MedClimate Health News Daily http://medclimate.com/feed en-us Copyright MedClimate, Inc2018 NIH Clinical Center releases dataset of 32,000 CT images http://medclimate.com/external/index.php?https://www.nih.gov/news-events/news-releases/nih-clinical-center-releases-dataset-32000-ct-images http://medclimate.com/external/index.php?https://www.nih.gov/news-events/news-releases/nih-clinical-center-releases-dataset-32000-ct-images Fri, 20 Jul 2018 16:45:00 CDT NIH News Release Lesion data may make it easier for scientific community to identify tumor growth or new disease ]]> Payer Roundup—After advocating for AHPs for years, NFIB says it will not establish one http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/payer-roundup-after-advocating-for-ahps-for-years-nfib-says-it-will-not-establish-one?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/payer-roundup-after-advocating-for-ahps-for-years-nfib-says-it-will-not-establish-one?utm_source=internal&utm_medium=rss Fri, 20 Jul 2018 16:21:41 CDT Rose Meltzer at FierceHealthcare: Payer NFIB says the Trump administration's new AHP policy wouldn't really help them. Plus, amid news of rising premiums across the nation, a new study suggests state individual mandates could be the cure. AHIP: Rebates not driving rise in drug pricing http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/rebates-not-driving-rise-drug-pricing-ahip-study-indicates?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/rebates-not-driving-rise-drug-pricing-ahip-study-indicates?utm_source=internal&utm_medium=rss Fri, 20 Jul 2018 15:28:44 CDT Eli Richman at FierceHealthcare: Payer A recent analysis prepared on behalf of America's Health Insurance Plans (AHIP) indicates that drug rebates have not been the primary driver of rising drug prices—as some advocates have claimed. Medicare Advantage plans taking advantage of new policies that give them flexibility http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/medicare-advantage-plans-taking-advantage-new-policies-give-them-flexibility?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/medicare-advantage-plans-taking-advantage-new-policies-give-them-flexibility?utm_source=internal&utm_medium=rss Fri, 20 Jul 2018 15:28:11 CDT Rose Meltzer at FierceHealthcare: Payer "High-touch" services can improve satisfaction among patients with serious or advanced illnesses while reducing costs, a new paper from Duke-Margolis says. More than half of Maine prescribers are now EPCS-enabled http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/more-half-maine-prescribers-are-now-epcs-enabled http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/more-half-maine-prescribers-are-now-epcs-enabled Fri, 20 Jul 2018 12:07:25 CDT walmeida at Healthcare IT News - Government & Policy Prescription opioid abuse in the U.S. is soaring. As the country's policymakers grapple with how to address this national emergency, great progress has been made in the state of Maine, which this month marks the first anniversary of a state law requiring the use of electronic prescribing of controlled substances technology. Since Maine's mandate went into effect in July 2017, making it only the second state in the country with such a law after New York, a significant number of physicians have responded to the new law, known as Chapter 488, which prohibits hand-written paper prescriptions for controlled substances. Maine now ranks No. 3 among the states for leveraging EPCS to fight against the opioid epidemic, and more than half of Maine prescribers now are EPCS-enabled (51 percent) compared to the national average of 22 percent, according to the Surescripts National Progress Report. "The opioid issue has created challenges for those prescribing but it has also given them a more effective tool to treat their patients who are dealing with long-term chronic pain issues," said Maine Republican State Senator Andre Cushing III, co-chair of the state's opioid task force. "In many cases, it has opened discussions about how to effectively treat their underlying problems and perhaps move away from continued use of opioids." It creates a better safety net for those who have developed a significant addiction and have been seeking multiple means of access to opioids, Cushing added. "Maine's governor was committed to a multiple-pronged approach to fighting this battle against misuse and the associated dependence on prescription drugs," Cushing explained. "His administration, with the help of the medical association and our department of HHS, crafted the plan and then worked through the implementation process to educate providers and amend the law to address some of the challenging issues that arose." Prior to the law's enactment, electronic prescribing of opioids in the state was very limited, down in the 1 to 2 percent range, said Gordon Smith, executive vice president of the Maine Medical Association. "Enactment of the mandate dramatically increased EPCS in the state," Smith said. "The two lessons learned: A) While difficult for prescribers, a legal requirement will dramatically increase EPCS in a state, and, B) There will be some pushback, largely from small or solo prescribers who do not have access to EHR systems that can incorporate the change and thus have to go to some expense to buy software or hardware to meet the requirements of the law." Prescribers did have the ability to apply for a waiver from the state and the state was quite generous in granting them, which greatly helped in the implementation, he added, explaining why almost half of providers are still not in compliance. "While nearly all pharmacies were already able to accept electronic prescriptions for controlled substances, not many prescribers had implemented the technology to send them." Ken Whittemore Jr., Surescripts "The biggest obstacle going forward is the enormous pressure on primary care from all directions and the lack of adequate reimbursement to meet the demands of laws such as Chapter 488," Smith said. "The unfunded mandates can be handled by the larger systems but the small and solo practices – for example, a psychiatrist practicing part-time – struggle." In a perfect world, mandates such as Chapter 488 should be funded and paid for through an appropriation when enacted, he said. Without funding and adequate training, this type of legislation contributes to primary care burnout, he added. E-prescribing vendor Surescripts has helped many physicians in Maine conducting EPCS. The vendor is an example of other organizations joining state organizations to help push the adoption of EPCS. "Maine was one of the first states in the nation to enact a law that requires the use of e-prescribing for all opioid prescriptions," said Ken Whittemore Jr., vice president of professional and regulatory affairs at Surescripts. "While nearly all pharmacies were already able to accept electronic prescriptions for controlled substances, not many prescribers had implemented the technology to send them." Surescripts, he said, worked with a number of organizations across the state to get the word out that the mandate was coming and that the technology was available. One example of how it educated prescribers is an online resource it developed at GetEPCS.com. It includes videos, Q&A and other resources designed to make it easier for prescribers to get up and running quickly. Twitter: @SiwickiHealthIT Email the writer: bill.siwicki@himssmedia.com Primary Topic: Electronic Health RecordsAdditional Topics: TechnologyEHRPolicyTechnologySecuritySpecific Terms: Electronic Health RecordsPrivacy & SecurityCustom Tags: Electronic Health RecordsPrivacy & SecurityDisable Auto Tagging: Short Headline: More than half of Maine prescribers are now EPCS-enabledNewsletter hed: More than half of Maine prescribers are now EPCS-enabledNewsletter teaser: On the first anniversary of the state's mandate, 51 percent of prescribers in the state are fighting the opioid crisis by using electronic prescription for controlled substances.HOT @HIMSS: Featured Decision Content: 

Prescription opioid abuse in the U.S. is soaring. As the country's policymakers grapple with how to address this national emergency, great progress has been made in the state of Maine, which this month marks the first anniversary of a state law requiring the use of electronic prescribing of controlled substances technology.

Since Maine's mandate went into effect in July 2017, making it only the second state in the country with such a law after New York, a significant number of physicians have responded to the new law, known as Chapter 488, which prohibits hand-written paper prescriptions for controlled substances.

Maine now ranks No. 3 among the states for leveraging EPCS to fight against the opioid epidemic, and more than half of Maine prescribers now are EPCS-enabled (51 percent) compared to the national average of 22 percent, according to the Surescripts National Progress Report.

"The opioid issue has created challenges for those prescribing but it has also given them a more effective tool to treat their patients who are dealing with long-term chronic pain issues," said Maine Republican State Senator Andre Cushing III, co-chair of the state's opioid task force. "In many cases, it has opened discussions about how to effectively treat their underlying problems and perhaps move away from continued use of opioids."

It creates a better safety net for those who have developed a significant addiction and have been seeking multiple means of access to opioids, Cushing added.

"Maine's governor was committed to a multiple-pronged approach to fighting this battle against misuse and the associated dependence on prescription drugs," Cushing explained. "His administration, with the help of the medical association and our department of HHS, crafted the plan and then worked through the implementation process to educate providers and amend the law to address some of the challenging issues that arose."

Prior to the law's enactment, electronic prescribing of opioids in the state was very limited, down in the 1 to 2 percent range, said Gordon Smith, executive vice president of the Maine Medical Association.

"Enactment of the mandate dramatically increased EPCS in the state," Smith said. "The two lessons learned: A) While difficult for prescribers, a legal requirement will dramatically increase EPCS in a state, and, B) There will be some pushback, largely from small or solo prescribers who do not have access to EHR systems that can incorporate the change and thus have to go to some expense to buy software or hardware to meet the requirements of the law."

Prescribers did have the ability to apply for a waiver from the state and the state was quite generous in granting them, which greatly helped in the implementation, he added, explaining why almost half of providers are still not in compliance.

"While nearly all pharmacies were already able to accept electronic prescriptions for controlled substances, not many prescribers had implemented the technology to send them."

Ken Whittemore Jr., Surescripts

"The biggest obstacle going forward is the enormous pressure on primary care from all directions and the lack of adequate reimbursement to meet the demands of laws such as Chapter 488," Smith said. "The unfunded mandates can be handled by the larger systems but the small and solo practices – for example, a psychiatrist practicing part-time – struggle."

