$31M in EHR incentives returned, supermarket chemo, doctor demand, and more
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Health Management Technology News
November 8, 2013

In this issue:

HMA misstated $31M of EHR incentives

Top U.S. insurer sees weak Obamacare sign-ups, prepares for delay

Grocery store chain moves into healthcare, administers chemo and more

Doctor demand will grow by up to a third by 2025 - study

Hospital room lighting may worsen patients' mood, pain

Meaningful Use

HMA misstated $31M of EHR incentives

Naples, Fla.-based Health Management Associates (HMA) is in the process of repaying CMS $31 million after finding out 11 of its hospitals did not achieve meaningful use.

Between July 2011 and June 2013, Health Management said it received $31 million in Medicare and Medicaid electronic health record incentive payments. The 11 unnamed hospitals and associated physician practices had implemented EHRs and claimed to achieve meaningful use. However, the for-profit hospital chain determined it made errors in determining proper MU due to accounting errors.

Health Management will restate financial statements for 2010, 2011, 2012 and the first two quarters of 2013. In a filing with the Securities and Exchange Commission, Health Management officials also said the financial reports and guidance for fiscal year 2013, which were prepared by Ernst & Young, “should no longer be relied upon.”

Health Management said it has repaid most of the EHR funds back to CMS and state programs, and it expects to re-enroll the 11 hospitals in Medicare and Medicaid EHR incentive programs.

Read the full Becker’s Hospital Review article.

Read the HMA statement.

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Health Law

Top U.S. insurer sees weak Obamacare sign-ups, prepares for delay

A top U.S. health insurer gave the first detailed view of how the problem-plagued rollout of President Barack Obama's signature healthcare law is affecting the industry, saying on Wednesday it had cut its enrollment forecasts by at least a half and expected the government to delay the sign-up deadline.

Humana Inc said that because of technical problems preventing millions of Americans from accessing the federal HealthCare.gov website since it opened on October 1, the company had slashed its expectations of signing on 500,000 new plan members to an estimate of closer to 250,000.

The open enrollment period ends on March 31, and Republican and Democratic lawmakers are asking the Obama administration to give people more time to sign up for plans offered in online marketplaces. U.S. Health and Human Services Secretary Kathleen Sebelius rejected the idea at a Senate hearing on Wednesday.

UnitedHealth Group, the largest healthcare insurer in the United States, said on Wednesday it would work with the federal government "if a decision is made to allow individuals more time to sign up."

The insurance industry has lobbied against an extension that would include delaying the law's penalty for Americans who do not obtain coverage by the end of March, saying it would leave them with a heavier concentration of sicker, costlier patients. That would create even greater business losses and higher prices for consumers down the road, and could require the federal government to come in and cover some of the damage.

But Humana said on Wednesday it was assuming a delay at this point, and that it already cut its view for profits from the new business that it had expected from healthcare reform.

"We're waiting for guidance from the government around whether they are going to change mandates and whether they are going to do things to extend the enrollment period," Humana Chief Operating Officer Jim Murray said during a call with investors to discuss quarterly results.

"Given where we're at today, our assumption is that there will be an extension to the open enrollment period," he said.

Read the Reuters article.

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Care Centers

Grocery store chain moves into healthcare, administers chemo and more

It’s not uncommon to see pharmacies, floral shops and cooking classes in grocery stores. Now, a Midwest supermarket chain has taken the next big step – into health care.

“It’s not something you associate with a supermarket,” said Michael Abrams, managing partner at a St. Louis health care consulting firm.

Schnucks, the Midwest and St. Louis chain, opened its first Schnucks Infusion Solutions facility on Page Service Road in September to treat acute and chronic conditions.

Infusion therapy involves injecting medicine through a needle or catheter. It is used for conditions such as infectious diseases, nutrition disorders, immune deficiencies, hemophilia, multiple sclerosis, rheumatoid arthritis, cancer, Crohn’s disease and more.

At the 6,500-square-foot center, nurses, pharmacists and technicians prepare infusions and administer them either in the patients’ homes or in the facility’s ambulatory infusion center.

