Tag Archives: Health System

Bringing Moneyball to Medicine

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http://www.chcf.org/articles/2017/02/bringing-moneyball-medicine

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For most of the last year I had the privilege of serving as director of the US Agency for Healthcare Research and Quality (AHRQ), the lead federal agency charged with improving the safety and quality of America’s health care system. AHRQ is not a payer or regulator. It develops the knowledge, tools, and data needed to improve the health care system and help Americans, health care professionals, and policymakers make informed health decisions.

Change is a reality of our political process. When the new administration took over last month, I reluctantly departed to return to my work as a primary care physician and a health services researcher at the University of California, San Francisco (UCSF). The completion of my work at AHRQ did nothing to dampen my excitement about AHRQ’s future and its readiness to support transformation to an improved health care system.

In meetings with staff at AHRQ, I described our challenge as bringing Moneyball to medicine. It was my way of pointing out how major league sports have integrated data analytics into their workflow to improve team performance. There is a parallel opportunity for us in health care.

Moneyball is a movie based on the true story of Billy Beane, the general manager of Major League Baseball’s Oakland A’s. The film tells the story of a ballplayer-turned-executive, played by Brad Pitt, who finds himself stuck with an underperforming team that makes roster choices based largely on the opinions of “expert” scouts. While these scouts know a lot more than the average person does about the star potential of young players, they also have a remarkable number of misfires, leading the team to spend money on players who don’t pan out.

Right-To-Die Fight Hits National Stage

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http://khn.org/news/right-to-die-fight-hits-national-stage/?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202017-02-17%20Healthcare%20Dive%20%5Bissue:9137%5D&utm_term=Healthcare%20Dive

WASHINGTON, DC - FEBRUARY 13: Delegate Eleanor Holms Norton (D-DC) talks with Chairman of the House Oversight and Government Reform Committee, Jason Chaffetz (R-UT) before a business meeting at the Rayburn House Office Building on Monday February 13, 2017 in Washington, DC. The "Death with Dignity Act" was discussed in the meeting. (Photo by Matt McClain/The Washington Post via Getty Images)

Opponents of aid-in-dying laws are claiming a small victory. They won the attention of Congress this week in their battle to stop a growing movement that allows terminally ill patients to get doctors’ prescriptions to end their lives.

The Republican-led effort on Capitol Hill to overturn the District of Columbia’s aid-in-dying law could fail by Friday. But advocates worry the campaign will catalyze a broader effort to fully ban the practice, which is legal in six states and being considered in 22 more.

“The D.C. legislation has catapulted the issue of medical aid in dying onto the federal agenda at a time when Congress has the power to enact a ban on this end-of-life care option nationwide — even criminalizing the practice in the six states where this option is currently authorized,” warned Jessica Grennan, national director of political affairs and advocacy for Compassion & Choices, which supports right-to-die laws.

“If that happens, it will set the end-of-life care movement back to the last century,” Grennan said.

No matter how the effort plays out, both sides agree that the debate on Capitol Hill, featuring a Republican moral protest, could be only a taste of what’s to come.

 

 

Memorial Healthcare Systems to pay $5.5M over potential HIPAA violations

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http://www.healthcaredive.com/news/memorial-healthcare-systems-to-pay-55m-over-potential-hipaa-violations/436400/

Dive Brief:

  • Memorial Healthcare Systems has paid HHS $5.5 million to settle potential HIPAA violations, HHS disclosed on Thursday.
  • The six-hospital nonprofit system disclosed to HHS’ OCR that 115,143 individuals’ protected health information (PHI) had been impermissibly accessed by employees and impermissibly disclosed to affiliated physician office staff.
  • The settlement comes weeks after Children’s Medical Center of Dallas was fined $3.2 million over HIPAA violations.