In a perfect world, mandates such as Chapter 488 should be funded and paid for through an appropriation when enacted, he said. Without funding and adequate training, this type of legislation contributes to primary care burnout, he added.

E-prescribing vendor Surescripts has helped many physicians in Maine conducting EPCS. The vendor is an example of other organizations joining state organizations to help push the adoption of EPCS.

"Maine was one of the first states in the nation to enact a law that requires the use of e-prescribing for all opioid prescriptions," said Ken Whittemore Jr., vice president of professional and regulatory affairs at Surescripts. "While nearly all pharmacies were already able to accept electronic prescriptions for controlled substances, not many prescribers had implemented the technology to send them."

Surescripts, he said, worked with a number of organizations across the state to get the word out that the mandate was coming and that the technology was available. One example of how it educated prescribers is an online resource it developed at GetEPCS.com. It includes videos, Q&A and other resources designed to make it easier for prescribers to get up and running quickly.

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com

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More than half of Maine prescribers are now EPCS-enabled
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On the first anniversary of the state's mandate, 51 percent of prescribers in the state are fighting the opioid crisis by using electronic prescription for controlled substances.
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New Mexico Health Connections to appeal portions of risk adjustment ruling regardless of pending decision http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/new-mexico-health-connections-hhs-risk-adjustment-appeal-lawsuit-bronze-plans?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/new-mexico-health-connections-hhs-risk-adjustment-appeal-lawsuit-bronze-plans?utm_source=internal&utm_medium=rss Fri, 20 Jul 2018 10:10:03 CDT Evan Sweeney at FierceHealthcare: Payer As a New Mexico district judge weighs a request from CMS to reconsider the court's risk adjustment ruling, the lead attorney for New Mexico Health Connections said the insurer plans to appeal portions of the court's February ruling. CMS revives Kentucky waiver debate, puzzling legal experts http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/cms-to-open-second-comment-period-kentucky-work-requirement-proposal-but-what-it-will-gain?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/cms-to-open-second-comment-period-kentucky-work-requirement-proposal-but-what-it-will-gain?utm_source=internal&utm_medium=rss Thu, 19 Jul 2018 14:54:58 CDT Rose Meltzer at FierceHealthcare: Payer CMS plans to open a second 30-day comment period on Kentucky's Medicaid work requirement waiver, a move that has experts scratching their heads, especially as numbers from Arkansas' work requirement demonstration roll in. CMS readies potential fix to risk adjustment payments http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/cms-risk-adjustment-interim-rule-omb-hhs-eric-hargan?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/cms-risk-adjustment-interim-rule-omb-hhs-eric-hargan?utm_source=internal&utm_medium=rss Thu, 19 Jul 2018 14:42:43 CDT Evan Sweeney at FierceHealthcare: Payer The Office of Management and Budget is reviewing an interim final rule from CMS on the "ratification and reissuance of the methodology" for the risk adjustment program, a sign the agency may be preparing to unfreeze the payments. Rural hospitals need more funding for broadband, telehealth, AHA says http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/rural-hospitals-need-more-funding-broadband-telehealth-aha-says http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/rural-hospitals-need-more-funding-broadband-telehealth-aha-says Thu, 19 Jul 2018 14:33:41 CDT walmeida at Healthcare IT News - Government & Policy The American Hospital Association said rural healthcare entities need more federal funding for technological infrastructure as basic as broadband connectivity, reimbursement for virtual visits and the means to conduct remote patient monitoring.  AHA’s testimony before the Energy and Commerce Subcommittee on Communications and Technology this week came just days after the Center for Medicare and Medicaid Services proposed a new rule that would pay doctors for more virtual care performed via audio or video and otherwise relieve some administrative burdens. What’s more, rural hospitals are once again in the spotlight this week for common struggles, including an abundance of uninsured patients, Medicaid populations and their lower reimbursement rates, as well as other patients seeking care outside the rural areas they call home. Webinar: Telehealth from setup to application To that end, AHA made several recommendations, the first being to allow remote patient monitoring to be deemed an eligible expense, saying they enable providers to better manage care for patients with chronic illness by allowing greater oversight over treatment plan compliance, possibly preventing acute episodes and cutting down on unnecessary readmissions. They are also calling for cost control within the program, asking that healthcare providers are able to get services that meet their connectivity demands at affordable rates.  “Congress should ensure that the FCC takes steps to identify any unjustified increases in pricing that drive up program costs; however, the FCC’s policy response cannot be to increase the out-of-pocket expenses for health care providers,” the AHA said. AHA is also asking for a revision of the term “rural” as it is used by the FCC within the program to define whether a provider is eligible for program participation and support. The AHA called the current definition “quite restrictive” and argued that other agencies have adopted more inclusive and equitable definitions. The AHA urged Congress to revise their own definition to be more inclusive and aligned with program objectives.  “The goal of the program should be to support all health care providers that provide essential health care services to individuals who reside in rural areas, notwithstanding their status according to the census,” the AHA said. AHA praised the FCC’s potential creation of a $100 million Connected Care Pilot Program to support telehealth for low-income Americans, especially those in rural areas and veterans, but suggested that be separately funded and not run in competition with the Rural Health Care Program.  Much like other legislation that has come into effect in the last couple years, the AHA also urged Congress to make sure that the level of administrative burden that comes with participation in the RHCP does not become prohibitive, dissuading providers from involvement because they are already buried in paperwork through the course of routine care delivery operations.  According to AHA survey data, more than three-fourths of U.S. hospitals are using or implementing solutions to connect with patients and consulting practitioners at a distance through video and other technology. But barriers persist to further widening the use of telehealth. Insurance coverage for such services varies, as do reimbursement rates.  The AHA expressed appreciation that the FCC has voted to increase the program’s annual cap to $571 million, after stagnating at $400 million for more than two decades. The cap was established in 1997, so the increase represents what it would be had there been an inflation adjustment. There will now be annual adjustments for inflation, and unused funds from one year will carry over to the future.  “These changes will enable rural health care providers to expand broadband connections in their communities,” the AHA said. But the revenue needed to invest in such technologies can be elusive, especially for strained rural providers who are short on resources. Also, cross-state licensure is a major issue. Despite recently expanded Medicare coverage for telehealth services for stroke patients, Medicare still limits coverage and payment for many telehealth services. Often, public payers dominate payer mixes for rural facilities and systems.  The AHA wants to see Medicare’s limitations on telehealth including: eliminating geographic and setting requirements so patients outside of rural areas can benefit from telehealth; expanding the types of technology that can be used, including remote monitoring; covering all services that are safe to provide, rather than a small list of approved services; and  including telehealth in new payment models.  “Electronic health records, technology-based patient engagement strategies, health information sharing for coordinated care, and remote-monitoring technologies all require robust broadband connections,” AHA explained. “According to the FCC, tens of millions of Americans still lack access to adequate broadband, and rural communities are more likely to be in need.”   Twitter: @BethJSanborn Email the writer: beth.sanborn@himssmedia.com   Primary Topic: PolicyAdditional Topics: PolicyTelehealthTechnologyTelehealthTechnologyCustom Tags: TelehealthTelehealthDisable Auto Tagging: Short Headline: AHA: Rural hospitals need telehealth, broadband fundingNewsletter hed: Rural hospitals need more funding for broadband, telehealth, AHA saysNewsletter teaser: American Hospital Association called on Congress to advance remote patient monitoring, reduce restrictions on tech, and include more hospitals in the Rural Health Care Program.HOT @HIMSS: Featured Decision Content: 

The American Hospital Association said rural healthcare entities need more federal funding for technological infrastructure as basic as broadband connectivity, reimbursement for virtual visits and the means to conduct remote patient monitoring. 

AHA’s testimony before the Energy and Commerce Subcommittee on Communications and Technology this week came just days after the Center for Medicare and Medicaid Services proposed a new rule that would pay doctors for more virtual care performed via audio or video and otherwise relieve some administrative burdens. What’s more, rural hospitals are once again in the spotlight this week for common struggles, including an abundance of uninsured patients, Medicaid populations and their lower reimbursement rates, as well as other patients seeking care outside the rural areas they call home.

To that end, AHA made several recommendations, the first being to allow remote patient monitoring to be deemed an eligible expense, saying they enable providers to better manage care for patients with chronic illness by allowing greater oversight over treatment plan compliance, possibly preventing acute episodes and cutting down on unnecessary readmissions.

They are also calling for cost control within the program, asking that healthcare providers are able to get services that meet their connectivity demands at affordable rates. 

“Congress should ensure that the FCC takes steps to identify any unjustified increases in pricing that drive up program costs; however, the FCC’s policy response cannot be to increase the out-of-pocket expenses for health care providers,” the AHA said.

AHA is also asking for a revision of the term “rural” as it is used by the FCC within the program to define whether a provider is eligible for program participation and support. The AHA called the current definition “quite restrictive” and argued that other agencies have adopted more inclusive and equitable definitions. The AHA urged Congress to revise their own definition to be more inclusive and aligned with program objectives. 

“The goal of the program should be to support all health care providers that provide essential health care services to individuals who reside in rural areas, notwithstanding their status according to the census,” the AHA said.

AHA praised the FCC’s potential creation of a $100 million Connected Care Pilot Program to support telehealth for low-income Americans, especially those in rural areas and veterans, but suggested that be separately funded and not run in competition with the Rural Health Care Program. 

