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Health Management Technology News
  May 2, 2014
In this issue:

 Health Management Technology’s Resource Guide sign-up

 Go fish or cut bait

 CMS says October 2015 marks new ICD-10 implementation deadline

 Global healthcare megatrends: Clinical challenges

 Only 67 percent of all sign-ups have paid first month’s premium: congressional report

 Leaning In to change healthcare

 HCA will pay additional $77M to healthcare foundation

 Analysis: Healthcare costs have risen nearly 10 percent

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Go fish or cut bait

Before reading this editorial, please go to your computer and perform a Google search of “ICD-10 delayed.”

Now that you are back, the reactions are pretty extreme, aren’t they? All the vitriol and gnashing of teeth would suggest that the healthcare industry had been ambushed by a nefarious network seeking to eradicate any signs of order and reason in medicine. Instead, the reality of the situation is that a piece of legislation, “Protecting Access to Medicare Act of 2014,” H.R. 4302, was approved by our elected representatives, as is their custom, and then the president signed the bill into law; again, not an act unfamiliar to those of us with a passing knowledge of ABC’s “Schoolhouse Rock” episode “I’m just a bill.”

So what if only days before the most recent delay former Secretary of Health and Human Services, Kathleen Sebelius, stated that her office would remain firm on the Oct. 1, 2014, compliance date? Did you forget April 9, 2012, when Sebelius announced a proposed rule that would delay the compliance date for ICD-10 from Oct. 1, 2013, to Oct. 1, 2014? Her call for that delay was meant to “give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition among all industry segments.”

How did our industry, as a whole, use the extension created in 2012? That’s not a rhetorical question. Seriously, why did we not use the extra time to prepare fully and move away from a four-decade-old coding system? And what makes anyone think that this new extension will be any different than the others? Will we really use the extra time to become compliant in 2015, or will we just kick the can even farther down the road until 2017 when ICD-11 is released?

Read the full editorial from HMT here  

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CMS says October 2015 marks new ICD-10 implementation deadline

In releasing the 2015 Inpatient Prospective Payment System (IPPS) final rule, the Centers for Medicare & Medicaid Services (CMS) is proposing October 2015 as the new deadline for the implementation of ICD-10.

References to the deadline can be found on page 648 and again on pages 1065 and 1074. Could this have been an inadvertent misstep by the agency?

“I do not think this is inadvertent on the part of CMS and believe this is a way for CMS to set a new date without going back through a separate rulemaking process,” Devin Jopp, president and CEO for the Workgroup for Electronic Data Exchange (WEDI), told ICD10monitor in an email. “This same approach was taken last time when ICD-10 was delayed as part of an unrelated regulation. WEDI will continue to work with its members and will operate under the assumption that we need to all work together to hit a Oct. 1, 2015 deadline.”

On the other hand, Stanley Nachimson urges caution in concluding that the 2015 date is truly being proposed.

“The ICD-10 date does not appear to be a proposal in this rule,” Nachimson said in an email to ICD10monitor. “On page 128, the NPRM (notice of proposed rulemaking) says of the delay in the law ‘As of now, the Secretary has not implemented this provision under HIPAA.’”

Read the full article from

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Global healthcare megatrends: Clinical challenges

There are more than 7 billion people on the planet today. Our growing global population has triggered some of the biggest healthcare challenges we’ll ever face. Listening to clients in Australia, Canada, Singapore, United Kingdom and United States, I believe many of these issues are universal. This post is the first of a five-part series that explores the clinical, population health, financial, regulatory and technical challenges we share as a global healthcare community.

Caring for more patients than ever before

Worldwide healthcare providers are seeing more patients than ever before. In part, because we’re living longer. In developed nations, there has been a huge increase in life expectancy over the last 50 years, and experts believe the trend will continue.

For example, U.S. citizens had a life expectancy of 68.2 years in 1950, which jumped to 76.6 years in 2000, and is expected to reach 83.9 years by 2050. Not only does that mean caregivers have more patients overall, but these patients are aging and require more health care.

Other cultural and economic factors contribute to an increasing number of patients. As middle classes expand in some nations, they seek more health care, more often. Countries that adopt universal health care models will also increase the patient population.

This growing number of patients heightens another global challenge: a shortage of primary care providers.

Read the full blog post from Allscripts here  

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Only 67 percent of all sign-ups have paid first month’s premium: congressional report

Only 67 percent of those who have signed up for health insurance coverage through website have paid their first month’s premium, the House Energy and Commerce Committee said Wednesday, citing data from multiple insurance providers.

This means that only two-thirds of sign-ups are formally enrolled in a health insurance plan under the Affordable Care Act, President Barack Obama’s signature domestic achievement.