Memorial Healthcare System provided Healthcare Dive the following statement on the subject:

It’s important to put this settlement in perspective to the fact that this situation happened six years ago, and that Memorial Healthcare System proactively reported the actions of the two employees and the findings of its internal investigation regarding the affiliated physicians’ staff to the Department of Health and Human Services’ Office of Civil Rights (OCR). Upon learning of the breaches, Memorial quickly acted to implement new, sophisticated technologies designed to monitor use and access of patient data, further restricted access to protect patient information, and enacted new policies and procedures to enhance password security. 

Memorial’s February 2017 settlement with the OCR resolves all allegations surrounding these breaches.  While Memorial strongly disagrees with many of OCR’s allegations, has admitted no liability and has chosen to settle this case, it nevertheless agrees with the importance OCR places on maintaining the security of patient information. We will continue to vigorously monitor access and use of patient information and maintain rigorous cybersecurity and internal safeguards.

EHR vendors continue to push the nation closer to interoperability

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http://www.healthcaredive.com/news/ehr-vendors-continue-to-push-the-nation-closer-to-interoperability/424578/

Dive Brief:

  • Providers at more than 200 U.S. hospitals and 3,000 clinics can now share patient health information even though they use different EHR vendors, thanks for the Carequality Interoperability Framework, The Sequoia Project collaborative announced this week.
  • The hospitals and clinics use EHR software and services from athenahealth, eClinicalWorks, Epic, HIETexas, NextGen and SureScripts, which have agreed to the information exchange.
  • The Carequality Interoperability Framework, published in December, provides the necessary legal and policy requirements, technical specifications, and governance processes to enable interoperability among different health systems.

 

Epic to add care management content to its EHRs

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http://www.healthcaredive.com/news/epic-to-add-care-management-content-to-its-ehrs/436330/

Dive Brief:

  • Epic announced that it will incorporate care management content from xG Health Solutions, which is developed by the Geisinger Health System, into its electronic health records (EHRs).
  • xG Health Solutions content helps to guide clinical decision-making with evidence-based assessments and care plans for 60 conditions commonly seen in care management programs, according to the EHR vendor.
  • The content should be available to users of Epics Health Planet software, a population management platform, by later this year.

 

High costs give palliative care increased industry interest

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http://www.healthcaredive.com/news/palliative-care-healthcare-costs-investment/436065/

While a nascent industry of for-profit companies is eyeing palliative care, some believe a more viable response would be for health systems to build out internal capacities.

Efforts to improve palliative care are growing as both providers and payers struggle to control costs and provide quality end-of-life care. A recent Kaiser Family Foundation report found roughly 25% of Medicare dollars are spent on beneficiaries in the last year of life for services including hospitalization, post-acute care and hospice.

Palliative care is medical care that’s been customized to meet the needs of people with complex and serious illnesses. The goal is to reduce stress and improve the quality of life for both the patient and their family through pain relief, symptom control and help managing care and basic living tasks. “Palliative care teams are able to pull everyone together into the same room — not only the family but also the many different sub-specialists — and actually have a conversation about what is medically appropriate for this patient, so that the care plan becomes rational and appropriate,” says Center to Advance Palliative Care Director Diane Meier.

Today, nearly all hospitals with more than 300 beds and roughly two-thirds of hospitals with more than 50 beds have palliative care teams. While the size of the U.S. palliative care market is hard to pin down, the combined hospice and palliative care market totals $31 billion and is growing at an annual rate of 1.4%, according to research firm IBISWorld.

 

More than a third of health systems unprepared for MACRA: 8 findings

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http://www.beckershospitalreview.com/finance/more-than-a-third-of-health-systems-unprepared-for-macra-8-findings.html

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While most healthcare providers expect to participate in the Medicare Access and CHIP Reauthorization Act, only 35 percent have a strategy for doing so, according to a study published by Health Catalyst and Peer60.

For the study, researchers surveyed 187 healthcare professionals, including 37 CEOs and 94 other C-suite executives. Survey respondents came from organizations ranging from some of the nation’s largest urban academic medical centers and integrated delivery networks to small, rural critical access facilities.

Here are eight survey findings.

