KROGER HEALTH PRESIDENT TALKS ‘FOOD AS MEDICINE,’ PRESCRIPTION DRUG PRICES

https://www.healthleadersmedia.com/finance/kroger-health-president-talks-food-medicine-prescription-drug-prices

Colleen Lindholz, president of Kroger Health, spoke about the grocery store’s plans to expand further into healthcare.


KEY TAKEAWAYS

Kroger is look to assist customers who have issues with the accessibility and affordability of prescription drugs.

To that end, the Cincinnati-based grocery store giant launched a pharmacy savings club in partnership with GoodRx last December.

Lindholz also impressed the need to incorporate ‘food as medicine’ into the company’s healthcare plans.

Cincinnati-based grocery and retail giant Kroger Co. has ambitions to continue its healthcare expansion mission, according to Colleen Lindholz, president of Kroger Health.

Kroger is one of the largest grocery stores and retail companies in the country, with about 2,300 pharmacies and 221 retail clinics, offering it a sizable footprint to compete in healthcare. Lindholz has been with the company for more than two decades and has helped craft its business strategy focused on health and wellness.

“Our vision is to help people live healthier lives, and our mission statement states that we’re going to simplify healthcare by creating solutions that combine health, wellness, and nutrition to connect with people on a personal level,” Lindholz told HealthLeaders.

From Lindholz’s perspective, there are several opportunities for Kroger to grow in healthcare, most notably through improving prescription drug delivery in a way that benefits consumers and focuses on promoting ‘food as medicine.’ However, she also spoke to the lingering challenges Kroger faces, including industry consolidation, difficult negotiations with pharmacy benefit managers (PBM), and rising direct and indirect remuneration (DIR) fees.

Below are some takeaways from Lindholz on what lies ahead for Kroger in the healthcare sphere.

MANEUVERING PBMS AND DIR FEES

Lindholz said that Kroger, like other healthcare players, is subject to the pressures produced by widespread vertical integration and consolidation. Kroger’s strategy to drive prescriptions into its stores has been affected by the fact that it contracts with multiple PBMs, the major ones being owned by large health plans.

“We’re seeing a lot of pressure as far as reimbursements are concerned and DIR fees, which are escalating out of control,” Lindholz said. “I know there’s some activity going on in Washington right now with a call for DIR reform and where should most of the cost reduction be.”

Lindholz added that Kroger remains a supporter of the concept of DIR fees, citing the purpose for their initial creation as a way to provide a higher quality of care for patients.

“However, we are getting hit with DIR fees that are 300% ahead of where we were in 2016,” Lindholz said.

PBMs also compound the problem for Kroger, according to Lindholz, since they act as a negotiator with the drugmakers but ultimately set the standards for how rebates are passed through to pharmacies.

“The way that they measure us and the way that we compete to get those rebates back, where 2,300 pharmacies are compared to an independent that has five pharmacies, is crazy,” Lindholz said. “I think the way that they’re measuring it is all for their gain, not necessarily for the patient’s gain. We want the lowest cost to be at the point of sale where the patient actually is.”

‘FOOD AS MEDICINE’

A key component to addressing chronic disease is addressing what people eat, Lindholz said. Kroger introduced its free “OptUp” app in an attempt to correct some of the root problems that contribute to chronic disease.

In 2017, Kroger conducted a study to analyze A1Cs, the average blood sugar over 90 days, and blood pressure in diabetic employees and leverage nutritional science to assist them in making food purchasing decisions.

Kroger was so encouraged by the results of the study that it had nutrition and technology experts at the company design an app driven by the Kroger loyalty card  as a way to “simplify Kroger customers’ ability to shop for healthier foods.”

“The results were so statistically significant that we decided to bring the app to the market because we believe that over time it can sustain behavior change,” Lindholz said. “What we’re trying to do is be in the prevention space, specifically around diabetes, where we’re helping our diabetics make those food choices that they critically need in order to keep from progressing with their disease and going from two oral medications onto insulin.”

A spokesperson from Kroger said the company will soon be rolling out an update to the app to allow customers the ability to shop for healthier foods, even if they do not shop at Kroger.

Lindholz also commented that healthcare is a fragmented industry, citing the lack of communication between different electronic medical records (EMR) systems.

Lindholz said the company sought to create a solution to foster a better line of communication with systems that run on Epic and Cerner.

“We’re building a platform that we’re going to be able to see across all of our pharmacies and will connect with the top 17 EMRs in the country,” Lindholz said. “It’s important in our quest to go after the triple aim and to decrease some of this fragmentation while closing gaps in care.”

