have another conversation with their doctor about treatment alternatives. It just empowers the patient to have that."

Read the full article from Becker’s Hospital Review here  

Return to the table of contents  


Three factors that corrupted VA healthcare and threaten the rest of American medicine

Veterans Affairs Secretary Eric Shinseki has resigned in the wake of the waiting times scandal. But the problems at the VA go much deeper than a single man. His eventual successor will have his hands full dealing with the toxic combination of problems that fueled the crisis: a shortage of doctors, perverse incentives, and a widespread culture of dishonesty. And these problems could affect the rest of America under ObamaCare.

The New York Times described each of these problems in greater detail in their recent piece, “Doctor Shortage Is Cited in Delays at V.A. Hospitals”.

First, the physician shortage:

In the past three years, primary-care appointments have leapt 50 percent while the department’s staff of primary care doctors has grown by only 9 percent, according to department statistics.

Those primary care doctors are supposed to be responsible for about 1,200 patients each, but many now treat upward of 2,000…

Second, perverse incentives:

The inspector general’s report also pointed to another factor that may explain why hospital officials in Phoenix and elsewhere might have falsified wait-time data: pressures to excel in the annual performance reviews used to determine raises, bonuses, promotions and other benefits. Instituted widely 20 years ago to increase accountability for weak employees as well as reward strong ones, those reviews and their attendant benefits may have become perverse incentives for manipulating wait-time data…

Read the full article from Forbes here  

Return to the table of contents  


  READ ALL NEWS AT HEALTHMGTTECH.COM

June 2014  HMT digital book

White Paper

What you need to know about ICD-10

Seven Strategies to Improve Patient Satisfaction

Read more



Industry News
5.30.14
AMA reminds physicians to begin Sunshine registration process
Keeping with its continued commitment to fully inform physicians about the implementation of the Physician Payment Sunshine Act...
Read more  
5.23.14
CMS: Prior Authorization to Ensure Beneficiary Access and Help Reduce Improper Payments
The Centers for Medicare & Medicaid Services announced plans to expand a successful demonstration for prior authorization for...
Read more  
5.23.14
AMA statement on proposed rule regarding Meaningful Use
"The American Medical Association (AMA) appreciates the changes proposed by the Centers for Medicare and Medicaid Services (CMS)...
Read more  
5.23.14
HHS: New funding gives states and innovators tools and flexibility to implement delivery system reform
Health and Human Services Secretary Kathleen Sebelius announced new delivery system reform efforts made possible by the...
Read more  
5.23.14
AMA to host virtual discussion at the Innovation Health Jam, June 17-19, 2014
The American Medical Association (AMA) announced details of a virtual brainstorming discussion on potential transformative goals...
Read more  

Resources
 

Subscribe to the
HMT newsletter

HMT Online Only Features

Archives

Subscribe to HMT

Resource Guide

Media Kit

Products

Career Builder

White Papers

Advertising Inquiries

Editorial Inquiries

Events

Subscribe to Health Management Technology | Contact the Publisher | Advertise With Us  |   Privacy Statement

Copyright 2014       NP Communications LLC, 2477 Stickney Point Rd, Suite 221B, Sarasota, FL 34231