Much like other legislation that has come into effect in the last couple years, the AHA also urged Congress to make sure that the level of administrative burden that comes with participation in the RHCP does not become prohibitive, dissuading providers from involvement because they are already buried in paperwork through the course of routine care delivery operations. 

According to AHA survey data, more than three-fourths of U.S. hospitals are using or implementing solutions to connect with patients and consulting practitioners at a distance through video and other technology. But barriers persist to further widening the use of telehealth. Insurance coverage for such services varies, as do reimbursement rates. 

The AHA expressed appreciation that the FCC has voted to increase the program’s annual cap to $571 million, after stagnating at $400 million for more than two decades. The cap was established in 1997, so the increase represents what it would be had there been an inflation adjustment. There will now be annual adjustments for inflation, and unused funds from one year will carry over to the future. 

“These changes will enable rural health care providers to expand broadband connections in their communities,” the AHA said.

But the revenue needed to invest in such technologies can be elusive, especially for strained rural providers who are short on resources. Also, cross-state licensure is a major issue. Despite recently expanded Medicare coverage for telehealth services for stroke patients, Medicare still limits coverage and payment for many telehealth services. Often, public payers dominate payer mixes for rural facilities and systems. 

The AHA wants to see Medicare’s limitations on telehealth including: eliminating geographic and setting requirements so patients outside of rural areas can benefit from telehealth; expanding the types of technology that can be used, including remote monitoring; covering all services that are safe to provide, rather than a small list of approved services; and  including telehealth in new payment models. 

“Electronic health records, technology-based patient engagement strategies, health information sharing for coordinated care, and remote-monitoring technologies all require robust broadband connections,” AHA explained. “According to the FCC, tens of millions of Americans still lack access to adequate broadband, and rural communities are more likely to be in need.”

 

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com

 

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In a blow to PBMs, Trump administration mulling overhaul to drug rebate safe harbor protections  http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/pharmacy-benefit-managers-safe-harbors-drug-price-hhs-omb?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/pharmacy-benefit-managers-safe-harbors-drug-price-hhs-omb?utm_source=internal&utm_medium=rss Thu, 19 Jul 2018 13:47:06 CDT Paige Minemyer at FierceHealthcare: Payer The Trump administration is considering a proposal to overhaul safe harbor protections for pharmaceutical company rebates, a plan that could lead to a significant shift in how drug prices are determined.  Altarum: Growth in spending on privately insured patients outpacing Medicaid, Medicare http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/hospitals-health-systems/altarum-cost-spending-privately-insured-growing-faster-than-medicare-and?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/hospitals-health-systems/altarum-cost-spending-privately-insured-growing-faster-than-medicare-and?utm_source=internal&utm_medium=rss Thu, 19 Jul 2018 11:26:59 CDT Tina Reed at FierceHealthcare: Payer A new analysis from the Altarum Institute found that spending and price growth among the privately insured sped up in 2017 and the first half of 2018 compared to public payers. It's a reversal from prior trends when private spending growth was near or below Medicare and Medicaid rates. GAO finds 340B hospitals are mostly rural or qualify for DSH payments http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/government-accountability-office-340b-program-hospitals?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/government-accountability-office-340b-program-hospitals?utm_source=internal&utm_medium=rss Thu, 19 Jul 2018 11:16:15 CDT Paige Minemyer at FierceHealthcare: Payer Amid increased scrutiny of the 340B drug discount program, the Government Accountability Office has released a report diving into the characteristics of hospitals in the program.  Doctors, executives see little progress on value-based care http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/hospitals-health-systems/doctors-executives-see-little-progress-value-based-care-survey?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/hospitals-health-systems/doctors-executives-see-little-progress-value-based-care-survey?utm_source=internal&utm_medium=rss Thu, 19 Jul 2018 10:54:49 CDT Eli Richman at FierceHealthcare: Payer Value-based healthcare may be the hot topic right now, but all that attention has yet to make much of a mark on the industry. That's the perspective of physicians and health plan executives who said that despite advances in technology, there's still a long way to go. VA, IBM Watson Health extend precision cancer partnership to help veterans http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/va-ibm-watson-health-extend-precision-cancer-partnership-help-veterans http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/va-ibm-watson-health-extend-precision-cancer-partnership-help-veterans Thu, 19 Jul 2018 09:22:20 CDT walmeida at Healthcare IT News - Government & Policy The Department of Veterans Affairs and IBM Watson Health have announced a one-year extension to an ongoing public-private partnership applying the AI company’s technology to genomic data for cancer therapy. The precision oncology collaboration has so far assisted the treatment of more than 2,700 veterans, according to a statement, although the original agreement in 2016 had proposed the lofty goal of treating 10,000 patients. Dr. Michael Kelley, professor of medicine at Duke University and the national program director for oncology at the VA, admitted that the initial benchmark was a bit ambitious, but is more attainable now that the two partners have laid a groundwork for future patients. “I think we [IBM and the VA] were both pleased with what we’ve accomplished so far, and we both see that the immediate future looks bright for extending that,” Kelley told MobiHealthNews. “When the initial agreement was made, we set a limit of how many patients we would do. We are below that limit, so we’re basically having what would be thought of as a no-cost extension. But clearly, when we looked back at those two years, initially there was some startup activities — getting used to each other’s data and how our systems talk to each other. We really started to ramp it up about a year ago, where we went from a drip to opening the fire hose.” Whereas a single oncologist or care team doesn’t have the time or capacity to memorize all of the available information regarding treatments and specific cancer-linked genes, IBM’s Watson for Genomics is able to reference these data to match patients with appropriate therapies or clinical trials, Kelley explained. Currently, VA oncologists and pathologists caring for stage 4 cancer patients with solid tumors can send a tumor or blood sample for testing a panel of roughly 100 genes, he said. “Initially we wanted to get this up and running, and we’re actually doing it in more than half of the [VA] medical centers around the country,” Kelley said. “I think we’re going to continue to amplify its availability, and I do imagine before too long — maybe later this year — that this will become the default approach to doing this type of testing.” While the early clinical data has shown promising results, Kelley also noted that implementing the AI technology will help the VA reduce variability that is common in cancer care. “[Cancer treatment] is still somewhat of an art, and I think one of the nice things about Watson is it starts to turn it into a more predictable science,” Kelley said. “Of course we don’t want to take [doctors] out of the equation, but we want to make their job very efficient so that the quality of that is very good. What we’ve shown is there’s quite a lot of variability [in interpreting results], so I think one of the nice things about Watson is that it is more standardized — you get similar results all the time, and there’s some clear basis for the decision-making processes. It’s not perfect, but we think it has promise in that regard. “ More than one-third of those treated through the VA’s precision oncology program are vets living in rural areas of the country, according to a statement. The new agreement will allow VA oncologists to continue using Watson for Genomics through June 2019, at least. “VA is leading the nation to scale and spread the delivery of high-quality precision oncology care, one veteran at a time,” Dr. Kyu Rhee, chief health officer for IBM Watson Health, said in a statement. “It is incredibly challenging to read, understand, and stay up-to-date with the breadth and depth of medical literature and link them to relevant mutations for personalized cancer treatments. This is where AI can play an important role in helping to scale precision oncology, as demonstrated in our work with VA, the largest integrated health system in the U.S.” Twitter: @dave_muoio Email the writer: dave.muoio@himssmedia.com Primary Topic: PolicyAdditional Topics: PolicyPrecision MedicineCarePolicyCustom Tags: Precision MedicineDisable Auto Tagging: Short Headline: VA, IBM Watson Health extend precision cancer partnershipNewsletter hed: VA, IBM Watson Health extend precision cancer partnershipNewsletter teaser: The agreement is to continue the public-private partnership to connect AI technology with genomic data to provide cancer therapy for veterans.HOT @HIMSS: Featured Decision Content: 

The Department of Veterans Affairs and IBM Watson Health have announced a one-year extension to an ongoing public-private partnership applying the AI company’s technology to genomic data for cancer therapy.

The precision oncology collaboration has so far assisted the treatment of more than 2,700 veterans, according to a statement, although the original agreement in 2016 had proposed the lofty goal of treating 10,000 patients. Dr. Michael Kelley, professor of medicine at Duke University and the national program director for oncology at the VA, admitted that the initial benchmark was a bit ambitious, but is more attainable now that the two partners have laid a groundwork for future patients.

“I think we [IBM and the VA] were both pleased with what we’ve accomplished so far, and we both see that the immediate future looks bright for extending that,” Kelley told MobiHealthNews. “When the initial agreement was made, we set a limit of how many patients we would do. We are below that limit, so we’re basically having what would be thought of as a no-cost extension. But clearly, when we looked back at those two years, initially there was some startup activities — getting used to each other’s data and how our systems talk to each other. We really started to ramp it up about a year ago, where we went from a drip to opening the fire hose.”

Whereas a single oncologist or care team doesn’t have the time or capacity to memorize all of the available information regarding treatments and specific cancer-linked genes, IBM’s Watson for Genomics is able to reference these data to match patients with appropriate therapies or clinical trials, Kelley explained. Currently, VA oncologists and pathologists caring for stage 4 cancer patients with solid tumors can send a tumor or blood sample for testing a panel of roughly 100 genes, he said.

