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Health Management Technology News
  July 10, 2014
In this issue: site stumps 'highly educated' millennials. Here's why

  Man pleads guilty to stealing patient records to file false tax returns

  The new normal of healthcare spending

  Holes in healthcare

  The 5 best healthcare stocks so far in 2014

  CMS releases proposed 2015 hospital outpatient payment rates: 7 things to know

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Millennials who struggled to sign up for health insurance on have some simple advice for the Obama administration: Make the website more like Yelp or TurboTax.

President Obama famously told doubters that they could use the government’s health insurance site to pick a health plan "the same way you shop for a plane ticket on Kayak, same way you shop for a TV on Amazon." Speaking at a community college in Maryland last fall, he promised that the process was “real simple.”

That turned out not to be the case, of course. A studypublished Monday by Annals of Internal Medicine lays out some of the specific ways that– a centerpiece of the Patient Protection and Affordable Care Act – went wrong.

A team of doctors, lawyers, health economists and health policy experts from the University of Pennsylvania recruited 33 volunteers and observed them as they struggled to sign up for health insurance on the highly touted website. These volunteers should have been in pretty good shape: With ages ranging from 19 to 30, they were all members of a Web-savvy generation. In addition, the study described the young adults as “highly educated.”

But when they got to, they ran into problems. Some of them had anticipated that they could type in their preferences – what services they wanted to have covered, how much they wanted to spend on premiums, how much flexibility they want in picking their doctors – and get a list of options that met their criteria. (It could have been the health insurance equivalent of using Yelp to find a sushi bar near Santa Monica that has outdoor seating and takes reservations.)

Read the full article from The Los Angeles Times

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Man pleads guilty to stealing patient records to file false tax returns

A Dothan man pleaded guilty to charges related to stealing patient records while working as a lab technician at a medical facility.

Kamarian D. Millender pleaded guilty to one count of aggravated identity theft, Deputy Assistant Attorney General Ronald A. Cimino of the Justice Department's Tax Division and U.S. Attorney George L. Beck Jr. for the Middle District of Alabama announced. He will serve the mandatory sentence of two years in prison and could be fined to up to $250,000.

According to court documents, Millender and others stole patient medical records, which contained personal identification information, from the medical facility where he worked. The name of the facility wasn't available.

Millender used this information to file false tax returns in an attempt to obtain fraudulent tax refunds from the Internal Revenue Service.

Read the full article from here  

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The new normal of healthcare spending

A rather interesting shockwave came across the newsfeeds this week. I was actually doing a TV interview when the host announced that GDP was down 2.9% for the first quarter. There was not much else I could do but note that that was a really bad, ugly, terrible, not very good number. But I had no real basis, without any facts in front of me, by which to understand why the revision was so extreme.

Sure, we were all expecting a pretty large revision, but what we got was the worst decline in five years and the largest downward revision since recordkeeping began. Later, a quick perusal of the data on the BLS website revealed the culprits: exports and healthcare spending.

Last year I was one of the very few who suggested that the implementation of Obamacare could cause a recession (see more below). Such a suggestion was universally dismissed by all right-thinking economists, and for very good reasons based in sound economic theory, I might add. But sometimes the real world neglects to adhere to our models and theories, and that was my concern.

While I doubt we’ll see a recession – classically understood as two quarters in a row of negative GDP – this rather large bump in the road offers a number of teaching opportunities. This week’s letter will look at the actual numbers; and then, rather than try to spin the numbers to fit some preconceived political agenda, we will examine what actually happened in the spending data and why. And while it may surprise some of you, I actually think a few good things did happen, things I find encouraging.

Read the full article from Forbes here  

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Holes in healthcare

The safety net of healthcare services in La Plata County has big holes.

Area residents are going without critical mental-health, substance-abuse, dental and primary care because of a lack of services, providers or access. Local health agencies, including Mercy Regional Medical Center, San Juan Basin Health Department and Axis Health System, are trying to close the gaps, but without something comprehensive, it could be just a patchwork solution.

Behavioral health describes the connection between our behaviors and our health and well-being. It can cover a lot of things, but many health professionals use it to describe people who have a mental illness and a substance-abuse problem, or have a mental-health and a physical health problem.

Southern Ute Community Action Programs Inc. has a program, Peaceful Spirit, that treats many residents with a co-occurring diagnosis of mental illness and substance abuse, Executive Director Eileen Wasserbach says.

“It’s sort of a chicken-and-egg thing. It’s really hard to tell which came first,” Wasserbach said. “Best research tells us that just treating addiction doesn’t always effectively address other behavioral health issues.”

Read the full article from The Durango Herald

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The 5 best healthcare stocks so far in 2014

Healthcare stocks put up impressive returns last year and are trumping the S&P 500 yet again this year.

The S&P health care select index ETF (XLV) is up more than 10% this year and the iShares Nasdaq biotechnology ETF (IBB) has gained more than 13% through the first six months.

Those returns handily outpaced the S&P 500, but they're just a fraction of the returns notched for those lucky enough to own shares in Intercept Pharmaceuticals, Intermune, Achillion Pharmaceuticals, Accelerate Diagnostics, and Horizon Pharma. All five of them are already up more than 100% this year, so let's take a closer look.

Read the full article from The Motley Fool here  

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CMS releases proposed 2015 hospital outpatient payment rates: 7 things to know

CMS has released proposed changes to Medicare's Hospital Outpatient Prospective Payment System for calendar year 2015. Here are seven things to know about the Hospital OPPS and the proposed rule.

1. More than 4,000 hospitals receive reimbursement through the OPPS, which provides payment for most hospital outpatient department services and partial hospitalization services administered by hospital outpatient departments and community mental health centers. OPPS rates vary depending on Ambulatory Payment Classification groups for procedures and services.

2. CMS has proposed updating the OPPS market basket by 2.1 percent in 2015. That overall increase reflects a projected hospital market basket increase of 2.7 percent, minus a 0.4 percentage point multi-factor productivity adjustment and a 0.2 percentage point adjustment required by law.

3. The proposed rule for 2015 includes additional comprehensive ambulatory payment classifications. Comprehensive-APCs were created to pay for high-cost device-dependent services using a single payment for a hospital stay in 29 device-dependent APCs. A comprehensive-APC policy meant to expand the items and services packaged into a single payment for a comprehensive primary care service was included in a final rule for calendar year 2014, CMS delayed implementation by a year to give the agency and hospitals more time to evaluate and comment on the policy.

4. For 2015, CMS has proposed conditional packaging of all ancillary services — which are integral, supporting or adjunctive to a primary service — assigned to APCs with a geometric mean cost of $100 or less.

Read the full article from Becker’s Hospital Review here  

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