“One of the unique pieces of that new platform is that it will be the first time that anyone’s ever included a food score. We’re going to test in Cincinnati with a cardiologist and an endocrinologist around getting to look at how customers eat, if we can help change their behavior, and will their overall outcomes be better over time?”

TACKLING PRESCRIPTION DRUG PRICES

Given Lindholz’s background as a pharmacist, it should come as no surprise that one of her major initiatives at Kroger is improving the availability and affordability of prescription drugs for customers. To that end, Lindholz noted that Kroger currently has three central prescription fill facilities around the country that fill prescriptions overnight so Kroger can have the lowest cost to fill.

“This allows us to spend more time with the patients that are in the store and deliver the highest quality of care that we can at the lowest cost,” Lindholz said. “We’re doing a lot more one-on-one counseling with customers, both at the counter and also through a center of excellence that we have. We’re up 320% in clinical interventions versus a year ago and that is due to us putting a system in place that queued up pharmacists at the time either when they’re with patients at the store or through our call center.”

Kroger also launched a pharmacy savings club in partnership with GoodRx last December to assist customers dealing with high prices and limited access to prescription drugs.

“What that club does is it brings transparency and pricing directly to the customer. It costs $36 for an individual, $72 for a family, and we are delivering a significant amount of savings to the consumer,” Lindholz said. “What we’re doing with the savings club is cutting out the middleman. We’re taking all the rebates that we would get from the manufacturers and passing them directly down to our customers, which is saving them a whole lot of money.”

 

 

 

Cerner, Epic’s analytics tools prove most popular in clinical surveillance market

https://www.beckershospitalreview.com/healthcare-information-technology/cerner-epic-s-analytics-tools-prove-most-popular-in-clinical-surveillance-market.html?origin=cioe&utm_source=cioe

Image result for Cerner, Epic's analytics tools prove most popular in clinical surveillance market

 

Cerner and Epic offer the most frequently adopted clinical surveillance tools in the provider market, according to a KLAS Research report.

KLAS interviewed providers about their experiences with vendors offering popular clinical surveillance tools for its report. These tools review information from data sources such as EMRs to alert clinicians about a range of patient care activities that decrease readmissions and mortality. The most common use case for clinical surveillance tools today is sepsis detection, according to KLAS.

Cerner and Epic were the only vendors KLAS validated as having “extensive adoption” for their clinical surveillance tools. Of the 17 Cerner customers surveyed, most were using the vendor’s clinical surveillance for sepsis detection. The 18 Epic customers KLAS surveyed tended to use the vendor’s functionalities for sepsis detection, orders checking and floorwide alerts, among a few other less-common use cases.

KLAS noted that although Cerner and Epic were the most widely adopted clinical surveillance vendors, customers of these two vendors tended to be “less satisfied than customers of the other charted vendors in this report,” which included companies like Bernoulli and Stanson Health.

Cerner customers told KLAS they felt the system needed to better integrate with physician workflows and lacked customization options. Epic customers said that the vendor’s alerts were difficult to set up, but were pleased with its ease of use after implementation. KLAS noted Epic does not have a dedicated clinical surveillance modality, but customers have adapted its EMR to provide similar features.

 

Optum360, WayStar Named Top Revenue Cycle Management Vendors

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Revenue cycle management vendors

 

Health systems preferred Optum360 for end-to-end healthcare revenue cycle management software and outsourcing, while physician practices favored Waystar.

 – The eighth annual revenue cycle management technology and outsourcing solutions survey from Black Book recently uncovered the top client-rated healthcare revenue cycle management vendors for health systems, hospitals, and physician practices.

The market research company polled nearly 4,500 hospital and health system CFOs, VPs of Finance and Revenue Cycle Management (RCM), Controllers, Business Officer Managers, and other financial staff. Another 3,660 physician office business managers and 941 staff from outpatient, alternative care, clinics, IDN physician practices, and ancillary facilities also participated in the 2018 ratings.

The survey showed that providers are investing in healthcare revenue cycle management solutions as health system margins shrink to less than three percent nationwide and providers in all settings transition away from fee-for-service.

“The latest wave of challenges accompanying the shift to value-based care find most providers navigating through empowering virtual health, initiating highly patient positive experiences and sinking margins,” stated Black Book’s Managing Partner Doug Brown. Revenue cycle management is now the most pressing strategic focus in health systems nationwide with system transformation vendors, solutions optimization consultants and RCM outsourcing firms in huge demand.”