“Initially we wanted to get this up and running, and we’re actually doing it in more than half of the [VA] medical centers around the country,” Kelley said. “I think we’re going to continue to amplify its availability, and I do imagine before too long — maybe later this year — that this will become the default approach to doing this type of testing.”

While the early clinical data has shown promising results, Kelley also noted that implementing the AI technology will help the VA reduce variability that is common in cancer care.

“[Cancer treatment] is still somewhat of an art, and I think one of the nice things about Watson is it starts to turn it into a more predictable science,” Kelley said. “Of course we don’t want to take [doctors] out of the equation, but we want to make their job very efficient so that the quality of that is very good. What we’ve shown is there’s quite a lot of variability [in interpreting results], so I think one of the nice things about Watson is that it is more standardized — you get similar results all the time, and there’s some clear basis for the decision-making processes. It’s not perfect, but we think it has promise in that regard. “

More than one-third of those treated through the VA’s precision oncology program are vets living in rural areas of the country, according to a statement. The new agreement will allow VA oncologists to continue using Watson for Genomics through June 2019, at least.

“VA is leading the nation to scale and spread the delivery of high-quality precision oncology care, one veteran at a time,” Dr. Kyu Rhee, chief health officer for IBM Watson Health, said in a statement. “It is incredibly challenging to read, understand, and stay up-to-date with the breadth and depth of medical literature and link them to relevant mutations for personalized cancer treatments. This is where AI can play an important role in helping to scale precision oncology, as demonstrated in our work with VA, the largest integrated health system in the U.S.”

Twitter: @dave_muoio
Email the writer: dave.muoio@himssmedia.com

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Maryland health regulator expands hospital price transparency efforts http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/hospitals-health-systems/maryland-health-regulator-expands-hospital-price-transparency-efforts?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/hospitals-health-systems/maryland-health-regulator-expands-hospital-price-transparency-efforts?utm_source=internal&utm_medium=rss Thu, 19 Jul 2018 06:17:30 CDT Tina Reed at FierceHealthcare: Payer The Maryland Health Care Commission expanded its price transparency initiative with hospital cost comparison tools to inform consumers about large differences in price and quality—and push hospitals to examine their costs. Payer Roundup—Walmart taps former Humana executive for health unit; Azar appoints value-based care lead http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/payer-roundup-wal-mart-taps-former-humana-vp-for-healthcare-venture-azar-appoints-lead-value?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/payer-roundup-wal-mart-taps-former-humana-vp-for-healthcare-venture-azar-appoints-lead-value?utm_source=internal&utm_medium=rss Wed, 18 Jul 2018 15:17:08 CDT Rose Meltzer at FierceHealthcare: Payer Amid rumors that Walmart is in talks to buy Humana, the retail giant poached one of the insurer’s former vice presidents last week. Plus, two investigations suggest insurers and pharma are trying to dodge the law. CMS head Seema Verma: 'We are not leveraging the value of American clinicians' http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/cms-head-seema-verma-we-are-not-leveraging-value-american-clinicians http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/cms-head-seema-verma-we-are-not-leveraging-value-american-clinicians Wed, 18 Jul 2018 12:12:24 CDT walmeida at Healthcare IT News - Government & Policy The Centers for Medicare and Medicaid Services on Wednesday called for documentation of E/M visits to be scaled back.  The move follows last week’s proposed rule that would bring sweeping policy changes and a dramatic reduction in the documentation CMS would require of physicians. In line with its Patients over Paperwork initiative, the new effort would streamline coding for evaluation and management visits. Existing E/M documentation guidelines – first developed nearly 25 years ago – too often nowadays lead to physicians cutting and pasting of large chunks of text across electronic health records, strictly for billing purposes, said CMS Administrator Seema Verma on Wednesday. https://t.co/BcoYG6hHwU — Administrator Seema Verma (@SeemaCMS) July 18, 2018 "This is a poor use of their time," Verma said during a call with reporters. "We are not leveraging the value of American clinicians." So, as part of the 2019 Physician Fee Schedule Proposed Rule, CMS has called for documentation of E/M visits to be scaled back. The rules call for "new, single blended payment rates for new and established patients for office/outpatient E/M level 2 through 5 visits and a series of add-on codes to reflect resources involved in furnishing primary care and non-procedural specialty generally recognized services," according to the proposed fee schedule. They would also: allow practitioners to choose how they document office/outpatient E/M visits; let them "use time as the governing factor" in selecting the visit level they choose; enable docs to "focus their documentation on what has changed since the last visit or pertinent items that have not changed, rather than re-documenting information," and also "allow practitioners to simply review and verify certain information in the medical record that is entered by ancillary staff or the beneficiary, rather than re-entering it." All told, those relaxed rules could save U.S. providers more than 50 hours per clinician per year, said Verma. Add it up across all physicians nationwide and that's "500 years of additional time for patient care," she said. By moving to a system with a single payment rate, collapsing the codes between level 2 and 5, CMS is allowing the doctor to "focus on what is most important for the patient in front of them," said CMS Chief Medical Officer Kate Goodrich, MD. A boon for EHR usability, patient safety, pop health analytics? Beyond the promise of removing redundancies and jettisoning superfluous requirements, the new rules could have big implications for the efficiency and efficacy of health information technology, said National Coordinator Don Rucker, MD. Noting that the E/M documentation rules were first put together way back in 1995, and that they now require a lot of needless "medical school-type text" shuffled around EHRs in "big, templated notes," Rucker said it was time for a new approach. "It may not have made sense then, but in an era of electronic health records, we've heard from everyone that it just doesn't make sense." The drawbacks and even dangers of note bloat are obvious and long-documented. Trying to sort through and find relevant clinical information in non-templated data is very hard, he said, and there are real patient safety issues when important data is "buried in boilerplate." There are other big disadvantages too, Rucker said, affecting everyone from med students ("it has distorted our education system for medical trainees") to patient (the "see the doctor looking at the computer and not at them") to the U.S. taxpayer (all this documentation requires armies of coding and billing specialists: "a lot of money is spent on that and patients and the American public pay for it.") More to the point, such a profusion of dubiously necessary data is at cross purposes with the "modern, app-based world," he said. As we move toward a healthcare ecosystem where patients' health records are readily available on smartphones, "we want those notes to reflect the care you receive – not just billing boilerplate." To the question of whether reducing the documentation requirements would lead to less data and perhaps undermine analytics efforts, Rucker said it would actually be the "exact reverse." He called templated text the "anti-matter of information," creating a "classic signal to noise problem" for data governance efforts. By "taking the clutter out," he said, it would be a very powerful boost for EHR efficiency and better algorithms for quality improvement.   Indeed, added ONC Chief Medical Officer Thomas Mason, MD, the proposed rule – if finalized, it will take effect in 2019 – will have a significant impact on EHRs and usability. The American College of Physicians has called documentation burdens the number one usability challenge, he pointed out. By ameliorating them, it will lead to physician effectiveness and efficiency, innovation, improved data analytics and a clearer focus on patient engagement. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Primary Topic: AnalyticsAdditional Topics: AnalyticsDataTechnologyEHRPolicyQuality & SafetyTechnologyTechnologyEHRPolicySpecific Terms: Electronic Health RecordsWorkflowCustom Tags: AnalyticsElectronic Health RecordsQuality & SafetyWorkflowDisable Auto Tagging: Short Headline: CMS outlines plans to streamline coding, reduce paperwork burdenNewsletter hed: CMS head Seema Verma: 'We are not leveraging the value of American clinicians'Newsletter teaser: The Centers for Medicare and Medicaid Services proposes a new rule to combat note bloat, improve patient safety, advanced analytics and enable IT innovation.HOT @HIMSS: Featured Decision Content: 

The Centers for Medicare and Medicaid Services on Wednesday called for documentation of E/M visits to be scaled back. 

The move follows last week’s proposed rule that would bring sweeping policy changes and a dramatic reduction in the documentation CMS would require of physicians.

In line with its Patients over Paperwork initiative, the new effort would streamline coding for evaluation and management visits. Existing E/M documentation guidelines – first developed nearly 25 years ago – too often nowadays lead to physicians cutting and pasting of large chunks of text across electronic health records, strictly for billing purposes, said CMS Administrator Seema Verma on Wednesday.

https://t.co/BcoYG6hHwU

— Administrator Seema Verma (@SeemaCMS) July 18, 2018

"This is a poor use of their time," Verma said during a call with reporters. "We are not leveraging the value of American clinicians."

So, as part of the 2019 Physician Fee Schedule Proposed Rule, CMS has called for documentation of E/M visits to be scaled back. The rules call for "new, single blended payment rates for new and established patients for office/outpatient E/M level 2 through 5 visits and a series of add-on codes to reflect resources involved in furnishing primary care and non-procedural specialty generally recognized services," according to the proposed fee schedule.

They would also: allow practitioners to choose how they document office/outpatient E/M visits; let them "use time as the governing factor" in selecting the visit level they choose; enable docs to "focus their documentation on what has changed since the last visit or pertinent items that have not changed, rather than re-documenting information," and also "allow practitioners to simply review and verify certain information in the medical record that is entered by ancillary staff or the beneficiary, rather than re-entering it."