And of the 67 percent who have paid, only 25 percent are between the ages of 18 and 34.

The Subcommittee on Oversight and Investigations plans to hold a hearing next week with representatives from the insurance industry to discuss the enrollment data.

The figures come after House Energy and Commerce Committee members sent letters to insurance providers requesting enrollment data that included demographic breakdowns and figures on who has paid their premiums.

The most recent figures date to April 15, 2014, more than two weeks after the official deadline for the open enrollment period.

“Due to the administration’s repeated and unilateral extensions and changes, as well as the fact that many insurers have reported that individuals will still have time to pay their first month’s premium,” the committee has requested that insurers providers in the federally run exchanges to provide updated enrollment figures by May 20, 2014.

The president and his allies have stated repeatedly that approximately 8 million Americans have “signed up” for Obamacare. However, as noted by the committee and several analysts, “sign-ups” are far different than “enrollments,” which require actual payment.

Read the full article from The Blaze here  

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Leaning In to change healthcare

In late March, 140 women filed into a former chapel on the grounds of a luxury resort in Sausalito, Calif. to hear confessions about lives that often took messy turns. Colleen Reitan shared the detours of her climb as chief operating officer of Health Care Service Corp., a Chicago-based insurer with $55 billion in revenue. Kathleen Sidenblad shattered stereotypes recounting her life as a Silicon Valley software developer from circa 1976. The discourses were heartfelt, and keeping the girlfriend tone genuine was emcee Lisa Suennen, a successful health IT venture capitalist, who shared her anecdotes as the lone female on company boards. “We can learn from each other,” said Suennen. “Be shameless, say what’s on your mind.”

Bringing this eclectic group together to create an exclusive “Lean In” for women called XX in Health, was its founder 30-year-old Halle Tecco. “It’s one movement out of a bigger movement,” she says, to provide a forum for women who are passionate about health care to connect, mentor, and exchange ideas with the potential to impact the industry.

Although women occupy the top positions at the FDA, the Centers for Medicare & Medicaid Services and the Department of Health & Human Services, and the majority of health care professionals are women, only 19% are hospital CEOs, 14% are on company boards, and none head large, publicly-traded health care companies. According to an XX in Health survey, women are most dissatisfied with opportunities to advance their career.

For many who pride themselves on their accomplishments regardless of gender, Tecco clearly hit a nerve. Bridget Duffy, a physician and former Medtronic executive who created the first post ever of chief experience officer while at Cleveland Clinic before selling her company ExperiaHealth to Vocera, calls herself an XX in Health devotee. More than 400 women–many willing to travel long distance for the daylong retreat, were waitlisted.

Read the full article from Forbes here  

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HCA will pay additional $77M to healthcare foundation

HCA Midwest Health System will have to pay another $77 million to the Healthcare Foundation of Greater Kansas City, in addition to the $162 million it already has been ordered to pay.

Jackson County Circuit Judge John Torrence issued an order in January that awarded the foundation $162 million after it sued HCA for failing to fulfill its obligations to invest in the former Health Midwest hospitals. The Healthcare Foundation of Greater Kansas City was formed from proceeds of HCA's purchase of the Health Midwest hospitals in 2003.

The court appointed a special master in the case to complete an accounting of the charity care and capital expenditures HCA has provided since it acquired the Health Midwest properties.

A hearing was scheduled in May for both parties to discuss the amount owed related to HCA's capital expenditures, said Paul Seyferth, an attorney with Seyferth Blumenthal and Harris LLC who is representing the foundation. But as a result of that accounting, both parties were able to agree that HCA will pay $77 million and avoid the hearing.

Read the full article from Kansas City Business Journal here  

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Analysis: Healthcare costs have risen nearly 10 percent

Health care costs rose in the first quarter of 2014 by 9.9 percent, according to a quarterly report from the Bureau of Economic Analysis. The jump in costs with respect to real GDP comes after several periods of more modest health care cost growth. In 2013, for instance, costs only grew 2.4 percent from the previous year.

The rise in costs and rate of growth calls into question claims from supporters of the federal health care law, including President Obama, who claimed Obamacare would "bend the cost curve" and slow down the rate of growth in health care spending. Obama and Obamcare supporters have been trumpeting, for instance, their exceeding a goal of signing up nearly 8 million enrollees on health-insurance plans by way of the law's provisions.

But before the BEA's release of the newest numbers on health care costs, economist Charles Blahous warned earlier this month of an "unfolding fiscal disaster" behind those enrollment numbers, mainly because of Medicare cost increases.

Read the full article from The Weekly Standard

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