Abrams said the new venture is smart.

He said infusion centers are profitable because they administer expensive treatments. They’re also attractive to consumers and insurance companies because they provide outpatient care and are more cost-effective than visiting a hospital.

Dr. David Parks, an internal medicine specialist who sees a lot of HIV patients, said he used to dislike prescribing IV medications because it meant hospital admissions. Not only was that more expensive, but Medicare patients were required to stay at long-term facilities during their treatments.

Schnucks Infusion Solutions, though, accepts Medicare D, Medicaid and Illinois Public Aid.

“I can have the best of both worlds,” Parks said. “So can the patient, so can the payers. It’s just way more cost-effective.”

Drugstore retailer Walgreens has been in the infusion business for decades.

The company offers home services and infusion centers with 75 infusion pharmacies nationwide, 100 alternative treatment sites, and a staff of more than 1,400 infusion nurses, pharmacists, dietitians.

Walgreens has an infusion center in Fenton that’s been open for around four years.

Chism hopes opening Schnucks Infusion Solutions will bring more grocery customers because patients and their families will become regular Schnucks pharmacy customers.

Read the St. Louis Post-Dispatch article.

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Doctor demand will grow by up to a third by 2025 - study

Driven by an aging population and increased access to health insurance, the U.S. will need more doctors by 2025, says a new study.

The expected rise in demand varies by state and medical specialty, according to the study's lead author.

"What's happening at the state level can be very different than what's happening at the national level," Timothy Dall told Reuters Health. He is a managing director at the research and information service firm IHS in Washington, D.C.

The new study, published in Health Affairs, looks at future demands for primary and specialized healthcare providers. Those specialists include cardiologists, neurologists and urologists.

The researchers used a computer model to estimate future healthcare demand by taking into account a growing and aging population and increased access to health insurance due to the Affordable Care Act - commonly known as Obamacare.

The researchers found the expected increase in doctor demand was largely attributed to a growing number of diseases among an older population. Obamacare, on the other hand, was only linked to an increase of a few percentage points.

Overall, the researchers found the demand for primary care or family doctors will grow by 14 percent by 2025. That's less than the expected growth among some medical specialties.

Dall and his colleagues estimate that demand for vascular surgeons – who perform bypass surgeries and insert stents, for instance – will increase by about 31 percent and demand for cardiologists will increase by 20 percent.

But those estimates vary by state.

Read the Reuters article.

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Hospital room lighting may worsen patients' mood, pain

Patients in an average hospital room are exposed to so little light during the day that their bodies cannot adopt a normal sleep-wake cycle, a small study suggests.

Researchers found the lowest levels of daytime light exposure were tied to worse mood and more fatigue and pain among patients, compared to those whose rooms were better-lit during the day.

"Until now, no one has looked at the associations among light and outcomes such as sleep, mood and pain experienced in the hospital," said Esther Bernhofer, lead author of the study and a nurse researcher at the Cleveland Clinic's Nursing Institute.

"This study forms a basis for testing future lighting interventions to improve sleep-wake patterns, mood and pain in hospitalized adults," Bernhofer told Reuters Health.

Past research has shown that exposure to light during the day is important for setting the body's internal clock. Too little light and too much – or exposure to light at the wrong times – can affect sleep quality at night and mood during the day.

To see whether light might play a role in hospital patients' healing, Bernhofer and her colleagues gathered data on 40 men and women admitted between May 2011 and April 2012 to a large academic hospital. The patients wore a wrist device for 72 hours to measure their sleep-wake patterns and light exposure, and completed questionnaires to evaluate their mood and pain levels.

The researchers found that patients were exposed to low levels of light around the clock, including overnight.

And like many hospital patients, those in the study slept poorly, with frequent interruptions and an average of only about four hours of sleep per night. Patients who had less light exposure during the day reported having a more depressed mood and being more fatigued than those exposed to more light.

The results of her group's small study could potentially open the door to simple ways to boost patient wellbeing in the hospital, Bernhofer said.

Read the Chicago Tribune article.

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