Based on 18 indicators of client experience, loyalty, and customer satisfaction, the survey revealed the top-rated RCM solutions for various parts across the entire healthcare revenue cycle.

In terms of end-to-end revenue cycle management software, health systems and large hospital chains preferred Optum360, followed by Waystar, Change Healthcare, Recondo, and Conifer.

Health systems named Optum360 as their top end-to-end revenue cycle management software solution for the second year in a row.

Waystar and Optum360 also took top spots for hospitals with 101 to 200 beds, while small hospitals favored the RCM software from Trubridge and large hospitals ranked Change Healthcare as number one.

Physician practices and groups rated Waystar as their top RCM software vendor, followed by Change Healthcare, Allscripts, Cerner RevWorks, and athenaCollect.

Optum360 was also the highest ranked revenue cycle management outsourcing solution for health systems and large hospital chains shifting their financial and business functions outside of their organizations.

However, top revenue cycle outsourcing solutions was a mixed bag for standalone hospitals and physician practices.

Small hospitals identified Trubridge as their top outsourcing solution, while medium-sized hospitals preferred Gebbs and large hospitals liked Cognizant Trizetto.

R1 RCM was the highest rated end-to-end RCM outsourcing solution among physician practices and groups.

Additionally, the survey found the highest ranked vendors for other parts of the healthcare revenue cycle, including patient payments, provider contract management, and claims and denials management. Notable rankings included:

  • Patient payment solutions: InstaMed
  • Complex claims solutions: Cognizant Bolder
  • Patient access solutions: Recondo Technology
  • Hospital claims and denials management: Experian Health
  • Physician claims clearinghouse: Cognizant Trizetto
  • Patient payment analytics: RevSpring
  • Provider contract management systems: nThrive
  • Revenue recovery solutions: Revint Solutions
  • RCM optimization consultants: Hayes Management Consulting
  • RCM business intelligence and decision support: Dimension Insight

Provider organizations of all sizes are seeking healthcare revenue cycle management solutions to optimize all parts of their financial and business processes.

Revenue cycle management optimization was a top priority for hospitals, according to a September 2017 Black Book survey. Almost three-quarters of struggling hospitals prioritized revenue cycle management over other initiatives key to the value-based reimbursement transition, including population health, data analytics, and patient engagement.

The hospital and physician practice leaders surveyed said they planned to allocate 2018 capital resources for revenue cycle management upgrades, including dashboards, data analytics, and business intelligence solutions.

Revenue cycle management optimization investments are likely to continue well into the near future as provider organizations face more competition, greater patient financial responsibility, and a shifting healthcare environment.

“Healthcare providers will have no choice but to evaluate and optimize their solutions end-to-end in a future state that leverages analytics and enhanced connectivity with payers, all keeping pace with the advances in healthcare technology,” Black Book’s Brown stated in 2017.

 

Softer bookings dampen Cerner’s Q3 growth

https://www.healthcaredive.com/news/softer-bookings-dampen-cerners-q3-growth/540694/

Dive Brief:

  • Cerner’s new bookings fell short of expectations in the third quarter of 2018, leading to lower than expected revenue for the period. While sales of licensed software grew 43% from a year ago to $1.59 billion, the EHR vendor didn’t match the second quarter’s $1.78 billion.  
  • Third quarter revenue totaled $1.34 billion, up 5% from the same period the prior year.
  • The earnings report comes as Cerner is under fire again for its performance on a Department of Defense contract. According to Politico, independent investigators for the Pentagon gave the company poor marks on its MHS Genesis EHR implementation, calling the system “not effective and not suitable” and “not interoperable.” The low assessment echoes an April DOD report.

Dive Insight:

Cerner attributed the lower-than-expected software bookings to timing and pointed to a strong pipeline of potential business hookups. Technology resales were also somewhat off in the third quarter.

“There isn’t anything that’s forcing clients to go get deals done,” Cerner CFO Marc Naughton said during a Thursday earnings call. “The market is still active. We just didn’t get much of it in Q3.”

Cerner also said it is not yet seeing the full impact of government contracts. Nonetheless, officials called it a strong quarter with solid results.

“We continue to have good contributions from our key growth areas” of population health, revenue cycle management and health IT outsourcing, said Chief Client Officer John Peterzalek, who replaces departing President Zane Burke starting next week.

“As we look at our portfolio and our investment plans, there’s some transformation of our own that we need to do to make sure we’re positioned well for the opportunities in front of us,” said Cerner Chairman and CEO Brent Shafer. “Part of that work is creating an operating model that is really designed to support innovation at scale. We are at scale now and want to continue to scale.”

