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#WWBR Week of December 1, 2014

by John Moore lll | December 05, 2014

What Caused the Collapse of the Nevada HIE?
Gabriel Perna for Healthcare Informatics
“This article overviews the reasons why Nevada’s state-designated entity shut down last January. This story has no car chases and the boy does not get the girl but it turns out that timing is everything. A ponderous planning process imposed by a well-meaning state disclosure law gave a private statewide HIO a window. Transparency in government in this case helped doom this effort from the start.” – Brian

SHRM Survey Findings: SHRM/EBRI 2014 Health Benefits Survey
Society for Human Resource Management
“Results from the Society for Human Resource Management 2014 Health Benefits Survey which provides some good insight into 2015 employer health benefit trends. Contrary to a few other industry reports, almost none of the employers surveyed (1%) planned on dropping coverage in 2015. Instead, they are continuing to tinker with benefit design including a greater emphasis on wellness incentives and increasingly adopting reference pricing and value-based insurance plans usually in the form of narrow networks. As for the looming excise tax in 2018, 85% percent of employers don’t think they will be effected by it in 2018. Gov’t-based employers indicated the highest likelihood of being impacted by the excise tax (28%) in 2018 and the benefit plan that employers felt was most likely to reach the excise tax limit in 2018 was overwhelmingly PPOs (78%).” – Matt

RIP Meaningful Use Born 2009 – Died 2014???
Bob Wachter, MD for The Health Care Blog
“Nice summary here about the state and future direction of Meaningful Use. By framing the program in its original context, Bob makes a balanced argument that it’s time for ONC to stop tinkering with the minutiae of reporting requirements, deadlines, penalties, etc., and double down on fostering interoperability.” – Naveen

Staffing data at skilled Nursing facilities is a part of IMPACT Act focus
Tyler L. Arnold for The Association of Corporate Counsel
“Gaming the “Five Star Quality Rating System” for nursing homes apparently will be frowned on in the future. This three paragraph overview of Congress’s response talks about how CMS will use payroll data, rather than self-reporting, as the basis for the staffing information provided on the Nursing Home Compare website. I still think that the nursing time needs to be split out between meds administration and everything else.” – Brian

CMS’s Latest Move on ACOs: A Shift Towards Greater Realism Going Forward?
Mark Hagland for Healthcare Informatics
“Making the news this week is the new proposed rule by CMS for a separate category of ACOs. This third class would be distinct from both the Pioneer program as well as the MSSP program in several areas: the amount of shared savings participating HCOs can keep, the amount of penalty they pay, inclusion of telehealth and post-acute programs. It would also allow organizations to delay paying penalties for three years, though doing so would reduce the overall amount of savings they’d be able to keep. All in all, this seems like a bold proposal by CMS, but one that may be too much for most HCOs to stomach in today’s environment.” – Naveen

California Hospitals Make Hundreds of Errors Every Year, Public is Unaware
Steven Stock, Julie Putnam, Jeremy Carroll and Scott Pham for NBC (Bay Area)
“Investigative Journalism unit reveals there is no mechanism in place to ensure that CA hospitals are reporting their adverse events to the system. Results that are reported to the system can take up to 9 months to be added. While other states are doing a better job of making adverse event information available to consumers, there is still considerable variation from state-to-state and efforts to make information on hospital safety readily available to consumers is sadly little better than it was a decade ago when the IOM reports first really raised the issue of patient safety and the number of deaths attributable to medical errors in hospital to the broader public.” – Matt

JASON Data for Individual Health (PDF)
Prepared by JASON
“JASON strikes again with a followup to its opus on healthcare interoperability. This time, it focuses on the use of healthcare data by individual patients. I have not had time to read this through but it has a whole chapter on interoperability and EHRs. I can’t wait to get a few hours to give this the treatment it deserves.” – Brian

HL7 Launches Joint Argonaut Project to Advance FHIR (PDF)
Press Release
“Jason begets Argonaut. Although all the coverage does little more than rewrite the press release, HL7 is moving forward with all due dispatch on the FHIR front. All of the major EHR vendors (except Allscripts) have signed on to Project Argonaut to make interoperability commonplace in healthcare.” – Brian

Workplace Wellness Produces No Savings
Al Lewis, Vik Khanna, and Shana Montrose in Health Affairs
“Two of the most vocal critics of wellness programs – Al Lewis and Vik Khanna, wrote an insightful post about the limitations and potentially limited value of current wellness programs. The authors highlight how a meta-analysis in 2010 in Health Affairs and a highly publicized study on Safeway’s wellness program were key in adding an amendment to PPACA which greatly expanded the ability of employers to tie wellness programs to health insurance premiums. While this sounds like sound theory, in practice the evidence to support wellness programs was fairly scant and recent evidence including a new meta-analysis in American Journal of Health Promotion and recent review of wellness programs by RAND have found neutral/negative ROIs on these programs.” – Matt

Insurers’ Listings of In-Network Doctors Often Out of Date (subscription to WSJ required)
Melinda Beck for The Wall Street Journal
“Article in the WSJ that criticizes the accuracy and completeness of provider information of in-network providers in the exchange products and Medicare Advantage plans. This has been a festering problem for health plans that moving to online provider directories from paper-based ones was supposed to solve completely over a decade ago. Instead, insurers still lag in providing the correct information. Sadly this isn’t a surprise and as someone who recently used the exchange to purchase health insurance, I ran into the same issue with an Independence Blue Cross product (‘silver-tier’ plan) that had incorrect information for 2 out of the 12 providers I checked.” – Matt


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