6 latest hospital bankruptcies, closures

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http://www.beckershospitalreview.com/finance/6-latest-hospital-bankruptcies-closures-020717.html

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From reimbursement landscape challenges to dwindling inpatient volumes, many factors lead hospitals to file for bankruptcy or close.

Here are six hospitals that have filed for bankruptcy or closed since Dec. 1, starting with the most recent.

1. Louisiana Heart Hospital in Lacombe and its affiliated medical group filed for Chapter 11 bankruptcy Jan. 30 and will close by the end of February. The hospital has faced financial challenges in recent years, as it struggled to balance shrinking reimbursements with rising operating costs.

2. North Texas Medical Center, which is owned by the Gainesville Hospital District, filed for Chapter 9 bankruptcy Jan. 17. The hospital’s board approved a partnership agreement with King of Prussia, Pa.-based Universal Health Services in December. On Jan. 24, the bankruptcy court approved a debtor-in-possession loan that will allow UHS to provide financial support to North Texas Medical Center during the course of the bankruptcy case.

3. The public trust that operates Atoka (Okla.) County Medical Center filed for Chapter 9 bankruptcy Jan. 10. The critical access hospital is about $16 million in debt.

4. North Philadelphia Health System filed for Chapter 11 bankruptcy Dec. 30 after years of financial troubles. NPHS currently operates two facilities in Philadelphia: Girard Medical Center, a 168-bed psychiatric hospital, and Goldman Clinic, a substance abuse treatment center.

5. Marshalltown-based Central Iowa Healthcare, which includes a 49-bed acute care hospital, an outpatient center and four primary care clinics, filed for Chapter 11 bankruptcy Dec. 20. Interested parties are bidding on CIH’s assets. A hearing to approve a sale to the highest bidder is scheduled for March 17.

6. Indianapolis-based Community Health Network closed Community Westview Hospital Dec. 16 after a gradual step-down of services over the past few years. When the hospital closed, many of its services were relocated to other Community Health Network sites in the area.

Trump administration withdraws 340B mega-guidance: 6 things to know

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http://www.beckershospitalreview.com/finance/trump-administration-withdraws-340b-mega-guidance-6-things-to-know.html

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The Trump administration has withdrawn guidance on the 340B Drug Pricing Program that was under review at the end of the Obama administration.

Here are six things to know about the guidance.

1. HHS’ Health Resources and Services Administration released the omnibus guidance on the 340B Drug Pricing Program in August 2015. The 340B Drug Pricing Program allows certain safety-net healthcare organizations to purchase outpatient drugs at discounted prices.

2. The guidance addressed a broad range of topics within the 340B program, including the definition of patient, contract pharmacy compliance requirements, hospital eligibility criteria and eligibility of off-site outpatient locations.

3. On Jan. 30, the White House Office of Management and Budget marked the final guidance document as withdrawn.

4. Although the pharmaceutical drug industry generally supported the guidance, hospitals raised concerns about the proposal. The American Hospital Association previously expressed concern about the guidance, arguing that redefining patient eligibility for the 340B program would have inappropriately narrowed the number of drugs that qualify for 340B pricing.

5. On Wednesday, AHA Executive Vice President Tom Nickels said, “We are pleased that the administration chose not to finalize the Health Resources and Services Administration’s guidance, which, if enacted, would have jeopardized hospitals’ ability to service vulnerable populations, including low-income and uninsured individuals and patients receiving cancer treatments.”

6. For HRSA’s guidance to move forward, it would have to be resubmitted to the Office of Management and Budget.

100 things to know about Medicare reimbursement in 2017

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http://www.beckershospitalreview.com/finance/100-things-to-know-about-medicare-reimbursement-2017.html

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Since its launch in 1965, Medicare has been one of the most influential programs for hospitals, health systems and other providers. Medicare has played a prominent part in various reform movements, including the shift from fee-for-service to value-based payment models, and the program’s policies and reimbursement rates have acted as a catalyst for change nationwide.

The following list sheds some light on several facets of Medicare reimbursement, covering everything from the latest update to the Inpatient Prospective Payment System to mandatory bundled payment models.