All told, those relaxed rules could save U.S. providers more than 50 hours per clinician per year, said Verma. Add it up across all physicians nationwide and that's "500 years of additional time for patient care," she said.

By moving to a system with a single payment rate, collapsing the codes between level 2 and 5, CMS is allowing the doctor to "focus on what is most important for the patient in front of them," said CMS Chief Medical Officer Kate Goodrich, MD.

A boon for EHR usability, patient safety, pop health analytics?

Beyond the promise of removing redundancies and jettisoning superfluous requirements, the new rules could have big implications for the efficiency and efficacy of health information technology, said National Coordinator Don Rucker, MD.

Noting that the E/M documentation rules were first put together way back in 1995, and that they now require a lot of needless "medical school-type text" shuffled around EHRs in "big, templated notes," Rucker said it was time for a new approach.

"It may not have made sense then, but in an era of electronic health records, we've heard from everyone that it just doesn't make sense."

The drawbacks and even dangers of note bloat are obvious and long-documented. Trying to sort through and find relevant clinical information in non-templated data is very hard, he said, and there are real patient safety issues when important data is "buried in boilerplate."

There are other big disadvantages too, Rucker said, affecting everyone from med students ("it has distorted our education system for medical trainees") to patient (the "see the doctor looking at the computer and not at them") to the U.S. taxpayer (all this documentation requires armies of coding and billing specialists: "a lot of money is spent on that and patients and the American public pay for it.")

More to the point, such a profusion of dubiously necessary data is at cross purposes with the "modern, app-based world," he said. As we move toward a healthcare ecosystem where patients' health records are readily available on smartphones, "we want those notes to reflect the care you receive – not just billing boilerplate."

To the question of whether reducing the documentation requirements would lead to less data and perhaps undermine analytics efforts, Rucker said it would actually be the "exact reverse."

He called templated text the "anti-matter of information," creating a "classic signal to noise problem" for data governance efforts.

By "taking the clutter out," he said, it would be a very powerful boost for EHR efficiency and better algorithms for quality improvement.  

Indeed, added ONC Chief Medical Officer Thomas Mason, MD, the proposed rule – if finalized, it will take effect in 2019 – will have a significant impact on EHRs and usability.

The American College of Physicians has called documentation burdens the number one usability challenge, he pointed out. By ameliorating them, it will lead to physician effectiveness and efficiency, innovation, improved data analytics and a clearer focus on patient engagement.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

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]]>
Blue Cross Blue Shield Association reports major drop in opioid prescriptions among members nationwide http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/blue-cross-blue-shield-association-reports-major-drop-opioid-prescriptions-among-members?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/blue-cross-blue-shield-association-reports-major-drop-opioid-prescriptions-among-members?utm_source=internal&utm_medium=rss Wed, 18 Jul 2018 11:36:38 CDT Rose Meltzer at FierceHealthcare: Payer BCBS Association Chief Medical Officer Trent Haywood, M.D., attributes the trend to not just educating providers but working with them to change their prescribing behavior. Good or bad idea? Some worry that E/M coding update could underpay doctors with sickest patients http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/e-m-coding-update-underpay-doctors-ehr-cms-seema-verma?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/e-m-coding-update-underpay-doctors-ehr-cms-seema-verma?utm_source=internal&utm_medium=rss Wed, 18 Jul 2018 11:20:51 CDT Joanne Finnegan at FierceHealthcare: Payer CMS’ plans to update evaluation and management codes is either a good idea that will simplify documentation and free up doctors’ time to spend with patients or a bad one that will leave physicians who treat high-acuity patients underpaid. HHS reviewing reforms to the Anti-Kickback Statute in addition to Stark Law http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/eric-hargan-anti-kickback-statute-stark-law-reform-value-based-care-hhs?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/eric-hargan-anti-kickback-statute-stark-law-reform-value-based-care-hhs?utm_source=internal&utm_medium=rss Tue, 17 Jul 2018 19:45:56 CDT Evan Sweeney at FierceHealthcare: Payer During a House subcommittee hearing on Tuesday, HHS Deputy Secretary Eric Hargan said a request for information on changes to the Anti-Kickback Statute is forthcoming, following an RFI on changes to the Stark Law last month. Hargan said reform is necessary to allow providers to experiment with value-based arrangements. Premier Management streamlines ACO reporting across 33 metrics to improve quality scores http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/premier-management-streamlines-aco-reporting-across-33-metrics-improve-quality-scores http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/premier-management-streamlines-aco-reporting-across-33-metrics-improve-quality-scores Tue, 17 Jul 2018 15:51:00 CDT jfinison at Healthcare IT News - Government & Policy Premier Management Company manages accountable care organizations. Two of its ACOs are leveraging clinical, financial and operational health IT to meet key performance and quality measures under the Medicare Shared Savings Program and the Medicare Access and CHIP Reauthorization Act. That's impressive, given that some of its physician practices were still using paper charts and had failed to meet meaningful use requirements According to the company (not to be confused with the Premier healthcare alliance), the adoption of electronic health records by those practices is helping them manage information more efficiently, better monitor their patient populations and make more informed decisions for patient care. It's also helped streamline reporting for the 33 metrics they must report on as Medicare ACOs. Despite early successes, in fact, CEO Anwar Kazi said there were areas it needed to improve upon. "While the Premier ACOs had been successful in generating Medicare shared savings every year since 2014, in 2015, some of the Premier physicians did not meet the minimum threshold in performance when attesting for meaningful use because they were still using paper charts and had fallen out of attestation for not having an EHR," Kazi said. Looking toward the requirements for MACRA, Premier knew that penalties for these doctors would grow if changes were not made. Premier also struggled with too many lab vendors across its network, which was driving up costs and the ability for clinicians to receive data quickly. Additionally, the data frequency for Medicare claims patients from CMS claims to ACOs is every three months, which added to the challenges. "We not only felt that this was too long to wait for the ACO physicians to take action on the information being provided, but when physicians did gather the data they needed, they'd have to capture it from a manual chart audit or study printouts of spreadsheets from old claims data and then try and aggregate the data sources to have a complete picture," Kazi explained. "We needed to manage information faster, to better monitor the patient population, and to make more informed decisions for patient care." So Premier turned to a technology from Quest Diagnostics called Quest Quanum. Other IT and services vendors that work with ACOs include Aledade, Caravan Health, Conifer Health, Evolent, McKesson and Optum. "Central to our goals was improving upon our quality scores," Kazi said. "We have 33 metrics to report as a Medicare ACO. The tools make that easier. In 2017, we implemented Quanum EHR, Practice Management, and Revenue Cycle Management systems, along with Quanum Interactive Insights, and an enhanced results data set to supplement claims information. "Of the 12 physicians who had not been meeting meaningful use, because they were still using paper charts, nine already have shifted to the EHR," Kazi said. "One doctor in Highland Village, Texas, a member of the ACO, switched from paper to the EHR and she appreciates the fact that the lab results populate into the EHR – cutting down on staff time because instead of having to print out the labs and file them in paper charts for review, everything is already in the EHR." For prescriptions and refills, there are no longer any callbacks from the pharmacy, Kazi added. And finally, since that practice has implemented RCM, its collection rate is much higher and it has fewer denials, Kazi said. "Premier is looking forward to seeing what kind of savings it will achieve for the 2017 reporting year," Kazi said. "In the meantime, building on our continued success, we have plans to expand and grow beyond MSSP with new commercial contracts, Medicare Advantage contracts, and commercial ACO products with other payers." Twitter: @SiwickiHealthIT Email the writer: bill.siwicki@himssmedia.com Primary Topic: Accountable CareAdditional Topics: Accountable CareCareTechnologyEHRPolicyQuality & SafetyTechnologyTechnologyEHRQuality & SafetyTechnologySpecific Terms: Electronic Health RecordsWorkflowCustom Tags: Accountable CareElectronic Health RecordsQuality & SafetyWorkflowQuality & SafetyDisable Auto Tagging: Short Headline: Premier Management streamlines ACO reporting across 33 metricsNewsletter hed: Premier Management streamlines ACO reporting across 33 metricsNewsletter teaser: Organization plans to expand beyond MSSP with new commercial contracts, Medicare Advantage contracts, and commercial ACO products with other payers.HOT @HIMSS: Featured Decision Content: 

Premier Management Company manages accountable care organizations. Two of its ACOs are leveraging clinical, financial and operational health IT to meet key performance and quality measures under the Medicare Shared Savings Program and the Medicare Access and CHIP Reauthorization Act.

That's impressive, given that some of its physician practices were still using paper charts and had failed to meet meaningful use requirements

According to the company (not to be confused with the Premier healthcare alliance), the adoption of electronic health records by those practices is helping them manage information more efficiently, better monitor their patient populations and make more informed decisions for patient care. It's also helped streamline reporting for the 33 metrics they must report on as Medicare ACOs.

Despite early successes, in fact, CEO Anwar Kazi said there were areas it needed to improve upon.

"While the Premier ACOs had been successful in generating Medicare shared savings every year since 2014, in 2015, some of the Premier physicians did not meet the minimum threshold in performance when attesting for meaningful use because they were still using paper charts and had fallen out of attestation for not having an EHR," Kazi said.

Looking toward the requirements for MACRA, Premier knew that penalties for these doctors would grow if changes were not made.

