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Health Management Technology News
  May 1, 2014
In this issue:

 Health Management Technology’s Resource Guide sign-up

 The ICD-10 delay: Don’t squander the chance to get strategic

 Healthcare stocks higher in late trade

 Price tag for repairs jumps to $121 million; 'back end' still a mess

 State healthcare innovation is blossoming under Obamacare

 Big Data in biomedicine conference set at Stanford

 Tax fraud gang targeted healthcare firms

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The ICD-10 delay: Don’t squander the chance to get strategic

A collective sigh of relief could be heard around the healthcare industry when Congress recently voted to extend the deadline for the transition from ICD-9 to ICD-10 from Oct. 1, 2014, to Oct. 1, 2015. However, leaders will be making a big mistake if they collectively decide to put their feet up and relax for any extended period of time. We all know how quickly these deadlines can creep up on us – as this most recent delay represents the third time that the transition to ICD-10 (a coding system that has been widely adopted by other countries) has been put off.

Instead of relaxing, leaders need to get busy now. Fortunately, they can do so with a renewed sense of strategic purpose. Instead of merely checking things off a long to-do list, leaders now can turn the transition to ICD-10 into an opportunity to create a clinically driven revenue cycle, instead of a cumbersome chore that needs to get done to avoid government penalties.

Here’s how: With the one-year extension in place, healthcare leaders should turn their immediate attention to implementing 2014 Edition software in an effort to meet Meaningful Use requirements. To qualify for incentives under the Stage 2 requirements, eligible professionals must meet 17 core objectives and three menu objectives that they select from a total list of six (or a total of 20 core objectives), while eligible hospitals must meet 16 core objectives and three menu objectives that they select from a total list of six (or a total of 19 core objectives).

With the ICD-10 burden delayed, though, it will be much easier to get into the Meaningful Use zone, so to speak. Vendors now have more time to get clinical systems up to speed and tested, and provider organizations have more time to implement these systems – while also training users to fully leverage the more advanced functionality.

Read the entirety of HMT’s Industry Watch

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Healthcare stocks higher in late trade

Healthcare stocks were narrowly higher just before the closing bell Wednesday with the NYSE Healthcare Sector Index rising 0.2% and shares of healthcare companies in the S&P 500 climbing less than 0.1% as a group.

In company news, net income at WellPoint during the three months ended March 31 fell 21% compared to year-ago levels but still managed to beat analyst projections for the period, helping lift the company's shares over 5% higher today.

WLP shares were up nearly 6% at $100.90 each in late Wednesday trading, down from an intra-day high of $101.94 a share earlier today. The stock has a 52-week range of $72.05 to $102.56 a share, advancing almost 41% over that span.

Overall, the healthcare insurer earned $701 million, or $2.40 per share, during its March quarter, down from $885.2 million in the year-ago period. Excluding one-time items, EPS was $2.30, topping Wall Street expectations looking for a $2.10 per share adjusted profit.

Operating revenue was up just slightly over the same quarter last year at $17.64 billion, trailing analyst estimates by around $310 million.

WLP also raised its FY14 earnings forecast by $0.20 per share over its prior outlook, now expecting at least $2.40 per share in per-share earnings this year. Analysts, on average, are looking for FY14 EPS of $2.41.

Read the full article from here  

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Price tag for repairs jumps to $121 million; 'back end' still a mess

After shelling out $677 million to build the federal health care website, the government will spend an additional $121 million in 2014 to repair it—$30 million more than previously estimated—the Washington Times reported last night. This comes just as the Obama administration is starting the hunt for next year’s diverse group of contractors.

CGI Federal, the original lead contractor awarded $93.7 million, was replaced by Accenture this past January. Accenture received an initial payment of $45 million—an amount that was supposed to double by year’s end, according to the Washington Post. But yesterday, Accenture Federal Services announced their final agreement of $121 million for work through January 10, 2015.

The search for Accenture’s successor has commenced, and the administration has some specific criteria on its applicants’ gender, race, and socioeconomic status. From the New York Times yesterday:

Federal officials said Monday that they intended to hold a new competition before awarding a contract and that they were particularly interested in responses from small businesses owned by women, disabled veterans and “socially and economically disadvantaged individuals,” including black and Hispanic Americans.

Read the full blog post from The Weekly Standard here  

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State healthcare innovation is blossoming under Obamacare

Obamacare was passed, in part, to control the imbalance between the nation’s high health spending and poor health outcomes.  The law includes several provisions that enhance coordination between health care delivery and public health systems to help improve overall health in the population while lowering costs.  To that end, it gives states new funding to support community-based interventions that can be replicated nationally if they prove effective.