Meanwhile, Cerner faces fresh competition from commercial health giant UnitedHealth, which is expanding into EHRs with a fully integrated system in 2019. During a recent earnings call, UnitedHealth CEO David Wichmann said the company will launch a “fully individualized, fully portable” EHR early next year leveraged off its Rally mobile wellness platform.

 

 

Top Ambulatory EHR Systems by Hospital Implementation

https://www.definitivehc.com/news/top-ambulatory-ehr-systems?source=newsltr-blog&utm_source=newsletter&utm_medium=email&utm_campaign=12-12-17

ambulatory ehr vendors market share

 

EHR system implementation has been on the rise over the past 10 years. This is, at least in part, attributed to the Centers for Medicare and Medicaid Services (CMS) Meaningful Use initiative that began in 2011. Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, eligible providers who demonstrated meaningful use of Electronic Health Record (EHR) technology received incentive payments. The intent was to encourage healthcare providers to utilize electronic data recording and sharing technology to improve clinical quality and care transparency.

More than 92 percent of hospitals in the U.S. use an EHR system, according to Definitive Healthcare data. The implementation rate is even higher among acute care hospitals, with over 95 percent of long- and short-term facilities using EHR systems. Vendors Epic and Cerner dominate the EHR market, holding a combined 52 percent market share. There are two varieties of EHR systems: inpatient and ambulatory. Inpatient EHR is designed for use on patients staying at a facility for at least one night and is therefore primarily used by hospitals. Ambulatory EHR is designed for outpatient facilities and small physician practices, where patient visits do not include an overnight stay.

Top 5 Ambulatory EHR System Vendors

  1. Epic
  2. Cerner
  3. Meditech
  4. CPSI (Evident and Healthland)
  5. Medhost

An EHR is the digital version of a patient’s medical history. Generally, a patient’s EHR includes demographic information, diagnosis history, prescription data, laboratory results, vital signs, immunizations, progress notes, and more. Digital records allow providers to quickly and easily share patient data with providers in other facilities, regardless of whether the facility is in-network. Electronic record sharing can improve patient care and experience by allowing providers anywhere to access and understand an individual’s medical history. This is particularly useful in cases where a patient may be unconscious or unable to communicate upon arrival to a facility, when a patient is visiting a facility out-of-state, or if a patient visits a retail clinic or freestanding urgent care clinic.

 

Most Significant Epic, Cerner Health IT Achievements of 2017

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Epic EHR, Cerner EHR

 

Epic and Cerner continue to dominate the healthcare industry and this year the two health IT companies have made key additions to their portfolios.

Epic Systems and Cerner Corporation solidified their status as top dogs in the health IT industry in 2017.

Both health IT companies scored massive contracts this year, with Epic continuing to gain popularity among the private sector and Cerner expanding its presence in the public sphere.

Cerner and Epic have also found success expanding their health IT offerings into other areas of care management, including population health and revenue cycle management. The companies have proven their ability to stay ahead of the curve by continuing to add more products and technologies to their arsenal in keeping with developments in the industry.

Over midway through 2017, here are a few of the most significant achievements of the year by the biggest players in health IT:

Cerner, Epic, McKesson Among Top 5 Global Health IT Vendors

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EHR Vendors

IDC ranks Cerner, Epic, and McKesson Technology Solutions among the top 5 largest health IT vendors to healthcare payers and provider institutions.

The winners of the IDC Health Insights 2017 HealthTech Rankings released this week named Cerner, McKesson, and Epic Systems among the leading global health IT suppliers.

IDC Health Insights supplied the rankings indicating new benchmarks for health IT hardware, software, and services vendors.

Among the top five largest health IT companies worldwide are Cerner, Epic, and McKesson. This list is the second annual global revenue ranking by IDC Health.

The 2017 HealthTech Rankings comprise the following two lists:

  • The Top 50 features the largest companies that derive more than one third of their revenue from healthcare payer and/or provider institutions. The largest of the Top 50 companies is Optum, a subsidiary of UnitedHealth Group.
  • The Enterprise Top 25 features the largest companies that derive less than one third of their revenues from healthcare payer and/or provider institutions. The largest of the Enterprise Top 25 companies is IBM.

Cerner was listed as the second largest vendor in the HealthTech Top 50.

GE Healthcare ranked third, McKesson Technology Solutions came in fourth, and Epic Systems ranked as the fifth largest health IT vendor to healthcare payers and providers worldwide.