Premier also struggled with too many lab vendors across its network, which was driving up costs and the ability for clinicians to receive data quickly. Additionally, the data frequency for Medicare claims patients from CMS claims to ACOs is every three months, which added to the challenges.

"We not only felt that this was too long to wait for the ACO physicians to take action on the information being provided, but when physicians did gather the data they needed, they'd have to capture it from a manual chart audit or study printouts of spreadsheets from old claims data and then try and aggregate the data sources to have a complete picture," Kazi explained. "We needed to manage information faster, to better monitor the patient population, and to make more informed decisions for patient care."

So Premier turned to a technology from Quest Diagnostics called Quest Quanum. Other IT and services vendors that work with ACOs include Aledade, Caravan Health, Conifer Health, Evolent, McKesson and Optum.

"Central to our goals was improving upon our quality scores," Kazi said. "We have 33 metrics to report as a Medicare ACO. The tools make that easier. In 2017, we implemented Quanum EHR, Practice Management, and Revenue Cycle Management systems, along with Quanum Interactive Insights, and an enhanced results data set to supplement claims information.

"Of the 12 physicians who had not been meeting meaningful use, because they were still using paper charts, nine already have shifted to the EHR," Kazi said. "One doctor in Highland Village, Texas, a member of the ACO, switched from paper to the EHR and she appreciates the fact that the lab results populate into the EHR – cutting down on staff time because instead of having to print out the labs and file them in paper charts for review, everything is already in the EHR."

For prescriptions and refills, there are no longer any callbacks from the pharmacy, Kazi added. And finally, since that practice has implemented RCM, its collection rate is much higher and it has fewer denials, Kazi said.

"Premier is looking forward to seeing what kind of savings it will achieve for the 2017 reporting year," Kazi said. "In the meantime, building on our continued success, we have plans to expand and grow beyond MSSP with new commercial contracts, Medicare Advantage contracts, and commercial ACO products with other payers."

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com

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Premier Management streamlines ACO reporting across 33 metrics
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Broadly acting antibodies found in plasma of Ebola survivors http://medclimate.com/external/index.php?https://www.nih.gov/news-events/news-releases/broadly-acting-antibodies-found-plasma-ebola-survivors http://medclimate.com/external/index.php?https://www.nih.gov/news-events/news-releases/broadly-acting-antibodies-found-plasma-ebola-survivors Tue, 17 Jul 2018 15:00:00 CDT NIH News Release NIAID-supported discovery could lead to therapy for deadly illness. ]]> Hospital groups vow to continue legal fight after losing challenge to 340B payment cuts http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/hospitals-health-systems/court-upholds-340b-payment-cuts-challenged-by-hospitals?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/hospitals-health-systems/court-upholds-340b-payment-cuts-challenged-by-hospitals?utm_source=internal&utm_medium=rss Tue, 17 Jul 2018 14:40:19 CDT Tina Reed at FierceHealthcare: Payer Groups including the American Hospital Association were part of an effort to fight 340B payment cuts pushed by the Trump administration. They said they plan to continue their legal challenge. Emergency physicians sue Anthem over ER policy change http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/anthem-acep-medical-association-georgia-er-policy-claims-denials?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/anthem-acep-medical-association-georgia-er-policy-claims-denials?utm_source=internal&utm_medium=rss Tue, 17 Jul 2018 14:34:32 CDT Evan Sweeney at FierceHealthcare: Payer ACEP and the Medical Association of Georgia are asking for a court to put an end to Anthem's new ER policy, which violates federal patient protection laws, according to a court filing. NIH and Prostate Cancer Foundation launch large study on aggressive prostate cancer in African-American men http://medclimate.com/external/index.php?https://www.nih.gov/news-events/news-releases/nih-prostate-cancer-foundation-launch-large-study-aggressive-prostate-cancer-african-american-men http://medclimate.com/external/index.php?https://www.nih.gov/news-events/news-releases/nih-prostate-cancer-foundation-launch-large-study-aggressive-prostate-cancer-african-american-men Tue, 17 Jul 2018 14:30:00 CDT NIH News Release Researchers will investigate environmental and genetic factors related to aggressiveness of prostate cancer in African-American men. ]]> Patient, provider groups urge CMS to reinstate risk adjustment payments http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/long-list-prominent-medical-organizations-urge-cms-to-reinstate-risk-adjustment-payments?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/long-list-prominent-medical-organizations-urge-cms-to-reinstate-risk-adjustment-payments?utm_source=internal&utm_medium=rss Tue, 17 Jul 2018 14:00:32 CDT Rose Meltzer at FierceHealthcare: Payer The AMA, AHA and the Federation of American Hospitals were among the 28 groups that say CMS' freeze on risk adjustment payments will cause premium hikes that prevent many people from obtaining coverage and limit access to medical care. House Democrats say GOP's ACA repeal efforts could scale back fraud prevention tools http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/house-democrats-take-aim-at-gop-anti-aca-efforts-hearing-about-medicare-fraud?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/house-democrats-take-aim-at-gop-anti-aca-efforts-hearing-about-medicare-fraud?utm_source=internal&utm_medium=rss Tue, 17 Jul 2018 12:24:46 CDT Rose Meltzer at FierceHealthcare: Payer Critical reporting and oversight provisions contained within the ACA would be lost if repeal efforts succeed, argued two Pacific Northwest representatives on the House Ways and Means Oversight Subcommittee. Continued push to value-based care the key to lower healthcare costs, experts tell legislators  http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/senate-help-committee-healthcare-costs-value-based-care?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/senate-help-committee-healthcare-costs-value-based-care?utm_source=internal&utm_medium=rss Tue, 17 Jul 2018 11:08:34 CDT Paige Minemyer at FierceHealthcare: Payer Policymakers looking to lower healthcare costs must continue to push the industry toward value-based models, experts told legislators at a hearing on Tuesday. In addition, healthcare providers with lower amounts of wasteful spending are targeting the social determinants of health and patients with complex needs, they said. LabCorp goes down after network breach, putting millions of patient records at risk http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/labcorp-goes-down-after-network-breach-putting-millions-patient-records-risk http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/labcorp-goes-down-after-network-breach-putting-millions-patient-records-risk Tue, 17 Jul 2018 10:52:48 CDT at Most Popular News from healthcareitnews.com Hackers breached one of the largest clinical laboratories over the weekend, forcing a shutdown of the network to contain the cyberattack. CareZone sues Express Scripts for defamation following contract fight http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/express-scripts-carezone-lawsuit-defamation-contract-pbm-pharmacies?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/express-scripts-carezone-lawsuit-defamation-contract-pbm-pharmacies?utm_source=internal&utm_medium=rss Mon, 16 Jul 2018 19:42:53 CDT Evan Sweeney at FierceHealthcare: Payer A mounting battle between Express Scripts and online pharmacy CareZone just got a little more heated. Weeks after CareZone accused Express Scripts of anticompetitive practices, the company claims the PBM made defamatory statements that affected the company's profits. ONC opens innovation contest for Certified Health IT Product List data http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/onc-opens-innovation-contest-certified-health-it-product-list-data http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/onc-opens-innovation-contest-certified-health-it-product-list-data Mon, 16 Jul 2018 14:56:12 CDT walmeida at Healthcare IT News - Government & Policy The Certified Health IT Product List Data Challenge, launched this past week by the Office of the National Coordinator for Health IT, is offering big money for new ideas about how its voluminous and detailed specs can better serve hospitals and health systems. The CHPL is ONC’s list of every technology product that has been tested and certified under the office’s Health IT Certification Program. It's a large and granular trove of data. With 300-plus listings for active 2015 Edition certified IT products, it comprises information detailing all the criteria to which those products have has been certified, has expansive usability testing results and lists of any nonconformities – such as ONC surveillance activities for specific technologies and any corrective action plans performed by the vendors. "In the past, much of the testing and certification data was unstructured, making an analysis of that data difficult," said Steven Posnack, director of ONC's Office of Standards and Technology, in a blog post co-authored with colleagues. "In 2016, to allow CHPL users to have better access to the data, ONC updated the CHPL with structured data and discrete formats. For users who want greater access to the data, the CHPL has a set of application programming interfaces and downloadable XML files containing the complete data available." Now ONC says it wants to find new ways to make that structured data work for IT decision-makers at hospitals and practices. The new CHPL Data Challenge is calling on developers and data experts to submit new approaches to helping providers access and examining all that data.  A total of $40,000 in prizes will be available to those who can develop new apps to make use of the data and are able to perform a live demo for ONC. Submissions are due Oct. 31, and there will be more details discussed during an Aug. 1 webinar. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Primary Topic: AnalyticsAdditional Topics: AnalyticsDataDataData ManagementPolicyPolicySpecific Terms: Data WarehousingCustom Tags: AnalyticsData WarehousingDisable Auto Tagging: Short Headline: ONC opens innovation contest for Certified Health IT Product List dataNewsletter hed: ONC opens innovation contest for Certified Health IT Product List dataNewsletter teaser: The agency's new challenge is seeking ways to help hospital decision-makers access and make use of the information contained in the CHPL.HOT @HIMSS: Featured Decision Content: 

The Certified Health IT Product List Data Challenge, launched this past week by the Office of the National Coordinator for Health IT, is offering big money for new ideas about how its voluminous and detailed specs can better serve hospitals and health systems.