A new report from the National Academy for State Health Policy profiles how eight states—California, Maryland, Massachusetts, Minnesota, North Carolina, Oregon, Texas, and Vermont—have successfully used this provision in combination with existing state programs to improve care and reduce costs. These efforts show how important state initiatives can be in improving health care.

The report highlights three types of strategies that states have used to take advantage of the Obamacare assistance.  They have implemented innovations in their Medicaid programs through waivers of federal requirements.  They have encouraged experiments with delivery system reforms, such as accountable care organizations. And they have pushed non-profit hospitals to be more responsive to community needs.

These approaches are not all new. However, new funding and regulatory powers under health reform have given states new tools for implementing them. Most people think of Obamacare in terms of its primary goal of expanding individual access to coverage. But other aspects of the law, like support for state-supported initiatives such as these, may be more important in bringing about effective and transformative changes in the health care system.

Read the full blog post from here  

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Big Data in biomedicine conference set at Stanford

Todd Park, chief technology officer of the United States, will be among the featured speakers at the Big Data in Biomedicine conference May 21-23 at the Stanford University School of Medicine. The conference, jointly sponsored by Stanford Medicine and Oxford University, will highlight opportunities for mining the rich repositories of biomedical information available today.

The gathering will bring together hundreds of participants from academia, information technology corporations, venture capital firms, the U.S. government and foundations interested in harnessing the power of big data to improve human health around the globe. The event will be held at the Li Ka Shing Center for Learning and Knowledge on the Stanford campus.

“We are excited to bring together such a diverse group of participants,” said Euan Ashley, MD, PhD, associate professor of medicine and of genetics and director of the Stanford Clinical Genomics Service. “To realize the potential of large-scale data for biomedicine will require collaboration among professionals, and integration among data sources at population, individual and molecular scales. We are thrilled to be enabling that conversation.”

Read the full press release from Stanford School of Medicine here  

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Tax fraud gang targeted healthcare firms

Earlier this month, I wrote about an organized cybercrime gang that has been hacking into HR departments at organizations across the country and filing fraudulent tax refund requests with the IRS on employees of those victim firms. Today, we’ll look a bit closer at the activities of this crime gang, which appears to have targeted a large number of healthcare and senior living organizations that were all using the same third-party payroll and HR services provider.

As I wrote in the previous story, KrebsOnSecurity encountered a Web-based control panel that an organized criminal gang has been using to track bogus tax returns filed on behalf of employees at hacked companies whose HR departments had been relieved of W-2 forms for all employees.

Among the organizations listed in that panel were Plaintree Inc. and Griffin Faculty Practice Plan. Both entities are subsidiaries of Derby, Conn.-based Griffin Health Services Corp.

Steve Mordecai, director of human resources at Griffin Hospital, confirmed that a security breach at his organization had exposed the personal and tax data on “a limited number of employees for Griffin Health Services Corp. and Griffin Hospital.” Mordecai said the attackers obtained the information after stealing the organization’s credentials at a third-party payroll and HR management provider called UltiPro.

Mordecai said that the bad guys only managed to steal data on roughly four percent of the organization’s employees, but he declined to say how many employees the healthcare system currently has. An annual report  from 2009 states that Griffin Hospital alone had more than 1,384 employees.

Read the full article from KrebsonSecurity

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Administration begins search for new contractors to run healthcare site

The Obama administration has begun a wide-ranging search for companies to run the online federal health insurance exchange, seeking new talent to prevent a repeat of problems that immobilized the website last fall.

In laying out specifications for the project, the administration also provided insight into the next phase of development of the insurance marketplace, which is expected to handle a significant increase in enrollment over the next several years.

Federal officials said Monday that they intended to hold a new competition before awarding a contract and that they were particularly interested in responses from small businesses owned by women, disabled veterans and “socially and economically disadvantaged individuals,” including blacks and Hispanic Americans.

Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, said the move was a prelude to “the expected recompetition” of the contract for operation of the federal exchange. “We must perform market research in order to determine if there are any small businesses that could perform this work,” Mr. Albright said.

The focus on smaller companies may reflect the administration’s displeasure with how the project was managed by large government contractors like CGI Federal, the American subsidiary of the CGI Group of Montreal, which had much of the responsibility for Administration officials blamed the company for many of the problems that prevented people from enrolling online last fall, and in January they brought in another company, Accenture, as the “lead contractor.”

Read the full article from The New York Times here  

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