“IDC Health Insights is excited to release the second annual HealthTech Rankings,” said Research Vice President for IDC Health Insights Lynne Dunbrack. “These global revenue rankings offer a valuable industry benchmark of the leading global technology and service suppliers within the healthcare payer and provider services industry.”

The top five largest vendors listed in the HealthTech Enterprise Top 25 in descending order were IBM, Royal Philips, Siemens, Intel, and Microsoft.

A recent KLAS global EHR market share report similarly named Epic and Cerner among the EHR companies enjoying the highest level of worldwide success across the industry in 2016.

While Cerner maintained its hold as a top contendor, Epic Systems and InterSystems gained more clients than any other EHR vendor last year due in part to the technologies’ vast scope of functionalities and usability.

Epic and InterSystems both boast a wide array of functionalities and user-friendly technologies, but InterSystems won more contracts last year due to its more affordably priced product packages.

However, Epic contracted 8,190 beds in 2016—3,000 more than the next closest competitor.

While Cerner was less lucrative abroad in 2016 than it has been in years past, the vendor still earned the majority of the market share in foreign markets including the Middle East.

The recent spike in contracts for EHR vendors both within the US and abroad are indicative of the widespread adoption of EHR technology in healthcare systems around the globe.

Epic, Cerner hold majority of EHR market share in acute care hospitals

http://medcitynews.com/2017/05/epic-cerner-ehr-market-share/?utm_source=hs_email&utm_medium=email&utm_content=51576445&_hsenc=p2ANqtz-_oun95jfxmwa2hCPJQ5NNitO3MntwAz0GdPBwDGZLAkLMvuPAgNxzQnuLrCZvr2AcTK2Y2ekQ_O8IfZek4JiOb9rro6Q&_hsmi=51576445

technology, EHR, EMR, doctor, physician, tablet

A new report from KLAS found Epic and Cerner each held about one-quarter of the acute care hospital EHR market share in 2016. Epic had 25.8 percent of the market, while Cerner had 24.6 percent. Meditech followed close behind, claiming the next biggest share of the market at 16.6 percent. McKesson and athenahealth were closer to the bottom of the pack, with 4.6 percent and 1.6 percent respectively.

These findings come as small hospitals are increasingly making EHR purchasing choices. KLAS found hospitals with less than 200 beds made 78 percent of EHR purchasing decisions in the United States in 2016.

Despite claiming their own unique portions of the market, each vendor went through a different experience in 2016.

With the largest market share, Epic is the “[s]ix-year leader in net acute care hospital growth.” Additionally, KLAS identified only two hospitals that left Epic in 2016, both of which did so involuntarily because they were spun off or acquired.

Cerner had the second-largest percentage of the market, primarily due to its wins in the small hospital space. “Small hospitals moved to Cerner more than any other vendor in 2016,” the KLAS report said. Though these hospitals seem to like Cerner CommunityWorks due to its integration functionalities, many community hospitals lamented both Cerner’s and Epic’s lack of customization capabilities.

Meditech claimed nearly 17 percent of the market, but many of its customers were wary of its ability to provide for their needs going forward. Still, Meditech snatched 17 new hospitals in 2016, and according to KLAS, “there are early indications that the release of Meditech’s integrated ambulatory offering and new development on the inpatient side are changing the market’s perception” of the vendor.

McKesson had 4.6 percent of the market. However, the vendor saw a “[s]ignificant decline in Paragon market share.” KLAS found few of McKesson’s Paragon EHR users were pleased with the system’s functionality.

athenahealth only claimed 1.6 percent of the market in 2016. Nevertheless, the vendor “[h]as maintained significant energy since entering the acute care market in 2015.” In fact, the “number of hospitals that contracted with athenahealth more than doubled in 2016,” according to KLAS. While one-third of its wins were in hospitals with more than 25 beds, the other two-thirds were in critical access hospitals.

Other notable vendors include CPSI, Medhost and Allscripts. Though it held 10.8 percent of the market, KLAS found CPSI wasn’t frequently considered among community hospitals. Medhost, which held 4 percent of the market, had a slight decrease in its overall acute care market share. Allscripts, however, had a net gain in 2016 and possessed 3.5 percent of the market.

Epic Systems Tops Cerner as Top-Used Physician EHR Vendor

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epic-ehrepic-ehr

Epic Systems is used by 28 percent of physicians, taking the cake as the most popular physician EHR vendor, according to the Medscape EHR Report 2016.