The CHPL is ONC’s list of every technology product that has been tested and certified under the office’s Health IT Certification Program.

It's a large and granular trove of data. With 300-plus listings for active 2015 Edition certified IT products, it comprises information detailing all the criteria to which those products have has been certified, has expansive usability testing results and lists of any nonconformities – such as ONC surveillance activities for specific technologies and any corrective action plans performed by the vendors.

"In the past, much of the testing and certification data was unstructured, making an analysis of that data difficult," said Steven Posnack, director of ONC's Office of Standards and Technology, in a blog post co-authored with colleagues. "In 2016, to allow CHPL users to have better access to the data, ONC updated the CHPL with structured data and discrete formats. For users who want greater access to the data, the CHPL has a set of application programming interfaces and downloadable XML files containing the complete data available."

Now ONC says it wants to find new ways to make that structured data work for IT decision-makers at hospitals and practices.

The new CHPL Data Challenge is calling on developers and data experts to submit new approaches to helping providers access and examining all that data. 

A total of $40,000 in prizes will be available to those who can develop new apps to make use of the data and are able to perform a live demo for ONC. Submissions are due Oct. 31, and there will be more details discussed during an Aug. 1 webinar.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

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ONC opens innovation contest for Certified Health IT Product List data
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ONC opens innovation contest for Certified Health IT Product List data
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The agency's new challenge is seeking ways to help hospital decision-makers access and make use of the information contained in the CHPL.
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Payer Roundup—Cigna, Express Scripts schedule merger vote; physician groups back risk adjustment payments http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/payer-roundup-cigna-and-express-scripts-announce-merger-vote-physician-orgs-tell-cms-to?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/payer-roundup-cigna-and-express-scripts-announce-merger-vote-physician-orgs-tell-cms-to?utm_source=internal&utm_medium=rss Mon, 16 Jul 2018 14:50:27 CDT Rose Meltzer at FierceHealthcare: Payer Shareholders of Cigna and Express Scripts will vote on the proposed merger in August that the companies say will create “a blueprint for integrated and personalized healthcare." Meanwhile, six major physician organizations call for the risk adjustment freeze to be reversed and Colorado insurers request smaller premium hikes. Industry groups weigh in on HHS' drug price blueprint http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/american-patients-first-drug-prices-aha-phrma-340b-health-pcma-coa?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/regulatory/american-patients-first-drug-prices-aha-phrma-340b-health-pcma-coa?utm_source=internal&utm_medium=rss Mon, 16 Jul 2018 14:50:16 CDT Paige Minemyer at FierceHealthcare: Payer As the Trump administration takes aim at rising drug costs, organizations from across the healthcare industry are weighing in on proposals from its blueprint to address the issue. Fruit fly mating driven by a tweak in specific brain circuit http://medclimate.com/external/index.php?https://www.nih.gov/news-events/news-releases/fruit-fly-mating-driven-tweak-specific-brain-circuit http://medclimate.com/external/index.php?https://www.nih.gov/news-events/news-releases/fruit-fly-mating-driven-tweak-specific-brain-circuit Mon, 16 Jul 2018 14:00:00 CDT NIH News Release NIH-funded study suggests that slight changes in a brain’s wiring can greatly change behavior. ]]> Opioid epidemic: UNC Health Care to integrate Epic EHR with state's PDMP http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/opioid-epidemic-unc-health-care-integrate-epic-ehr-states-pdmp http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/opioid-epidemic-unc-health-care-integrate-epic-ehr-states-pdmp Mon, 16 Jul 2018 13:44:13 CDT walmeida at Healthcare IT News - Government & Policy The University of North Carolina Health Care at Chapel Hill announced plans to integrate its Epic EHR with the state’s controlled substance reporting system.  UNC, in so doing, joins the growing ranks for providers aligning with Prescription Drug Monitoring Program efforts to fight back against the opioid epidemic. Indiana, for instance, said in 2017 it would integrate electronic health records software with its Inspect platform to better track prescribing of controlled substances statewide.  In January 2018, Nebraska became the first state to require all drugs to be reported to its PDMP and, in that same month, Ochsner Health System, in New Orleans, integrated opioid monitoring within its Epic EHR. PDMPs are among the tactics hospital leaders, technology vendors, as well as state and federal policymakers are taking to address the growing opioid epidemic.  UNC Health Care’s CIO Tracy Parham said the integration will enable clinicians to access the controlled substance database when ordering medications.  What had been a 13-step process is now three steps for providers to confirm prior controlled substance prescriptions. “Before, they had to jump between two systems – taking three minutes per patient report,” she said in a statement. “Now the process takes seconds to retrieve the patient-specific report directly within Epic.” The functionality provides clinical information necessary, such as the drugs prescribed, number of prescribers, and different pharmacies a patient has used, to help ensure that opioids and other controlled substances are not prescribed inappropriately.   "One of the contributing factors to the opioid crisis is a lack of quick and easily accessible information regarding the controlled substances patients have filled in our state as well as surrounding states," added Vinay Reddy, MD, a UNC Health Care family medicine physician. “Access on the same screen where we order medications removes the previous barriers to accessing the controlled substance database at the point of care.” In the first two weeks, more than 540 UNC clinicians used the PDMP when treating some 2,950 patients, which officials said has saved physicians about 119 hours already. Opioid Crisis: Tech fights epidemic Learn how tech is being used to battle abuse. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Primary Topic: PolicyAdditional Topics: PolicyDisable Auto Tagging: Short Headline: UNC Health Care to integrate EHR with state's PDMPNewsletter hed: Opioid epidemic: UNC Health Care to integrate Epic EHR with state's PDMPNewsletter teaser: UNC Health says the move will help tackle the opioid problem and save clinicians time.HOT @HIMSS: Featured Decision Content: 

The University of North Carolina Health Care at Chapel Hill announced plans to integrate its Epic EHR with the state’s controlled substance reporting system. 

UNC, in so doing, joins the growing ranks for providers aligning with Prescription Drug Monitoring Program efforts to fight back against the opioid epidemic. Indiana, for instance, said in 2017 it would integrate electronic health records software with its Inspect platform to better track prescribing of controlled substances statewide. 

In January 2018, Nebraska became the first state to require all drugs to be reported to its PDMP and, in that same month, Ochsner Health System, in New Orleans, integrated opioid monitoring within its Epic EHR.

PDMPs are among the tactics hospital leaders, technology vendors, as well as state and federal policymakers are taking to address the growing opioid epidemic. 

UNC Health Care’s CIO Tracy Parham said the integration will enable clinicians to access the controlled substance database when ordering medications. 

What had been a 13-step process is now three steps for providers to confirm prior controlled substance prescriptions.

“Before, they had to jump between two systems – taking three minutes per patient report,” she said in a statement. “Now the process takes seconds to retrieve the patient-specific report directly within Epic.”

The functionality provides clinical information necessary, such as the drugs prescribed, number of prescribers, and different pharmacies a patient has used, to help ensure that opioids and other controlled substances are not prescribed inappropriately.  

"One of the contributing factors to the opioid crisis is a lack of quick and easily accessible information regarding the controlled substances patients have filled in our state as well as surrounding states," added Vinay Reddy, MD, a UNC Health Care family medicine physician. “Access on the same screen where we order medications removes the previous barriers to accessing the controlled substance database at the point of care.”

In the first two weeks, more than 540 UNC clinicians used the PDMP when treating some 2,950 patients, which officials said has saved physicians about 119 hours already.

Opioid Crisis: Tech fights epidemic

Learn how tech is being used to battle abuse.

