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Health Management Technology News
  June 25, 2014
In this issue:
 Orion Health exclusive Living Case Study update excerpt

 Are Americans crazy to tolerate costly healthcare?

 A look at the bright spots in the American healthcare system

 New FL coalition fights for federal healthcare funding

 O.C. Grand Jury indicts 15 people in alleged healthcare scam

 Proposal would end license requirements for some healthcare workers

What you need to know about ICD-10
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Seven strategies to improve patient satisfaction
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Orion Health exclusive Living Case Study update excerpt

Dr. Christopher Jaeger of Sutter Health: When we were looking at care coordination platforms, we frankly didn’t include Orion Health in the mix initially. As we assessed the different vendors, we realized our scope was probably too broad, so we broke it down into two facets. One was the analytics, and the other was the care coordination workflow support. We weren’t terribly impressed by any of the analytics providers that we saw relative to what we were using already. From a care coordination perspective, we identified a couple of best-of-breed vendors, but as we looked at them, we realized that Orion Health also has a care coordination module that can be layered upon the HIE, which made perfect sense from an integration perspective. When we included them in the assessment, and they presented to us, it was a great eye opener for many of our internal stakeholders. Many of our personnel working in care coordination were like, “Oh, yeah. That’s right. Other countries have been working on this for decades, and we are just getting started on it. We could leverage that experience and what Orion Health has been doing with those countries to help our efforts.”

Orion Health has traveled the world gathering vital information that would be nearly impossible for us to do on our own. Of course we have made site visits to outside organizations, such as Alberta Health, which was a tremendously important visit, but to have Orion Health’s international expertise at hand has been invaluable.

In hindsight, I am grateful we took the time to consider our situation and to make the connections with the work Orion Health performed in other countries.

Read the full Orion Health exclusive Living Case Study update from Health Management Technology here  

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Are Americans crazy to tolerate costly healthcare?

A man in Connecticut walks into an outpatient clinic for his daughter to receive an electrocardiogram and sonogram. He later receives a bill for a "facility fee" of $5,000 that his insurance will not cover. A new resident in California looks for a primary care doctor but must wait 3 weeks for an appointment to get refills on medication. A 25-week pregnant woman who works two part-time minimum wage jobs cannot afford the $50 co-pay for regular visits or the $200 in prenatal vitamins her doctor recommends. When her labor begins, she goes to the emergency room where her baby is delivered.

Do any of these stories sound familiar? Probably.

The United States health care system ranks dead last among 11 peer nations for overall quality and costs. According to Commonwealth Fund's latest findings, we have the least efficient, least fair and worst health outcomes among the nations surveyed. Americans have the highest death rate, the highest infant death rate and worst health at age 60. Yet Americans pay more than double what people in these other nations pay.

Read the full article from here  

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A look at the bright spots in the American healthcare system

It is no secret that there are a number of problems with the current state of the American healthcare system.

Obamacare remains deeply flawed. And partisan gridlock in Washington has so far prevented fixes that will ease the burden it imposes on American families and businesses.

It follows that there is much that can be done to give Americans access to better, more affordable healthcare.

I have written before about the success of the Medicare Part D system. It’s saving Americans money and, according to the CBO, costs 45% – $349 billion – less than initial projections.

And there’s another part of our healthcare system doesn’t need much fixing at all: medicine.

Read the full article from Forbes here  

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New FL coalition fights for federal healthcare funding

Damien Filer is with Progress Florida. It's one of the nearly 100 organizations banding together to ask lawmakers to approve federal health care funding for low-income adults.

"This is a really minimal investment," he said.

"The federal government, if we said yes to expansion to access to health care here in Florida, would provide more than $50 billion."

They call it the coverage gap - about one million Floridians who earn too much to qualify for Medicaid, but make too much to afford to purchase insurance.

The coalition known as Health Care for Florida Now has created a statewide petition. It calls on lawmakers to accept affordable care act money for Medicaid – helping adults in the coverage gap.

In 2013, the Florida house voted down a measure that would bring in federal dollars for health care.

"The legislature here in Florida just simply needs to say yes to this unprecedented offer from the federal government," Filer said.

Read the full article from First Coast News

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O.C. Grand Jury indicts 15 people in alleged healthcare scam

More than a dozen Southern California healthcare providers, including a prominent donor to President Obama, have been indicted in an alleged multimillion-dollar insurance kickback scheme that resulted in the death of a 6-month-old Los Angeles boy.

An Orange County Grand Jury last week indicted 45-year-old Kareem Ahmed and 14 associates, alleging he formulated topical creams and oversaw an extensive network of kickbacks that paid doctors and pharmacists more than $25 million to prescribe and distribute the products.

Ahmed, president of Ontario company Landmark Medical Management, and the others face a total of 44 counts on felony charges including conspiracy, trading rebates for patient referrals, insurance fraud and involuntary manslaughter, according to two grand jury indictments.

According to the indictments, which were first reported by KPPC, Ahmed and two employees worked with a pharmacist to formulate three topical creams "based on the profitability of the ingredients," and then actively recruited doctors treating workers' compensation patients.

The indictment alleges that the scheme, which ran from 2009 to 2013, involved payments ranging from $600,000 to $8 million to doctors who prescribed creams made by pharmacists who had contracts with Ahmed. In addition to Ahmed, the indictment includes chiropractors, doctors and pharmacists.

Read the full article from The Los Angeles Times

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Proposal would end license requirements for some healthcare workers

When respiratory therapist Nicky Cope rolls a mechanical ventilator into a room, the situation is already life and death.

"I help the doctor put a breathing tube down into the patient's airway and put the patient on life-support," she said.

A new recommendation from the Texas Sunset Advisory Commission would deregulate her profession, along with 18 others -- including X-ray technicians and medical physicists, who calibrate MRI machines and other radiology equipment.

The commission was established in 1977 to evaluate state agencies and make fundamental changes to their missions or operations, if needed. Seventy-nine agencies have been abolished since 1977, saving Texas an estimated $945.6 million.

In a report released by the commission, the system that provides licensing for these medical professions is under-funded and understaffed. The commission believes hospital and private agency oversight would protect patient safety.

But Mark Barch, president of the Texas Society for Respiratory Care, disagrees with that assessment.

"The biggest danger is to patient safety and patient health," he said, adding that therapists would not have guaranteed training or background checks before walking into a patient's room or their home.

Read the full article from here  

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July 2014  HMT digital book

White Papers

What you need to know about ICD-10

Seven Strategies to Improve Patient Satisfaction

Click here to read the white papers

Industry News

Secretary Burwell announces steps to bolster management and accountability

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CMS: Opportunity to apply for Navigator grants

AMA adopts policy to define team-based medical healthcare


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