Twitter: @Bernie_HITN
Email the writer: bernie.monegain@himssmedia.com

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UNC Health Care to integrate EHR with state's PDMP
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Opioid epidemic: UNC Health Care to integrate Epic EHR with state's PDMP
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UNC Health says the move will help tackle the opioid problem and save clinicians time.
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]]>
CMS physician payment proposal nudges open the door for telehealth http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/tech/telehealth-cms-physican-payment-proposal-virtual-check-reimbursement?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/tech/telehealth-cms-physican-payment-proposal-virtual-check-reimbursement?utm_source=internal&utm_medium=rss Mon, 16 Jul 2018 12:58:08 CDT Evan Sweeney at FierceHealthcare: Payer Telehealth played a leading role in last week's 1,473-page proposed rule from CMS that included several new virtual care reimbursement methodologies. Jennifer Breuer, a partner with Drinker Biddle, said the proposed rule is a “game-changer” if it's finalized in its current form. Seeking clarity on racial disparities, Democrats ask insurers about maternal health coverage http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/seeking-clarity-racial-disparities-members-congress-ask-insurers-about-maternal-health?utm_source=internal&utm_medium=rss http://medclimate.com/external/index.php?http://www.fiercehealthcare.com/payer/seeking-clarity-racial-disparities-members-congress-ask-insurers-about-maternal-health?utm_source=internal&utm_medium=rss Mon, 16 Jul 2018 10:16:24 CDT Rose Meltzer at FierceHealthcare: Payer More than 30 members of Congress signed letters to 15 major health insurers asking if and how their plans are working to reduce racial disparities in maternal mortality. Social determinants of health gain traction as UnitedHealthcare and Intermountain build new programs http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/social-determinants-health-gain-traction-unitedhealthcare-and-intermountain-build-new-programs http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/social-determinants-health-gain-traction-unitedhealthcare-and-intermountain-build-new-programs Fri, 13 Jul 2018 13:35:33 CDT at Most Popular News from healthcareitnews.com Organizations are each expanding services to address non-medical factors that can have a significant impact on individual and population health. Experts weigh in on CMS' big changes to clinical documentation, EHRs and interoperability http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/experts-weigh-cms-big-changes-clinical-documentation-ehrs-and-interoperability http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/experts-weigh-cms-big-changes-clinical-documentation-ehrs-and-interoperability Fri, 13 Jul 2018 10:57:26 CDT walmeida at Healthcare IT News - Government & Policy The "historic changes" announced late yesterday by the Centers for Medicare & Medicaid Services, promising big adjustments to its policies around the Physician Fee Schedule and the Quality Payment Program, already have the healthcare industry talking. CMS says it wants to incentivize the use of and access to virtual care and telehealth, to ease the quality reporting burden on physicians by focusing on the most important and impactful measures. It also wants to spur better information sharing among healthcare providers, regardless of what electronic health record vendor they happen to use. Part of the way it plans to do this: making changes to the MIPS "Promoting Interoperability" performance category to better encourage interoperability and patient access, and aligning it with a similar program for hospitals. "CMS notes that these proposals will modernize Medicare payment policies to promote access to virtual care, saving Medicare beneficiaries time and money while improving their access to high-quality services no matter where they live," HIMSS said.  Soon after the announcement on Thursday, the Office of the National Coordinator for Health IT immediately put its support behind the CMS proposed rule, with ONC chief Don Rucker, MD, noting that Physician Fee Schedule changes would be a "historic shift in the documentation requirements associated with clinician office-based evaluation and management visits for Medicare," helping reduce administrative burdens and allowing physicians to spend more time with their patients." Rucker also said the new rules would encourage "more efficient, effective use of electronic health records in clinicians’ offices, improving the workflows needed to support patient-centered care instead of a focus on meeting billing documentation requirements." And he said the new proposal would "help shift the nation’s electronic documentation away from overly long, form-driven, hard-to-read documents written primarily to satisfy billing requirements to what it was originally intended for – providing high- quality care to patients." Premier, MGMA, AMGA weigh in Other industry groups also liked that the new rules would help ease physician busywork. Premier, for instance, praised CMS' efforts to "alleviate unproductive clinician burden," especially a streamlining of the Medicare Shared Savings Program reporting measures to "focus more on patient outcomes and satisfaction." The provisions for EHRs and data exchange were also a hit with Premier, said Senior Vice President of Public Affairs Blair Childs. As a longtime advocate for interoperability standards, Premier "strongly support proposals that support electronic health record interoperability and patient access to health information, as well as alignment with other interoperability requirements for hospitals," he said. "With this provision, we will take another step forward in our efforts to unlock healthcare data, optimize HIT investments and improve the quality of care across settings." But other organizations weren't so bullish on the new proposals. The Medical Group Management Association, for instance, said it was "disappointed" that CMS would continue with full-year MIPS quality reporting, rather than the 90-days reporting that had been asked for by many. "Reducing the reporting burden would allow more physicians to participate in MIPS and focus the program on rewarding quality care rather than quality reporting," said Anders Gilberg, MGMA's senior vice president of government affairs. "Requiring medical groups to submit excessive amounts of data to the government has little impact on the quality of care delivered to Medicare beneficiaries." Moreover, he took issue with the fact that the rules would require physicians to "deploy costly EHR upgrades for 2019 and takes further steps toward implementing burdensome appropriate use criteria. At first glance, the rule doesn’t meet MGMA’s definition of administrative simplification." Meanwhile, the American Medical Group Association said it too was disappointed by the proposed rules' high MIPS exclusion threshold and called them a "missed opportunity" to encourage value-based reimbursement. "AMGA members will continue to work to provide superior quality care to their patients," said Jerry Penso, MD, president and CEO of AMGA. "We are concerned that CMS has again opted not to recognize the efforts of high-performing AMGA members. As we enter the program’s third year, it is time for CMS to honor congressional intent and use MIPS to create value for Medicare." Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Primary Topic: Electronic Health RecordsAdditional Topics: TechnologyEHRPolicyInteroperabilityTechnologyQuality & SafetyTechnologyTelehealthTechnologyPolicySpecific Terms: Electronic Health RecordsCustom Tags: Electronic Health RecordsInteroperabilityQuality & SafetyTelehealthDisable Auto Tagging: Short Headline: Experts weigh in on CMS' big changesNewsletter hed: Experts weigh in on CMS' big changes to clinical documentation, EHRs and interoperabilityNewsletter teaser: Industry groups like easier quality reporting and advance applications of telehealth, but some say docs shouldn't have to make expensive EHR upgrades for 2019.HOT @HIMSS: Featured Decision Content: 

The "historic changes" announced late yesterday by the Centers for Medicare & Medicaid Services, promising big adjustments to its policies around the Physician Fee Schedule and the Quality Payment Program, already have the healthcare industry talking.

CMS says it wants to incentivize the use of and access to virtual care and telehealth, to ease the quality reporting burden on physicians by focusing on the most important and impactful measures.

It also wants to spur better information sharing among healthcare providers, regardless of what electronic health record vendor they happen to use.

Part of the way it plans to do this: making changes to the MIPS "Promoting Interoperability" performance category to better encourage interoperability and patient access, and aligning it with a similar program for hospitals.

"CMS notes that these proposals will modernize Medicare payment policies to promote access to virtual care, saving Medicare beneficiaries time and money while improving their access to high-quality services no matter where they live," HIMSS said. 

Soon after the announcement on Thursday, the Office of the National Coordinator for Health IT immediately put its support behind the CMS proposed rule, with ONC chief Don Rucker, MD, noting that Physician Fee Schedule changes would be a "historic shift in the documentation requirements associated with clinician office-based evaluation and management visits for Medicare," helping reduce administrative burdens and allowing physicians to spend more time with their patients."

Rucker also said the new rules would encourage "more efficient, effective use of electronic health records in clinicians’ offices, improving the workflows needed to support patient-centered care instead of a focus on meeting billing documentation requirements."

And he said the new proposal would "help shift the nation’s electronic documentation away from overly long, form-driven, hard-to-read documents written primarily to satisfy billing requirements to what it was originally intended for – providing high- quality care to patients."

Premier, MGMA, AMGA weigh in

Other industry groups also liked that the new rules would help ease physician busywork. Premier, for instance, praised CMS' efforts to "alleviate unproductive clinician burden," especially a streamlining of the Medicare Shared Savings Program reporting measures to "focus more on patient outcomes and satisfaction."

The provisions for EHRs and data exchange were also a hit with Premier, said Senior Vice President of Public Affairs Blair Childs.

As a longtime advocate for interoperability standards, Premier "strongly support proposals that support electronic health record interoperability and patient access to health information, as well as alignment with other interoperability requirements for hospitals," he said. "With this provision, we will take another step forward in our efforts to unlock healthcare data, optimize HIT investments and improve the quality of care across settings."

But other organizations weren't so bullish on the new proposals. The Medical Group Management Association, for instance, said it was "disappointed" that CMS would continue with full-year MIPS quality reporting, rather than the 90-days reporting that had been asked for by many.

"Reducing the reporting burden would allow more physicians to participate in MIPS and focus the program on rewarding quality care rather than quality reporting," said Anders Gilberg, MGMA's senior vice president of government affairs. "Requiring medical groups to submit excessive amounts of data to the government has little impact on the quality of care delivered to Medicare beneficiaries."

Moreover, he took issue with the fact that the rules would require physicians to "deploy costly EHR upgrades for 2019 and takes further steps toward implementing burdensome appropriate use criteria. At first glance, the rule doesn’t meet MGMA’s definition of administrative simplification."

Meanwhile, the American Medical Group Association said it too was disappointed by the proposed rules' high MIPS exclusion threshold and called them a "missed opportunity" to encourage value-based reimbursement.

"AMGA members will continue to work to provide superior quality care to their patients," said Jerry Penso, MD, president and CEO of AMGA. "We are concerned that CMS has again opted not to recognize the efforts of high-performing AMGA members. As we enter the program’s third year, it is time for CMS to honor congressional intent and use MIPS to create value for Medicare."

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

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Experts weigh in on CMS' big changes
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Experts weigh in on CMS' big changes to clinical documentation, EHRs and interoperability
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Industry groups like easier quality reporting and advance applications of telehealth, but some say docs shouldn't have to make expensive EHR upgrades for 2019.
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]]>
Experts weigh in on CMS' big changes to clinical documentation, EHRs and interoperability http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/experts-weigh-cms-big-changes-clinical-documentation-ehrs-and-interoperability http://medclimate.com/external/index.php?https://www.healthcareitnews.com/news/experts-weigh-cms-big-changes-clinical-documentation-ehrs-and-interoperability Fri, 13 Jul 2018 10:57:26 CDT at Most Popular News from healthcareitnews.com Industry groups like easier quality reporting and advance applications of telehealth, but some say docs shouldn't have to make expensive EHR upgrades for 2019.